Five Surprising Things You May Not Know About Bariatric Surgery: From Hair Loss to Going out to Eat

If you're considering getting bariatric surgery (also known as weight-loss surgery), we hope you've already talked to your primary care physician and done some research about how the different procedures are done (roux-en-y gastric bypass vs sleeve gastrectomy), weighed the benefits and risks and looked into the time and recovery process involved. There's a lot to this life-changing surgery, which is why at the Denver Health Bariatric Surgery Center, we require all of our patients to watch our educational video to make sure you know everything involved before taking this big step toward a new you! But there are also a few things about the surgery that we still get lots of questions about, so we decided to put together a blog with the five surprising things you may not know about bariatric surgery.

1. You might be able to go off your medication(s) after bariatric surgery. 

   

   
   Bariatric surgery, like gastric bypass or sleeve gastrectomy, can lead to big health improvements beyond just weight loss, according to director of the Bariatric Surgery Center, Alex Morton, MD. "One surprising benefit is that many people are able to stop taking some of their medications after the surgery," Dr. Morton said. "For instance, those who used to take insulin or metformin for diabetes might find that their blood sugar levels become normal again and they no longer need these medications. Similarly, people who were on blood pressure medicine often see their blood pressure drop to healthy levels, allowing them to stop those meds too. High cholesterol can also improve, allowing some people to stop taking cholesterol lowering medicines like statins. In fact, bariatric surgery has been shown to reduce the risk of major cardiovascular problems like heart attacks and stroke after surgery."
   
   "Another impressive result is that some patients with sleep apnea (OSA) can stop using their CPAP machines at night," Dr. Morton continued. "This happens because the significant weight loss from the surgery often reduces the excess tissue around the neck and throat area, making it easier to breathe while sleeping. The improvement in health conditions we see after bariatric surgery is mainly because losing weight can help the body function better which reduces the need for these medications and devices. While weight loss is very important, these other effects of bariatric surgery are just as important in improving peoples’ quality of life by reducing the burdens of many health problems related to excess weight, including by reducing or eliminating the need for some medications and treatments."


2. Bariatric surgery support groups could help you lose more weight. 

   

   
   Did you know participating in a bariatric support group can increase your chances of long-term weight loss success? According to Denver Health Bariatric Surgery Center psychologist Nergis Akkaya, PsyD, "Engaging in a support group offers a wealth of practical tips and shared experiences from peers who truly understand the journey. This collective knowledge can help you navigate the challenges of pre- and post-surgery life more effectively. Additionally, the motivational boost from being part of a supportive community can be a game changer, helping you stay committed to your goals."
   
   Studies have shown that those who regularly attend support groups not only achieve better weight loss outcomes but are also more likely to maintain weight loss in the long run. Participants report having better quality of life, improved mental health and stronger social connections. 
   
   Denver Health offers support groups that are included at no extra cost to all of our bariatric surgery patients. If you're considering bariatric surgery or are already on the path, a support group can be helpful in providing guidance and in living your healthier and happiest life!


3. You can still go out to eat after bariatric surgery. 

   

   
   Bariatric surgery requires changes to eating habits, and some patients may wonder if eating out is still allowed before and after their surgery. Denver Health Bariatric Surgery Center dietitian Michelle Darr says that the short answer is YES! "Eating or dining out after bariatric surgery is still possible if certain strategies are used to help ensure patients continue to follow nutrition guidelines," Darr said.
   
   Dining out includes eating meals from restaurants, drive through, pick up, delivery, fast food and food trucks. According to the Centers for Disease Control and Prevention, three in five Americans (60%) say they eat dinner out at least once per week, and according to a survey conducted by US Foods in 2023, Americans spend a monthly average of $166 dining out per person-meaning we all eat out quite often. Meals eaten out tend to be larger in portion size, higher in fat, added sugar, and overall calories, all of which can impact weight and health over time. The registered dietitians with the Denver Health Bariatric Surgery Center have listed a few favorite tips below to help you make healthy food choices and stay on track for bariatric surgery (and after surgery) when eating or dining out: 
   
