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Gastric Bypass Problems That May Surprise You

Gastric Bypass Problems That May Surprise You

Gastric bypass is a successful bariatric surgery option that helps people lose a significant amount of weight. However, like any surgery, there can be some problems after gastric bypass surgery. For many, the benefits of undergoing this type of surgery outweigh potential complications. For example, people who lose excessive weight often see improvement in co-morbidities, such as diabetes and obstructive sleep apnea. Additionally, weight loss surgery can help improve your quality of life and increase your longevity. Before committing to this surgery, it is essential to educate yourself on possible gastric bypass problems.

What is Gastric Bypass Surgery?

A good understanding of gastric bypass surgery is essential to understand what can cause gastric bypass problems. This type of bariatric or weight loss surgery changes the gastrointestinal tract anatomy to help you lose excess weight. Gastric bypass is a two-part procedure. First, the bariatric surgeon cuts the stomach to create a small pouch, limiting how much food you can eat. Second, the surgeon bypasses the rest of your stomach and part of your small intestine to decrease food absorption.

Gastric bypass helps people lose weight by:

  • Decreasing the amount of food you can eat at one time
  • Reducing the absorption of nutrients and calories
  • Changing your gut hormones to make you feel full more quickly and less hungry overall

Problems after Gastric Bypass

Because surgery significantly alters the digestive tract in gastric bypass, problems can arise not only in your stomach but elsewhere in your body as well. Here is a look at all of the organs and systems affected by gastric bypass surgery problems.

Gastric Bypass Post-op Problems

The immediate period after surgery is crucial for your recovery, which is why most people need to stay in the hospital for a few nights before heading home. During your hospital stay, your medical team will be watching for problems such as:

  • Breathing issues
  • Nausea and vomiting
  • Infection
  • Intestinal or stomach obstruction
  • Bleeding or blood clots
  • Digestive contents leaking into the abdomen

Your nursing staff will also use this time to help you start physical therapy, control pain, manage other health conditions, and educate you on your post-op diet.

A hospital stay is required after gastric bypass to monitor for any problems after surgery.

Digestive Problems after Gastric Bypass Surgery

Not surprisingly, people can experience some stomach problems after gastric bypass. Most of these problems occur during the first few weeks to months after surgery and are part of the process of getting used to a smaller stomach.

Overeating and consequently stretching the new, smaller stomach pouch is one of the more common problems after gastric bypass surgery. Overeating can be tremendously uncomfortable and can cause pain, nausea, and vomiting. In very few cases, the stomach can perforate and leak food content into the abdomen, which is a severe complication that requires immediate medical attention.

Gastric Bypass and Gallbladder Problems

Gallbladder problems after gastric bypass surgery can also occur. Some studies show that nearly 53% of gastric bypass patients will develop gallstones. Indeed, rapid weight loss after gastric bypass is a well-known risk factor for gallstones. Thus, some people who have this surgery may find they need surgery to remove gallstones or even the gallbladder in the future. Incidentally, some patients and surgeons may explore the option of removing the gallbladder during surgery if the patient is at exceptionally high risk for gallbladder problems after gastric bypass.

Gastric Bypass and Liver Problems

Additionally, people can also experience liver problems after gastric bypass. Nonalcoholic fatty liver disease occurs in almost 80% of people with obesity. In most patients, weight loss surgery improves overall liver function because of massive weight reduction. Yet, in some cases, people may develop liver dysfunction. It is also necessary to follow a liver-shrinking diet before surgery to reduce complications during and after your procedure.

People who lose a significant amount of weight are at greater risk of developing gallstones.

Lower Digestive Tract

Bowel problems after gastric bypass are common as well. Remember, gastric bypass alters not only your stomach but also your smaller intestine. Because the surgeon bypasses part of the small intestine, food is not always fully absorbed and digested. Thus, people may struggle with diarrhea, constipation, and gastric bypass gas problems. Dumping syndrome is one of the most unpleasant and standard post gastric bypass surgery problems that often resolves with time and dietary changes.

Thyroid Problems after Gastric Bypass

Obesity and hypothyroidism frequently occur together. Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormone to support the body’s metabolic needs. The thyroid gland is a small, butterfly-shaped organ seated at the nape of your neck. Although small, this mighty organ is responsible for controlling your metabolism and regulating growth and development. When the thyroid cannot produce enough thyroid hormone, many systems in your body can be affected, and one of the most common symptoms is weight gain.

