Bariatric Surgery – Gastric Bypass for Non-Obese

The gastric bypass for non-obese (overweight, slightly overweight or in the normal category) people suffering from Type 2 diabetes is a two-hour laparoscopic surgical operation Dr. Jacobo Zafrani at Hospital Clínica Bíblica in San José, Costa Rica, is the preferred surgical technique for curing Type 2 diabetes in non-obese (overweight, slightly overweight or in the normal category) people with a BMI of under 30. (Calculating your BMI is simple. Click here)

This surgery (there are several variants – Dr. Zafrani will find the right one for you) is done laparascopically: the surgeon creates a slightly smaller stomach pouch. He or she then attaches a Y-shaped section of the small intestine directly to the pouch. This allows food to bypass a large portion of the small intestine, which absorbs calories and nutrients. Having the slightly smaller stomach pouch causes patients to feel fuller sooner and eat less food; bypassing a portion of the small intestine means the patient’s body absorbs fewer calories.

The impact of this procedure on normal or slightly overweight diabetes patients can be dramatic. Some patients find that within a few days of the gastric bypass, they no longer need diabetes medication; others take just over a month, or find they can reduce their dose drastically. In addition, this health-bringing change usually occurs with very little weight loss. Preliminary studies of overweight or slightly overweight patients who had undergone gastric bypass revealed that 83.8% of the patients had a complete remission or great improvement of their Type 2 diabetes.

Advantages of the Gastric Bypass

A study in the Annals of Surgery showed that 83 percent of 240 people surveyed who underwent gastric bypass were cured of their diabetes, independent of their weight loss or gain over the period examined. Some actually gained weight, but were still diabetes free, often within days of surgery

Two studies in the New England Journal of Medicine found that bariatric surgery reduces the long-term mortality associated with obesity. In one of the two studies, the researchers found that long-term total mortality after gastric bypass surgery was significantly reduced, particularly deaths from diabetes.

The gastric bypass procedure requires some active follow-up participation on the part of patients. Patients can get back to normal life very quickly, and maintain a virtually normal diet with some restrictions on the types of food that they can eat.

Not everyone with a BMI under 30 is eligible for this surgery. The only way you can find out whether you are a candidate is to consult with Dr. Zafrani.

As we remind those contemplating gastric bypass, no form of surgery is foolproof, and this procedure is no exception. As with all forms of bariatric surgery, the patient must want and work for success in order for the operation to succeed as a treatment for curing Type 2 diabetes. Dr. Zafrani and your own doctor will work together with you on monitoring and evaluating your post-operative progress on an agreed schedule and regimen.

Gastric bypass surgery is the best option for many non-obese people with Type 2 diabetes. If you think you are in this category and are considering bariatric surgery to cure Type 2 diabetes, contact Americana WellcareCR to discuss duodenal exclusion with bariatric specialist Dr. Jacobo Zafrani.


Laparoscopic surgery, also referred to as minimally invasive surgery, describes the performance of surgical procedures with the assistance of a video camera and several thin instruments. During the surgical procedure, small incisions of up to half an inch are made and plastic tubes called ports are placed through these incisions. The camera and the instruments are then introduced through the ports which allow access to the inside of the patient.

The camera transmits an image of the organs inside the abdomen onto a television monitor. The surgeon is not able to see directly into the patient without the traditional large incision. The video camera becomes a surgeon’s eyes in laparoscopy surgery, since the surgeon uses the image from the video camera positioned inside the patient’s body to perform the procedure.

The benefits of minimally invasive or laparoscopic procedures are:

  • less post-operative discomfort since the incisions are much smaller
  • quicker recovery times
  • shorter hospital stays
  • earlier return to full activities
  • much smaller scars
  • there may be less internal scarring when the procedures are performed in a minimally invasive fashion compared to standard open surgery


Approach: Non-restrictive:  Limits somewhat the amount and types of food that can be eaten

Anatomy Changes: Upper small intestine – Bypasses a large part of the small intestine

Surgery Method: Laparoscopic

Operating Time:  Two hours

Hospital Stay: Usually one day

Adjustable: No

Reversible: No

Medical Implant: No

Success Rate: 80-90% succesful in curing Type 2 diabetes in non-obese patients

Surgery Benefits and Advantages:

  • Does not require a medical device implant into body
  • Stomach volume slightly smaller
  • Requires little change in diet or eating habits
  • Very few food intolerances
  • No malnutrition risk

Time Off Work: One week

Post-op recovery Time: One week

Dietary Guidelines:

  • Liquid diet first week after operation
  • Pureed diet second week
  • Gradual return to special, but not drastic diet beginning third week
  • maintain a healthy diet
  • avoid high fat and high calorie foods that will cause excessive weight gain

Nutritional Supplements: Not absolitely required but definitely recommended


  • Not FDA approved for those with a BMI of under 35
  • General surgical risks
  • Not reversible
  • Requires patient effort (changing diet and eating habits) for initial recovery