Bariatric surgery is known to cure diabetes, high blood pressure, sleep apnea and low back pain in at least 70 percent of the people who have it.

And in 2001-2002, when these data were collected, 40 percent had a postoperative visit–within 180 days– to the hospital with a “complication (through readmission, outpatient hospital visit, or emergency room visit).”

The improvement in symptoms and need for medicines is even true for lap band patients, whose quality of life goes way up.

So has bariatric surgery changed a great deal in 5 years? You bet. The patients referred to me in Santa Barbara are not just those with undiagnosed omega-3 fatty acid deficiency, Vitamin B12 deficiency and clear weight re-gain, although they still are most of them.

They’re people who never learned how to eat post-operatively, despite the good graces of a 90 day post-op period, Centers of Excellence, and willing clinicians.

The problem is simply this: most people do not know what is in what they eat. And many people with gastric bypass shop by calorie, not by nutrients. And calories are cheap.

If only these patients knew that food was their new medicine; learned how to separate wanting to eat from being hungry; eat solids separate and apart from liquids; eat protein-rich foods first. Then, we’d see post-op complications plummet, and with them, health care costs.

Until there is better information about what’s in what we eat, and consumers have clear choices about post-op programs, the surgery may be a success, but the patient will not be.