Life After Weight Loss Surgery
Gastric bypass surgery can definitely change a person's life for the better, but there are also some serious risks and profound life changes that go along with the surgery.
One thing for
certain, gastric bypass surgery isn't always easy, or necessarily safe. The
death rate nears 1%, meaning up to 400 people may die from the procedure
annually. As many as 20% of patients need additional surgery to mend
complications such as abdominal hernias. Due to malabsorption in the shortened
digestive tract in procedures such as the jejunoileal bypass, roughly
30% of patients develop conditions due to malnutrition, such as anemia
and osteoporosis, according to the National Institute of Diabetes and Digestive
and Kidney Diseases.
"There are immediate and long term issues following surgery,"
says C. Daniel Smith, MD, chief of general surgery and director of Emory
Bariatrics at Emory University School of Medicine in Atlanta. "The immediate
issue is the pain and suffering of surgery and the risk as it is a major
surgery and there is a risk of significant complications -- even death," he
tells WebMD. It's also expensive and is often not covered by insurance.
"In the long term, the upside is that medical conditions
related to weight will subside, but the downside is that the alteration in how
you eat is permanent. This is not something to try out for three to six
months," Smith stresses.
All candidates have
to undergo a fairly extensive pre-operation evaluation including medical
clearance for surgery, assessment of psychological appropriateness for weight
loss surgery, nutrition counseling and in some institutions, candidates take a
test to demonstrate a comprehensive understanding of the lifestyle changes and
what they will mean after weight loss surgery.
Not a magic bullet.
Jacqueline Odom, PhD, the psychological director of the
Beaumont Weight Control Center in Royal Oak, Mich., evaluates patients that are
on the path to weight loss surgery to help make sure they are ready for this
step and to handle the life afterward.
"A lot of people want a magic bullet and really don't
understand what is involved," she tells WebMD.
The new stomach requires several tiny, nutrient-rich meals a
day supplemented with additional vitamins and minerals. Eating too much or
indulging in rich, sugary or fried foods can overload the pouch and cause
dumping -- a term used to describe the sweats, chills and nausea that result
from food filling the pouch and overflowing straight into the small
The re-feeding process starts with getting in protein because
that will repair the cells and help them heal after surgery. "We use liquid
protein supplements to start, then pureed foods, then soft foods like scrambled
eggs and then eventually graduate to other foods," Odom says.
"It's not glamorous,' she says. "You have to chew your food
more thoroughly then you ever did and really emulsify it. You must eat very
slowly and in small portions."
Emory's Smith adds: "The volume of food they can eat and the
types of food they can eat changes dramatically. And there are indirect changes
surrounding eating. Many people who eat for social reasons have significant
changes in interpersonal relationships."