Does Weight Loss Surgery Make You Healthier? Maybe Not

Weight loss surgery, cutting away healthy stomach organs, is promoted as the only effective treatment for obesity. But the cracks are starting to show now – not surprisingly. Yesterday a 20-year follow-up of the largest study on weight loss surgery was published and it could be the largest setback yet.

It turns out that obese people undergoing weight loss surgery get an INCREASED need for medical treatment, even years after the surgery. Despite their weight loss! For example they need more inpatient care in hospitals. During the first six years after surgery the increase is very large (see figure above).

The cause is either complications from the surgery (like bleeding, infections, leakage of stomach contents into the abdominal cavity) or long-term dangers like bowel obstruction, anemia, gallstones or malnutrition.

Bloomberg News: Weight-Loss Surgery’s Health Benefits Found to Have Costs

Obese people who did not receive surgery ultimately needed less medical care. So how healthy is it to lose weight by surgery?

There was also an increased need for psychiatric medications (e.g. for depression and anxiety) for weight loss surgery patients.

We need a safer and wiser treatment for obesity. Amputating healthy organs is just an emergency solution. We need to stop giving simplistic calorie-fixated advice (the least effective advice in study after study) before exposing patients to risky surgery. These operations should be the last resort. Thus patients should first be offered advice on low carb (the most effective advice in study after study) and adequate support.

Weight loss surgery may be extremely lucrative for hospitals (the complications are an added bonus!) but if you are a patient: Be warned. And make sure you have good insurance.

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24 Comments

Top Comments

  1. Jay Wortman MD
    It always struck me as odd that the system is so willing to go to bat to provide a permanently disfiguring surgery with teams of doctors, nurses, nutritionists, etc. to guarantee that subjects will eventually have to eat a LCHF diet while completely rejecting the idea that any resources at all be directed at getting people on that diet without the permanent disfigurement. And, why the complicated gut surgery, why not just sew their lips shut - it amounts to pretty much the same thing. Crazy!
    Read more →
  2. Jay Wortman MD
    Here is a typical post-op diet: http://www.obesityhelp.com/forums/nutrition/Roux-en-Y-Gastric-Bypass-...

    It is, indeed, low in both carbs and fat. In the initial stages of weight loss this will work as you are burning off stored body fat. This is true in both bariatric surgery and simply doing a carb restricted diet. The problem develops once weight loss reaches a plateau and you are no longer burning stored calories. At that point you must add calories to your diet. Since protein cannot go too high, the added calories must be either fat or carbs. Those who experience long term success with surgery inevitably restrict carbs and eat what is essentially a LCHF diet. My source for this is a friend who is an experienced bariatric surgeon. He also told me of a case who regained 90 lbs simply by drinking lots of regular Coke.

    Read more →

All Comments

  1. Tia
    Not to forget what kind of nutrition will be advised to patients after surgery: LCHF!
    Why not hand out this advice BEFORE the surgery?
  2. murray
    There is an intrinsic conflict of interest in taking medical advice from a person or institution that stands to profit from recommending an expensive medical procedure.
  3. Gary Green
    And for those of us who DIDN'T need all that post surgery? Those of us who were like sugar alcoholics before the surgery and could then control ourselves afterwards? Who didn't get diabetes like the rest of their family? Sorry. I'm happy for all of you who could LCHF right out of the gate but some of us needed a little help first. I'm calling bullshit on this one.
    Reply: #9
  4. Nichelle
    I won't call bullshit on it, but I wish I was exposed to a doctor that supported my LC choices. I had the opposite, a doctor telling me the 60 lbs I'd lost was 'water weight' then assuring me that skim milk and oranges would be the key to health. I promptly gained 25 lbs and went to get a lap band. The lap band is not malabsorptive, so I wonder how the stats are with it. I do have to say that LC is the way I maintain my weight as I can easily eat around the band now, 6 years in.
  5. Kashi
    It seems so sad to me that doctors recommend surgery ti lose weight. My husband and I just made the HFLC/Paleo switch and we've each lost over 20 lbs and counting in 3 months. Every single day, the scale is lower than the day before- except the few when one of us slips, then it goes back up...hmmm
  6. mezzo
    Anyone who has got a doctor who thinks that a weight loss of 60 lbs is merely water needs another doctor quick.
    A lap band can be removed right? So the consequences may be less harmful that having half your stomach removed. Even so - if you look round the forums for people who have had a lap band you very often find the same statement: people have learned to "eat around their band". Unless you change your attitude to food and your way of eating I don't see much of a chance for long-term success. And no need to bullshit either.
  7. mezzo
    Gary - I would be interested to know who long ago you had your surgery?
  8. Jay Wortman MD
    It always struck me as odd that the system is so willing to go to bat to provide a permanently disfiguring surgery with teams of doctors, nurses, nutritionists, etc. to guarantee that subjects will eventually have to eat a LCHF diet while completely rejecting the idea that any resources at all be directed at getting people on that diet without the permanent disfigurement. And, why the complicated gut surgery, why not just sew their lips shut - it amounts to pretty much the same thing. Crazy!
  9. PJ
    Gary, I'm sorry that the options for cutting sugar addiction were not offered to you before you found it necessary to resort to surgery. For those desperate enough to contemplate surgery, I urge you to consult a good Naturopathic Doctor who can work with supplements and herbs to eliminate cravings. As an NC, I see natural methods used successfully all the time. I'm not sure I understand how having surgery aids in controlling cravings/addiction.
  10. Wertex
    You will eventually get over cravings after surgery, because it will be literally impossible to eat more than 200 grams of food per serving. Otherwise you will get horrible abdominal pain and in most cases you will throw up all the food because it is not in your stomach, but more still in your throat. So basicly they will have to choose between the two. That is why they recommend energy rich LCHF diet so that the patients can actually feed themselves.
  11. 1 comment removed
  12. Margaret
    Where are you getting the information that post surgical diet is LCHF? Anything I can find says high protein, low fat?
    Reply: #16
  13. Galina L.
    Just checked a hCG Diet. What a total BS! - all visible fat from meat must be removed, 100 grams of meat a day , one apple, one bread-stick, one type of a veggie a day. A classical LC starvation crash diet. Recently in the US a scandal involving similar Kimkins diet was all over the news http://lowcarbdiets.about.com/od/populardietplans/a/kimkinsdiet.htm.
    Vito, on a starvation diet a lot of muscle and organ tissues get lost besides some fat and body gets into starvation mode. I can't say "good luck" to you.
  14. 1 comment removed
  15. Jessica
    Enough with the hcg spam, Vito. Though it is kind of clever to have the site showing a blank page while you're dropping your links all around the net.
  16. Jay Wortman MD
    Here is a typical post-op diet: http://www.obesityhelp.com/forums/nutrition/Roux-en-Y-Gastric-Bypass-...

