News Flash: Studies have found that being overweight WILL NOT kill you in 5 years or less! One 500 lb lady, in her 50's, who describes herself as "supersized" has outlived 48 of her overweight friends who had weight loss surgery. click here to see more on this

WLS DOES NOT SUPPRESS your appetite past the first year - blood sugar levels may be erratic click here to see more

WLS does not cure diabetes click here to see more

Plain talk about bypass Weight Loss Surgery (RNY, gastric bypass, duodenal switch, gastric sleeve)

  1. A Gastric Bypass not only staples the stomach but bypasses part of the small bowel INCLUDING the section in which a lot of digestion of vitamins and minerals takes place. This means that even with a small amount of intestine bypassed, the post op might develop vitamin and mineral deficiencies. The stomach  "is a critical digestive organ and cannot be cut away or bypassed without compromising the digestive process." REF: Paul Ernsberger, PhD, Department of Nutrition, Case Western Reserve School of Medicine, 10900 Euclid Ave., Cleveland, OH 44106-4906

    • According to the (ASMBS - professional association of Weight Loss Surgery surgeons) "Any procedure involving malabsorption must be considered at risk to develop at least some of the malabsorptive complications exemplified by JIB (jejuno-ileal bypass). " All gastric bypasses include a bypass of part of the small bowel so according to the ASBS patients may experience the symptoms of vitamin shortages, liver failure, kidney failure etc experienced by JIB patients.

    That list can be found at :



  2. Several studies suggest that the gastric bypass may have a high complication rate.  According to at least two major studies, the complication rate (serious and can be life threatening) was 20 -40 percent (Mayo Clinic Study - 20 percent in five years - proximal gastric bypass, Livingston studies - 800 patients in 8 years - 40 percent)

Dr Edward Mason, inventor of the gastric bypass: "For the vast majority of patients today, there is no operation that will control weight to a "normal" level without introducing risks and side effects that over a lifetime may raise questions about its use for surgical treatment of obesity."

***The RNY (gastric bypass) trades one disease for another: it trades obesity for malabsorption. By re-arranging your guts you sometimes have severe side effects, and can have long-term problems such as iron deficiency anemia, calcium deficiency leading to osteoporosis. (Dr Terry Simpson, MD, WLS surgeon)

"The American Society of Bariatric Surgery says weight loss surgeries have increased from about 20,000 in 1995 to an estimated 45,000 in 2001. It estimates a 7 percent complication rate. But [Dr] Livingston's own study of 800 patients found complication rates of 20 to 40 percent, with everything from intestinal leaks to nutritional deficiencies. "

ABC News story, March 2001 (note: later in 2005, the insurance company actuarials also found a 20 percent re-operation rate in gastric bypass patients)

A non bariatric industry study which CT scanned 72 gastric bypass patients and found by CT scanning, that 41 of the 72 patients (i.e. 56 percent) had some 62 "abnormalities" in their digestive tract.

  1. Gastric bypass does NOT suppress the appetite in most people according to a clinical study of 61 patients presented at the 2009 ASBS convention.  On the contrary, 80 percent of patients in the study a couple of years post op, not only got extremely hungry soon after a meal but also many had an "uncontrollable urge" to eat.  This caused weight re-gain in several patients.

    REF: Dr Mitchell Roslin, MD Lennox Hill Hospital in NYC as presented at the ASMBS convention in 2009 (Dr Roslin found erratic blood sugar levels in most of the cohort (study taken out to 4 years) and feels that either the gastric bypass should be very much revised or abandoned in favor of another procedure
  2. With a gastric bypass or BPD, you may have a high risk of osteoporosis. The place where the body absorbs most calcium, is bypassed.  This means that no matter how much calcium supplements you take, it might not get into your body. 

  3. With a gastric bypass, your stomach might not make the enzyme to digest vitamin B12 which means you may have to take shots for the rest of your life -  Many post ops learn to inject themselves and buy the B12 and syringes from their veterinarian because insurance sometimes does not pay for vitamin shots.

  4. WLS does not CURE diabetes (no researcher used the word "cure").

    If you restrict calories mildly and exercise at least 5 times a week, regardless of size you will keep your sugar levels down for many years after diagnosis.

