Hair Loss and Bariatric Surgery

By: Laura Greaney MSN Nutritionist

One of the concerns of patients before having bariatric surgery is if they are going to experience hair loss. Unfortunately it is not something that is easily predicted. The safest guess is to assume you may lose a little hair. Your hair has two phases that it goes through, the anagen phase and the telogen phase. The anagen phase is your growth phase and your hair is in that 90% of the time. The telogen is your resting/dormant phase which lasts 10% of the time until it falls out. As you could guess, your hair is normally growing way more than it is losing so you generally don’t notice hair falling out. However, there are a number of things that can disrupt these phases. Undergoing any surgery can cause a shift in the telogen phase, but bariatric patients are at an even higher risk.

Although your hair may be extremely important to you, your body does not feel the same way. When undergoing extreme changes, the body will take nutritional storage from certain areas and give it to your vital organs. Sorry to say but it is more important for your brain and heart to receive adequate nutrition than your hair. After weight loss surgery your hair will transfer into what’s medically referred to as telogen effluvium. This is caused by stressors that will cause an increase of telogen hairs. During telogen effluvium the actual hair follicles are not damaged so the hair should return to normal within a few months. The normal span that hair is in the telogen phase before falling out is 100-120 days. Stressors that may cause an increase of hair to the telogen effluvium phase include: major surgery, infection, fever, chronic illness, hormonal disruption, acute weight loss, crash dieting, anorexia, decrease in protein as well as iron and zinc deficiencies. According to an article from St. Luke’s Bariatric Services, anesthesia can also cause a 30% increase of hair to move into the telogen phase. If you take away nutritional deficiencies, bariatric patients are at risk of hair loss due to anesthesia, major surgery, rapid weight loss and modified anorexia (due to great restriction for the first few months). These factors should not contribute to hair loss after your body is able to return to normal, roughly 6 months after surgery.

What if your hair loss continues after 6 months? If your hair continues to thin or fall out after 6 months then you may be looking at a nutritional factor as the cause. You can normally spot this if your hair loss continues to happens 1 year after surgery, started 6 months after surgery, not taking vitamins and supplements as recommended, and decreased levels of zinc, iron and protein. One of the first things you want to remember is to take your vitamins as advised. Remember, having low levels of iron is greatly correlated with hair loss. Furthermore, if you are not getting in enough protein, this will contribute to hair loss as your hair is mostly made of protein. The risk of not getting in enough protein after surgery is high due to your restriction, which is why it is essential to remain on protein drinks until being instructed to stop. A bariatric patient should be striving to finish 60-75g of protein daily. Blood work after surgery will also be imperative to rule out any deficiencies.

Hair loss is one of the concerns of people undergoing bariatric surgery. Unfortunately, there may not be much that you can do to prevent it. You have to weigh out the good and the bad, rapid weight loss or a little hair loss for the first six months. Some people will recommend taking biotin however there is no scientific evidence that supports biotin helps hair regrowth or prevents hair loss. As long as you get in adequate protein and take your vitamin supplements, any hair loss will be a minimal fear compared to the benefits of living a healthier life.

Obesity Action Coalition: ‘Weight-Loss Surgery, Nutrition and Hair Loss’ By Jacqueline Jacques ND
St Luke’s Bariatric Services: ‘Bariatric Surgery and Hair Loss’ By Dorothy McFadden RD, LDN

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