How to manage this crucial issue after significant weight loss.
Hair loss after rapid weight loss, as in bariatric weight loss surgery, is very common and can be stressful. Of course, we all want to achieve great weight loss results and still have great hair.
Why Hair loss with Weight loss?
Whether you are aware of it or not, you are always in the process of both losing and growing hair. Human hair follicles have two main stages: anagen (growth phase) and telogen (resting phase).
The growth phase is called anagen. 90% of our hair follicles are in this phase at any given time. All hairs begin in the anagen phase; they grow for a period of time and then shift into the telogen phase, which lasts about 100 days. Following this, the hair will fall out.
The resting phase, called telogen, lasts about 1 to 6 months, with an average of 3 months. About 5-15% of our hair is in the resting phase at any given time. It is also known that telogen effluvium has to do with stress to the body and hormonal changes that can occur. This means we are usually losing less hair than we are growing, so it is not noticeable.
Due to the stress, more hair follicles can enter into the resting phase. This is important because the hair in the resting phase at the time of surgery is most likely the hair you will shed. This is why your hair sheds between 1 to 6 months after surgery (usually about 3 to 4 months).
The hair loss associated with weight loss usually starts abruptly and very seldom lasts longer than 6 months.
Hair Loss Has Many Causes
The most common type of hair loss after weight loss surgery is telogen effluvium. This can have nutritional and non-nutritional causes. Stress on the body can move more hair into the dormant phase, which means a higher percentage of hairs falling out. Stress on the body can come in many forms, such as fever, infection, surgery, weight loss, deficiencies and some medications.
Common Reasons for Hair Loss After Bariatric Surgery
- Surgery, acute illness, trauma
- Chronic diseases such as liver disease or any chronic debilitating disease
- Hormonal imbalance such as hypothyroidism
- Crash dieting, low protein intake, anorexia, chronic iron deficiency
- Heavy metal toxicity
- Medications such as beta-blockers, excess vitamin A and anticoagulants
What is research telling us?
Hair loss is common after metabolic and bariatric surgery especially in younger women, and those with low serum levels of zinc, folic acid, and ferritin.
Top Tips for Minimising Hair Loss After Bariatric Surgery
- Eat a variety of healthy, nutrient-rich foods each day
- Take vitamin and mineral supplements as recommended by your Bariatric Surgeon, bariatrician or Bariatric Dietitian
- The recommendations are
- Biotin 1000micrograms/day
- Iron+Zinc + Folic Acid
- Ensure your post-surgery diet contains adequate protein
- If you have hair loss that continues for more than 12 months post-surgery speak to your Surgeon, bariatrician, or Dietitian about the adequacy of certain nutrients in your diet
- Hair Loss after weight loss is generally temporary.
- It is more common in younger women.
- Avoiding nutritional deficiencies can reduce hair loss.
1. Hair Loss After Metabolic and Bariatric Surgery: a Systematic Review and Meta-analysis. Obes Surg. 2021 Jun;31(6):2649-2659. Doi: 10.1007/s11695-021-05311-2. https://pubmed.ncbi.nlm.nih.gov/33675022/
2. Ledoux S, Flamant M, Calabrese D, Bogard C, Sami O, Coupaye M. What are the micronutrient deficiencies responsible for the most common nutritional symptoms after bariatric surgery? Obes Surg. 2020 May;30(5):1891-1897. doi: 10.1007/s11695-020-04412-8. https://pubmed.ncbi.nlm.nih.gov/31960214/
3. Ruiz-Tovar J, Oller I, Llavero C, Zubiaga L, Diez MA, Arroyo A, Calero A, Calpena R. Hair loss in females after sleeve gastrectomy: predictive value of serum zinc and iron levels. Am Surg. 2014 May;80(5):466-71. doi: 10.1177/000313481408000517 https://pubmed.ncbi.nlm.nih.gov/24887725/
If you find this topic interesting, you might also like to watch my YouTube video: 7 Strategies to Avoid Weight Regain after Gastric Sleeve Surgery
Helping You Discover, Empower & Prosper
Dr Arun Dhir | GI Surgeon, Health Reformist & Passionate Educator.
About Dr Arun:
Besides having a busy private practice at Melbourne Gastro Surgery – Centre for Weight Loss, Dr Arun is an active member of the ANZ Association of Gastro-Oesophageal surgeons (ANZGOSA), ANZ Society of Metabolic and Obesity Surgery (OSSANZ) and Australian College of Nutrition and Environmental Medicine (ACNEM).
Dr Arun is also a senior lecturer (University of Melbourne) and yoga and meditation teacher, with a strong interest in the mind-body-gut connection. He regularly writes and speaks about gut health, gut microbiome, obesity, gastrointestinal surgery and healing. Arun’s published works include Happy Gut Healthy Weight (Balboa Press 2018), Creating a New You – Health Journal (Metagenics 2019), and Your Mess Has a Message (2021).