    Also, with modern medications like metformin, few people who have TYPE II diabetes, get the complications typically seen 40 years ago.

    Finally, diabetes type II is GENETIC and NOT "caused" by obesity. If you do not have the gene which causes insulin resistance (your muscles do not take up insulin from the blood easily) then you will not' get diabetes until you are old enough for your pancreas to "wear out" (a friend just got diagnosed at the age of 95). The poor food choices which can cause obesity in prone people, can also bring on type II diabetes in people with the diabetes gene earlier in life.

  5. You might have to go back to the hospital for repeat surgeries for hernias, bowel obstruction, blockage of the opening between the pouch and the intestines (this is very painful until you have the surgery done) and scopes (tubes down your throat to see if all if ok). 

  6. Many WLS post ops end up still very overweight!  Often from the quick weight loss, plastic surgery is required to remove a lot of loose skin.

  7. "Weight Loss surgery does not make most people thin - it makes very obese people less obese" (REF: Flancbaum, Louis: THE DOCTOR'S GUIDE TO WEIGHT LOSS SURGERY (NY, 2001) )

    At a 10 year study, the average BMI was found to be 35, still clinically obese (REF: Obesity Surgery, Vol. 11 No. 4 August 2001, pp 464-468)

    Another 10 year study of gastric bypass patients found that 34% of those whose starting BMI was over 50, had regained all or most of their weight.  (REF: Annals of Surgery. 244(5):734-740, November 2006. Christou, Nicolas V. MD, PhD; Look, Didier MD; MacLean, Lloyd D. MD, PhD)

  8. Many Weight Loss surgery patients will gain weight if they eat less than 900 calories a day. If they have malabsorption, they may absorb even less.

  9. Dr. Greg Adams, a general surgeon at Valley Medical Center in San Jose: "I think it's a plan of controlled starvation" ( )

    Dr Matheis Fobi, a WLS surgeon, calls the gastric bypass "induced bulimia".

  10. With a gastric bypass, you may regain all or most of the weight.. Despite the low caloric intake of most gastric bypass patients (under 900 calories a day) are expected BY THE SURGEONS to regain 40-50 percent of the weight they initially lost. This may be due to the body getting used to the new arrangement of intestines and stomach..  (there are over 3000 members on the Yahoo groups Weight Loss surgery support groups for those who are fighting re-gain).  Revisions are risky, painful and for most, ineffective (30 lbs weight loss average)

    A 2006 study found within 10 years post op, that 34 percent of those whose starting BMI was over 50, regained all or most of the weight.  20 percent of those with a lower BMI regained all or most of the weight.

    Annals of Surgery. 244(5):734-740, November 2006.
    Christou, Nicolas V. MD, PhD; Look, Didier MD; MacLean, Lloyd D. MD, PhD

  11. Bad gut bugs: Disturbing the digestive system and compromising the stomach means you might have bad bacteria in the intestines which can escape into your bloodstream. This can cause many problems including lowered immunity, diarrhea, flatulance and immune disease like Lupus..

  12. Restrictive diet and exercise: There are many foods you might not be able to eat.  And many surgeons warn that if you don't exercise, you might gain back.  If you didn't like exercise before surgery, you might not like it after.  And if you dieted and exercised without surgery, you would lose weight also.

    "Measure TWICE, Eat ONCE and vomit NEVER"  (Dr Terry Simpson WLS surgeon from his book)

  13. You might be exchanging one set of problems for another.

Dr Edward Livingston, director of the University of California At Los Angeles Bariatric Surgery program wrote: "By doing this surgery, you're creating a medical disease in the body. Before you expose someone to that risk, you have to be absolutely sure that you are treating an illness which is equal to or greater than the one you are creating." Ref: p 175, Self Magazine, April 2001 "Would you have surgery to lose weight?"

If you believe this surgery will restore you to complete and normal health you are mistaken. You are trading one nutrition problem for another problem. Obesity alone, does not necessarily kill you. You need to understand that when researchers do studies on the obese and find that they are more likely to die, this does not necessarily  mean that how much they weigh, killed them. Obesity is a symptom. It is just as likely that what they ate killed them. and also happened to make them heavy at the same time.

