Mental health improves initially, but at the end of two years most patients return to their preoperative emotional state. Some patients appear to become even more depressed after surgery, especially if they have had a major change in body image. Emotional counseling may be needed during the phase of adjusting to the new physique and the many changes that follow the surgery for morbid obesity. The gastric bypass is a remarkable safe procedure in view of the fact that many of the morbidly obese patients are afflicted with diabetes, hypertension, heart disease, pulmonary insufficiency, and malnutrition. Six of these eight died of infection, two died from a pulmonary embolism.
Late complications do occur.
The other deaths were due to anemia, AIDS, malnutrition, asphyxia, pneumonia, and one of unknown origin. The most common late complication is vitamin deficiency. Dietary supplementation, especially with the B vitamins and vitamin B12 is essential. If vitamin intake is not maintained, severe neuropathies and other neurologic problems may develop suddenly and be difficult to return to normal. Mild to moderate hair loss can occur usually at 3-6 months after surgery and is only temporary.