There are also long-term issues : Anemia, nutritional deficiencies (iron, calcium, vitamin B12 and folate), that request a regular follow-up (blood samples) and supplements. A gastric ulcer can occur in 3% of the cases, but can be cured most often by drugs. A stenosis of the anastomosis occurs in 5 to 7% of the cases, with vomiting, and can be cured by endoscopic dilatation. There is also a risk of late small bowel obstruction due to adhesions or an internal hernia: symptoms can be difficult to recognize if the obstruction is located on the small intestinal limb (bilio-pancreatic limb) because there is no vomiting, but isolated abdominal pain. A CT-scan should be performed.

One wonders what becomes of the remaining part of the stomach : is there more risk of cancer and how will it be detected, knowing that is no more access through endoscopy? As a matter of fact, thousands of operations have been performed worldwide and this complication has not been significantly reported, whereas modern exams allow a safe examination of the remaining stomach.

Weight-loss is constant and sustained . If you consider the excess weight, that can be calculated according to an "ideal body weight" given by the tables of the Life Insurance Companies,this excess should go down by 60% in 12 to 18 months.
Exemple : a woman is 160 cm tall and weighs 110 kg. Her theoretical excess-weight is 55 kg. She may hope loosing 36 kg after surgery.
Long-term results are deemed better than the results of restrictive operations such as Mason gastroplasty or lap-banding, the downside beeing more risks and more complexity. Many surgeons around the world have chosen this operation whatever the clinical condition, some prefer it when patients have special features (swee-eaters or binge eaters, superobese), and some perform it when there is a failure of a previous restrictive operation: this ultimate strategy makes sense although it carries even more risks due to post-operative adhesions, and may be called a "two-step strategy".