Can people lose too much weight following weight loss surgery, When should worry?

A general rule of thumb is that one loses 1-2 lbs for the 1st month. If you are over 400lbs you will lose more like 2lbs less than that more like a lb a day. The second month more like a 1/2 lb a day. If you vomit each time you eat say at 3 months after surgery & you are chewing your food well, something is clearly wrong you should see your surgeon immediately. At this point an upper endoscopy would be in order. Barium swallow is also ok. I prefer endoscopy because during the same sitting a balloon which stretches outlet can be inserted. Sometimes this will fix the problem. If this problems after 5 attempts of stretching, most experts would recommend revision of that anastomosis(hook up of the small bowel to the pouch) If the original surgery was a gastroplasty(VRG) also known as vertical banded gastroplast(VBG) or lap band procedure removal of the band with conversion to gastric bypass is in order. We dont recommend simple removal of the ring or band since this will make the patient regain weight. If one is severly malnourished, the patient may be fed through a percutaneoulsy place feeding tube if a radio opaque marker was placed at the original surgery over the bypassed stomach. All of our patients get this marker at the original surgery. If not the patient may be fed through a IV for at least 2 weeks. If one chooses not to have surgery in the face of excessive weight loss one could die from starvation. As a rule of thumb, one should always call the original surgeon if possible. It is good medicine. If one is not getting the right answers or corrective options then, clearly a second opinion is in order

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