doctor having surgery

Why Shouldn’t You Undergo Weight Loss Surgery?

Weight loss surgery is the easiest way to lose weight for some. Weight loss surgery is usually recommended to obese adults, especially those who are suffering from weight-related conditions, including type-2 diabetes. 

On the other hand, teens are not recommended to get weight loss surgery, except if they are severely obese and suffering from weight-related conditions. Teen with a body mass index of more than 35 gets weight loss surgery. So if you are thinking of getting one, it is best to talk to your doctor whether or not it’s a good option for you. 

In this article, we will mainly discuss the reasons why you should not undergo weight loss surgery. But before that, let us first understand the different weight loss surgeries, why you have to undergo such, and its risks and long-term side effects. 

Types of Weight Loss Surgery

1. Roux-en-Y gastric bypass

This weight loss surgery allows your doctor to make a small pouch at the top of your stomach. This pouch is responsible for receiving but limiting the number of foods you eat or the beverages you drink. This small pouch is connected directly to your small intestine, thereby bypassing your stomach, as well as the first few sections of your small intestine. This is the most common weight loss surgery in the US. And it is usually required when diet and exercise are not effective or if you are suffering from serious weight-related health problems (1).

2. Laparoscopic adjustable gastric banding

This weight loss surgery allows your doctor to place an adjustable silicone band which contains an inflatable balloon around the topmost part of your stomach. This weight loss surgery limits the number of foods you can consume so that you will feel fuller quickly. This method does not affect the absorption of nutrients and calories (2). 

3. Sleeve gastrectomy

This weight loss surgery separates and removes a part of your stomach from your body. The remaining part of your stomach is made into a tube-like structure. If your stomach is made smaller, it holds a smaller amount of food. It also allows you to reduce the production of ghrelin, a hormone that regulates your appetite. This method also does not affect the absorption of nutrients and calories (3).

4. Biliopancreatic diversion with duodenal switch

This method also removes a large portion of your stomach and leaves the valve responsible for releasing food to your small intestine. The middle section of your intestine is closed, and the last section is connected to the duodenum. The separated intestine is reattached to the end of the intestine, which allows pancreatic digestive juices and bile to flow through it. This surgery allows the bypass of foods in most parts of your small intestine and limits the absorption of nutrients and calories. But this method will enable you to lose weight given the size of your stomach, which manifests your capacity of food consumption (4). 

Risks and Long-Term Side Effects of Weight Loss Surgery

Now that you already understand the different types of weight loss surgery, it is time for you to understand each of its risks according to the type of weight loss surgery you will undergo:

Risk of Roux-en-Y gastric bypass

Just like any other major surgery, this kind of weight loss also poses various health risks.  Risks directed with weight loss surgery are similar to other abdominal surgery such as excessive bleeding, blood clot, adverse reactions to anesthesia, gastrointestinal system leaks, and lung or breathing problems. 

This surgery also comes with long term risks such as gallstones, hernias, malnutrition, ulcers, vomiting, stomach perforation, low blood sugar, bowel obstruction, and dumping syndrome causing vomiting, nausea, or diarrhea (5). 

Risk of laparoscopic adjustable gastric banding

After surgery, you might experience infection, blood clots, or bleeding in your legs. General anesthesia might also breath-related problems and other reactions. This method might also expose you to risks of puncturing your stomach or slipping of the band placed in your stomach. There are also instances when the food you consume cannot enter your stomach. For instance, meat cannot enter your stomach. And this is a major source of iron. If you lack iron, you will be at risk of anemia (6).

Perhaps, the most common long-term effect of this surgery involves port problems, band slippage, and GERD. But you may also be at risk of band erosion, tubing or port malfunctions, band prolapse, pouch dilation, among others (7).

Risk of sleeve gastrectomy

As mentioned, all surgery carries various risks. And this weight loss surgery has both short and long term risks and side effects including acid reflux, weight gain, anesthesia-related risks, stomach obstruction, chronic nausea and vomiting, infection, esophagus dilation, and inability to eat certain foods. 

Long-term side effects of this surgery include low blood sugar, hernias, malnutrition, ulcers, vomiting, and dumping syndromes, such as dizziness and nausea. You will also be at risks of blood clots, iron and vitamin deficiency, gallstones, stricture, hernia, skin separation, internal bleeding, leakage, and perforation of intestines or stomach (8). 

Risks of biliopancreatic diversion with duodenal switch

This kind of surgery also comes with short term and long term health risks. This might make you at a higher risk of excessive bleeding, gastrointestinal system leaks, infection, lung or breathing problems, blood clots, and adverse reactions to anesthesia. 

Longer-term risks also include vomiting, bowel obstruction, ulcers, gallstones, hernias, stomach perforation, low blood sugar, malnutrition, and dumping syndrome, causing vomiting, nausea, or diarrhea (4). 

Reasons Why You Shouldn’t Undergo Weight Loss Surgery

Here are the top 5 reasons why you should not undergo weight loss surgery according to the type of weight loss surgery:

For Roux-en-Y gastric bypass (9):

#1 Since your stomach and the first section of your intestine are bypassed, you will most likely experience poor absorption of calcium and iron. If your body has low iron, you will be exposed to iron deficiency anemia. 

This is not favorable for someone who has chronic blood loss during bleeding hemorrhoids or excessive menstrual flow. Furthermore, if you are already at risk of osteoporosis, this will increase if you experience bone calcium loss. 

#2 If you bypass the duodenum, you will be at risk of various metabolic bone diseases. These diseases might result in height loss, bone pain, fractured hips and ribs, and a humped back. 

