The Risks of Weight Loss Surgery

September 19, 2017

Viewing weight loss surgery as an easy, cure-all option is tempting, but conditions and limitations that must be acknowledged and respected. Weight loss surgery requires investment in the body and mind. Recovery and long-term success are deeply rooted in patients’ physical, mental and emotional commitment to well-being. Realistic expectations are important, as are openness and willingness to work with your surgeon and team of nutritionists, physiologists and mental health professionals.

Acknowledging Risk

1.  Surgical Complications. The primary concerns are the common three that apply to any surgery—infection, clots and bleeding:

  • The digestive system is home to a multitude of bacteria, so the primary concern is infection.
  • Every surgery carries the risk of clotting, both deep vein thrombosis in the legs and pulmonary embolisms in the lungs.
  • Bleeding can be an issue for gastric sleeve, gastric bypass and duodenal switch patients.

Close monitoring and following your surgeon’s pre- and post-operative instructions are crucial.

2.  Excess Skin. As you lose weight, the fat will empty out of the cells, but cellular structures will remain, often resulting in excess skin. With no fat to fill or support it, skin may form folds on the stomach, breasts, hips, arms and legs. Removal of this excess skin is considered a cosmetic procedure and can require multiple surgeries like tummy tucks and arm, breast, thigh and lower body lifts.

3.  Gallstones. Gallstones are common in people who have high cholesterol, particularly in individuals who are obese. Gallstones are also prevalent in people who consume a lot of highly processed carbohydrates. The stonelike deposits may cause nausea, vomiting, abdominal pain and—in extreme cases—jaundice. During rapid weight loss, as fat is burned, the liver secretes extra cholesterol into bile, resulting in gallstones. Many bariatric surgeons prescribe the medication ursodiol to prevent gallstones from forming.

4.  Stomal Stenosis. About a month following surgery, some gastric bypass patients develop a narrowing, where their new stomach pouch joins to the small intestine. This condition can cause nausea, vomiting or trouble swallowing. An endoscopic balloon can dilate the stricture back to size, but patients should still cut food into small pieces, chew thoroughly, eat slowly and—equally important—avoid tobacco and NSAIDs. Both substances have been linked to a greater likelihood of developing a stricture. Taking a proton pump inhibitor to reduce stomach acid production may also help.

5.  Gastric Band Slippage or Erosion. Gastric bands operate on the principle that the adjustable band around the upper portion of the stomach creates a smaller, more restrictive stomach pouch. Bands are adjustable and designed to last a lifetime, but a very small percentage of the time—3 percent or less—a band shifts or twists, making a blockage more likely. In a small number of patients—fewer than 1 percent—the band sinks into, or erodes, the stomach wall. Erosion is more likely to occur in patients with a history of pelvic or abdominal infections. Gastric band complications require surgery to readjust or remove the band.

6.  Food Intolerance. Bariatric surgery results in a new digestive system. As patients re-learn how to eat, they may discover food intolerances—foods that can be difficult to eat or cause undesirable physical reactions. Some of the most common offenders are meats, eggs, fibrous vegetables, leafy greens, fruits with membranes or skins, seeds, dry starches like pasta or bread, and dairy. These issues may create a need for supplementation to replace lost nutrients. For most patients, food preparation—like peeling fruit or altering cooking methods—can help, as can adjusting portions. While many food intolerances can be resolved within the first year, prolonged, extensive intolerance can result in malnutrition.

7.  Depression. The majority of patients—70 to 80 percent—maintain a consistently positive psychological outlook following weight loss surgery. However, patients near the ends of the mood spectrum may experience either a marked improvement in mood or, alternatively, a deterioration leading to depression. The period 6 months to a year following the surgery is often an especially crucial time frame. Struggles with weight loss, slow progress, poor self-esteem, social pressures and emotional instability all play a part. Outlook depends heavily on a patient’s ability to balance the aspects of life that must change over time against the ones that will remain the same.

Risk Versus Benefits

Understanding the risks of bariatric surgery is an important factor in reaping the benefits of each procedure. If you’re mentally, emotionally and physically prepared to change your life through weight loss surgery, call us at 337-233-9900, or visit our website today. The risks of a lifetime of obesity far outstrip the risks of doing something about it.