Kaiser Permanante release form for Weight Loss surgery

The RNY trades one disease for another: it trades obesity for malabsorption. By re-arranging your guts you sometimes have severe side effects, and can have long-term problems such as iron deficiency anemia, calcium deficiency leading to osteoporosis. (Dr Terry Simpson, MD, WLS surgeon)
  1. Weight Loss Surgery (WLS) might not fix depression. Sometimes WLS can cause an eating disorder.

JoAnn Mann, RN and eating disorders specialist: "I've seen massive infection, I've seen people hospitalized for malnutrition. I've seen people obsessed with food. I've seen people unable to stop vomiting. I've seen people develop massive eating disorders, I've seen people who are terrified of gaining weight. Terrified. It runs their lives."

Dr. Jenn Berman, a Los Angeles psychotherapist and an expert on eating disorders, has counseled more than 70 gastric bypass patients in the past six years. The patients who come to her are unable to keep down food and suffer from chronic diarrhea and/or vomiting. Berman said some patients have developed eating disorders and are afraid that if they eat too much, they will be sick.

  1. Prolonged strict dieting (lower caloric intake) can permanently damage your metabolism which means you may gain back weight faster.   Your body does this by cannibalizing it's own muscles and even parts of organs. There is a growing body of evidence that starvation can cause brain damage and a lessening of mental abilities as well. This would make sense as the brain is not necessary to maintain life. (see Pool, Robert: FAT - FIGHTING THE OBESITY EPIDEMIC, also the studies of the Food Institute in UK on starvation or prolonged dieting or calorie restriction and permanent brain damage)

  2. The gastric bypass is NOT a new procedure. It was invented in the 1960's and modeled on a surgery invented in 1880 for bleeding duodenal ulcers.  When the gastric bypass was invented, scientists did not know how important vitamins are and how people can become very ill if they are lacking in even trace elements like zinc.  Recently the inventor of the gastric bypass wrote for an article published by the U of I, that since the 1990's we have discovered that the digestive tract is in delicate balance and that he felt it was best to NOT disturb that balance by rearranging the small bowel or bypassing the small bowel.

The only thing 'new' about the gastric bypass is the mass advertising we see on TV featuring stars who are "new ops" who do not tell about what complications they have experienced.

  1. Experts differ about how many die from the gastric bypass.  Estimates of death rate range from 1 in 1000 (  )  to many surgeons stating that the death rate within 2 weeks of surgery is more like .5 percent to 1 percent.  (The David Flum study of 62,000 actual patient records found that 2 in 100 died within 30 days of surgery). Many deaths from gastric bypass are attributed to other causes mostly "obesity". This is due to the manner in which the M.E. investigates a death - the M.E. may not have access to the information that the patient recently had a gastric bypass. In the Fresno investigation (2001) investigators found some 27 deaths directly attributable to gastric bypass in the last 3 months of 2001 - none of them had been officially recorded as deaths from gastricbypass.  Often the media tries to cover up a death from weight loss surgery. For example when the Detroit council person died after the insertion of an adjustable band, the news service reported that she had died "after minor abdominal surgery" and only when her family hired a very famous attorney to sue the surgeon did it come out that she had, in fact, died from Weight Loss surgery!

Dr Gary Anthone: "As a matter of fact, one patient out of 200 that has weight loss or obesity surgery dies."

Merkle, associate professor of radiology at Duke University Medical Center in Durham, N.C., worked with a team of investigators when he practiced at University Hospitals of Cleveland. They followed 335 patients who underwent a type of gastric bypass surgery known as Roux-en-Y between March 1998 and December 2002.

Among these patients, 57 had complications and 17 required readmission to the hospital within 30 days after surgery. Two patients, or less than 1%, died as a result of postoperative complications.

The complications included a leak in the juncture attaching the intestine to the stomach, which occurred in eight patients, and a disruption of the staple line compartmentalizing the stomach, occurring in five patients. Other complications of gastric bypass surgery included a blood clot in the lung, blood infection, bleeding, pneumonia, bowel obstruction, and injury to the esophagus.


