Weight-loss surgery is one of the fastest growing major surgeries in the United States ( 1 Shikora S.A. Kim J.J. Tarnoff M.E. Nutrition and gastrointestinal complications of bariatric surgery. Nutr Clin Pract. 2007; 22: 29-40 Google Scholar ). In recent years, weight-loss surgery has increased by more than 600% ( 1 Shikora S.A. Kim J.J. Tarnoff M.E. Nutrition and gastrointestinal complications of bariatric surgery. Nutr Clin Pract. 2007; 22: 29-40 Google Scholar ). As of 2005, the most frequently performed weight-loss surgery has been the Roux-en-Y gastric bypass surgery (RYGB), accounting for approximately 85% of all weight-loss surgery performed in the United States ( 2 Schauer P. Gastric bypass for severe obesity: Approaches and outcomes. Surg Obes Relat Dis. 2005; 1: 297-300 Google Scholar ). The RYGB procedure involves reducing the stomach to a gastric volume of 15 to 30 mL ( 3 Mulholland M.W. Lillemoe K.D. Doherty G.M. Maier R.V. Upchurch G.R. Greenfield's Surgery: Scientific Principle and Practice. 4th ed. Lippincott Williams & Wilkins, Philadelphia, PA2006 Google Scholar ). The Roux-en-Y configuration consists of an intestine limb connected to the small gastric pouch (gastrojejunostomy), which prevents the bile from entering the newly formed stomach pouch and esophagus (Figure 1) ( 3 Mulholland M.W. Lillemoe K.D. Doherty G.M. Maier R.V. Upchurch G.R. Greenfield's Surgery: Scientific Principle and Practice. 4th ed. Lippincott Williams & Wilkins, Philadelphia, PA2006 Google Scholar ). The purpose of RYGB surgery is to decrease gastric volume and induce a substantial weight loss in morbidly obese individuals who have failed previous nonsurgical weight-loss attempts and who are suffering from weight-related comorbidities ( 4 Buchwald H. Consensus conference statement bariatric surgery for morbid obesity: Health implications for patients, health professionals, and third-party payers. Surg Obes Relat Dis. 2005; 1: 371-381 Google Scholar ). It is estimated that within the first 6 months postoperatively, RYGB surgery patients lose approximately one half of their excess weight ( 4 Buchwald H. Consensus conference statement bariatric surgery for morbid obesity: Health implications for patients, health professionals, and third-party payers. Surg Obes Relat Dis. 2005; 1: 371-381 Google Scholar ). S. Benson-Davies is a nutrition consultant in private practice in Spearfish, SD. D. R. Quigley is a general surgeon, Queen City Regional Medical Center, Spearfish, SD.