Hair Loss After Bariatric Surgery

Sep 23rd, 2018 Written by a Staff Member of Hair Loss in Women

According to Dr. Wiljon W. Beltre, Bariatric Surgeon at Center for Metabolic Obesity & Surgery in Altamonte Springs, Florida, hair loss after bariatric surgery is common, occurring in around 40% of all patients. It happens for several reasons.

The first is because the emotional, hormonal, and physical stress of surgery can make your hair shift from the anagen (growth phase) to the telogen (resting phase). Hair in the telogen phase will shed more easily.

The second reason for hair loss after bariatric surgery is nutritional deficiency. After surgery, bypass patients have a drastic reduction in their vitamin and mineral intake, which can affect the hair. The body will prioritize where to send limited nutrients, sending them to the internal organs before the hair. This is why hair loss is less common in patients who have undergone gastric banding or gastic sleeve because there’s less calorie restriction with these methods.

The third reason for hair loss after bariatric surgery is that weight loss. Weight loss can affect hormone levels, which can cause hair loss as well.

Patients experiencing hair loss after bariatric surgery generally start losing their hair 3 to 6 months after surgery. The good news is that the hair will return to pre-surgery levels 12 to 18 months after surgery.

To avoid or reduce hair loss after bariatric surgery, follow the diet that your bariatric surgeon has prescribed, and contact your doctor if you have any concerns. As hair is mostly protein, the minimum recommended daily intake of protein is generally 60g per day, but many surgeons will recommend 80g for women and 100g for men.

Recommended Diet After Bariatric Surgery

The University of California San Francisco recommends the following diet:

Immediately After Surgery

You will begin with a clear liquid diet, and gradually start adding thicker liquids after you’re discharged from the hospital.

Two weeks following surgery, you can move on to blended and puréed foods. At this point you can start consuming high-protein (more than 20 grams), low-calorie (less than 200 calories) smoothies to meet your protein requirements during this period.

Remember that the size of your stomach has reduced drastically — it’s now the size of an egg. The opening that allows food to pass out of your stomach is also very small, so you’ll have to take only 2 or 3 sips or bites at a time, then wait for 10 minutes before you eat any more. If you eat too quickly, or too much, you might experience pain or even nausea.

At this point, you are to avoid rich, creamy liquids like ice cream, gravies, and sauces.

Diet in the Hospital

You’ll be consuming clear liquids such as juices, Jell-O and broth as your first meal following surgery. Juice and Jell-O are high in sugar content, but your portions will be very small at this stage. Gradually increase the amount you drink at each meal as you can tolerate it.

Diet for the First Two Weeks Post-Surgery

You’ll begin adding thicker liquids that are high in protein and low in fat and sugar, such as protein drinks and smoothies. Begin with 1 tablespoon and increase to 2 tablespoons as it becomes more tolerable. Over time you’ll be drinking 1/4 cup at a time and increase to a 1/2 cup as tolerated. Your daily caloric intake should not exceed 400 calories.
It is also very important to stay well hydrated. Drink 1 to 1.5 liters of water per day.
Other options for thicker liquids include nonfat or 1% milk, sugar-free nonfat yogurt or pudding, low-fat soups or broths, cream or wheat or cream of rice (but not oatmeal), and low-fat cottage cheese.
In order to increase your consumption of protein, add 2 tablespoons non-fat dry milk powder, egg substitute or powered egg, or a protein powder to each 1/2 cup of nonfat or low-fat milk, or to soups, hot cereal and other thick liquids.
Remember to drink 1 cup of water between meals. In order to get enough nutrition, take a multivitamin every day.

Diet for Weeks Two to Four Post-Surgery

At this point you can begin to add very small amounts of puréed and soft foods as tolerated. This could include canned fruits, canned fish, yogurt, applesauce, tofu, lean ground meats or poultry, well cooked, puréed vegetables, scrambled eggs or egg substitute, or noodles. Avoid bread and meats that you can’t chew easily.
Take very small bites and chew everything very well. Do not take more than two bites every 20 minutes when adding a new food.

Recommended Meal Plan For Weeks Two to Eight Until Two Months Post-Surgery

By this time, your caloric intake should be no more than 500 calories a day, and you should be eating 6 to 8 small meals. Your portion sizes should be 1/4 cup for solids and 1/2 cup for liquids.
Continue drinking 1 cup of water or other non-caloric fluids between meals, as well as taking a multivitamin every day, plus additional iron if required, and calcium and vitamin D supplements two to three times per day.

Recommended Meal Plan for Two to Six Months Post-Surgery

You can now consume 900 to 1,000 calories per day, with at least 65 to 75 grams of protein. For balanced nutrient intake, your daily servings should include 3 servings of non-fat and low-fat milk and dairy products, 3 servings of lean and low-fat meat or meat alternative, 2 servings of well-cooked vegetables, 3 servings starch (limit bread and rice), 1 serving fruit (avoid dried fruits and fruits with skin).
Recommended portion sizes are 1/4 cup for solids and 1/2 cup for liquids.
At this point you should discontinue taking high-protein liquid supplement drinks or powders if possible, getting your protein via food.
You may wish to eat more or less often, but be sure to eat at least six times each day.
Continue taking 1 cup of water between meals, a multivitamin, and an iron supplement if you need it. You should also be taking a calcium and vitamin D supplement 2 to 3 times per day.

Long-term Dietary Guidelines

Over time, you’ll be able to increase the variety and consistency of foods in your diet. Some foods may continue to be poorly tolerated, including red meats, chicken, bread, and high-fiber fruits and vegetables. Focus on low-fat, low-sugar and low-calorie foods and continue to count your calories every day. Try to meet your serving goals for all food groups based on the 900 to 1,000 calories diet plan described above.

Drink at least 2 liters of water or non-caloric fluids daily, unless this is contraindicated due to a medical condition.

Signs That You’re Nutritionally Deficient

According to Dorothy McFadden, RD, LDN Bariatric Dietitian, you may be not getting enough nutrition if your hair loss continues more than one year after surgery, or if your hair loss didn’t start until six months after surgery. Additionally, if your blood work indicates low levels of ferritin, zinc or protein, and if you have difficulty tolerating protein-rich foods and vitamin and mineral supplements. Post-op blood work is typically done at 6 weeks, 6 months and annually after bariatric surgery.

Have you undergone bariatric surgery? How long did it take for you to regrow your hair? Was there anything you did that helped regrow your hair? Leave a comment below.