The proximal gastric bypass is an international standard in bariatric surgery. In Germany the gastric bypass is the one of the most frequently used procedures. The main principle is solid food restriction, but there is a number of additional mechanisms. Hormonal regulations and changes are just under investigation. Intestinal malabsorption is responsible for potential deficiencies and their metabolic side effects, if consequent life-long supplementation of minerals and vitamins was missed.
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