    It is, indeed, low in both carbs and fat. In the initial stages of weight loss this will work as you are burning off stored body fat. This is true in both bariatric surgery and simply doing a carb restricted diet. The problem develops once weight loss reaches a plateau and you are no longer burning stored calories. At that point you must add calories to your diet. Since protein cannot go too high, the added calories must be either fat or carbs. Those who experience long term success with surgery inevitably restrict carbs and eat what is essentially a LCHF diet. My source for this is a friend who is an experienced bariatric surgeon. He also told me of a case who regained 90 lbs simply by drinking lots of regular Coke.

  17. Galina L.
    Yes, I completely discourage anyone to go on a starvation diet whatever it is called HCG or Kimkins or Anorexia Nervosa . Why the hell do you declare that " hCG causes to release 3500 calories from abnormal fat stores in your body" while it is more likely associated with adverse side effects such as loss of lean muscle mass?
    I checked the protocol, don't worry about it. It completely fits the starvation diet definition from Wiki (Very low calorie diets provide 200–800 calories per day, maintaining protein intake but limiting calories from both fat and carbohydrates). Down-side of starvation is well studied and there is nothing "beautiful" about it.
  18. 1 comment removed
  19. Jessica
    Dr. Eenfeldt, "Vito's" comments are spam.
    Reply: #20
  20. Thanks. Deleted.
  21. Alan
    One possible reason why these patients need more follow up medical care could be because of side effects from fluoroquinolone (FQ) antibiotics. Interestingly, sadly, some of these people are given larger doses of antibiotics because of their obesity. This family of antibiotics has a poor safety record---ripped tendons, diabetes, seizures, fibromyalgia like permanent damage, neuropathy, mitochondrial toxicity, etc.. Many MDs are unaware of the scientific literature. The science of reporting and studying these events is very poor--about 90% of them go unreported.

    If these data were mined for use of FQs with respect to medical care use then there might be a signal.

  22. Peggy Holloway
    This post couldn't be more timely. I learned last night that an acquaintance had died on Tuesday. She had battled weight problems and Type II Diabetes for many years. About 10 years ago, I heard that she had been on an Atkins diet and was losing weight and feeling great. I was so please, since I was having such good results from my switch to a low-carb diet. It was not long before I noticed that she was regaining weight and looking sick and "diabetic" again. I was told that her doctor was alarmed because of some "number" going up (probably LDL-C) and that she had gone off the low-carb diet. I remember at some point around 4 or 5 years ago, attending a social function that included a home tour. I saw her in the bathroom checking her blood sugar and taking an insulin injection, and soon after at the hors d'oeuvres table helping herself to all sorts of sugary and carby foods. A few months ago, it was reported that she was going in for bariatric surgery. The story after her death is that she never recovered from the surgery, was in and out of the hospital, and was not absorbing nutrients, suffered some sort of cardiac arrest, was resuscitated, but had suffered severe brain damage and was taken off life-support the same day. What a tragedy. In many ways, I wish, although I did not know her well, that I had taken the time to talk to her about the Atkins diet years ago when she decided to follow the conventional medical advice. To know that her heatth issues might have been alleviated and her ultimate sad death prevented leaves me feeling angry at the medical establishment and resolved to be more vocal in the future.
    Reply: #23
  23. Karin Wenholt
    Such a sad story :-(
  24. hcg1234
    Unintentional weight loss occurs in many diseases and conditions, including some very serious diseases such as cancer, AIDS, and a variety of other diseases. Thanks.
    Regards,
    http://www.hcg1234.com/
  25. Diane
    I knew a guy who had bariatric surgery. He has kept all the weight off and he's very thin. However, he now has multiple sclerosis. I don't know if the surgery causes that, but he will never be able to try Terry Wahl's 9 cups of vegetables a day method to overcome it.
  26. 2 comments removed
  27. The best way to loose weight is to eat five kinds of fruits a day. Fruits are rich in fiber which helps in dissolving excess fats in the body. So, do enjoy eating your favorite fruits a day.
  28. If you are considering weight loss surgery then you now have one more reason to take action. Weight loss surgery will make both your body and your mind healthier.
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