Is Weight Loss Surgery for You? (cont.)
Risks and Side Effects
- Vomiting. This is a common risk of
restrictive surgery caused by the small stomach
being overly stretched by food particles that have
not been chewed well.
- "Dumping syndrome." Caused by gastric
bypass surgery , this is when stomach contents move
too rapidly through the small intestine. Symptoms
include nausea, weakness, sweating, faintness, and,
diarrhea after eating, as well as the inability
to eat sweets without becoming extremely weak.
- Nutritional deficiencies. Nearly 30% of
patients who have weight-loss surgery develop
nutritional deficiencies such as
osteoporosis, and metabolic bone disease. These
deficiencies can be avoided if vitamin and mineral
intakes are maintained.
- Complications. Ten to 20% of patients who
have weight-loss operations require follow-up
operations to correct complications. Abdominal
hernias (ruptures) are the most common complications
requiring follow-up surgery. Less common
complications include breakdown of the staple line
(used to make the stomach smaller) and stretched
stomach outlets (when the stomach returns to its
Gallstones. More than one-third of obese
patients who have gastric surgery develop
gallstones. Gallstones are clumps of
cholesterol and other matter that form in the
gallbladder. During rapid or substantial weight loss
a person's risk of developing gallstones increases.
Gallstones can be prevented with supplemental bile
salts taken for the first 6 months after surgery.
- Need to temporarily avoid
pregnancy. Women of childbearing age should
avoid pregnancy until their weight becomes stable
because rapid weight loss and nutritional
deficiencies can harm a developing fetus.
- Side effects. These include nausea,
vomiting, bloating, diarrhea, excessive sweating,
increased gas and dizziness.
- Lifestyle changes. Patients with
extensive bypasses of the normal digestive process
require not only close monitoring, but also
life-long use of special foods and medications.
Am I a Candidate?
If you have a body mass index (BMI) above 40 -- which
is about 100 pounds overweight for men and about 80
pounds for women -- you are considered severely obese
and therefore a candidate for surgery.
Surgery may also be an option for people with a BMI
between 35 and 40 who suffer from life-threatening
cardiopulmonary problems (for example, severe
sleep apnea or obesity-related heart disease) or
diabetes. For these people, the risk of death from not
having the surgery is greater than the risks from the
possible complications from undergoing the procedures.
Keep in mind that as in other treatments for obesity,
successful results depend mainly on motivation and
behavior. In many cases, patients are required to show
proof that their attempts at dietary weight loss have
been ineffective before surgery will be approved. A
psychological evaluation is considered essential by most
doctors to determine your potential response to weight
loss and change in body image. Most surgeons require
patients to demonstrate serious motivation and a clear
understanding of the extensive dietary, exercise and
medical guidelines that must be followed for the
remainder of their lives after having weight loss
surgery. In addition, studies are performed to assess
the health of your heart and hormonal systems.
Nutritional counseling is also a must before surgery.
For patients who remain severely obese after
nonsurgical approaches to weight loss have failed, or
for patients who have an obesity-related disease,
surgery may be an appropriate treatment option. But for
most patients, greater efforts toward weight control,
such as changes in eating habits, lifestyle changes, and
increasing physical activity, are more appropriate. The
following questions may help you decide if weight loss
surgery is right for you.
- Have you tried to lose weight through
conventional methods of weight loss. group classes,
one-on-one counseling, calorie controlled meal
plans, food journals, exercise?
- Are you well informed about the surgical
procedure and the effects of treatment?
- Are you determined to lose weight and improve
- Are you aware of how your life may change after
the operation (adjustment to the side effects of the
surgery, including dramatically different eating
- Are you aware of the potential for serious
complications from the procedure, the associated
dietary restrictions, and the slight chance that the
procedure will not help you lose weight?
- Are you committed to life-long medical
Reviewed by the Department of Nutrition Therapy at The Cleveland Clinic.
Edited by Charlotte Grayson, MD
, WebMD, August 2004.
Portions of this page © The Cleveland Clinic
2000-2004Last Editorial Review: 7/14/2005