Weight loss surgery can be an extremely effective strategy for people who are severely overweight. However, there are risks, some minor and some serious, associated with weight loss surgery, and it is by no means an easy option.

If you are considering having any sort of weight loss surgery, it is important to consider the risks as well as the benefits, so that you can make an informed decision about whether it is safe and right for you.

This article on weight loss obesity surgery is by Kathryn Senior, a freelance journalist who writes health, medical, biological, and pharmaceutical articles for national and international journals, newsletters and web sites.

What types of surgery are available?

There are several different types of weight loss surgery, including:

  • Having a gastric band fitted ­– an adjustable band, or collar, is fixed in place around the stomach. The tightness of the band is adjusted regularly by injecting a saline solution through a port situated just under the skin.
  • A gastric bypass – surgery is used to create a small stomach ‘pouch’, to which a division of the intestine is then attached, thus bypassing part of the intestine and reducing the absorption of food.
  • A duodenal switch – a new stomach is created and a long intestinal bypass is put in place, dramatically reducing the amount of food and drink that can be consumed and absorbed.
  • A sleeve gastrectomy – a new, smaller, sausage-shaped stomach is created, but with no intestinal bypass.
  • A gastric balloon – the balloon is inflated inside the stomach to induce a feeling of fullness.

What are the benefits?

If you are dangerously obese and have tried to lose weight using diets and exercise and failed because of overeating, weight loss surgery can allow you to lose weight very quickly. Achieving this type of dramatic weight loss can bring both physical and emotional benefits. The benefits of weight loss surgery include positive effects on blood pressure, cholesterol levels and diabetes. Weight loss surgery may also reduce your risk of cancer. As you reduce in size, you will feel more active, more mobile and you can have a wider choice of fashionable clothes.

Is it safe?

No surgery is 100% safe. As with any operation, weight loss surgery carries with it the risk of complications. Risks associated with surgery, in general, include haemorrhage (bleeding), complications due to anaesthesia/medications, blood clots, problems with wound healing, and infections.

Other risks are associated with weight loss surgery more specifically, including:

  • Stenosis (narrowing of bowel or stomach opening) at the site of surgery
  • Suture Line Disruption (SLD) occurs when there is disruption of the staple line in the digestive tract, allowing food to pass into the wrong places. This can lead to serious infections and severe abdominal pain, and can be life-threatening
  • Nausea and vomiting (due to over-eating or stenosis)
  • Gastric band migration (slipping)
  • Leakage at the site of surgery
  • Ulcers/bleeding at the site of surgery
  • Small bowel obstruction
  • Hernias
  • Constipation
  • Gallstones

Some people do not adjust well after the operation and can experience ‘dumping syndrome’, or rapid gastric emptying. This happens when undigested foods enter the small intestine too quickly, leading to symptoms including dizziness, weakness, fatigue and diarrhoea. Many of the types of weight loss surgery available reduce your ability to absorb food as efficiently. This makes you lose weight, but it can also lead to malnutrition, which can cause osteoporosis and bone degeneration or anaemia.

Risks after this

In the days just after weight loss surgery, you cannot eat normally and it is important to take only tiny amounts of fluid at once, with no solid food at all, so that the wounds have a chance to heal. On the second week, you will be able to start eating thin pureed food but it may be several weeks before you can eat solid food. Eating too much too quickly can put pressure on the sutures and staples, or on the gastric band, causing rupture, causing leakage through the wound or slippage of the band.

After several weeks, your diet needs to be adapted to your much smaller stomach capacity, while still providing the nutrients that you need to stay healthy. It is possible to push your stomach to the limit, even with a band firmly in place, or after a stapling operation. This can cause you to lose weight more slowly than expected. Overeating with a gastric band in place can also cause the band to damage the outside of the stomach, causing erosions and soreness, which can be very painful.

At the other end of the spectrum, people whose food intake does reduce dramatically can find that they become thinner very rapidly after weight loss surgery. Loose skin can then become a problem and further cosmetic surgery may be required to remove folds of excess skin left behind.

Impact of this on lifestyle

The important thing to consider before you have any type of weight loss surgery is that the procedure is disturbing the natural digestive process and is highly abnormal. Although the actual obesity surgery may go well, with no surgical problems, the overall safety of weight loss surgery depends on how well you manage to adapt your lifestyle afterwards. Having weight loss surgery can prevent illness due to obesity without needing to think about dieting but you will need will power to control your intake of food to prevent malnutrition and long-term damage to your digestive system.

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