202: Part 2: The Truth About Weight Loss Surgery: Does It Really Make You Thin and Healthy?

Nov 18, 2025

Delving deep into weight loss surgery, this insightful discussion uncovers the realities of post-surgery weight loss and the emotional toll it can take. Listeners will learn about alarming mental health outcomes, including increased risks of depression and even self-harm. The conversation also addresses the complexities surrounding informed consent, especially among children, and highlights troubling racial disparities in surgical outcomes. With compelling patient stories, the episode challenges the myth that surgery is an easy solution and examines broader societal issues.

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INSIGHT

Weight Regain Is Common And Early

Most bariatric surgery patients regain a large portion of weight within years after surgery.
Studies report 46% with significant regain by 2 years and 63% by 4 years, showing short-term gains often reverse.

INSIGHT

Long-Term Net Loss Often Is Small

Long-term follow-ups show most people end up with only modest net weight loss.
One 12-year study found 93% maintained less than 10% weight loss and only 40% kept ≥30% loss.

INSIGHT

More Loss Can Mean Worse Health

Greater surgical weight loss can correlate with worse health outcomes in some studies.
One analysis found more weight loss after surgery associated with poorer clinical outcomes like diabetes progression.

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Join us for part 2 of this deep dive into weight loss surgery! We talk about how much weight people lose, the mental health outcomes of people (big trigger warning there), surgery in kids and informed consent. TW: Mention of su!c|de, depression, children and surgery as well as general awful stuff fat people endure.

Episode show notes: http://www.fiercefatty.com/202

Support me on Ko-Fi and get the Size Diversity Resource Guide: https://kofi.com/fiercefatty/tiers

Comparison of the Performance of Common Measures of Weight Regain After Bariatric Surgery: https://jamanetwork.com/journals/jama/fullarticle/2707460

All‑Cause and Cause‑Specific Mortality Associated with Bariatric Surgery: A Review: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055056/

Body Image Disturbances and Weight Bias After Obesity Surgery: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8012323/

Coping With "Ob*sity" Stigma Affects Depressed Mood: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5670735/

Death Rates and Causes of Death After Bariatric Surgery: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4888907/

Depression, Anxiety, and Binge Eating Before and After Bariatric Surgery: https://www.scielo.br/j/abcd/a/tZXDCfc855KxdXcFKTbVtHR/?lang=en

Diabetes after Bariatric Surgery: https://www.canadianjournalofdiabetes.com/article/S1499-2671(16)30072-7/fulltext

Ethical Questions About Surgery Raised by Scientists: https://jamanetwork.com/journals/jama/article-abstract/196339

Late Relapse of Diabetes After Bariatric Surgery: https://diabetesjournals.org/care/article/43/3/534/35625/Late-Relapse-of-Diabetes-After-Bariatric-Surgery

Long-Term Follow-up After Bariatric Surgery: A Systematic Review: https://jamanetwork.com/journals/jama/fullarticle/1900516

Long-Term Outcomes After Bariatric Surgery: Systematic Review & Meta-analysis: https://link.springer.com/article/10.1007/s11695-018-3525-0

Mineral Malnutrition Following Bariatric Surgery: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3771134/

Patient Experiences of Outcomes of Bariatric Surgery: Systematic Review: https://onlinelibrary.wiley.com/doi/10.1111/obr.12518

Prevalence of Alcohol Use Disorders Before and After Bariatric Surgery: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3682834/

Recent Experiences of Weight-based Stigmatization in a Weight Loss Surgery Population: https://onlinelibrary.wiley.com/doi/full/10.1038/oby.2008.457

Risk of Suicide and Non-Fatal Self-Harm After Bariatric Surgery: Two Cohort Studies: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5932484/

Risk of Suicide and Self-Harm Is Increased After Bariatric Surgery: Meta-analysis: https://link.springer.com/article/10.1007/s11695-018-3493-4

Substance Use After Bariatric Surgery: A Review: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4789154/

Survival Among High-Risk Patients After Bariatric Surgery: https://pubmed.ncbi.nlm.nih.gov/21666276/

No Evidence That Bariatric Surgeries Save Healthcare Costs or Lives: http://junkfoodscience.blogspot.com/2008/09/no-evidence-that-bariatric-surgeries.html

The Impact of Bariatric Surgery on Psychological Health: https://www.hindawi.com/journals/jobe/2013/837989/

Untold Stories of Living with a Bariatric Body: Long-Term Experiences of Weight-Loss Surgery: https://onlinelibrary.wiley.com/doi/10.1111/1467-9566.12999

"But Everything Is Supposed to Get Better After Surgery!" Understanding Postoperative Suicide and Self-Injury: https://bariatrictimes.com/understanding-postoperative-suicide-self-injury/

Long-Term Weight Regain After Gastric Bypass: A 5-Year Prospective Study: https://www.researchgate.net/publication/5459557_Long-term_Weight_Regain_after_Gastric_Bypass_A_5-year_Prospective_Study

Anti-Diet by Christy Harrison: https://christyharrison.com/book-anti-diet-intuitive-eating-christy-harrison

Food Junk Science Blog: http://junkfoodscience.blogspot.com/2007/01/junkfood-science-weekend-special.html

Suicide Rates After Bariatric Surgery: https://bariatrictimes.com/understanding-postoperative-suicide-self-injury/#:~:text=Based%20on%20their%20analysis%2C%20the,3.2%E2%80%935.1%2F10%2C000

Kaitlin Anderle Who Had Surgery: https://www.instagram.com/p/B9B7HwSh3RM/

Roxane Gay - What Fullness Is: https://gay.medium.com/the-body-that-understands-what-fullness-is-f2e40c40cd75

Lindo Bacon on Bariatric Surgery: https://www.lindobacon.com/HAESbook/pdf_files/HAES_Bariatric-Surgery.pdf

Prevalence of Alcohol Use Disorders Before and After Bariatric Surgery: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3682834/#:~:text=There%20is%20some%20evidence%20that

Mineral Malnutrition Following Bariatric Surgery: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3771134/#:~:text=Bariatric%20surgery%20exacerbates%20preexisting%20malnutrition,with%20micronutrient%20supplementation%20following%20surgery

Substance Use After Bariatric Surgery: A Review: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4789154/

Early Mortality Among Medicare Beneficiaries Undergoing Bariatric Surgery: https://pubmed.ncbi.nlm.nih.gov/16234496/#:~:text=The%20rates%20of%2030%2Dday,001

Death Rates and Causes of Death After Bariatric Surgery for Pennsylvania Residents: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4888907/

No Evidence That Bariatric Surgeries Save Healthcare Costs or Save Lives: http://junkfoodscience.blogspot.com/2008/09/no-evidence-that-bariatric-surgeries.html

Ethical Questions About Surgery Raised by Scientists: https://jamanetwork.com/journals/jama/article-abstract/196339

Suicide Rates: https://bariatrictimes.com/understanding-postoperative-suicide-self-injury/#:~:text=Based%20on%20their%20analysis%2C%20the,3.2%E2%80%935.1%2F10%2C000

Long-Term Weight Regain After Gastric Bypass: https://www.researchgate.net/publication/5459557_Long-term_Weight_Regain_after_Gastric_Bypass_A_5-year_Prospective_Study

Association of Race With Bariatric Surgery Outcomes (Wood et al., 2019): https://jamanetwork.com/journals/jamasurgery/fullarticle/2727128

Racial Disparities in Bariatric Surgery Complications and Mortality Using the MBSAQIP Data Registry (Welsh et al., 2020): https://pmc.ncbi.nlm.nih.gov/articles/PMC7223417/