Veggie Blog

Weight loss surgery and its health risks

If you have been watching your weight climb for years and are worried about it, you may wonder whether weight loss surgery works. Can it stop future weight gain? Here is what you should know before you decide.

What is weight loss surgery?

Weight loss surgery, also called metabolic and bariatric surgery, is a group of operations that change your digestive system to help you lose weight. Some of them make your stomach smaller, so that you feel full sooner. Others change the small intestine, so that your body absorbs fewer calories. Surgery can also affect hormones that control hunger. Surgical techniques and monitoring have improved over the years, but it is still major surgery with real risks.

For this reason, appearance should not be the main reason for having it. It is meant for people with obesity who have not been able to lose weight and keep it off in other ways, and its main aim is to improve health problems linked to obesity, such as type 2 diabetes.

Who is it for?

According to the US National Institute of Diabetes and Digestive and Kidney Diseases, it may be an option for adults with a body mass index (BMI) of 40 or more, or a BMI of 35 or more together with a serious health problem linked to obesity, such as type 2 diabetes or sleep apnea. In some cases it is considered for people with a BMI of 30 to 35 whose type 2 diabetes is hard to control.

How much weight do people lose?

It varies. Studies show that many people lose, on average, 15 to 30 percent of their starting weight, depending on the type of operation. No method, including surgery, is sure to work. Some people lose less than they hoped, and over time some regain part of the weight. How well it works depends on your weight before surgery, the type of operation, your age, your ability to exercise, your overall health, your commitment to follow-up care and the support you get from family and friends.

What are the risks?

Side effects right after surgery can include bleeding, infection, leaks where the stomach or intestine was stapled or sewn, diarrhea and blood clots in the legs that can travel to the lungs or heart. Follow-up procedures or hospital stays are fairly common, affecting about one in three patients within five years. Rarely, complications can be fatal.

Problems can also appear later. Your body may not absorb enough nutrients, especially if you do not take the vitamins and minerals you are prescribed, which can lead to anemia or osteoporosis. This matters for vegetarians, who need to plan their intake of vitamin B12, iron, calcium and protein with a dietitian. Gallstones can form after rapid weight loss, gastric bands can slip, and some patients develop strictures (a narrowing that makes it hard to eat) or hernias. Some research suggests that gastric bypass may change how the body handles alcohol.

How can you prepare?

Learn as much as you can. Talk to an experienced bariatric surgeon, or at least a family doctor who knows the field, and ask about the types of surgery, the risks and the follow-up. Speak to a dietitian, and consider seeing a psychologist or psychiatrist for advice on long-term goals, since eating habits and emotions play a big part in the results. Make sure that you have people around you who will support you.

What happens after surgery?

Surgery is a tool, not a cure. To keep the weight off, you still need lifestyle changes: healthy eating, regular exercise, your vitamins and regular check-ups. Read our posts on a weight loss plan, natural weight loss and weight loss tips for ideas that work for the long term. For a summary of surgery types, risks and benefits, see the NIDDK guide to weight-loss surgery.

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