Weight Loss Surgery: Long-Term Results
Bariatric surgery can help you get past those cravings, get healthier, and be more active.
Health Problems After Weight Loss Surgery continued...
Malnutrition can be a big problem for some gastric bypass patients.
It occurs in rare cases, when the person has lost too much weight, explains
Madan. This can be related to surgery, when the connection between the small
bowel and the stomach is too small.
"They can only eat very little, even less than the normal four ounces," he
says. "They're hungry but they can't eat. They're vomiting all the time."
An outpatient procedure easily relieves the problem. It involves a flexible
endoscope into the mouth, then a balloon is used to dilate the connection,
which relieves the problem.
However, when patients having this problem don’t go and see their doctor, it
can develop into severe nutrition, Madan says.
Regaining Weight -- or Not Losing Weight. For gastric bypass
patients, eating too frequently is a typical problem. Since the pouch restricts
how much you eat, it's difficult to overeat in any one meal.
"A patient may bring lunch to work, eat only a quarter of it at noon, but
eat the rest over the afternoon," says Courcoulas. "They're eating more
calories than they should -- just eating them in small amounts."
Also, the stomach pouch will "give" a little over time, so people can eat a
little more several years after surgery -- especially if they're pushing the
limit anyway. "Even if they get a fullness sensation pretty quickly, they must
learn to tune into it and stop eating," she says.
Another problem: Over time, the body adapts to the surgical changes -- so
there is less malabsorption. At that point, lifestyle to maintain your weight
loss is key, Courcoulas says.
Madan says there can also be mechanical problems:
- Food may be going into the old stomach, rather than to transitioning
through to the intestine. This indicates that the stomach pouch and the stomach
have somehow reconnected themselves -- what's known as a fistula. Surgery can
correct this problem.
- The connection from the stomach pouch to the small bowel may be too large.
This can be corrected in an outpatient procedure. Patients who are two years
after surgery -- and have lost feeling of satiety after eating -- may be
candidates for that procedure.
Gastric Banding Surgery Problems
Regaining weight -- or not losing weight -- also happens with gastric
banding surgery. It's likely because of liquid calories (sodas, juices) or
easily digestible snack foods.
"The band only restricts portion size, it doesn't affect calories. If you
eat chicken, fish, fruits and vegetables at three meals a day, you will be
successful with the band," says Courcoulas. "If you're drinking too much soda
or juices or snacking on soft snack foods, you won't lose weight."
"After surgery, overeating can cause aggressive vomiting -- which can affect
the surgery," says Madan. "It can cause the band to slip. If it slips, another
operation is required to fix it."
He outlines other mechanical problems that can occur:
- Chronic overeating will stretch the stomach pouch (part of the stomach
above the band). That may cause a stomach stitch to become torn and the band to
slip. Surgery can correct this problem.
- If the band is too tight, it can erode. "When it erodes, it goes into the
stomach layers and becomes infected and needs to be removed," says Madan. "The
patient may have to undergo another bariatric surgery or will most likely gain
the weight back."