Medically reviewed by Susan Kerrigan, MD and Marianne Madsen, University of Utah
Gastric band, bypass, stomach stapling… for many, it sounds like a perfect solution; finally lose the weight and slim down quickly. But bariatric surgeries are serious procedures that often also require a significant change of diet and lifestyle. In some cases, the benefits may outweigh the risks–and it’s important to be aware of exactly what those risks are.
Although most people may be familiar with the term “stomach stapling,” new procedures are more likely to input a gastric band or rearrange the digestive system to restrict the amount of food that can be consumed. While some procedures such as the gastric band are reversible, many of the other procedures are not. Like with any major surgery, there are some potential postoperative problems that need to be looked out for.
So what are some of the potential risks involved?
First, there is the possibility for things that go wrong within the surgery itself. Post-surgery, the patient may suffer from vomiting and “dumping syndrome,” also called rapid gastric emptying. This occurs when food moves from your stomach into your bowel too rapidly. This can, in turn, result in nutrient deficiencies (notably B12 and iron) as well as other long term metabolic problems. Some of these problems can occur as a result of how the patient is choosing to eat post surgery.
Often, abdominal pain can be caused by improper diet post surgery. It is important to realize the dietary and lifestyle changes that will be necessary to both maintain the benefits of the surgery but also to make sure the patient doesn’t experience pain afterwards. For the first two weeks after surgery, patients can only consume liquids after which they can eventually transition to blended or pureed foods. But even after restarting regular food consumption and larger calorie amounts, there will still be foods that will cause problems and potential indigestion. After surgery, people can also experience problems if they eat too quickly or don’t chew their food well enough. Even drinking a soda or other carbonated beverage or using a straw can cause pain if air gets stuck in the reduced stomach.
Even with the limits placed on the digestive system, if people don’t keep to a low-calorie diet and/or exercise, it is possible to gain weight back. Dr. Kasey Goodpaster, a psychologist in the Bariatric & Metabolic Institute at the Cleveland Clinic says: “I always tell my patients that bariatric surgery is a “stomach surgery,” not a “brain surgery,” and much of eating is triggered by thoughts, feelings, and situations which will remain after surgery if not tackled proactively. Loss of control eating before surgery is likely to re-emerge, but it manifests differently.” Indeed, a study showed that after surgery, patients who were previously binge eaters developed graze eating which cannot be prevented by the surgery and can cause weight regain.
Although some may think that people would decide to undergo surgery because of how they look or feel about their body, very often the biggest reason is loss of functional ability or a medical problem. For patients who are morbidly obese or have a medical condition such as diebetes that is related to their condition, surgery can be a literal life saver. Ultimately, the body is good at trying to prevent change–even if that means maintaining a dangerous weight. This can make it very difficult to lose weight naturally, especially if physical function is limited. After surgery and weight loss, conditions such as diabetes can improve–blood sugar will go down and patients can often stop taking medication. Sometimes they can even go into remission.
The key is that it’s important to remember that there is no such thing as a magical solution. Patients who undergo bariatric surgery need to make significant lifestyle changes. While in many cases the benefits are definitely worth it and patients may experience a new lease on life, it’s important to be educated on the risks as well as how lifestyle choices will need to change post surgery.
- Follow-up of Nutritional and Metabolic Problems After Bariatric Surgery, Ken Fujioka, Diabetes Care Feb 2005, 28 (2) 481-484; DOI: 10.2337/diacare.28.2.481