#3 Anemia occurs when your body is deprived of iron. Chronic anemia happens if you are deficient of Vitamin B12. 

#4 You will experience dumping syndrome. Although it seemed like it is not a serious health risk, this might cause extreme problems such as weakness, nausea, faintness, sweating, and even diarrhea. Some cannot even eat sweets after the procedure. 

#5 If your stomach pouch is left larger than 15 to 30 cc or if it is stretch, the surgery won’t be effective in losing weight. Furthermore, the bypassed part of your body cannot be visualized easily using endoscopy or X-ray. And this might be a problem if you are suffering from bleeding, malignancy, or ulcer. 

For laparoscopic adjustable gastric banding (10):

#1 If this is considered as the slowest means of weight loss surgery, then you should have done the more natural way of losing weight. This makes most patients less motivated of strictly complying with the standard required for the surgery. That is the reason why it is reported that patients who undergo laparoscopic adjustable gastric banding do not lose at least 50 percent of the excess weight than the other weight-loss surgeries. 

#2 This weight loss surgery requires your doctor to place an adjustable silicone band which contains an inflatable balloon around the topmost part of your stomach. This is totally foreign in your body. And this could result in a strange feeling or discomfort. 

#3 You are prone to the possible side effects related to the band. As mentioned earlier, this surgery exposes you at risk of band erosion or band slippage. This might also result in the dilation of your esophagus, especially if you cannot control your food intake. 

#4 To avoid mechanical problems with the tube, port, or band, you need to adhere to the required diet strictly. You also need to have a follow-up check-up to your doctor to ensure that the results are successful and to avoid the health-related risks of the surgery. 

#5 If you fail to comply with the requirements to maintain the gastric band strictly, it will not be effective for weight loss. Plus, it will make you exposed to risks of complications. 

For sleeve gastrectomy (11):

#1 This weight loss surgery promises an encouraging result. But this involves an aggressive procedure which cuts and removes a part of your stomach. 

#2 This procedure might result in various complications, including staple line leaks. And this can lead to severe cases such as organ failure, sepsis, much worse, death. Some patients experience bleeding and strictures after their weight loss surgery. 

#3 You will be at risk of long-term vitamin deficiencies. And this will make your body demand magnesium, calcium, iron, phosphorus, and other vitamins. Remember how crucial these vitamins are in your body

#4 Since patients are at risks of deficiencies, and they will be restricted when it comes to their diet for the rest of their lives. They may even be required to take daily supplements. 

#5 This procedure is non-reversible. It means that you will carry this on your lifetime. 

For biliopancreatic diversion with duodenal switch (12):

#1 This surgery promises great results when it comes to weight loss and entire well-being. But this is considered as the most aggressive surgery and makes you at a higher risk of mortality. 

#2 This gives the quickest result when it comes to weight loss. But over time, it becomes ineffective for weight loss because patients tend to consume less restricted amounts of food. 

#3 This surgery requires you to stay longer in the hospital to recover. 

#4 Since this surgery limits the combination of the food and the pancreatic and bile enzymes until the end section of your small intestine, and you will most likely decrease your nutrients and calories absorption. 

#5 You need to strictly adhere to your diet, as well as your vitamin supplements to avoid various complications. 

Conclusion

Obesity is prevalent since then. In fact, one-third of people in the US are obese. That is why weight loss surgeries are in demand (13). There are four common types of weight loss surgery, including roux-en-Y gastric bypass, laparoscopic adjustable gastric banding, sleeve gastrectomy, and biliopancreatic diversion with duodenal switch.

The risks and long-term side effects of weight loss surgery depends upon the type of weight loss surgery you undergo.  Some of the most common risks and side effects of these weight loss surgeries include gallstones, hernias, malnutrition, ulcers, vomiting, stomach perforation, low blood sugar, bowel obstruction, and dumping syndrome causing vomiting, nausea, or diarrhea. 

There are also various reasons why you should not undergo weight loss surgery. For Roux-en-Y gastric bypass, there are instances when this procedure will not be effective for weight loss, especially if your stomach pouch is left larger than 15 to 30 cc or if it is stretch. For laparoscopic adjustable gastric banding, you need to place a foreign adjustable silicone band which might cause a strange feeling or discomfort, though it is reversible. 

Sleeve gastrectomy, on the other hand, requires an aggressive procedure involving the cutting and removing a portion of your stomach. And lastly, the biliopancreatic diversion with a duodenal switch makes you at a higher risk of mortality as it is considered as the most aggressive weight loss surgery.

References:

(1) https://my.clevelandclinic.org/health/treatments/17285-obesity-surgery

(2) https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.111.040139

(3) https://www.ncbi.nlm.nih.gov/pubmed/28840343

(4) https://www.mayoclinic.org/tests-procedures/biliopancreatic-diversion-with-duodenal-switch/about/pac-20385180

(5) https://www.mayoclinic.org/tests-procedures/gastric-bypass-surgery/about/pac-20385189

(6) https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/laparoscopic-adjustable-gastric-banding

(7) https://www.aafp.org/afp/2014/0515/p813.html

(8) https://www.upmc.com/services/bariatrics/candidate/risks-and-complications

(9) https://www.midmichigan.org/conditions-treatments/bariatric/roux-en-y/

(10) https://obesitynewstoday.com/adjustable-gastric-band-pros-cons/

(11) https://obesitynewstoday.com/sleeve-gastrectomy-pros-cons/

(12) https://obesitynewstoday.com/biliopancreatic-diversion-duodenal-switch-pros-cons/

(13) https://www.medicalnewstoday.com/articles/269487.php

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