After surgery, most patients have improved mental health but there may be a small increase in the risk of suicide. This is why patients are required to have a mental health screening before surgery.

People affected by severe obesity who are seeking weight loss surgery are more likely to suffer from depression or anxiety and to have lower self-esteem and overall quality of life than someone who is normal weight. Weight loss surgery results in significant improvement in mental health for the majority of patients. However, studies have found a small but significant increase in suicide following weight loss surgery. In some cases, these may have been patients with undiagnosed mental disorders, and in others, patients may have experienced major life stressors that can increase the risk for suicide, but in rare cases, the suicides are unexplained. For this reason, comprehensive bariatric programs require psychological evaluations prior to weight loss surgery. Many programs have therapists available for patient counseling after surgery. In addition, if a patient sees a psychologist or psychiatrist before surgery, they should continue seeing them after surgery.

After surgery, most patients have improved mental health but there may be a small increase in the risk of suicide. This is why patients are required to have a mental health screening before surgery. People affected by severe obesity who are seeking weight loss surgery are more likely to suffer from depression or anxiety and to have lower self-esteem and overall quality of life than someone who is normal weight. Weight loss surgery results in significant improvement in mental health for the majority of patients. However, studies have found a small but significant increase in suicide following weight loss surgery. In some cases, these may have been patients with undiagnosed mental disorders, and in others, patients may have experienced major life stressors that can increase the risk for suicide, but in rare cases, the suicides are unexplained. For this reason, comprehensive bariatric programs require psychological evaluations prior to weight loss surgery. Many programs have therapists available for patient counseling after surgery. In addition, if a patient sees a psychologist or psychiatrist before surgery, they should continue seeing them after surgery.

Does weight loss surgery increase the risk for alcohol abuse?

There is a small group of patients after weight loss surgery who have a problem with alcohol abuse. Most of those people, but not all, already had experiences with alcohol abuse before surgery.

Recommended precautions after weight loss surgery:

• Avoid alcoholic beverages during the rapid weight loss period, and then drink only rarely

• Be aware that even small amounts of alcohol can cause intoxication (‘being drunk’)

• Avoid driving or operating heavy equipment after drinking any alcohol

• Remember that you may feel less intoxicated than you are, and will not be a reliable judge of whether it is safe for you to drive

After drinking.

• Seek help if drinking becomes a problem

If you feel drinking alcohol may be an issue for you after surgery, please contact your primary care doctor or surgeon and discuss this further. They will be able to help you identify resources available to address any alcohol-related issues.

It has been found in scientific research that a small percentage of weight loss surgery patients report having problems with alcohol after surgery (7-10%). (6) Many who abuse alcohol after surgery had problems with alcohol abuse at some time prior to surgery, but occasionally alcohol problems can arise in patients who never had such issues before their surgery. Alcohol sensitivity is increased after weight loss surgery so that the effects of alcohol are felt with fewer drinks than before surgery. Studies also find that with certain weight loss procedures (such as the gastric bypass or sleeve gastrectomy), drinking an alcoholic beverage increases blood alcohol to levels that are considerably higher than before surgery or in comparison to the alcohol levels of individuals who have not had a weight loss procedure. In addition, studies have found that alcohol takes much longer to clear out of a person’s system if they have had weight loss surgery, which can pose safety and legal hazards for driving. Furthermore, it has been found that some patients may feel as though they are sober (‘not drunk’) even when they are over the legal blood alcohol limit for driving. For all of these reasons, weight loss surgery patients are advised to take precautions regarding alcohol

As long as patients take their appropriate vitamins, it is rare to have health problems from vitamin deficiency. Weight loss surgery can lead to reduced amounts of vitamins and minerals because people eat less and may absorb less in the intestines. Weight loss surgeries have different effects on vitamins and minerals based on how much change in absorption they cause. Deficiencies in vitamins, minerals, and protein can negatively affect health causing:

• fatigue (feeling tired)

• anemia (low levels of red blood cells that carry oxygen through your body)

• bone and muscle loss

• impaired night vision

• low immunity (your body’s ability to stay healthy)

• loss of nerve function (can affect your senses such as touch, taste, and smell)

• mental function deficits (changes how clearly you think)

Fortunately, nutrient deficiencies following surgery can be easily avoided with a good diet and the use of supplements including vitamins, minerals, and sometimes protein supplements. Before and after surgery, patients are advised of the appropriate diet and vitamin supplement needed. Most weight loss surgery programs also require patients to have their vitamins and minerals checked on a regular basis after surgery. Nutrient deficiencies and any associated health problems are preventable with monitoring and patients following diet and supplement (vitamin and mineral) recommendations. Health problems due to deficiencies usually occur in patients who do not regularly follow-up to monitor healthy vitamin and mineral levels. Be sure you stay in touch with your weight loss surgery team for best results!