What Is the Most Common Complication of Bariatric Surgery? Risks You Should Know

Written by Heather Smith, B.S. and medically reviewed by Dr. Stephen Boyce, MD

Key Takeaways

  • Bariatric surgery can offer significant health benefits, but there are some risks associated with the surgery, such as surgical site complications, nutritional deficiencies, dumping syndrome, and others. 
  • Taking proactive steps like achieving your pre-surgical weight goal, making certain lifestyle changes, and keeping up with regular follow-ups can help reduce your risk of complications. 
  • Knowing the risks of bariatric surgery can help you prepare and watch for potential complications so you can address them quickly.

Bariatric surgery is a life-changing tool that offers significant benefits for weight loss and improved overall health.

However, like any major surgery, there are certain risks. 

Having an understanding of the most common complications helps you make an informed decision, prepare for your surgery, and know when to seek help. 

Keep reading to discover the different types of bariatric surgery and the complications related to them.

Overview of Bariatric Surgery

what is the most common complication of bariatric surgery

There are a variety of surgical procedures designed to help people reduce their weight. These surgeries are known as bariatric surgeries. 

Some of the common types of bariatric surgeries include:

  • Roux-en-Y gastric bypass
  • Sleeve gastrectomy
  • Adjustable gastric band

Each surgery offers its own benefits and potential risks. However, complications such as late complications of bariatric surgery and conditions like depression after bariatric surgery may occur, underscoring the importance of informed decision-making.

People who qualify for these surgeries typically have a body mass index (BMI) over 40 or a BMI over 35, accompanied by serious obesity-related health conditions such as type 2 diabetes or high blood pressure. 

To minimize risks, many healthcare providers recommend lifelong supplementation with bariatric vitamins, bariatric multivitamins, or liquid bariatric vitamin options. Additionally, products like bariatric calcium chews and bariatric multivitamin with iron can help address deficiencies effectively.

Importance of Understanding Complications 

Understanding the potential risks and complications of any medical procedure, including bariatric surgery is essential when considering the procedure. 

Being aware of the risks allows you to make an informed decision by carefully weighing the benefits and risks. 

Knowing these things helps you take proactive steps to minimize your risks, such as following pre-surgical guidelines and being proactive in adopting necessary lifestyle changes. 

It also helps to recognize early signs of complications to ensure you get timely medical intervention and prevent minor issues from escalating into serious problems. 

Common Post-Operative Complications of Bariatric Surgery

Here are some of the most common post-operative complications that can arise after bariatric surgery

  • Nutritional deficiencies: Many bariatric surgeries alter the digestive system, reducing the absorption of essential nutrients like vitamins and minerals. Common deficiencies include vitamin B12, iron, calcium, and vitamin D, which may require lifelong supplementation to prevent issues like anemia, bone loss, and fatigue.
  • Dumping syndrome: This condition occurs when food moves too quickly from the stomach to the small intestine. Symptoms include nausea, diarrhea, abdominal cramping, and dizziness, often triggered by sugary or high-fat foods. Dietary adjustments can help manage this complication.
  • Surgical site complications: Infections, excessive bleeding, and anastomotic leaks (a leak at the surgical connection site) are potential risks. These complications may require prompt medical attention and, in some cases, additional surgeries.
what are potential complications from bariatric surgery?

Other less common but possible complications include bowel obstructions, gallstones, and chronic gastrointestinal issues like acid reflux.

Understanding these risks and maintaining close follow-up with your healthcare team can help you address problems early and improve overall outcomes.

Procedure-Specific Risks and Complications 

Here is a look at some of the main bariatric surgeries and their most common risks and complications. 

Gastric Bypass:

  • Bowel obstructions: Scar tissue or twisting of the intestines can block the digestive tract, sometimes requiring surgery to correct.
  • Ulcers: Ulcers can develop particularly at the site where the stomach is reconnected to the small intestine. The risk of ulcers is often increased by smoking or taking nonsteroidal anti-inflammatory medications.
  • Gallstones: Rapid weight loss increases the risk of gallstones, which may require the gallbladder to be removed.
  • Dumping syndrome: This condition, as noted earlier, is particularly common with this procedure.

Sleeve Gastrectomy:

  • Gastric leaks: A rare but serious complication where stomach contents leak into the abdominal cavity, potentially causing infection.
  • Gastroesophageal reflux disease (GERD): Some people experience worsening acid reflux symptoms after surgery, requiring medication or further interventions.
  • Strictures: Narrowing of the stomach can occur, leading to difficulty eating and requiring endoscopic dilation.

Adjustable Gastric Banding:

  • Band slippage: The band can move out of place, causing discomfort, vomiting, or other issues that may require repositioning or removal.
  • Erosion: The band can gradually wear through the stomach wall, a serious complication that usually requires surgery.
  • Esophageal dilation: Over time, the esophagus can enlarge, leading to swallowing difficulties or other complications.
  • High revision rates: Many patients require additional surgeries to adjust, replace, or remove the band due to complications or insufficient weight loss.

Managing Complications 

Managing complications after bariatric surgery is important for your long-term success and minimizing health risks. 

It’s important to have regular monitoring through scheduled follow-ups with your healthcare providers. They can help with early detection and treatment of complications before they become more serious.

what are the risks of bariatric surgery

Supporting your body with the right nutrition is equally as important. Many bariatric procedures alter your body’s ability to absorb nutrients, increasing your risk of deficiencies. Working with a registered dietitian can help you understand your nutritional needs and how to best meet them.

If you notice a complication, it’s important to inform your healthcare professional immediately. Symptoms you should not ignore include:

  • Severe abdominal pain
  • Persistent vomiting
  • Fast heartbeat
  • Fever
  • Redness, swelling, or discharge at the surgical site

Prevention of Bariatric Surgery Complications

While it’s not possible to prevent all complications, there are some steps you can take to lower your risk of complications.

  • Complete a preoperative assessment: Meet with a healthcare professional to identify and address any risk factors that could impact your surgical outcomes. 
  • Make lifestyle modifications: Adopting healthy eating habits, engaging in regular physical activity, and achieving pre-surgery weight loss can reduce surgical risks and set the foundation for long-term success.
  • Participate in patient education: Learning about the potential complications and following pre and post operative guidelines helps reduce your risk of complications. 

Conclusion

Bariatric surgery can be an amazing tool for improving your health and quality of life, but it’s not without risks. 

Knowing the general and specific potential complications can help you make an informed decision about surgery and take proactive steps to reduce your risk. 

If you want to learn more, why not check out these articles below: 

References

Iacobellis, F. (2022). Common, Less Common, and Unexpected Complications after Bariatric Surgery: A Pictorial Essay. Diagnostics.

Lim, R., et al. (2018). Early and late complications of bariatric operation. Trauma Surgery & Acute Care Open

Bariatric and Metabolic Institute: Risks and Complications. (N.D.) Cleveland Clinic.

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