Is Bariatric Surgery Worth It? It May Increase Epilepsy Risk, Study Shows

With obesity rates in America on the rise (four in 10 have the condition), many people are looking for a long-term solution that leads to sustainable weight loss. Bariatric surgery, also called weight loss surgery or metabolic surgery, is becoming more common as a result — especially among women, who make up roughly 80 percent of patients. But do the risks outweigh the benefits? In addition to the known complications, including acid reflux, chronic nausea, stomach obstruction, and nutrient malabsorption, other potential risks are coming to light. A study published in Neurology found that people who undergo bariatric surgery may have a higher risk of epilepsy than those who don’t.

Understanding Bariatric Surgery

Bariatric surgery is an umbrella term for any surgery that alters your digestive system — with the goal of reducing weight and improving a person’s metabolic function. In general, this type of surgery treats obesity, but also helps treat diabetes, high blood pressure, sleep apnea, high cholesterol, and other obesity-related diseases. These are the five types of bariatric surgery.

Sleeve Gastrectomy

Surgeons remove 80 percent of the stomach until it resembles a shirt sleeve. This reduces the amount of food and liquid the stomach can hold — thereby decreasing hunger and increasing satiety. This procedure is technically simple and is a good option for patients with high-risk medical conditions, though it may worsen or cause heartburn. It is non-reversible.

Roux-en-Y Gastric Bypass (RYGB)

A surgeon cuts out most of the stomach and some of the small intestine. Then, the surgeon joins what’s left of the stomach (a small pouch) to the rest of the small intestine. This is a common surgery with a high success rate, but it is technically more complex and may cause vitamin and mineral deficiencies.

Adjustable Gastric Band (AGB)

A surgeon cinches the top of the stomach with an adjustable silicone band to limit how much food a person can eat. The AGB has the lowest rate of complications early after surgery. However, the band may need adjustments during the first year, weight loss is slower, and the band could cause stomach damage.

Biliopancreatic Diversion with Duodenal Switch (BPD/DS)

A surgeon removes most of the stomach until it resembles a shirt sleeve. Then, they attach the bottom of the stomach to a different part of the small intestine, much further along. (So, food bypasses most of the small intestine, which reduces the calories a person absorbs.) The scientific community considers a BPD/DS to be the most effective bariatric surgery for type 2 diabetes. However, it has slightly higher complication rates, and there is a significant risk of vitamin and mineral deficiencies.

Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy (SADI-S)

This is a newer variation of BPD/DS. Surgeons still remove most of the stomach and connect it to a different part of the small intestine. However, it’s a shorter procedure with fewer cuts.

A Look at the Neurology Study

Researchers from Western University in London, Canada, collected data on obese people in Ontario. They examined health records of 16,958 obese people who had bariatric surgery, and compared them to the records of 622,514 obese people who didn’t have the surgery. (The researchers excluded any participants who had a history of seizures, epilepsy, psychiatric disorders, or drug or alcohol abuse.) In addition, they followed the participants’ health records for three years.

Here’s what the researchers found: 73 people (0.4 percent) in the bariatric surgery group developed epilepsy in the three years following the surgery. 1,260 people (0.2 percent) in the non-surgery group also developed epilepsy. The study authors then adjusted that data for factors that could raise epilepsy risk, including diabetes and high blood pressure. Upon doing so, they found that people who had bariatric surgery were 45 percent more likely to develop epilepsy.

“While bariatric surgery is an effective treatment for obesity and obesity-related chronic conditions like high blood pressure and type 2 diabetes, our research found that bariatric surgery recipients have an elevated risk of epilepsy,” study author Jorge G. Burneo, MD, MSPH confirmed in a press release. It is not yet clear why this surgery could increase a person’s chances of epilepsy, but Dr. Burneo thinks doctors and patients should be aware of this risk.

Limitations of the Study

As with all studies, this research had its limitations. First, the authors collected data from the Ontario area only. In future studies outside of Ontario, the risk of epilepsy in bariatric-surgery patients may not be as high — or it may not be there at all. In addition, the researchers did not know the participants’ BMIs before, during, and after bariatric surgery. A higher BMI could indirectly raise a person’s epilepsy risk, so this factor could have influenced the study’s findings. Lastly, this study did not make it clear whether certain kinds of bariatric surgery increase epilepsy risk more than others.

Benefits of Bariatric Surgery

While bariatric surgery comes with risks — including a potentially higher risk of epilepsy — some scientists and doctors argue that the pros outweigh the cons for certain patients. For instance: A 2021 study found that bariatric surgery reduces ischemic stroke risk in both the short and long term. (An ischemic stroke occurs when a blockage cuts off blood supply to part of your brain and kills neurons.) And a 2016 study found that certain bariatric surgeries led to long-term type 2 diabetes remission for most participants.

Other benefits beyond weight loss include: no more sleep apnea, joint pain relief, better cardiovascular health, and potentially better mental health.

Bottom Line

This research highlights a potential risk that warrants the attention of patients and doctors alike. However, it doesn’t necessarily mean that you shouldn’t get bariatric surgery if you are considering it. Only you and your doctors can know whether bariatric surgery is the right route. The surgery may lead to severe complications in some cases, but in others, it could be life-saving.

This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.