1. You'll gain all the weight back!
2. You'll have to take vitamins for the rest of your life!
3. You'll have all kinds of health problems or die during surgery!
4. That's the easy way out for people who don't know how or don't want to diet
5. You'll have problems with your pouch or need more surgery
I was able to answer each misconception by researching, asking friends who had been through it, and actually receiving this information first hand as a bariatric surgery candidate. I'll address each item
1. You'll gain all the weight back - As with any diet or exercise program, weight loss surgery is only a tool. Yes, you'll lose a lot of weight in the first year but after that your body will adjust to its new weight, new food intake amount, and if you stop eating healthy and instead fill whats left of your stomach with junk, you will gain weight. Healthline reports this as the "Honeymoon" period and explains why this is the case here. This will happen with anyone who diets, loses weight and then returns to eating poorly.
The actual statistics for weight loss surgery show overall positive results. Bariatric Surgery Source reports over half of bariatric surgery patients regain weight within two years but despite the weight regain, the average patient has still kept off over 60% of their excess weight after 5 years. These are great results! The page goes on to explain how this can be avoided.
The American Society for Metabolic and Bariatric Surgery also reports
"As many as 50 percent of patients may regain a small amount of weight (approximately 5 percent) two years or more following their surgery. However, longitudinal studies find that most bariatric surgery patients maintain successful weight-loss long-term. ‘Successful’ weight-loss is arbitrarily defined as weight-loss equal to or greater than 50 percent of excess body weight. Often, successful results are determined by the patient, by their perceived improvement in quality of life. In such cases, the total retained weight-loss may be more, or less, than this arbitrary definition. Such massive and sustained weight reduction with surgery is in sharp contrast to the experience most patients have previously had with non-surgical therapies."2. You'll have to take vitamins the rest of your life! - This is actually true. You will have to take a multivitamin containing iron for the rest of your life. The sad part about this concern is that this is something most people should be doing anyway! This was actually my least concern because I already take a daily multivitamin and many other health supplements that help me get the nutrients I'm missing from my food supply and also give me other benefits such as more restful sleep, less sickness, and heightened energy levels. I'm not really sure why people would be so concerned about this. If anything, its a great habit to get into and a positive benefit from surgery.
The American Society for Metabolic and Bariatric Surgery also reports
"Bariatric operations can lead to deficiencies in vitamins and minerals by reducing nutrient intake or by causing reduced absorption from the intestine. Bariatric operations vary in the extent of malabsorption they may cause, and vary in which nutrients may be affected. The more malabsorptive bariatric procedures also increase the risk for protein deficiency. Deficiencies in micronutrients (vitamin and minerals) and protein can adversely affect health, causing fatigue, anemia, bone and muscle loss, impaired night vision, low immunity, loss of appropriate nerve function and even cognitive defects. Fortunately, nutrient deficiencies following surgery can be avoided with appropriate diet and the use of dietary supplements, i.e. vitamins, minerals, and, in some cases, protein supplements. Nutrient guidelines for different types of bariatric surgery procedures have been established by the ASMBS Nutritional Experts Committee and published in the journal, Surgery for Obesity and Other Related Disorders. Before and after surgery, patients are advised of their dietary and supplement needs and followed by a nutritionist with bariatric expertise. Most bariatric programs also require patients to have their vitamins and minerals checked on a regular basis following surgery. Nutrient deficiencies and any associated health issues are preventable with patient monitoring and patient compliance in following dietary and supplement (vitamin and mineral) recommendations. Health problems due to deficiencies usually occur in patients who do not regularly follow-up with their surgeon to establish healthy nutrient levels."3. You'll have all kinds of health problems or die during surgery - Ok, first of all lets think of all the problems obesity causes. Do you know anyone who is severely overweight that doesn't also have severe health problems? Joint pain, diabetes, sleep apnea, asthma or breathing trouble, mobility issues, headaches, heart problems, high blood pressure... need I go on? The most eye opening moment for me was when I went to my first support group and saw so many people who had just had surgery who were already off of their CPAP machines and all diabetic medications after only one month of weigh loss!!! After two months they are moving more and exercising and feeling amazing! Hearing their stories and how much their lives have changed in a positive way is so motivating! The reality is:
"As your body size increases, longevity decreases. Individuals with severe obesity have a number of life-threatening conditions that greatly increase their risk of dying, such as type 2 diabetes, hypertension and more. Data involving nearly 60,000 bariatric patients from ASMBS Bariatric Centers of Excellence database show that the risk of death within the 30 days following bariatric surgery averages 0.13 percent, or approximately one out of 1,000 patients. This rate is considerably less than most other operations, including gallbladder and hip replacement surgery. Therefore, in spite of the poor health status of bariatric patients prior to surgery, the chance of dying from the operation is exceptionally low. Large studies find that the risk of death from any cause is considerably less for bariatric patients throughout time than for individuals affected by severe obesity who have never had the surgery. In fact, the data show up to an 89 percent reduction in mortality, as well as highly significant decreases in mortality rates due to specific diseases. Cancer mortality, for instance, is reduced by 60 percent for bariatric patients. Death in association with diabetes is reduced by more than 90 percent and that from heart disease by more than 50 percent. Also, there are numerous studies that have found improvement or resolution of life-threatening obesity-related diseases following bariatric surgery. The benefits of bariatric surgery, with regard to mortality, far outweigh the risks. It is important to note that as with any serious surgical operation, the decision to have bariatric surgery should be discussed with your surgeon, family members and loved ones."
