Things to think about when you are considering Weight Loss Surgery

by Sue Widemark

The results of the Hebrew University study in 1993 showed that only 7 percent of gastric bypass patients kept all their weight off, another 25 percent gained back to clinical obesity and the rest kept off 'some weight'.  Surgeons will call your surgery a success if you keep off 40 percent of your initial weight loss. So if you lose 100 lbs and keep off 40 lbs, you are considered a 'success'.

Dept. of Surgery C, Soroka Medical Center, Beer Sheba (Israel study)
Harefuah 1993 Feb 15;124(4):185-7, 248 (article is in Hebrew)

Evidence exists that the absence of bile and pancreatic juice, the shortness of the gut, the protein malnutrition, and possibly the presence of undigested food in the colon are all factors predisposing to bacterial overgrowth.

(DS/BPD - Marceau, Surg Clin North Am - 01-Oct-2001; 81(5): 1113-27)

Some feel that long term protein malnutrition is also a danger with the BPD:

The BPD and the duodenal switch involve permanent removal of part of the stomach and bypassing of a large amount of intestine. It is more radical than the original intestinal bypass operation that was abandoned many years ago. BPD is associated with horrific side effects including kwashiorkor. It takes several years for the body to be fully depleted of stored nutrients so most likely recent post ops have not been affected yet. DS patients should be followed by a gastroenterologist.

Paul Ernsberger, PhD, Department of Nutrition, Case Western Reserve School of Medicine, 10900 Euclid Ave., Cleveland, OH 44106-4906 Web address:  Email: ;  FAX: (216) 368-6644

Some patients get loose bowels with the BPD (several soft bowel movements a day)


Listing of jejuno-ileal bypass complications:

Mineral and Electrolyte Imbalance:

Protein Calorie Malnutrition:


Enteric Complications:

Extra-intestinal Manifestations:

Renal Disease: (in other words, kidney disease and kidney failure)


If you join one of the post operative support groups, you will indeed see several people with the above complications. The longer ago they had the surgery, the more complications seen. You will also see some of those people say that their complications are not because of the Weight Loss Surgery, even though what they are describing is listed as one of the side effects of WLS. Some people are in denial about the cause of their physical problems, perhaps because it would be too painful to wonder whether they made the right decision to have the surgery.

As with all things, take time with your decision. You can always have the surgery at a later date when you have a greater comfort level about it.  It is entirely possible that in the near future there may be a medication obese individuals can take which will work directly on the appetite centers.  The billroth II, the surgery from which the gastric bypass was invented, is not done anymore because the condition of duodenal ulcers is now treated with medications.

Weight Loss surgery is a miracle for some, for others, the tradeoffs are worth the results and for still others, it can be a disaster. It is serious invasive surgery and all factors should be considered. The idea behind weight loss surgery is that although it IS a painful risky solution, it can be LESS painful or risky than remaining clinically obese.  Each person must decide for themselves if they feel they would benefit from this solution.

These books are helpful:


Weight Loss Surgery a Lighter Look at a Heavy Subject

by Terry Simpson, MD

Dr Simpson, a Bariatric Surgeon who has done thousands of WLS procedures has written what is probably the most authoritative book on the subject.  The book is illustrated and written in a readable style with Dr Terry's own brand of humor throughout.  More information or order book


I Want To Live - Gastric Bypass Reversal by Dani Hart

Dani Hart takes you on her journey through Weight Loss Surgery (RNY gastric bypass) and the reversal.

See more information or order book


Doctor's Guide To Weight Loss Surgery by Dr Louis Flancbaum et al

Very pro surgery but pretty honest about the risks etc

See more info or order book


For more information about Weight Loss surgery, click here.