Question:
How do they determine how much of your stomach to bypass?

I have read where a couple of people have written something like "they only bypassed....this much...". What is that based on? your size before the surgery? Also, is it better to have more or less bypassed and what is the advantage and disadvange of it?    — Ronda B. (posted on August 17, 2000)

August 17, 2000
They don't bypass your stomach. I invite you to read up in this (AMOS) site's library on the various surgery types. Most people have a form of gastric reduction, that is, making the stomach smaller by a couple of different means. The 'bypass' part comes from re-routing the small intestine so that less food is absorbed. This is the malabsorptive component to the surgery. The shorter the "common channel"(where food and digestive enzymes meet), the more weight loss occurs. This is what is the exact language for 'bypassing' part of the small intestine. The doctor makes his decision on how much to bypass on several factors if he is a good doctor. these factors include starting weight, historical weight, lenth of time obese, genetic influence, degree of co-moorbidity, etc. It is not a SWAG decision (SWAG=Scientific Wild Ass Guess). I have one of the shortest that my doctor has ever done, have only 7.93% of a common channel (about 75cm or 2 feet), but then, I am 42, a few co-morbidities, was around 500 pounds, have been very heavy all my pre and post pubescent life, and have strong family genetics for obesity. I fully expect to lose to and then maintain a weight of about 170-180, after plastic surgery removes the excess flesh that will exist after my weight loss. Hope this answers your question. Fondly,
   — merri B.

August 18, 2000
I can't add much to Merri's answer, which was FABULOUS, but I will say that along with the SWAG method, there is also the One Size Fits All method, which is what we see so commonly. "THIS is the surgery I do and if it works, great, if not, it's all YOUR fault". I agree that your doc will work with you to select a correct model. I am extremely distal, too, about 40" of common channel. Us types have to supplement like mad, but we also don't diet much at all. In my case, I just avoid milk & sugar. And hey, I'm here to tell you that it is WAY easier to put things IN my face than it was to keep them out! So, distal gets the best wt loss, but imposes higher risks, especially nutritionally. Proximal is safer, but less effective. I was "lucky" enough to need a revision so I had the chance to choose again. I choose to remain EXACTLY as I was, though I wouldn't have minded an even shorter common channel. I'm almost 6 yrs post-op (revised Jan 2000). My husband is also distal, but when his staple line disrupts, he would actually elect to be a smidge less distal, maybe graft back in 10" or so. But he's a man, so makes NO effort to maintain his wt.
   — vitalady