Gastric bypass surgery (Roux-en-Y gastric bypass) is a type of weight-loss surgery. This procedure makes changes to the digestive system. These changes help with weight loss by limiting the amount of food the stomach can hold.

During gastric bypass surgery, part of the stomach is closed off to make a small pouch. This pouch is the new, smaller stomach. This surgery also reroutes food from the stomach pouch to the middle of the small intestine. This reduces the amount of nutrients and calories that are absorbed from food that is eaten.

If your teen has been struggling with being severely overweight or obese, this surgery may be a choice for them. Talk with your child's doctor. It's important to know that gastric bypass surgery is not a quick fix. Your teen will have to commit to making lifestyle changes. They will have to learn new ways to eat and drink after this surgery. And they will have to take nutritional supplements.

This surgery may be advised for teens and adults who are severely overweight or obese who have tried other methods to lose weight. Getting to a healthier weight is helpful because obesity is linked to long-term (chronic) health problems, such as:

• Type 2 diabetes
• High blood pressure
• High cholesterol
• Sleep apnea
• Heart problems
• Joint problems
• Anxiety
• Depression

In general, weight-loss surgery may be advised for teens who have either:

• Class 2 obesity, along with one or more health problems linked to obesity. Class 2 obesity means that body mass index (BMI) is 35 or higher, or it is 120% of the 95th percentile for BMI for the teen's age and sex, whichever is lower.
• Class 3 obesity, with or without other health problems linked to obesity. Class 3 obesity means that BMI of 40 or higher, or it is 140% of the 95th percentile for BMI for the teen's age and sex, whichever is lower.

To be a candidate for this surgery, a teen should also:

• Be mentally and emotionally mature
• Understand and be ready to commit to making diet and lifestyle changes after surgery
• Have support from their family
• Not have an untreated eating disorder or mental illness
• Not be pregnant or planning a pregnancy in the next 12 to 18 months
• Not have a substance use problem

In most cases, this surgery is done laparoscopically. This means it uses very small cuts (incisions). Tiny tools are put into these incisions. These include a small video camera (laparoscope). The video images are displayed on a screen to help guide the surgeon.

The surgery may take about 2 hours. In general, here is what you can expect during the procedure:

• An I.V. (intravenous) line is put into your teen's arm or hand. They will be given medicine (general anesthesia) through the I.V., and a breathing tube will be inserted. This makes them sleep during the surgery.
• The surgeon will make several small incisions in the belly. They put tiny tools into these incisions.
• The surgeon separates the stomach into two parts. They create a small pouch at the top. This pouch becomes the new stomach. It can hold only about 1 ounce of food.
• The surgeon then links the middle part of the small intestine to the pouch. Food will then travel from the small stomach pouch directly into the middle of the small intestine. It will go around (bypass) a large part of the stomach and the first part of the small intestine.
• The small incisions are closed with stitches or surgical glue. They are covered with bandages.

As with any surgery, there are some risks. The possible risks for this surgery include:

• Bleeding
• Infection at the incision sites
• Blood clots in the legs (deep vein thrombosis) or lungs (pulmonary embolism)
• Lack of certain vitamins and minerals
• Food moves too quickly from the stomach to the small intestine, causing nausea, abdominal cramping, and diarrhea (called dumping syndrome). If food is eaten too quickly, vomiting may occur.

Adolescent females should avoid pregnancy for 12 to 18 months after the surgery. Talk to your doctor about preventing pregnancy and effective contraception both before and after weight loss surgery.

The emotional aspect of this surgery is important as well. It may be helpful for your teen to find online or in-person support groups and connect with others who have had this surgery.