   
   • Practice portion control: Share a meal with a family member or friend, or take half of your meal home in a to-go box. Some restaurants have an "ala carte" or sides menu that you can order off, and after surgery this may be the perfect size meal as your stomach is much smaller. 
   • Look at the menu ahead of time: If the menu is available online, look it over before you even leave for the restaurant or place your order. This allows you to think and compare cooking methods and ingredients used to cook that meal. Nutrition information may also be available which can further help you decide your order. 
   • Have a snack ahead of time: Don't order food or go out to eat when you are really hungry as you are more likely to overeat or choose less healthy food options. 
   • Think about cooking methods: Choose baked, grilled, steamed or sautéed foods instead of deep fried or crispy. 
   • Choose your sides wisely: Side salads, cooked vegetables, or fruit are great side options. These can help limit extra fat and calories, while also helping you get in your fruit and veggies for the day. 
   • Ask for sauces and dressings on the side: This allows you to control how much is used. 
   • Pack in the protein: Protein is so important after surgery for ensuring a healthy weight loss and helping meet nutrition needs. Make sure your order has a high protein food included! 
   • Avoid "extras": Avoid ordering appetizers or combo meals to prevent over eating. 
   • Stick with water: Limit ordering drinks such as soda, juice or any other flavored drink with added sugars. These drinks are full of empty calories and can make you feel sick with dumping syndrome (when your stomach empties too quickly into your small intestine) after surgery. Bring crystal light packet sticks or MiO drops to flavor your water when dining out. 
   • Invite friends and family over: Often times, people eat out as a way to socialize and spend time with family and friends-invite family and friends over to your home instead. This allows you to control the ingredients and cooking methods used in the preparation of the meal, while still enjoying the company of your loved ones.


4. Hair loss is real after bariatric surgery (but it grows back!). 

   

   
   Hair loss is a common fear and side effect experienced by many people who undergo bariatric surgery. It usually happens within the first three to six months after surgery. The good news is that hair loss is usually temporary. In most cases, your hair should start to grow back six to 12 months after surgery. 
   
   "Major surgeries, including bariatric surgery can be a stressful experience for the body, which is what causes temporary hair loss," according to Tara Gray, a registered dietitian with the Denver Health Bariatric Surgery Center. "Rapid weight loss is common in the first few months after surgery, which can also put the body into a state of stress. In response to these stressors, the body may temporarily stop some non-essential functions, which includes hair growth."
   
   Weight loss surgery can also make it more difficult for the body to absorb many of the essential nutrients and vitamins and minerals required for healthy hair growth. Protein, iron, zinc and vitamin D are especially important for hair growth and common deficiencies that are seen in patients post-operatively. Untreated nutritional deficiencies will likely worsen, or prolong post-operative hair loss.
   
   "Although it may be difficult to avoid hair loss completely, there are a few things you can do to help minimize hair loss and promote healthy hair growth," Gray said. "Patients should make sure they are eating enough protein. Protein goals are individualized, but generally, patients need at least 60-80 grams of protein per day, divided into small frequent meals. Patients should also take the recommended vitamin and mineral supplements daily as prescribed by the bariatric team. In addition, patients should make sure to have routine lab checks in order to identify and treat any deficiencies as soon as possible." 
   
   "Hair loss after bariatric surgery can make you feel more vulnerable and self-conscious," added Dr. Akkaya. "To cope, try talking to a mental health professional, join support groups to share experiences and be kind to yourself. Focus on good nutrition, make sure to get enough vitamins and minerals. Remember, hair loss is usually temporary and your hair will often grow back over time. Your journey is unique and every challenge you overcome is a victory worth celebrating."


5. There is a lot of loose skin after bariatric surgery (but you can manage it!). 

   

   
   Prior to undergoing weight loss surgery, your skin has expanded over time to accommodate your extra weight. After weight loss surgery, patients often lose a significant amount of weight quickly which can result in loose skin. The amount of loose skin a person has depends on factors such as the amount of weight lost, age and genetics. Patients tend to have more loose skin in areas they carried most of their extra weight (commonly the abdomen, arms, thighs or breasts). In some cases, surgery may be an option to remove excess skin. However, there are several non-surgical things patients can do to help improve the appearance of loose skin. 
   
   "After bariatric surgery, it is important to follow a high protein, well balanced diet to build and maintain lean muscle mass," said Gray. "This can help to 'tighten' your skin over time. It is also important to stay hydrated by drinking at least 64 ounces of fluid per day to help improve skin health and elasticity. Regular, consistent exercise can help improve loose skin and confidence after weight loss surgery. Patients should aim for at least 150 minutes per week of moderate intensity aerobics and incorporate strength training exercises at least twice per week. Strength training is crucial for building lean muscle mass and can help to fill out areas on the body where extra fat was lost."
   
   "Loose skin after bariatric surgery can affect how you feel about yourself, even after losing weight," added Dr. Akkaya. "Some people may feel okay with it, while others may struggle more. To cope, patients can consider counseling to address body image concerns, connect with support groups to receive encouragement and practice self-acceptance and patience. Embrace the positive changes in your health and lifestyle and recognize that each step forward is a testament to your dedication and courage!

Bariatric surgery (or weight-loss surgery) for those age 16-65 can be an effective treatment many weight-related health issues even when medical and behavioral weight loss programs have failed. We focus on supporting our patients and their families/support team through the process of bariatric surgery and beyond. To get started on your weight loss journey at Denver Health and determine if surgery is right for you, please watch the informational video and answer the questions below it.