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An Update to Gastric Bypass Stomach Pouch Tightening Without Surgery

Posted on: 8th May, 2020

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Over the last five years, we’ve had an opportunity to evaluate procedures for tightening or revising the stomach after prior gastric bypass. We’ve learned a great deal, and we’ve been able to improve the procedures that jumpstart weight loss and lead to better health. Today, I’m sharing an update to gastric bypass stomach pouch tightening without surgery.

The Stretched Stomach Pouch

For the millions of individuals who have undergone gastric bypass surgery with successful results, some percentage does experience weight re-gain. For those who had the procedure ten or fifteen years ago — or longer — the sense of “restriction” that helped them lose weight initially may be gone. It might be related to a stomach pouch that has stretched over time, leading to a reduced sensation of restriction, more food consumption, and weight gain. So what can be done?

Two Strategies, Two Options

To address a stretch stomach pouch from prior gastric bypass, there are two strategies to restore healthy weight loss, reverse conditions like type 2 diabetes, and restore energy. Strategy one is to shrink or tighten the stomach pouch itself, with the idea that better restriction will restore the weight loss trajectory.

For people who feel as though they lost all sense of restrictions and they can eat a much larger quantity of food, they may have good success with the incision-less tightening of the pouch. We’ve been able to successfully tighten the pouches using an endoscopy suturing method that involves a tube passed down the mouth, without cutting and with no scars. That also translates to no need for recovery time because it’s not “surgery” in the normal sense.

However, it’s important for anyone who wants to undergo this procedure to realize that there are no guarantees. Sometimes the sense of restriction and satiety is restored, the person feels fuller and less hungry, and weight loss ensues. In other cases, the body‘s biochemistry is powerful enough that a person continues to feel hungry and the weight is difficult to budge because of metabolism factors. The procedure is not covered by insurance, so be prepared for substantial out-of-pocket costs. But because it is so non-invasive, the endoscopic or incision-less pouch tightening or stomach tightening remains an option.

Strategy two for improving the metabolism and biochemistry is building upon more recent science that describes our body’s “thermostat,” the one that regulates body weight. We’ve learned how the hormones of the stomach and intestines play a major role in that bodyweight thermostat. A strategy for gastric bypass patients involves revising the bypass, specifically by lengthening one of the limbs known to improve that biochemistry and help reset the thermostat to a lower body weight setpoint. This procedure is done with the laparoscopy so there tends to be about five small Band-Aids afterwards and it does require an overnight stay in the hospital. The success rate here is good, with around 75% of people achieving success, and in most (but not all) cases, insurance does cover the procedure.

The Takeaway

If you or someone you love had gastric bypass surgery years ago and is now experiencing weight regain, or a return of conditions like type 2 diabetes, there are excellent strategies available to help restore a healthy weight and improve quality of life. Contact Dr. Sasse’s office today to schedule a telemedicine appointment for more information.

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