  1. Some physicians link some autoimmune disease like LUPUS and MS with WLS.  This may be because the incoming food, not "sanitized" with stomach acid, retains the bacteria in it and that bacteria can get into the blood stream and cause different reactions to the body's immune system.  Autoimmune disease can also be caused by vitamin deficiencies.

    Gastric surgery for weight loss causes nutritional deficiency in nearly 100% of individuals who have it done. The most common deficiencies are Vitamin B12, Iron, Calcium, Magnesium, Carotene (beta-carotene and other carotene vitamins) and potassium.****

    Kaiser Permanante Release form for gastric bypass

  2. Reversing the procedure: Dr Flancbaum says it's like when you remodel your house, can you make it go back to the way it looked before you re-modeled it? (re: Flancbaum, Louis, MD: DOCTOR'S GUIDE TO WLS, NY, 2001).  Dr Flancbaum states that the gastric bypass involves some permanent changes so even if they do a "takedown" you may have side effects remaining.  Most procedures cannot be reversed - only the adjustable band can be totally reversed.

    I am also put off when people say something is reversible -- because while we can change anatomy back, no surgery is truly reversible== kind of like remodeling the house-- try to put it back the same way -- doesn't happen.
    --- Dr Terry Simpson, WLS surgeon


  3. After a gastric bypass or duodenal switch which rearranges your intestines, you will have a "high Maintenance" body. You will have to be careful every day, to take vitamins, eat nutritious foods, eat in a certain manner, be closely followed by medical personnel.  If you are not compliant to the after surgery rules, you will LIKELY get very ill and may die.  The most common cause of illness and death after a gastric bypass is non compliancy.  So if you couldn't stay on a diet, remember with Weight Loss surgery, compliancy won't be any easier but if you are non compliant, it will really bite you.

  4. Is Surgery the only way? Will you die without it? Truly this is what the diet industry would like us to believe but in truth, for as many studies which have suggested there is a risk to obesity alone, there are the same number of studies which suggest obesity alone does not pose any significantly higher risk.  (ref: "The Diet Myth" by Paul Campos, NY 2006 for one)

    One study showed that 50 percent of people who are obese die SLIGHTLY earlier than thin people IF THEY DO NOT EXERCISE. The 30 year Cooper Institute Studies on 30,000 people DID take in consideration whether the participants exercised or not and they found that fat people who exercised, lived as long as thin people who exercised.  They also found that thin couch potatoes were at even higher risk than fat couch potatoes.

The HAES study of UCLA found in a 2 year clinical study that those in the cohort who ate healthy and exercised moderately WITHOUT A WEIGHT LOSS, reduced their health risks more than those who dieted plus they had a better body image than the dieters who initially lost weight but regained it all during the second year of the study. For more info about HAES, see Dr Linda Bacon's website

Remember science can only give us POSSIBLE explanations based on observations of nature and not definitive answers.  As Roy Spencer, former senior climatologist for NASA wrote:

"If you want possible explanations based on observations of nature, go to science. If you want TRUTH, go to church!"  (from GLOBAL WARMING CONFUSION by Dr Roy Spencer)

Thus, we are pretty sure that improving your eating and exercise habits may make you healthier but whether losing weight does that, no one really knows...

  1. According to the inventor of the BPD, this surgery was a variation of the JIB intestinal bypass which caused liver failure in many patients (the BPD or bileopancreatic diversion is usually done with the duodenal switch type gastrectomy the DS - in the duodenal switch, 80-90 percent of the stomach is separated off and removed from the body).  In this type of bypass usually done with a duodenalswitch, over 60 percent of the small intestine is bypassed! Many surgeons feel this surgery might carry a high risk of malnutrition.  About 10 percent of BPD patients develop malnutrition regardless of supplementation.  About 30 percent of DS/BPD patients develop anemia, a certain percentage of DS/BPD patients develop kidney stones - this is thought to be because their body does not absorb fat - therefore the fat mixes with the unabsorbed calcium in the small bowel and ends up in the kidneys.  DS/BPD patients are told to be on a low fat diet.  Of course, many folks HAVE this type of surgery so they CAN eat fat but eating fat may really harm them since their bodies can no longer handle it.

