Bariatric surgery is a very complex and invasive procedure. However, thanks to regular medical advancements in the field, this weight loss surgery is getting safer and safer each year. 

In a recent study, Stanford University researchers looked at the outcomes of nearly 270,000 weight loss surgeries to calculate just how safe it is. 

What they found was that for the most common procedure, a sleeve gastrectomy, less than 1 percent of patients ended up in the ER within 30 days of the surgery.

That’s not too bad, is it? 

Of course, that still means there is a chance that something serious could happen after your bariatric surgery. Thankfully, there is a lot you can do to stop this from happening to you. Yeah, this is the one instance where you don’t want to be in the one percent.

Read on to find out the top 7 reasons bariatric surgery patients get sent to the ER after their procedure and what you can do to prevent them.

1. Dehydration

With just the mention of “emergency,” I’m sure your mind is already racing to the worst possible complications. But the reality is, one of the primary reasons that bariatric surgery patients are sent to the ER is dehydration. 

Why is this? Often, the reason behind this is that one of the most common side effects after surgery feeling nauseous, which can make it extremely difficult to consume liquids. 

Not only does this lead to dehydration, but it can also cause electrolyte abnormalities. On top of nausea, electrolyte imbalance can lead to a number of other symptoms including headaches, confusion, irritability, and fatigue.

In more extreme cases it can also lead to muscle cramping, vomiting, and diarrhea, which is what sends people to the hospital.

What can you do?

Obviously, to prevent this, you’re going to want to drink plenty of fluids. Though not all fluids are created equal. 

The best course of action is to seek out fluids that contain electrolytes. You can find them in common drinks like Gatorade and Powerade, though these typically come with a high amount of sugar. 

My personal preference is to try an electrolyte powder like Ultima, which does not include any added sugars. 

A more natural option is to mix water with lemon juice and Himalayan pink salt. 

Best of all, I recommend having bone broth, which not only will improve your electrolyte balance, but also contains healthy fats and collagen, which help with the healing process after surgery. 

Regardless of the option you chose, you should take small sips frequently throughout the day. 

If nausea is a problem, consider talking to your surgeon about a prescription for sublingual Zofran tablets. These can help take the edge off nausea so you may have a better time tolerating oral liquids.

2. Hypoglycemia

Another common cause that sends bariatric patients to the ER are complications that come with diabetes. 

It is important that you communicate closely with your doctor about your medications for chronic diseases like diabetes.

This might seem surprising since one of the reasons many undergo weight loss surgery is specifically to help reverse diabetes. 

That said, it is important to be aware of the changes that the surgery can have. If you are taking insulin or glipizide, you might be at risk for hypoglycemia. 

You need to keep close track of your blood sugar and your diabetes medications. I typically suggest a continuous glucometer as the best way to stay on top of sugars, especially during times that they may fluctuate.

To stay safe in the weeks after surgery, you should maintain close contact with your doctor to adjust your doses of medication as necessary.

3. Low Blood Pressure

It is also important to keep an eye on post-bariatric surgery complications related to your blood pressure levels. 

As mentioned above, it is crucial that you discuss the impact of the surgery on your blood pressure. For example, if you are on blood pressure medications, your blood pressure may go down as you lose weight.  

This is great, because it means that your hypertension is getting better.  But, this could cause your blood pressure to get too low if you keep taking the same doses of blood pressure lowering medications. You should keep in close contact with your doctor and regularly measure your blood pressure so you can make adjustments as needed. 

4. Eating Too Much

I’ve seen several cases of people who have serious complications in the days after bariatric surgery because they advance their diet post-surgery too quickly and eat far too much. 

In extreme cases, this can cause perforation of your stomach and lead to a surgical emergency. It is very important that you follow the post-operative diet directions, including consistency and amount, very closely, especially in the first few months after surgery.

5. Blood Clots

After surgery, you should not be staying in bed. You need to get up and walk as frequently as possible. 

It may feel like a challenge to get up and walk, but I can assure you, it’s worth it. The human body loves to move and laying in bed is very dangerous. It can lead to blood clots and even pneumonia. 

Your surgeon will likely encourage you to get out of bed and walk on the day after surgery. This is important to get the blood moving in your legs and also allows your lungs to function normally. 

When I had my surgery, I spent about 24 hours in the hospital, and during that time I took a lap around the surgical ward every hour that I was awake. 

It was definitely not fun, but it was necessary. 

You should continue this once you get discharged. Don’t sit on the couch all day while you’re recovering. 

I’m not saying you should do strenuous activity right after surgery, but you should be moving around. 

6. Not Taking Care Of Wounds

Another dangerous and painful complication of bariatric surgery is if your sutures (stitches) get infected.

To prevent this, be sure to follow your doctor’s instructions about care of your surgical wounds. You will have incisions on your abdomen, and these need to be kept clean, dry, and uncontaminated. 

You should follow your surgeon’s advice on this to stay safe.

In an unusual but necessary note: Going in the hot tub while your wounds are healing is a very risky activity since it can expose your wounds to bacteria that can cause infection

7. Traveling Too Soon After Surgery

For medical tourists, please do not leave your destination early. 

I’ve seen too many cases of medical tourists who go home—against their surgeon’s advice—right after surgery. Sometimes even with the drains in place!

If you do this, you are setting yourself up for trouble. 

It is very important to stay where your surgeon is for as long as they recommend. They need to evaluate you post-operatively, and conduct tests. If you jump in the car or on a plane right after surgery, you’re putting yourself at serious risk.

I had my vertical sleeve gastrectomy done in Mexico through a medical tourism facilitator. This company had done its research and included a mandatory hotel stay for three days after the procedure. I took that time to rest and even shop for souvenirs.  

When shopping around for a medical tourism facilitator for your procedure, be sure to keep this in mind. 


Getting bariatric surgery can be one of the best decisions you can make in your life. It certainly was for me. 

… Or it can turn out to be one of the worst decisions you’ve ever made if you end up with a complication. 

Sometimes things happen out of the blue, but as you can see from the above, in most cases the complications that may arrive after going through weight loss surgery are entirely preventable. 

All it takes is a bit of research and preparation. Be sure to share as much relevant information as possible with your surgeon. And whenever you are in doubt about something, ask!

This procedure is not magic, it will not change your life overnight. But if you take the time to recover properly and take care of your diet in the days that follow you can see incredible results.