We complete this 5 Part Series diving into our last topic of identifying surprising causes of weight gain after WLS. First we built our foundation in Part 1. Next we discussed an important gut function in Part 2. Identified our first negative bacterial shift in Part 3. Then discussed a form of bacterial imbalance called SIBO in Part 4. All contributing to weight gain.

Lastly, Part 5 is about a gut lining issue called leaky gut and it’s connection to weight.

What is leaky gut?

Your intestines(gut) are naturally semi-permeable. It’s designed to absorb nutrients, water and electrolytes from food. At the same time provide a tight barrier protecting you from harmful substances. This barrier controls what enters the blood stream.

To illustrate a healthy gut let’s visualize a rollercoaster track tightly lined with an army of troll dolls standing on both sides.

Do you remember those troll dolls with spiky colorful hair?

Well this rollercoaster would have each doll shoulder to shoulder, hair standing tall and no gaps between them. The troll dolls have strong bodies, vibrant skin, and thick full hair.

Now let’s see what happens in real life…

You go on vacation drink plenty of alcohol to celebrate, indulge in foods you wouldn’t normally eat, spend money you didn’t have, take medication to feel better and repeat day after day.

In fact, you look back and it’s been 3 months since vacation and you are still in this pattern.

Now let’s reevaluate your gut….

The rollercoaster track tightly lined with troll dolls now have dolls sitting, passed out & completely missing creating gaps!

No longer is their hair standing tall, it’s thin & bald in places. They look tired, weak and malnourished.

These gaps are allowing whole food particles, medications and toxins to pass right into your blood stream.

This is leaky gut!

Signs of leaky gut

Leaky gut comes with a variety of symptoms, some very similar to the “weeds” we discussed in Part 3. In addition, don’t forget SIBO causes leaky gut like we revealed in Part 4 making it difficult to identify the root cause of your symptoms.

Typically the most common signs are:

• Increased food & environmental sensitivities and allergies
• Vitamin & mineral deficiencies
• Digestive issues such as gas, burping, bloating, constipation & diarrhea
• Brain fog and difficulty concentrating
• Hormone issues
• Mood issues such as increased depression and anxiety
• Diagnosed with an Autoimmune disease

I’m sure you are wondering what causes leaky gut?

Common causes of leaky gut

An important understanding is research defines leaky gut as intestinal permeability. In this situation increased intestinal permeability would indicate leaky gut.

There are a few factors that are believed to play a role in the development of leaky gut:

• Excessive sugar & alcohol intake
• Stress
• Vitamin deficiencies
• Poor gut health
• Longterm use of NSAIDs
• Yeast overgrowth

In many studies obese individuals have a higher rate of increased intestinal permeability compared to non-obese.

Naturally you may be thinking, what happens after WLS?

Leaky gut after WLS?

First, one study demonstrated improved intestinal permeability & tight junction integrity 10 weeks after surgery. Reducing the risk of leaky gut. It would be interesting to see if there were changes at 6 and 12 months after surgery.

Second, another study found a pronounced increase in intestinal permeability after gastric bypass.

Although the evidence of improved gut barrier integrity can be seen after WLS, the reality that it’s maintained long-term would be unlikely. In fact, one stressful event can be at the root of leaky gut.

Leaky gut treatment

This is where a skilled practitioner can help get to the root of weight gain. Are your symptoms the result of leaky gut, dysbiosis or SIBO?

If working with an experienced practitioner he/she may be able to identify the root cause based off a combination of symptoms, but typically will require a thorough evaluation and tests.

There are several approaches to healing a leaky gut, but essentially requires supplements to “seal & heal” your gut in combination with diet & lifestyle changes.

It comes down to the 4 R approach in functional medicine:

• Remove
• Reinoculate
• Replace
• Repair

Healing a leaky gut requires repairing the gut lining with a single or combination of products like zinc carnosine, L-glutamine, butyrate, vitamin D, NAC, colostrum, mucin, aloe, DGL, specific probiotic strains & species and prebiotics.

Most importantly, your practitioner can help determine the best supplements based on your health history and symptoms.

To conclude this 5 part series, hopefully you have been exposed to some “out of the box” ideas on how to approach your health. Functional medicine offers a bigger tool box in treating chronic health conditions. In fact, gut health is at the root of most health conditions. As a result, focusing on healing and optimizing your gut health can boost your mood, motivation, and energy.