Staying Healthy After Bariatric Surgery
January 21, 2025
Losing weight can be challenging, even if it’s just 10 pounds. But when you have 100 pounds or more to lose, losing weight can seem nearly impossible — particularly when you’ve tried countless diets and exercise programs.
Bariatric surgery gives many people a safe and effective way to lose weight and keep it off for good.
“The majority of people who have bariatric surgery maintain about 70% of their maximum weight loss 10 years after surgery,” said Sandra Wischmeyer, DO, an independent general and bariatric surgeon who chooses to practice at Franciscan Health Michigan City.
But while bariatric surgery offers benefits such as significant weight loss and possible reduction of medications and other health conditions, it’s not without risk. Dr. Wischmeyer explains how doctors and patients can work together to prevent the most common complications of bariatric surgery and remain healthy in the years after their weight loss surgery.
Health-Enhancement Surgery
Bariatric surgery offers more than weight loss. It can prevent and even cure metabolic conditions like type 2 diabetes, high blood pressure and hyperlipidemia (too many fats in your blood). Weight loss can lower your risk of joint problems, sleep apnea, migraines, infertility and several types of cancer.
“I like to call it metabolic surgery rather than weight loss surgery because it’s so much more than weight loss,” Dr. Wischmeyer said. “For those with type 2 diabetes, the cure rate is as high as 50%, 10 years after surgery. Compared with medical management of type 2 diabetes — diet, exercise and medications — the cure rate is about 15 times higher after surgery. And, for those at risk of developing diabetes, surgery is 10 times more effective at preventing the disease than diet and exercise alone.”
Dr. Wischmeyer noted that many people still perceive bariatric surgery as high risk, possibly due to studies conducted when these procedures were new. Bariatric surgery was initially performed as an open procedure, and there were more complications.
“Today, we use minimally invasive laparoscopic and robotic approaches, rather than open surgeries, which improve safety,” she said. “Plus, we screen each person extensively to make sure surgery is safe for them. Additionally, people spend very little time in the hospital after surgery — only one or two days, depending on the procedure.”
The Most Common Long-Term Complications Of Bariatric Surgery
The two most common types of bariatric surgery are:
- Gastric bypass surgery, which changes the way you absorb and digest food.
- Gastric sleeve surgery, which removes part of your stomach to make it smaller.
Gastric bypass surgery has been around for decades and has a long track record of safety. But, because the procedure changes your body’s ability to absorb certain nutrients, your doctors will monitor you for possible vitamin and mineral deficiencies, such as iron, calcium, and vitamins B1, B12 and D.
“The risk of developing vitamin or mineral deficiencies is very low because we provide long-term follow-up care after surgery,” Dr. Wischmeyer said. “We make sure people take daily supplements, and we do periodic blood tests to ensure there aren’t any deficiencies.”
Gastric sleeve surgery, the most popular weight loss procedure in the U.S., can cause heartburn or gastric reflux in some people.
“These conditions can develop because this surgery changes the structure of your stomach and small intestine,” Dr. Wischmeyer said. “We treat these with anti-acid medicines. Gastric sleeve isn’t recommended for people with severe gastric reflux or esophagitis. Of course, we screen very thoroughly before surgery to determine what’s safest and best for each person.”
Lifestyle And Other Risk Factors
Gastric bypass surgery isn’t recommended for anyone who smokes, smoked heavily in the past, or has a history of alcohol abuse.
“Gastric bypass surgery can increase the risk of ulcers developing around the surgical site if you smoke or used to smoke heavily,” Dr. Wischmeyer said. “I never operate on someone who smokes —they must be smoke-free for at least a month. Bypass surgery also increases alcohol absorption, so it’s not a good option for anyone who has an alcohol-use disorder or recently received treatment for it.”
Because gastric bypass surgery changes how you absorb nutrients, it can also alter the absorption of medicines and stop them from working as they should.
“Most people who have bariatric surgery are taking medicines for blood pressure, cholesterol and diabetes, which aren’t usually an issue,” Dr. Wischmeyer said. “That’s because the need for these drugs usually decreases or goes away after weight loss. I’m mainly concerned with psychiatric medicines — the need for them doesn’t go away after surgery. In those instances, I recommend gastric sleeve surgery, which doesn’t affect absorption.”
How We Ensure Success And Prevent Complications
Nutrition, exercise and lifestyle guidance go hand in hand with bariatric surgery. When you have surgery, you’re well-prepared to keep the weight off permanently.
“We have frequent follow-up appointments the first year after surgery to ensure people have healthy eating habits and are beginning to exercise,” Dr. Wischmeyer said. “We want to be sure they don’t revert to old eating habits — we address any issues right away. We also do blood tests periodically after bypass surgery to check for nutrient deficiencies.”
Ongoing follow-up and support help prevent complications and ensure each person has what they need to maintain their health and weight loss for a lifetime.
