Who Needs Bariatric Surgery

Bariatric surgery (overweight surgery)

Effect and side effects
With gastric bypass the weight loss can be between 25 to 40% of the initial weight. The amount of weight loss depends on the food that can still be absorbed. Here, too, as with the other operations, the side effects can be varied. There may be narrowing in the areas that were newly sewn together by the surgeon. This is called a stenosis. In addition, the intestine can shift and become trapped - this is called an internal hernia. This is an absolute emergency situation and requires immediate action. The more pronounced the reduction in the intestinal absorption capacity, the higher the risk of massive diarrhea. Especially if the eating habits are not adjusted. Another problem is the lack of vitamins or trace elements. A life-long supplement therapy with vitamins and trace elements is therefore absolutely necessary.

Furthermore, the deeper (more distal) the bypass was created, the more strongly the so-called bile acid cycle can be changed. Usually 90% of the bile acids are recycled and returned to the liver. This completely changes the absorption of different acids. The oxalic acid, which normally hardly ever gets into the body, reaches the body in high concentrations and can lead to crystallization in both the bile and the kidneys, leading to severe stone diseases. Paying attention to oxalic acid in the diet is helpful, but is often not enough on its own, an intake of calcium while searching for food is often necessary, that calcium binds the oxalic acid and is not only important for the prophylaxis of osteoporosis. After all, up to 10% of all patients with gastric bypass get osteoporosis after ten years, which is another reason why calcium intake is necessary.

A supply of vitamin B12, either through an injection or through a very high-dose oral therapy, is always necessary, since vitamin B12 is absorbed in the duodenum, which is no longer passed through by food in all these procedures.

Regular iron administration is also often required in women. In distal gastric bypasses and BPD, fat-soluble vitamins vitamin A and vitamin E sometimes have to be replaced.