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Possibility of non-reversible complications?



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Hey everyone!

I am 27F trying to get the Bypass mostly for my GERD but also to lose weight. It's gotten to the point where I have pain every night and some days sleep 4 hours max.

The only thing keeping me away from the surgery is the fear of developing some very bad complications (like osteoporosis). If one follows the diet and Vitamin intake to a tee, how likely that I will get to old age without getting them? I would really like to live my 30s and 40s relatively healthy and not be "damaged" by the operation.

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If you eat a well balanced diet and take the prescribed Vitamins and minerals you should have no deficiency as you age. My plan calls for 1500 mg calcium citrate which protects from bone loss. It is important to take Calcium citrate, not other forms of calcium.

I had my RNY 30 years ago, and while it was not entirely successful (so I'm leading up to revision at age 73), the surgery had no long term negative effects on me. Indeed, I credit it for avoiding Type II Diabetes, which many of my overweight friends now have.

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I'm also worried about the long term effects nutritionally, especially as we age or get a chronic/serious disease, like cancer, etc. I've asked my team multiple times for data regarding the elderly who've had this surgery in the past, and I'm simply told there isn't any. Which can't be true. People have been having these surgeries for 30 years or more. There are a significant number of people 70+ who would be dealing with the long term effects.

One staffer who had the surgery 15 years ago says she has serious osteoporosis and now needs constant medical care.

I also wonder what happens if the supply chain/pandemic/economy issues prevent the required supplements and Vitamins from being available and/or affordable.

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You are right to have concerns & to ask questions about possible long term side effects as you should after any surgery or medication regime, etc. You should be fully informed before making any decision.

The unfortunate thing today is that our chances for cancer, osteoporosis, etc. are Increasing regardless of having weight loss surgery or not. A combination of many factors including poor diet, genetics, lifestyle, environment all increase our chances for developing serious health issues as we age. Being obese increases our likelihood even more. Most of these we have no control over. You may have the surgery & develop an issue but you may have developed it without the surgery & vice versa. There are some things we can’t control or predict.

As @Sunnyway said if you ensure you eat a balanced, nutritionally dense diet & follow the Vitamin regime you are prescribed you will actively be working to avoid any possible side effects. I’d also suggest you continue to have regular blood tests to ensure you’re never lacking in anything & have bone density tests to check for early signs of osteoporosis. Make them a regular event to keep ahead of things just like having a regular Pap smear & your teeth checked.

All the best.

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@Arabesque @Sunnyway Thank you for your inputs! I will also ask about it to my surgeon in December if they have some kind of statistics and then decide if I'll take the bullet or not :) So far I am 80% sure I want the operation.

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Someone asked about long-term complications in the elderly who had surgery decades ago. You can't really compare, because weight loss surgeries back in the 60s and 70s were very different than they are today. They were very risky and some people (including a former co-worker of mine) had them reversed - and some people died from them. But again, there's no comparison to the surgeries they do today. Plus the ones they do now are much safer and much less likely to have severe complications.

you should be fine as long as you follow your plan, keep on top of your supplements, and have regular blood work done to check for deficiencies. Most deficiencies can be reversed if they're caught early. I do have osteoporosis, but I have no idea if that's due to my weight loss surgery or not, since we didn't do a baseline before my surgery. But I'm also in my 60s and osteoporosis runs rampant on both sides of my family, so it could have been that as well. I'm on a drug now that maintains bone, though - and there are other drugs that actually build bone.

Honestly, at my starting weight (almost 400 lbs), I was much more concerned about complications from being severely obese (like premature death, for one) than I was about complications from my RNY.

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P.S. they do have about 30 years of data on the RNY - although even over that time period, the technique has been changed a bit (and improved). Not as much data on the sleeve since that is a newer surgery. The sleeve is phase 1 of the duodenal switch surgery, and it wasn't offered as a standalone surgery until a few years ago (because many patients lost enough weight with the sleeve part of the DS (before having phase 2 - the intestinal bypass part of the DS) that they decided to offer it as a standalone surgery. It wasn't really until it started replacing the lapband ten or so years ago that it really took off in popularity.

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