  2. Liver failure: patients are told that the old 'intestinal bypass' is no longer done due to the high incidence of liver failure in patients. However, many post op gastric bypass patients have elevated liver enzymes, a sign of possible liver damage.  Also high levels of vitamin B12 are observed in longer term gastric bypass post ops and this, too, can be evidence of cirrhosis of the liver (also seen in alcoholics).  Presently, the long term effects of the gastric bypass have not been studied (over 20 years from surgery).

  3. Stomach Cancer: According to medical books, anyone whose stomach is cut open, cut in two or surgically modified (called a 'gastrectomy') is of higher risk for stomach cancer.

What the American Medical Association feels about the gastric bypass and other Weight loss surgeries:

"Short-term outcomes are impressive-patients undergoing bariatric surgery maintain more weight loss compared with diet and exercise. Comorbidities such as type 2 diabetes can be reversed. But long-term consequences remain uncertain. Issues such as whether weight loss is maintained and the long-term effects of altering nutrient absorption remain unresolved."

They instruct their physicians to protect themselves from lawsuits by informing the prospective patient up front that weight loss surgery is investigational and that it is unknown whether Weight loss surgery will help that patient.

1762 JAMA, April 9, 2003-VoL 289, No. 14

Bottom line:

1. ignore ads and testimonials - seek long term patients - look at long term results and what studies we have. Possibly seek the advice of an expert NOT INVOLVED in WLS like a gastroenterologist and have him/her explain the possible repercussions of WLS to you. Read the release form CAREFULLY while you are making your decision.

Also realize that the patients you may encounter on the groups who are telling you it's the greatest thing ever, may not be sharing the whole truth about what they experience on a daily basis.
2. realize that obesity will not shorten your life more than 5 years or so whereas a gastric bypass may shorten your life more especially if you have complications
3. understand that even if you are slender, the quality of life after a gastric bypass if you are one of those who gets complications and problems, may be way less than it was when you were large.
4. Understand that no matter how compliant to rules you are, you may still have problems with such a drastic rearrangement of your stomach and bowel - be OK with this possibility before you go to surgery
5. Make SURE you know your doctor.  Do nurses who care for his patients go to HIM for their Weight Loss surgery?  Having a good skillful caring surgeon can make all the difference in life and death.
6. Be aware of the fact that if you have a gastric bypass, most of the weight you will lose in the first year will NOT be bodyfat but rather muscle, organs and bone mass. Less than 30 percent of what you will lose is bodyfat. Losing the weight more slowly like with the lap band will cause a greater percentage of fat loss.
7. You may have a lot of loose skin after a gastric bypass and may require plastic surgery.  Insurance might pay for a "tummy tuck" but usually does not pay for procedures like "lower body lifts" and "brachioplasty".  The plastic surgery procedures are long surgeries and can cause a lot of discomfort while healing.

A female patient pointed out that having a thigh lift may be difficult for a woman because of the location of the incisions, it's very difficult to keep from getting infections when toileting.

Following is a poem sent to me by a patient who did NOT have a good result - she is slender but very ill - she has given her permission for re-print to warn others:

Sent: Wednesday, August 21, 2002 3:13 PM
Subject: if only...

> oh, sue, I just found your site re: RNY GBP
> if only...
> if only the tears would stop
> if only I knew then half of what i know now
> if only I knew how to turn back the clock
> if only I had not trusted so blindly
> if only I had my life and my love of life back
> if only doctors understood and respected the value of living vs. the lack of value in existing
> if only the effects of malnutrition and slowly starving to death were not so bizarre that people assume and treat me as if I were terrifyingly contagious
> if only I knew someone who could/would reverse, not merely modify, this hell in which I exist
> if only I could hide from that emaciated creature who peeks at me in such a terrified manner when I glance at her reflection
> if only I had not learned so much about medical "error" and the resulting retaliation from the medical world if you dare to whisper those words
> if only I didn't have to hide from the world out of shame and fear
> if only I didn't know so much about PTSD* as I do now
> if only I could ever trust another medical care provider
> if only I didn't spend every moment wishing I could die or regretting I did not
> if only I knew how to protect others from the incompetent/unethical animal who did this to me
> if only
> if only
> if only

PTSD = post traumatic stress syndrome.


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