Hair Transplant Blog Featuring John P. Cole, MD

Bariatric Weight Loss Surgery And Hair Loss

My mother had esophageal band surgery a couple of years ago due to her excessive weight problem. Following this she has noted progressive hair loss and a change in her personality. I’ve read that band surgery and stomach stapling can cause hair loss. Is this true?

Bariatric (Weight Loss) Surgery: Metabolic, nutritional, psychological and physiological Consequences Bariatric or weight loss surgeries have become commonplace in the USA and in other countries, in part due to an ever increasing incidence of obesity in the context of a societal standard of beauty that emphasizes a thin, shapely physique. Lobbying by various organizations, as well as medical studies detailing the present and future consequences of untreated obesity, has led to insurance coverage for these surgeries, which were previously deemed “cosmetic”. This article will detail some of the physical and mental aspects of the often rapid weight loss which occurs after bariatric surgery.
The bariatric surgery community utilizes a number of procedures to promote rapid and hopefully permanent weight loss. Some of the earlier methods have been abandoned or modified due to unacceptable morbidity in the post-operative period, both immediate and long-term. Currently used techniques most often decrease absorption of calories or promote early satiety (feeling of fullness), or some combination of the two.

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Unfortunately, the decreased absorption of calories is accompanied by decreased absorption of macro- and micro-nutrients. This often leads to nutritional deficiencies of varying degrees of severity. Sometimes these deficiencies may go undetected for some time, until they have had a profound effect on the patient. Many of these deficiencies can be very difficult to treat (refractory) once established. They may cause significant derangement in the patient’s physical, mental and emotional health.

Nutritional deficiencies associated with bariatric surgery:
Multiple vitamin deficiencies: D, A, B12, B1
Multiple mineral deficiencies: iron, magnesium, calcium, zinc
Macronutrient deficiencies: protein, fatty acid, caloric
The endocrine system may also be deranged; hyperparathyroidism may occur, secondary to vitamin deficiencies, and this condition may cause multiple physical and mental/emotional disorders. This may lead to new micro nutrient disorders, or exacerbate those which have already resulted form the surgery. All of these factors together may set the stage for multiple, interrelated metabolic conditions that may have an overwhelming effect on the patient after bariatric surgery.
In addition to the physiological issues detailed above, mental and emotional distress or overt illness may also occur subsequent to these procedures. This may range from mild depression to full-blown psychosis. The etiology of these symptoms is only partially clear. Some may be due to radical, sudden changes in body image. Others manifestations may be due to metabolic derangements such as magnesium deficiency, hyperparathyroidism, and/or various B vitamin deficiencies. Unfortunately, authorities say that the psychological effects of bariatric surgery have yet to be as fully elucidated at the physiological ones have been.
Another major issue in the post-operative period has to do with the cause of the obesity itself. It is widely believed that many overeaters use food for “self-soothing”, in other words, it calms their anxieties, cures boredom, temporarily alleviates depression (but worsens it in the long run), may act as a substitute for caring relationships and love interests, and generally supports the individual emotionally. When the ability to eat is radically curtailed, this whole quasi-“relationship” the person has with foods is interrupted, sometimes with disastrous consequences. This is one of the many reasons that bariatric surgeons must screen the population of patients so strictly, and this is also one of the reasons that psychotherapy before and after such procedures is seen as mandatory. It is of interest that current studies reveal a substantial percentage of these patients eventually regain much or all of the weight they initially lost, despite the “permanent” nature of the surgery.
Hair loss is another very common consequence of bariatric surgery, and of course can exacerbate the psychological problems the patient may develop. The germinal cells found in the bulb at the base of the hair follicle are among the most rapidly dividing cells in the body. This is one reason that hair is so sensitive to any stressors experienced by the human organism.
It is well known that people may experience an effluvium, or shedding, under the influence of myriad stressors. These can be physiological or psychological, and the hair loss may be permanent or temporary. Bariatric surgery may be an overwhelming stressor, and even in the most optimal cases, it is a major perturbation to the body as well as the mind.

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  • Goerge

    I am pleased to get this in my hand bookmarking this right
    now… so that I could not lose it.