By now, you've probably heard about Al Roker's unfortunate bathroom-related incident at -- of all places -- the White House. Perhaps almost as surprising as the headlines themselves was the admission that the embarrassing episode was an often-ignored side effect of weight loss surgery.
"I probably went off and ate something I wasn't supposed to," he said on NBC's "Dateline."
"Which is a common side effect of the surgery," NBC's Dr. Nancy Snyderman responded.
The weatherman wasn't always so open about discussing his 2002 procedure. "In this country, if you have an alcohol problem or a drug problem, you can get treatment," Roker told USA Today after months of keeping mum about his dramatic weight loss. "If you have a weight problem, it's lack of willpower: 'Just push away from the table, tubby, and you'd lose that weight.' But you can stop drinking, you can stop sticking a needle in your arm. You cannot not eat."
Other celebs, like Carnie Wilson and Lisa Lampanelli, have also come forward about going under the knife to get slim, but there's an atmosphere of secrecy around such procedures similar to the "did she or didn't she?" whispers about cosmetic surgery. Weight-loss surgery, however, may come with additional stigma, as if diet and exercise changes weren't enough. In the same USA Today interview, Roker called owning up to his surgery "the ultimate admission of failure."
Still, the famous faces who do go public with bariatric surgery are showered with praise for their smaller size. And instead of talking about the risks of elective surgery or the myriad side effects, stars often explain that they're feeling better than ever and loving their new look. "I have been struggling with weight from age 18 to now -- that's 32 years of diets," Lampanelli said on a recent visit to HuffPost Live. "I'd had enough… but it's great, we needed to do it. I've done everything from really unhealthy stuff to healthy diets, but it just wasn't for me."
Bariatric surgery aims to "reduce the amount people can consume at a given time and the amount of digested food they can absorb," the New York Times reported. There are a number of procedures that fall under this umbrella that can achieve the same end result. Gastric bypass surgery entails creating a small pocket toward the top of the stomach and sealing off the rest, according to WebMD, thereby bypassing some of the small intestin so that fewer calories are absorbed from the food traveling through.
Lampanelli underwent gastric sleeve surgery, she said, which actually involves removal of part of the stomach. And Rex Ryan opted for lap band surgery, in which an inflatable silicon ring seals off part of the stomach.
Roker's incident was certainly embarrassing, but not uncommon. In fact, both fecal and urinary incontinence are common side effects, possibly because surgery may expose "prior weaknesses in the continence mechanism," according to a 2010 study. In the study, 55 percent of women and 31 percent of men with fecal incontinence felt their condition worsened after surgery.
But other side effects of weight-loss surgery can be dangerous and even life-threatening.
Eating too quickly, taking big bites, not chewing enough or eating foods that are too dry can bring on nausea or vomiting in many people after weight-loss surgery, and too much sugary or greasy food can lead to diarrhea. More than a third of patients develop gallstones, masses of cholesterol that form in the gallbladder, after surgery, according to WebMD.
About 20 percent of people who opt for weight-loss surgery require further procedures for complications, WebMD reported, and as many as 30 percent deal with complications relating to malnutrition, like anemia or osteoporosis, since the intestines are absorbing fewer nutrients.
Some weight-loss surgery patients may develop ulcers at the site where the small intestine is connected to the pocket created from the stomach, especially those who take aspirin or NSAIDs, according to the Mayo Clinic. A stoma, or a narrowing of the opening at this same site, may also occur, and require surgery to repair. Patients are also at risk for dehydration, since the stomach can no longer hold large quantities of water. And rapid weight loss can bring on feelings of fatigue, cold, mood changes and body aches, as well as cause hair thinning.
In rare instances, some patients may experience a serious complication called Noninsulinoma Pancreatogenous Hypoglycemia Syndrome (NIPHS), or very low blood sugar levels. In these cases, patients may experience neurologic symptoms like confusion or even seizures, according to the Mayo Clinic, and could require pancreatic surgery to cure.
Tragically, bariatric surgery patients seem to also be at greater risk of suicide, according to a review of nearly 17,000 operations performed from 1995 to 2004 in Pennsylvania. The researchers calculated suicide rates among the patients to be more than five times higher than the rate in the general population, the New York Times reported.
This could at least in part be due to the tremendous work required to maintain the results of weight-loss surgery. The procedure itself is not a quick fix; a number of habits have to change as well, if the weight loss is to be permanent, and as many as 20 percent of people will gain a significant amount of weight back, People magazine reported.
Appetite and emotional cravings don't shrink just because stomach size does, and emotional issues need to be addressed. When they aren't, some patients, fall into a "rebound relationship with something else" reported ABC News, namely, alcohol, drugs or cigarettes. "Many people who undergo bariatric surgery struggle with eating in response to different emotional cues," Alexis Conason of the New York Obesity Nutrition Research Center, told ABC News. "I [wondered] what happened afterward. If they are no longer able to cope with their emotions through eating... do they turn to something like drugs or alcohol to serve the purpose that food did originally." Conason's survey found that surgery patients had a 50 percent increase in frequency of substance abuse two years after their operations.
While recent research suggests that weight loss surgery may be effective in preventing Type 2 diabetes (assuming the necessary lifestyle changes are made), it's important that even the most highly-qualified surgery patients weigh the risks before opting for a surgical solution.
Roker's weight loss isn't the only high-profile, dramatic transformation of late. Check out some of our favorite celebrity weight loss stories of 2012 in the slideshow below.