Contemplating Bariatric Surgery

Weight loss surgery has garnered a lot of bad press, but not all of it is as hilarious as a piece titled “6 Bizarre Things Nobody Tells You About Weight Loss Surgery.” Here is a quotation from the tongue-in-cheek article variously attributed to Amanda Mannen, Alexandra, and Anonymous:

When you hear about all the horrifying problems that can arise after surgery — including leakages, blood clots, abdominal pain, bowel obstructions, osteoporosis, gallstones, vomiting, hernias, anemia, and malnutrition, to name a few — death on the operating table can start to sound like the best-case scenario.

The authors call out advertising that makes surgery sound as innocuous and delightful as a spa day. In reality, this is not “the kind of thing you can shrug off in a weekend.” The preliminary tests can feel very demanding, and might include endoscopy, ultrasound, and even colonoscopy, in addition to the drawing of what can seem like quarts of blood for lab work.

Then, two weeks before S-Day, the required diet changes to protein powder and a limited menu of vegetables. This is said to reduce the size of the liver, making the stomach easier to operate on.

On a more abstract level, insurance companies have mixed feelings. They might pay, but the cost in bureaucratic form-filling is high, and applicants sensitive to privacy can feel very invaded. Some mention the other time-sucking requirements like educational classes and support groups. Emotional affinity groups, built around the common background of weight loss surgery, can also be forever, which is probably the best idea.

Long-term, people who use traditional weight-loss methods based on the energy balance paradigm, tend to put the pounds back on. Those who opt for surgery maintain more successfully, but it is an unrelenting job that is reportedly more bearable when talked over with fellow patients. If a real-life meeting is not practical, Facebook and other social media offer a slew of bariatric support groups that it might be smart to consult before making a commitment.

Life goes on

And what is “dumping syndrome”? You don’t want to know. Or rather, you do, if contemplating gastric bypass surgery. Sugar and simple carbohydrates just rush right on through, and the patient has to stay close to a bathroom. Dumping syndrome may also include sweating, shaking, and cramps. It is said to be avoidable through keeping meticulous records of substances consumed, followed by avoiding those foods and beverages forever.

Life subsequent to surgery might involve choking down “a giant handful of vitamins every day” and frequent lab tests to assure that the vitamins are begin assimilated. Apparently, things can go along smoothly for years before complications arise. The author says,

I was warned that I could be minding my own business weeks or months or years later when the tiny tube that was now my stomach would stop handling anything but liquid. That’s because as it heals, it can develop scar tissue to the point that it constricts without warning.

Veterans of weight loss surgery warn that it can extensively affect a person’s social life, including their marriage, and that “bariatric divorce” is a thing. If both partners are obese, it is recommended that they both have surgery so their drastically reformed lifestyles will be in alignment, and so nobody can get jealous when the other one slims down.

Going through the process together also lessen the possibility of partner sabotage. This dynamic might be difficult for non-addicts to understand, but when John Lennon and Yoko Ono wanted to have a child, they both got off heroin.

Other people, especially close relatives, can have a hard time accepting the “new you.” Chances are, siblings and parents might be dangerously overweight too. A big change can unleash a storm of psychological disturbances. When a patient does something as radical as surgery, it can be perceived by family members as threat, accusation, declaration of independence, or rejection.

Unrelated people will have something to say, too, especially if the patient is a professional comedian, and even more so if his or her material is largely size-related. Losing weight can draw some serious blowback from agents, managers, casting directors, and fans.

The illustration on this page shows the aftermath of duodenal switch surgery which, as Childhood Obesity News has noted, is a type reserved for the super-obese. If the patient is meticulous about lifestyle, it can work out fine, except for a greater mortality rate, the possibility of not absorbing enough nutrients, and a severe chronic gas problem.

Your responses and feedback are welcome!

Source: “6 Bizarre Things Nobody Tells You About Weight Loss Surgery,”, 12/15/14
Image by Dale Leschnitzer via Flickr

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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