The importance of diet in bariatric surgery success stories

With over one-third of American adults age 20 and older being classified as obese—defined as a body mass index (BMI) of 30 or greater—more and more people are considering bariatric surgery to help them manage their weight.

One well-known bariatric medical expert told me that he believes it is statistically unlikely that anyone who reaches a BMI of 30 will be able to manage their weight long-term, without a weight-loss procedure. Medical research backs up his opinion. It is certainly easy to lose weight with a diet and then only regain it a few months later.

As a Houston, Texas medical malpractice attorney, I have filed lawsuits on behalf of many clients who had avoidable complications as a result of weight-loss surgeries. In my experience, the most common problems that lead to litigation involve gastric outlet obstruction, which prevents patients from being able to hold down food and liquids. In essence, they live in a miserable, chronic state of malnutrition and nausea.

Even bariatric patients who fly through surgery with no complications must confront lifelong dietary issues in order to maximize the results. This makes sense, considering that bariatric procedures are designed to either restrict stomach capacity and/or restrict absorption by the gastrointestinal system.

In reviewing bariatric medical malpractice cases, I have found that some surgeons treat these complex surgical procedures as a cookie-cutter or assembly-line process.

Some clients have told me that their surgeons handled the pre-operative education process in a seminar setting, where a dozen or two patients watch a video presentation, with little to no interaction with the surgeon. On the way out, the office staff gave them handouts discussing a bariatric diet. After the surgery, by the way, many clients have told me that their surgeons also handled the follow-up visits largely in a group setting. Both before and after the surgery, clients have told me that dietary guidelines were given minimal emphasis.

Bariatric diets

I recommend that patients considering a weight-loss surgical procedure to get as much information as possible from the surgeon, or the surgeon’s staff, concerning the short-term and long-term recommended bariatric diet.

People who choose to undergo bariatric surgery do so because they want to lose weight, keep it off, and improve their health. Unfortunately, I have found that some bariatric surgeons given an inadequate emphasis on the importance of patient compliance with dietary recommendations in order to achieve the desired long-term result.

In 2008, the American Society for Metabolic and Bariatric Surgery published health nutrition guidelines for bariatric surgery patients who had procedures including Roux-en-Y gastric bypass, adjustable gastric banding, and biliary pancreatic diversion. The Society is developing additional guidelines specific to the popular gastric sleeve procedure.

Research by dietitians have shown that some bariatric procedures, like the Roux-en-Y gastric bypass, can result in micronutrient deficiencies and associated complications which can include dizziness, lightheadedness, sweating, nausea, and lethargy, after eating.

Research shows that after bariatric surgery, vitamins and minerals that depend on fat absorption in order to be metabolized, such as vitamins A, D, E, and K, and zinc, are not fully absorbed. In addition, there is a heightened risk of other micronutrient deficiencies, including iron, calcium, thiamin (vitamin B1), vitamin B12 , folate 10, and folic acid.

Most experts believe that the best results are achieved when dietitians work closely with bariatric surgery patients. I recommend that patients ask their bariatric surgeons about the availability of dietitian counseling before undergoing a weight-loss procedure.

Here are some recommendations that many dietitians recommend for post-bariatric patients:

· Set an alarm clock for a reminder to eat and drink, because for the first several months after surgery, many patients do not get hungry.

· Monitor protein intake, which should be 60-80 g (1-1.5 g/kg of ideal body weight) on a daily basis. It's easy to supplement protein through whey protein powder or egg white protein powder, both of which are available in stores.

· Consider using liquid or powdered vitamin and mineral supplements, which are available in stores.

Bariatric medical/surgical malpractice

If you or someone you care for has been seriously injured as a result of bariatric medical/surgical malpractice, call the experienced attorneys at Painter Law Firm, in Houston, Texas, at 281-580-8800, for a free consultation about your potential case.


Robert Painter is a medical negligence and wrongful death attorney at Painter Law Firm PLLC, in Houston Texas. He has represented many patients who are seriously injured as a result of poor operative and post-operative bariatric surgical care.

Robert Painter
Article by

Robert Painter

Robert Painter is an award-winning medical malpractice attorney at Painter Law Firm Medical Malpractice Attorneys in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits all over Texas. Contact him for a free consultation and strategy session by calling 281-580-8800 or emailing him right now.