Treating obesity, defined as a Body Mass Index, or BMI, greater than or equal to 30, has been shown to significantly impact health hazards such as diabetes, stroke, certain cancers, arthritis, liver disease, depression and sleep apnea. BMI is calculated by dividing the weight in kilograms by height in inches squared. Procedures done through a scope, called laparoscopic, and open procedures done by making a large incision in the abdomen, are effective methods of performing bariatric surgery. However, these procedures can have potential complications.
Nutritional Deficiencies
Because gastric bypass can restrict calories or cause alterations in intestinal absorption, patients can suffer nutritional deficiencies. For example, calcium is absorbed in the part of the small intestine closest to the stomach, the duodenum. In gastric bypass surgery, food no longer passes through the duodenum, and this may result in a calcium deficiency, which in turn can cause osteoporosis in post-menopausal women, among other segments of the population who are at a higher risk for osteoporosis.
Other possible deficiencies due to this surgery include vitamins B12, A, D, E, K, thiamine and folate. These deficiencies are less likely to occur in gastric banding, and can be treated with supplementation.
Eating Disorders
Individuals who have eating disorders prior to obesity surgery may have significant difficulty following the necessary calorie-restricted diet after surgery. Eating patterns after surgery must be dramatically changed. Patients are required to eat fewer meals, take in no more than 400 to 800 calories per day, and are not allowed to binge. Patients who eat to soothe emotions will most likely have difficulty adjusting to these new eating patterns.
Anastomotic Leaks
One of the more severe complications of the roux-en-y gastric bypass procedure is a leak in the area where the jejunum, the second half of the small intestine, has been sewn to the stomach. Two to three percent of patients will have this complication, according to an UpToDate.com report. Patients will present one to two days after surgery with symptoms of a fast heart rate, difficulty breathing, nausea and vomiting. This complication can be dangerous and needs to be immediately addressed by a health care provider.
References
- Up To Date: Medical management of patients after bariatric surgery
- "Surgery for Obesity and Related Diseases: Health implications for patients, health professionals and third-party payers"; Henry Buchwald, M.D., Ph.D., F.A.C.S.; 2005
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