Although she had been under nutritional supervision for two years when she noticed she was gaining weight, 29-year-old Adryelle Jessica Bomfim reached 145 kilograms. Upon medical advice, the minibar replenishment supervisor decided to undergo bariatric surgery.
What seemed to be a successful journey against obesity turned into a nightmare during the post-operative period. Two weeks after the procedure, the incision on her chest completely opened up.
“I could see everything inside. I had an infection in the incision, the doctor prescribed antibiotics, and still, seroma started leaking from it. I lived for almost two months with this fluid leaking, having to use sanitary pads because there was no gauze that could stop it. It smelled really bad,” she recalls.
In addition to the issue with wound healing, during the first three months after bariatric surgery, Adryelle couldn’t keep any food inside her body, even though she strictly followed the post-surgical diet.
“It was during this period that I regretted it a lot because I had no life anymore. I vomited and had a lot of diarrhoea almost every day. At that moment, I had to have my family by my side all the time because I thought I wouldn’t live anymore,” she remembers.
When she sought emergency care, Adryelle was told that what she was experiencing was normal because it was part of her body’s adaptation. At other times, she was told that the vomiting and diarrhoea were her fault because healthcare professionals doubted that she was following the post-bariatric diet strictly.
Adryelle decided to consult a doctor covered by her health plan to understand what was happening to her. She found out that she had gastrointestinal and renal infections. The doctor advised her to seek the surgeon who had operated on her through the public health system because she was still in the waiting period for her health plan.
“Afraid of going back to the hospital, I spent two days without being able to eat, with a lot of diarrhoea and vomiting. When I was lying down, I started to have fever and seizures. So, I went to the doctor,” she says.
During her hospitalisation, it was found that the supervisor had an infection in the intestine and kidney, and her rib had been fractured since the surgery. She was treated with intravenous antibiotics for three days, and upon discharge, she needed to receive injections that helped in the healing of her rib.
“Before the surgery, I had kidney stones. However, after bariatric surgery, I discovered an organ malabsorption,” Adryelle says. This issue might require Adryelle to reverse the surgery, but it’s not certain yet. For now, her condition is stable.
Difficulty in absorbing vitamins
One of the most challenging consequences of bariatric surgery is the body’s difficulty in absorbing nutrients and vitamins.
“Bariatric surgeries induce programmed malnutrition to a level that leads to weight loss and attempts to prevent weight regain. Fine-tuning this balance is sometimes quite difficult through diet. Patients need to supplement some nutrients and vitamins for their entire life,” explains endocrinologist Bruno Geloneze, a member of the Brazilian Association for the Study of Obesity and Metabolic Syndrome (Abeso).
One of the nutrients that a person might have difficulty absorbing is iron. “This problem arises due to anatomical and functional modifications of the digestive tract, and patients have greater difficulty ingesting meat after surgery,” clarifies the specialist.
The lack of iron combined with reduced absorption of folic acid and vitamin B12 makes anaemia more likely, as it happened to Adryelle after three months of undergoing bariatric surgery.
“Now, at eight months, my B12 and ferritin levels are low, and I have to supplement these vitamins intravenously to prevent anemia again,” says the supervisor.
Some people also have deficiencies in proteins, zinc, and vitamin D, increasing the risk of osteoporosis. In this disease, a person undergoes a progressive loss of bone mass and has a higher risk of fractures.
“It’s worth noting that people with obesity may have nutritional deficiencies before surgery and should be adequately guided and treated before being operated on,” emphasises Bruno Geloneze.
“I wouldn’t do it again”
After eight months of bariatric surgery, Adryelle has lost 43 kilograms and managed to overcome the infections from the early post-operative period. Her rib has healed, and the kidney problem is under control. Still, the supervisor says she wouldn’t go through it all again to lose weight.
“Today, I don’t feel the regret I had at the beginning. However, I wouldn’t go through it all again, even doing bariatric surgery for health reasons. I never thought about doing it for aesthetics,” she emphasises.
Adryelle’s case serves as a reminder of the importance of healthcare professionals discussing the pros and cons of bariatric surgery with obese patients so that the person can prepare comprehensively.
Moreover, it is essential that surgical intervention is not prescribed for all cases of obesity as the quickest way to lose weight.
“The benefits of bariatric surgery outweigh the risks in well-indicated surgeries. Operating on people with fewer health problems (less weight as well) may result in a lower risk of complications. But these patients should not be the preference for surgical procedures, as they can be treated clinically and pharmacologically,” points out Bruno Geloneze.
The endocrinologist also adds: “Patients with higher body mass index have a higher chance of perioperative complications. However, these same patients are those with the greatest benefit in intense weight loss.”
According to the Brazilian Society of Bariatric and Metabolic Surgery (SBCBM), obesity affects 6.7 million Brazilians. In 2022, 863,086 people were diagnosed with morbid obesity or body mass index (BMI) grade III, a condition where bariatric surgery can be a significant aid for significant weight loss.
The World Health Organisation defines obesity as a chronic, progressive, recurrent disease. The condition is considered a global epidemic.
This article was syndicated from Marie Claire Brazil
Translated and adapted by Praise Vandeh, Marie Claire Nigeria Content Writer