"Individuals affected by severe obesity are resistant to long-term weight-loss by diet and exercise. The National Institutes of Health Experts Panel recognize that ‘long-term’ weight-loss, or in other words, the ability to ‘maintain’ weight-loss, is nearly impossible for those affected by severe obesity by any means other than metabolic and bariatric surgery. Bariatric surgeries are effective in maintaining long-term weight-loss, in part, because these procedures offset certain conditions caused by dieting that are responsible for rapid and efficient weight regain following dieting. When a person loses weight, energy expenditure (the amount of calories the body burns) is reduced. With diet, energy expenditure at rest and with activity is reduced to a greater extent than can be explained by changes in body size or composition (amount of lean and fat tissue). At the same time, appetite regulation is altered following a diet increasing hunger and the desire to eat. Therefore, there are significant biological differences between someone who has lost weight by diet and someone of the same size and body composition to that of an individual who has never lost weight. For example, the body of the individual who reduces their weight from 200 to 170 pounds burns fewer calories than the body of someone weighing 170 pounds and has never been on a diet. This means that, in order to maintain weight-loss, the person who has been on a diet will have to eat fewer calories than someone who naturally weighs the same. In contrast to diet, weight-loss following bariatric surgery does not reduce energy expenditure or the amount of calories the body burns to levels greater than predicted by changes in body weight and composition. In fact, some studies even find that certain operations even may increase energy expenditure. In addition, some bariatric procedures, unlike diet, also causes biological changes that help reduce energy intake (food, beverage). A decrease in energy intake with surgery results, in part, from anatomical changes to the stomach or gut that restrict food intake or cause malabsorption of nutrients. In addition, bariatric surgery increases the production of certain gut hormones that interact with the brain to reduce hunger, decrease appetite, and enhance satiety (feelings of fullness). In these ways, bariatric and metabolic surgery, unlike dieting, produces long-term weight-loss."5. You'll have problems with your pouch or need more surgery - First of all, can we agree that every surgery has potential for complications? I found that most of the complications related to bariatric surgery are the same as that of other surgeries (such as blood clots, bleeding, constipation, problems with the incision or other problem during surgery). The potential complications are listed by Bariatric Surgery Source - click the links for more information on each:
- Bleeding (also called “Hemorrhage”)
- Blood clots or blood clot symptoms (also called “thrombus”)
- Bowel function changes (sometimes diarrhea, but more often constipation after gastric bypass surgery)
- Bowel obstruction (also called an “internal hernia”)
- Dumping syndrome
- Dehydration
- Dyspepsia (indigestion)
- Gallstones
- Gastroesophageal reflux disease (GERD)
- Hypoglycemia (low blood sugar)
- Incision(al) hernia
- Intolerance to certain foods – With a changed stomach size or digestive system, there will be certain foods that you’ll need to avoid and certain diet habits you’ll need to maintain. See our Bariatric Diet section for details.
- Kidney stones
- Leaks ( including gastrointestinal leaks and staple line leaks )
- Nausea and vomiting
- Nutritional deficiency, especially iron and calcium. See our Bariatric Vitamins page for more information about getting the vitamins your body needs after gastric bypass surgery.
- Organ injury during surgery
- Stenosis/Stricture
- Marginal Ulcer
- Wound infection
Specifically for the sleeve surgery, obesity coverage provides a great article about demystifying surgery complications. I like that this article starts with the benefits of the sleeve:
- It’s quicker and technically easier than gastric bypass surgery.
- It results in an average of 60% excess weight loss.
- More weight loss than Lap Band and slightly less than gastric bypass.
- Reduces hunger.
- Does not produce dumping syndrome like gastric bypass.
- Does not require band adjustments like Lap Band surgery.
- Weight loss is rapid. The majority of weight loss occurs in the first year after surgery
I hope this post has answered some of your questions about misconceptions of bariatric surgery. Thanks for reading!
