Bariatric Surgery: Your Most Uncomfortable Questions Answered

Are you thinking about bariatric surgery? You might first want to know whether you qualify for the procedure and how much weight you will lose. But don’t be afraid to also ask embarrassing questions, such as:

Will I Have Excess Skin?

Perhaps the most common question that potential bariatric surgery patients ask is about the amount of excess skin they will have after they lose weight. Excess skin is a normal part of losing a lot of weight quickly, particularly in the abdomen, the arms, and the legs.

While some supplements and topical treatments claim to help reduce the effects of excess skin, such as sagging or stretch marks, there is no way for skin to return to the way it was once it has stretched. A plastic surgery consultation about 18 months after the procedure is recommended to discuss options for removing excess skin.

Will My Bathroom Habits Change?

Some bodily functions change with weight-loss surgery, including digestion. After surgery, you should not expect any significant issues -- such as diarrhea or constipation -- with bowel movements, but you are encouraged to:

• Follow the recommended food schedule and choices, both pre-surgery and post-surgery. This typically includes cutting out high-fat foods, sugar, caffeine and alcohol, and temporarily maintaining a liquid diet.
• Stick close to a bathroom in the early months of adjustment, as every patient will respond differently to the physiological changes.
• Avoid sugary foods -- both processed and natural -- as they can lead to abdominal pain and diarrhea in post-surgery patients.
• Contact your physician if diarrhea or constipation persists for several days.

Will Surgery Affect My Fertility?

Yes, in a good way. Multiple studies have found that bariatric surgery improves hormonal balance and sexual function, including higher sperm count in men and more instances of healthy pregnancies in women.

Many women arrive at consultations for bariatric surgery after their gynecologist has recommended it to improve their chances of conceiving a child. Men also ask about improving their fertility through bariatric surgery and can feel reassured that the procedure will make a positive impact.

Some women may have concerns about whether bariatric surgery increases the likelihood of congenital disabilities in future children, but this worry is unfounded. One study found that infants born to women who had undergone weight-loss surgery had lower instances of significant birth defects than infants born to women who had not had a similar surgery.

Will Surgery Affect My Sex Drive?

Both men and women typically can expect healthier libidos following bariatric surgery’s weight loss, but that will vary by individual.

For men: Obesity leads to lower testosterone levels, which can decrease libido and exacerbate erectile dysfunction. Weight loss via bariatric surgery can balance testosterone levels, improving sexual function and performance.

For women: Obesity leads to hormonal imbalances, including estrogen release, resulting in lower sexual desire. As hormones even out with weight loss, sex drive often improves.

Discussion of any concerns surrounding sexual health and habits is encouraged during psychological consultations and follow-ups accompanying bariatric surgery. 

Ask Questions

Remember that every question you have about your physical, emotional and sexual health is a valid one. You should also consider connecting with in-person and online support groups to get more insight from others who have been through the process. If you have a question, chances are it has been asked before -- and there are answers.