People who have hypothyroidism require lifelong medication to replace necessary thyroid hormones in your body. However, weight loss and dietary changes often decrease your thyroid medication dosage after gastric bypass. Thus, it is essential to stay in touch with the doctor who manages your hypothyroidism after gastric bypass surgery to adjust your dose as needed.

The thyroid is a small hormone-producing gland at the base of your neck.

Gastric Bypass Psychological Problems

The effects of bariatric surgery extend beyond physical changes; it can also affect your mental health. For some, the mental changes are positive, including an improved body image, increased self-confidence, and greater happiness.

However, some people have a challenging time adapting to their new self-image and changing how they perceive themselves. In particular, relationships with your family and friends may vary, as some of your loved ones may have difficulty accepting and encouraging your health goals. Furthermore, many people often find their loved ones and even acquaintances ask invasive questions about their weight loss, causing them to attract unwanted attention.

People with obesity are also more prone to mental health conditions, like anxiety and depression. For example, about 50% of people with obesity report a lifetime of depression. In many cases, surgery can help improve mood dysfunction. Personality changes after gastric bypass may occur as well.

Finally, people who have eating disorders related to their obesity may experience an addiction transfer, where they transfer their food addiction to other sources, like alcohol and opioids. Most bariatric surgery centers will conduct a psychological evaluation before surgery. However, if you find you are struggling with addiction, depression, anxiety, or any other mental or emotional problems after gastric bypass surgery, be sure to connect with your doctor. Your mental health is as equally important as your physical health.

Weight Loss Problems with Gastric Bypass Surgery

People pursue bariatric surgery for a variety of reasons. Many people (obviously) choose surgery for weight loss, but others use it to control destructive eating habits or manage chronic health conditions like diabetes. Whatever your reasons, weight loss is expected and desired with gastric bypass. However, most people will reach a point where their weight loss begins to slow or reach a plateau. This can be frustrating, especially after enjoying the initial decrease in weight following surgery.

Slipping up on your diet can put the pound back on your frame and add to your discomfort.

Sometimes, overcoming a weight plateau requires a simple evaluation of your eating behaviors or diet. Other times, it may be more complex and may need you to revisit your surgeon to keep progressing on your weight loss journey.

Problems with Gastric Bypass Surgery Years Later

Along with weight plateaus and re-gaining weight, people can have gastric bypass surgery problems after many years. Sometimes, people can experience hernias or acid reflux (also known as GERD). In severe cases, some people may develop perforations in their digestive tract.

Additionally, malnutrition and nutrient deficiencies are possible problems with gastric bypass surgery as well. Because nutrient deficiencies can be harmful and even life-threatening, all post-bariatric surgery patients require a personalized vitamin regimen to prevent this complication.

Preventing Gastric Bypass Problems

Gastric bypass surgery is a popular solution for treating obesity and is performed frequently in North America. However, surgery is certainly not the easy way out when it comes to weight loss. To prevent problems after surgery, you must be willing to follow your surgeon’s advice and make the necessary lifestyle changes to improve your outcome and ward off complications. However, even when you do everything “right,” problems can still arise.

Here are some tips to give yourself an excellent platform for success after surgery:

  • Attend all of your post-surgery follow-up visits
  • Follow your doctor’s instructions, including diet, exercise, and medications.
  • Make sure to manage other health conditions as well, such as diabetes and hypertension
  • Work with a nutritionist and keep a food diary
  • Exercise regularly as permitted by your doctor
  • Work with a therapist who specializes in working with bariatric surgery patients
  • Meet with a support group for people who have undergone weight loss surgery

Find support in your family, friends, and people who have also been through weight loss surgery.

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Julia Rae Walker, RN, BSN, BA


Julia is an experienced critical care nurse with a background in pediatric and adult patient populations. Her passion is helping patients maximize their quality of life.

Gintas Antanavicius, MD, FACS, FASMBS

Medical Reviewer

Dr. G is a co-founder of BariBuilder. A US-based expert surgeon with over 10 years of bariatric experience, he regularly publishes research in medical journals like SOARD, Obesity Surgery, etc.