Weight loss surgery is highly advertised for people trying to lose weight, but many people don’t know about its risks and effectiveness long-term.

Weight Loss Surgery: What Are My Options?

There are multiple surgeries available for people looking to lose weight. Two of the most common types are:

• Gastric bypass. The surgeon creates a small stomach pouch and attaches it to the small intestine. The small stomach can hold less food than the normal stomach, reducing the calories you absorb and causing you to feel full after eating a small amount.
• Gastric sleeve. The surgeon reduces the size of the stomach and makes it into a narrow tube. The new stomach is much smaller, does not stretch when eating, and feels full after eating a small amount.
• Less common procedures are gastric banding, duodenal switch, and intragastric balloon.

What are the Immediate Risks?

According to the American Society for Metabolic and Bariatric Surgery (ASMBS), the risk of a major complication is roughly 4%. The most common risks of surgery include:

• Bleeding or hemorrhage
• Blood clots in the legs or lungs
• Infection of the incision

The most common complications after weight loss surgery include:

• Gallstones
• Leakage of stomach fluid
• Nutritional deficiencies
• Vitamin deficiencies
• Dumping Syndrome: Rapid gastric emptying resulting in nausea, sweating, and diarrhea
  
  

For more information on the immediate risks associated with weight loss surgery, visit: https://asmbs.org/resources/metabolic-and-bariatric-surgery/

What are the Long-Term Challenges?

• Substantial changes in eating habits. This includes a lifetime commitment to eating small amounts of food, eating more frequently throughout the day, chewing food slowly, and eating mindfully. Before you decide to have weight loss surgery, you must commit to life-long health goals including following up with your health care team, exercising most days, and maintaining a high-quality diet. Surgery is only a tool for weight loss that will only work if it is used properly and accompanied by healthy habits.
• Increased sensitivity to alcohol. Weight loss surgeries change how the body metabolizes alcohol; the lining of the stomach contains an enzyme that breaks down alcohol, so with less of this enzyme available after surgery, drinking wine, beer, or liquor will expose you to a higher dose of unmetabolized alcohol. Studies have shown that gastric surgery can leave people more likely to develop an alcohol use disorder. For more information on alcohol use disorder risk after weight loss surgery, visit: https://www.health.harvard.edu/blog/is-alcohol-and-weight-loss-surgery-a-risky-combination-202304242916
• Pouch can stretch over time. It’s important not to overeat after weight loss surgery, because your pouch can stretch enough for you to regain the weight you lost. This is a particular challenge for people who undergo surgery with untreated binge eating disorder or struggling with emotional eating, nighttime eating, or overeating. Without treating the underlying causes of weight gain, many people will regain weight lost with surgery.
• Lifelong vitamin requirements. Weight loss surgery changes your digestion and limits the amount of nutrients your body absorbs. You will need to take vitamin and mineral supplements daily for the rest of your life, including but not limited to a multivitamin, vitamin B12, calcium, vitamin D, and iron.
• Other dietary restrictions. After surgery, you will need to consume only clear liquids for 24 hours. You will then transition to a full liquid diet for 2 weeks, consisting of protein shakes and other milk products. The next phase, lasting 5-6 weeks, will include pureed foods – think baby food texture – during which you will slowly rebuild your tolerance of solid foods. Even after this period of time, there are certain foods that are difficult for post-surgery patients to eat indefinitely, including meat, bread, and carbonated beverages.
  

Does It Work for Long Term Weight Loss?

In the short-term, most patients lose weight rapidly and continue to do so for 18-24 months. Patients may lose 30-50% of their excess weight in the first 6 months, and 77% in 12 months.

Long-term data on weight loss surgery, however, is less convincing. One systematic review showed that 20 years after surgery, average weight loss was only about 22%. Two additional studies showed that 37% of gastric bypass patients had significant weight regain after 7 years and 76% of sleeve gastrectomy patients had significant weight regain after 6 years.

While weight loss surgery may be a good option for some people, its many risks and effectiveness long-term must be considered. Surgery will only work for sustainable weight loss if it is accompanied by healthy habits and treatment of underlying medical and psychiatric barriers to weight loss. At Dignity Weight Center, we focus on a healthy lifestyle as an avenue to weight loss. We would love to meet with you to discuss how we can optimize your health and weight without surgery.

If you are interested in learning more about metabolic health and weight loss, please consult us at Dignity Weight Center. We would be honored to meet you, and we take most insurances!

If you are interested in learning more about metabolic health and weight loss, please consult us at Dignity Weight Center. We would be honored to meet you, and we accept most insurances.

https://www.dignityweightcenter.com/book-online

References

• https://www.uptodate.com/contents/bariatric-operations-early-fewer-than-30-days-morbidity-and-mortality?search=gastric%20sleeve&topicRef=88610&source=see_link#H1283924088
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6203132/
• https://www.health.harvard.edu/blog/is-alcohol-and-weight-loss-surgery-a-risky-combination-202304242916 https://www.upmc.com/services/bariatrics/surgery-process/post-surgery/diet/vitamin-supplements
• https://www.pennmedicine.org/updates/blogs/metabolic-and-bariatric-surgery-blog/2019/may/what-you-eat-after-bariatric-surgery#:~:text=After%20the%20full%20liquid%20diet,three%20and%20four%20after%20surgery.
• Cooper TC, Simmons EB, Webb K, Burns JL, Kushner RF. Trends in weight regain following Roux-en-Y gastric bypass (RYGB) bariatric surgery. Obes Surg. 2015;25(8):1474–1481. doi: 10.1007/s11695-014-1560-z.
• Lauti M, Kularatna M, Hill AG, MacCormick AD. Weight regain following sleeve gastrectomy-a systematic review. Obes Surg. 2016;26(6):1326–1334. doi: 10.1007/s11695-016-2152-x.
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6320354/
• https://uihc.org/educational-resources/how-effective-bariatric-surgery#:~:text=Clinical%20studies%20show%20that%2C%20following,as%2012%20months%20after%20surgery.