The Unspoken Cons of Gastric Bypass

Gastric bypass is probably one of the greatest crimes committed against Baby Boomers in medical history. I feel it is an atrocious option for weight loss due to the cons of gastric bypass that get swept under the rug. Clinicians who recommend it ignore the body’s weight loss chemistry.

Even worse, once the surgery was over patients were abandoned. The typical surgical package includes a year of follow-up. Once those 365 days are over, the surgical team disappears. click to read Patients are left with their new rerouted anatomy and severe nutrient malabsorption problems. Patients are entirely on their own as they attempt to manage the medical consequences of bypass surgery. On. Their. Own.

These obese patients entered surgery with ‘inflamed brains’ from years of high insulin and no ketones. Insurances will not pay for this surgery until the patient spends years carrying over 100 extra pounds.  It guarantees their inflamed brain combined with malnutrition.

They underwent major surgery. No matter what label the surgery team used, mini-bariatric or sleeve bypass or gastric banding, there’s no denying this type of surgery is major. This procedure added more inflammation and trauma to already burdened and unhealthy patients.

Next, they undergo a year of post-surgery starvation. It injures the patient’s body and brain anew. With starvation-based weight loss in full swing, the year following surgery is often remembered by the patient as a cloudy, dark, and depressed time.

These patient are expected to attend classes to master the advanced science behind their surgically induced, lifelong malabsorption problems. Years after this crime-of-a-surgery, patients suffer from extreme depression, wilted immune systems, tingling or dead nerves and diarrhea with most meals.

They had no idea their gastric bypass was destroying them one day at a time. The majority of them continue to struggle with significant obesity after having spent upwards of $50,000 for this procedure.

Problems Found After These Surgeries
The following nutrients are no longer absorbed correctly after surgery:

  • Thiamin, Pyridoxal Phosphate, Folate
  • Vitamin A, Vitamin K, Vitamin D, Vitamin B12
  • Omega 3 and Omega 6
  • Magnesium, Phosphorus, Potassium
  • Selenium, iodine
  • Zinc, Copper, Iron,

Copper and zinc levels do not return to normal causing hair loss, poor immunity, anemia and poorly functioning nerves and muscles. Surgery removed the section of their gut that’s responsible for absorbing iron and many of the listed compounds above.

After surgery, these nutrients slowly decrease. Years later, gastric bypass patients live with brain fog, low energy, thinning hair, and slower disease recovery. This malnourishment is PREDICTABLE and PREVENTABLE.

If you’ve had gastric bypass, PLEASE follow up annually with your doctor to measure these nutrients. It is VERY IMPORTANT.

Thanks to the high-density nutrients found in keto-compliant foods, bariatric bypass patients can overcome the nutrient deficiency caused by their surgery. I insist my weight loss patients add two nutrient-dense foods to their menu: liver and sardines. For real!

I show them these charts on the following page. Look carefully at the rows for sardines and liverwurst. These two food items solve a lot of deficits.

Let me expand on the reason I encourage patients to develop a taste for liver. Iron builds healthy brains. When patients present in a brain fog, I first check to see how much iron circulates within their system. Iron provides one of the primary starting points to make our brain hormones. To make serotonin, norepinephrine, dopamine, and GABA the patient needs iron to begin.

Iron studies of thousands of patients over the last 20 years have taught me to look at their iron first. Specifically, ferritin level less than 20 guarantees the patient will not get better until I fix that problem.

We Replace Iron in Two Ways. Elemental Iron or Hemoglobin Iron.
Elemental iron refers to iron that comes from the soil. If you are eating vegetables that are toted as a source of high iron, the type of iron those foods deliver to your system is elemental iron. The plants obtained iron through their roots grabbing the iron found in our soil.

Elemental iron, commonly used in vitamins or supplements, follows an absorption rule that catches 1 out of 10 iron particles that pass by the intestinal area that absorbs iron.

When using a tag to observe how much iron is absorbed, elemental iron has one particle out of 10 that is absorbed into our circulation. It is consistent with the side effect that iron causes constipation. You know this to be true if you’ve ever started taking iron supplements. Start taking 1-2 iron replacement tablets per day. Within 2 to 3 days you will find your stools are much darker. Along with those dark stools, you will see that unfortunate side effect of constipation.

Hemoglobin-Based Iron
Conversely hemoglobin-based iron is iron found with several hemoglobin proteins surrounding the iron element.

Hemoglobin is added to the iron mineral allowing it to enter the creatures circulation. Who ’s circulation? It doesn’t’ matter if the iron came from a cow, or a pig, or a duck, or a moose, or a fish. All of them added hemoglobin to that element of iron. When we eat these foods, we have the chance of absorbing iron as part of our nourishment.

The absorption rate for hemoglobin-based iron is far superior when compared to elemental iron. Hemoglobin-based-iron adds 9 out of every ten swallowed. Almost the exact opposite of what happened with elemental iron. Replace someone’s iron with a supplement, and you will cause many weeks of constipated side effects trying to boost their numbers. Use hemoglobin-based iron, and the task becomes more attainable.

Most patients with iron deficiency present to the clinic with failing health. They are tired, weakened immune systems and a brain that seems sluggish. Also, their gut was unable to keep up with the ideal absorption rates. These ideal absorptions rates of 1 out of 10 elemental iron or 9 out of 10 hemoglobin iron apply to those patients with normal absorption.

Using the ideal absorption numbers, I calculated out how many tablets of iron supplements is found in a tablespoon of a liver. It took more than 20 tablets of iron supplements to equal 1 tablespoon of iron found in liver.

A tablespoon of liver improves the deficit of iron far greater than a handful of iron supplements. When asking someone with a gastric bypass to absorb iron, it is nearly impossible to meet the demands of their body through supplements. Copper and zinc are also absorbed in the same section as iron. All three of these must be adequately replaced for their body and brain to flourish again.

If you want your system to operate at peak performance, you need to nourish it properly.

Use These Charts To Inspire Your Shopping List:

If you want to learn more about the ketogenic diet, check out the book ANYWAY YOU CAN on Amazon or Audible by Annette Bosworth, MD.


  1. Kratz, Mario, et al. “The Relationship between High-Fat Dairy Consumption and Obesity, Cardiovascular, and Metabolic Disease.” European Journal of Nutrition, vol. 52, no. 1, 2012, pp. 1–24., doi:10.1007/s00394-012-0418-1
  2. Ness, A. “Diet, Nutrition and the Prevention of Chronic Diseases. WHO Technical Report Series 916. Report of a Joint WHO/FSA Expert Consultation.” International Journal of Epidemiology, vol. 33, no. 4, 2004, pp. 914–915., doi:10.1093/ije/dyh209
  3. Nestle, M. “Mediterranean Diets: Historical and Research Overview.” The American Journal of Clinical Nutrition, vol. 61, no. 6, Jan. 1995,  doi:10.1093/ajcn/61.6.1313s
  4. Mechanistic and regulatory aspects of intestinal iron absorption; Sukru Gulec, Gregory J. Anderson, James F. Collins; Am J Physiol Gastrointest Liver Physiol. 2014 Aug 15; 307(4): G397–G409. Published online 2014 Jul 3. doi:10.1152/ajpgi.00348.2013  PMCID: PMC4137115

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