While bariatric surgery has become fairly common, it’s still misunderstood. Many people have preconceived notions about their weight loss surgery options and what to expect, but much of that information is outdated or just plain incorrect.
Sara Tortorici, MS, ACNP-BC, CBN, a nurse practitioner at the Center for Surgical Weight Loss at Lahey Hospital & Medical Center in Burlington, Massachusetts, often counsels patients about the risks and rewards associated with bariatric surgery. Here, she dispels common surgical weight loss myths.
1. It’s Too Risky
The mortality rate for bariatric surgery is about 1 in 1,000 — less than the risk associated with gallbladder or joint replacement surgeries.
“Back in the early 2000s, the risk was about 1 in 200,” said Tortorici. “It’s getting safer because surgeons have become more familiar with the procedure, and the techniques have really been solidified. Surgery is a big decision, but remaining obese is often a greater risk. Some very large research studies have compared patients who underwent bariatric surgery with those who didn’t. Right after surgery, the risk is greater, but about six months after surgery, the risk of doing nothing is actually greater.”
2. Recovery Is Long and Painful
Not so long ago, bariatric surgery required a lengthy hospital stay and a couple months out of work. These days, there are many weight loss surgery options and most can be done laparoscopically, with only a tiny incision and minimal downtime.
“Our patients stay one or two nights for observation,” said Tortorici. “We usually recommend taking about two weeks off work, and pain usually only lasts about two to four days.”
3. Bariatric Patients Eventually Regain the Weight
Tortorici said people often hear stories about the 20 to 25 percent of bariatric surgery patients who regain significant weight, rather than the overwhelming majority of patients who keep it off.
“Obese people who attempt to lose weight on their own — with diet, exercise and maybe some weight loss medications — have about a 10 percent chance of success with a 90 percent regain rate,” Tortorici said. “Surgery gives patients the best chance of keeping the weight off long-term.”
4. Surgery Is the Easy Way Out
Tortorici said she would argue that bariatric patients have to work just as hard, if not harder.
“Surgery is only changing the stomach, not the brain,” she said. “You have to make good, healthy food choices the majority of the time and exercise regularly. Surgery helps people maintain weight loss more easily, but if they’re eating small portions of high-fat foods most of the time or eating mindlessly throughout the day, those patients are probably going to set themselves up for weight regain. It’s something you still have to work hard for and think mindfully about every day.”
5. Bariatric Patients Are Just Lazy and Eat Too Much
Of all the surgical weight loss myths, this is one of the most frustrating for obese people, said Tortorici. And it’s not always true.
“The majority of our patients have done a lot of positive things to try to lose weight,” she said. “Obesity is a chronic disease that’s brought on over time by so many different factors — dietary intake, activity levels, hormones, medications, environment, genetics. Many patients coming in for bariatric surgery feel like failures because they haven’t been successful on their own, but their bodies are often working against them. As they start to lose weight, their bodies start driving up hormonal signaling that drives hunger and decreases metabolism. Bariatric surgery causes hormonal and metabolic changes that help to regulate hunger signals and improve metabolism.”
6. Bariatric Patients Can Never Eat Normally Again
Bariatric surgery decreases the amount of food your stomach can hold. Following surgery, patients can expect a slow dietary progression to allow the new stomach pouch time to heal. They can, however, eventually eat full, balanced meals.
“Initially the portion sizes are very small,” Tortorici explained. “After about four weeks, patients can have softer proteins. By three to six months, most people are eating a pretty good balance of nutrition — a portion of protein that’s roughly the size of deck of cards, a serving of fruit or vegetable and maybe some carbohydrates. By about a year, they can eat a full meal of an appropriate portion size.”
7. People Become Alcoholics After Bariatric Surgery
Though transfer of addiction can happen, the number of patients who develop drinking problems after surgery is quite low and usually affects people who were already at risk of alcoholism.
“For some people, food is an addiction. When they lose the ability to use food for management of stress or emotions, sometimes people transfer to a different addictive behavior such as alcohol, drugs, gambling or shopping,” Tortorici said. “Alcohol is the most commonly cited addiction transfer because alcohol gets into the system much more quickly after bariatric surgery. But it’s not all that common. I might see it once a year out of 350 patients who have surgery at our hospital. It’s something we monitor for, especially with patients who have a personal or family history of alcoholism.”
8. Bariatric Patients Can’t Have Children
By helping people lose weight, bariatric surgery can actually boost reproductive health.
“Women often come to us for fertility reasons,” she said. “Maybe they want to undergo IVF treatments and need to lose weight to be candidates or they just want to be healthier during pregnancy. Obese pregnant women are at a higher risk for gestational diabetes, high blood pressure and delivering babies with a high birth weight, which increases the baby’s future diabetes risk. Obesity can also impact male fertility, and bariatric surgery has been shown to improve testosterone levels.”
If you’re considering bariatric surgery, forget the surgical weight loss myths and talk to an expert about the real risks and rewards at Lahey’s Center for Surgical Weight Loss.