Bariatric surgery is not just another weight loss program. It is surgery, and as with any surgery, there are risks. However, thanks to the advancement of surgical technologies and several other factors, the procedures have become progressively safer since they were first performed years ago. In fact, the risks of weight loss surgery – whether gastric bypass, gastric sleeve or LAP-BAND − are comparable to many common, well-accepted procedures, such as elective gallbladder or gallstone surgeries.
Therefore, when deciding if weight loss surgery is right for you, the risks of bariatric surgery should be measured against the relative risks of being obese. Studies have shown that being obese can shorten your life and increase your risk of serious health issues such as diabetes, hypertension, infertility, sleep apnea and even cancer, while the risks of surgery are low, and the majority of patients have no complications. Your weight, age and medical history play a significant role in determining your specific risks. The New Jersey Bariatric Center clinical team will assess your risk factors through your medical history and testing and help you to decide the best course of action for you. Specific risks of surgery are listed below.
These risks are those that are associated with any Abdominal Surgery, including but not limited to bariatric surgery.
- Shoulder pain
- Complications due to anesthesia and medications
- Deep vein thrombosis
- Injury to stomach, esophagus, or surrounding organs
- Pulmonary embolism
- Stroke or heart attack
The following are the risks that are associated specifically with Bariatric Surgery.
- Abdominal hernia
- Chest pain
- Collapsed lung
- Constipation or diarrhea
- Enlarged heart
- Gallstones, pain from passing a gallstone, inflammation of the gallbladder, or surgery to remove the gallbladder
- Gastrointestinal inflammation or swelling
- Stoma obstruction
- Stretching of the stomach
- Surgical procedure repeated
- Vomiting and nausea
- Migration of implant (band erosion or band slippage)
- Tubing-related complications (tube kinking or leak)
- Band leak
- Leak from staple lines
- Stenosis (narrowing of a passage, such as a valve)
- Gastroesophageal reflux (GERD)
- Leak from staple lines
- Dumping syndrome, an unpleasant side-effect that may include vomiting, nausea, weakness, sweating, faintness and diarrhea
- Stenosis (narrowing of a passage, such as the stoma)
This chart compares the mortality rate of the three bariatric surgeries — Gastric Bypass, Gastric Sleeve and LAP-BAND® — with the mortality rates at U.S. hospitals following some other commonly performed procedures.
Side Effects of Bariatric Surgery
Certain side-effects are seen with weight-loss operations simply because of the amount of weight loss in such a short period of time. These are seen also in people who have had successful weight loss without surgery.
Dumping Syndrome (Gastric Bypass patients only)
“Dumping syndrome” is what many bariatric surgeons like to call a “good” side effect because it encourages patients not to eat sweets. Dumping syndrome occurs when high fat, high sugar foods move too quickly through the small intestine, causing nausea, weakness, sweating, faintness and sometimes diarrhea. There can also be an inability to eat sweets without severe weakness and sweating, causing patients to having to lie down until the symptoms pass.
Transient Hair Loss (Gastric Bypass, Gastric Sleeve, LAP-BAND®)
Hair loss and thinning is a common side-effect that may occur during the first 6 months after surgery. Although it is alarming, it will not lead to baldness. Once your weight stabilizes, the hair will grow back. Harsh hair treatments, such as straightening and coloring, should be avoided. Be sure to take in an adequate amount of protein and ask your doctor for other recommendations.
Nausea or Vomiting (Gastric Bypass, Gastric Sleeve or LAP-BAND®)
Since your “new” stomach is smaller, it will not be able to hold as much food. If you get full but continue to eat more or eat quickly without chewing thoroughly, chances are an episode of vomiting will result. These habits should change after several episodes of vomiting occur. You will have to “relearn” your way of eating by eating slower, chewing food well and stopping when you feel full.
Lactose Intolerance (Gastric Bypass or Gastric Sleeve patients)
Because the enzyme lactase, which is needed to digest milk and other dairy products, does not reach food in the usual fashion, bypass and sleeve patients may not be able to fully digest milk. Undigested milk can lead to gas, cramping and diarrhea. If this occurs, you may have to avoid dairy products or switch to lactose-free foods such as milk or cheese products made from soy, almond, rice or coconut. Fortunately, there are many of these products available today.
Hernia (Gastric Bypass, Gastric Sleeve or LAP-BAND®)
Hernias are weaknesses in wounds and lead to a sometimes-painful bulge that can enlarge with time. The risk of a wound hernia occurring is 1%-2% with laparoscopic surgery, making this a much lesser risk than when the procedures were done as open surgery, when they would occur in 10%-20% of cases. If a wound hernia occurs, another operation is required to repair it. Typically, surgeons wait one year until maximum weight loss has occurred before repair.
Gallstones (Gastric Bypass, Gastric Sleeve or LAP-BAND®)
Up to one-third of obese patients who have bariatric surgery may 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. Additional surgery to remove the gallbladder may be necessary. Some patients may have their gallbladder removed at the time of the obesity surgery if they have gallstones.
Vitamin and mineral deficiencies (Gastric Bypass patients only)
Vitamin and mineral deficiencies in Gastric Bypass patients can be prevented by regularly taking vitamins, minerals and protein supplements and routinely seeing your primary care physician and a nutritionist to be tested for deficiencies. Women of childbearing age should avoid pregnancy until their weight becomes stable because rapid weight loss and nutritional deficiencies can harm a developing fetus. Most patients are required to take daily multivitamins and calcium with vitamin D. Some patients may require vitamin B12 or iron supplements as well.