Surgical operations for the control of severe obesity are based on one or both of two principles. The first is restriction, where the amount of calories or food ingested is controlled by limiting the space available to receive food. "Restrictive" procedures decrease or limit the intake of food, giving a feeling of "fullness" much more readily. The second principle is malabsorption, where the absorption of food is limited. "Malabsorptive" procedures cause incomplete "digestion" or "absorption" of food intake. Roux-en-Y Gastric Bypass is a restrictive procedure with some malabsorption.

Roux-en-Y Gastric Bypass is recognized by the National Institutes of Health (NIH) for the treatment of severe obesity. This operation is performed using the laparoscopic or open technique and combines gastric restriction with slow gastric emptying and some malabsorption.

With the procedure, the stomach is divided to form a new, smaller pouch for food. The small bowel is re-routed to empty the new, smaller pouch. As food enters the pouch it quickly fills and causes one to have a sensation of fullness after eating only a small portion of food. The remainder of the stomach is present, but no longer acts as a reservoir for food.

The video below depicts laparoscopic gastric bypass surgery. The small bowel is reattached to the new stomach pouch and the food intake is restricted.

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Roux-en-Y Gastric Bypass is one of the most frequently performed weight loss procedures in the U.S. with 70-80% of excess weight loss after 5 years. Additionally, a high percentage of certain associated health conditions or co-morbidities (sleep apnea, high blood pressure, diabetes and depression) are typically improved or resolved following surgery.

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