Will I Lose My Hair?

A hair in the head is worth two in the brush. - Oliver Herford

This is a common question and one of real concern for many people who are embarking on a weight loss journey – whether it is surgical or non-surgical weight loss. Why does hair loss occur?

Hair follicles have two stages: the anagen (hair growth) stage and the telogen (inactive) phase. All hairs begin their cycle in the anagen phase, grow for a period of time and then move into the telogen phase – which lasts for about 100 – 120 days. Then, the hair falls out. This entire process, if sped up, is known as telogen effluvium.

Telogen effluvium is the cause of hair loss in people who are losing weight at a fairly rapid pace. Weight loss is beneficial for those people that are carrying too much weight.  Yet, rapid weight loss is a stress to the system. This stress will accelerate the hair growth cycle and telogen effluvium will result. Hair loss after Gastric Bypass Surgery or a rapid non-surgical weight loss typically occurs within the first three to six months after surgery or after significant weight loss. As the body adjusts to the changes, the hair loss will stop. Any lost hair WILL grow back.

However, if hair loss continues beyond that six month time frame, nutritional deficiencies are often involved. People who have had Gastric Bypass Surgery or Adjustable Gastric Banding are at risk for nutritional deficiencies. This is because of malabsorption of food and nutrients and the fact that they are taking in less food and are often not taking in all of their needed nutrients. This also applies to people who are “dieting” and restricting important food groups and nutrients from their eating plan.

Daily Protein Intake

To determine your needed protein intake, take your weight in pounds and multiply by 0.4. This will give you the number of grams of protein you should take in each day.

For example:
Weight = 250 pounds.
250 x 0.4 = 100grams of protein /day

This is a general rule of thumb, but you should always check with your doctor before implementing this degree of protein as the amount may change dependent upon health conditions and medications taken.

The nutrients related to hair loss are protein, iron, biotin, zinc, essential fatty acids and Vitamin B12. Inadequate protein can result in thinning of the hair, changes in the normal hair growth process and diffuse hair loss. L-lysine is one of the most important amino acids needed for healthy hair. L-lysine is found primarily in fish, meat and eggs.

Iron is the micronutrient most related to hair loss. Decreased iron absorption occurs in people who have had Gastric Bypass Surgery – thus it is important to supplement with appropriate Bariatric vitamins that contain iron. Ferritin levels are indicative of iron storage in the body and low ferritin levels are associated with hair loss. For people with hair loss, iron supplementation in the form of ferrous fumarate at 320 mg may be recommended.

A biotin deficiency can cause depigmentation of hair and hair loss because this vitamin plays an important role in the development of the hair follicles. Excellent sources of biotin include chard, tomatoes, romaine lettuce and carrots. Very good sources include almonds, chicken eggs, onions, cabbage, cucumber and cauliflower. Good sources include goat's milk, cow's milk, raspberries, strawberries, halibut, oats and walnuts.

Zinc is an important factor for the growth and development of healthy hair. Oysters contain more zinc per serving than any other food, but red meat and poultry provide the majority of zinc in the American diet. Other good food sources include beans, nuts, certain types of seafood (such as crab and lobster), whole grains, fortified breakfast cereals and dairy products.

Not all fats are “bad” and we need Essential Fatty Acids (EFA) in our diet everyday. EFAs and flaxseed and olive oils are needed for healthy cellular function and the growth of healthy hair. People who have had bariatric surgery or who are on restrictive weight loss “diets” should supplement with fish oil or EFAs, as they are not able to take in adequate amounts through food alone.

The body has stores of Vitamin B12 on average for three to five years – dependent on one’s intake. However, due to the nature of Gastric Bypass Surgery, deficiency of B12 will occur unless appropriate supplementation occurs. Change in hair pigmentation and hair loss can be a symptom of a B12 deficiency

To summarize, hair loss right after bariatric surgery or after a larger non-surgical weight loss is due to the stress that weight loss has on the hair growth cycle. This will stop and the hair will grow back. If hair loss continues, it is due to nutritional deficiency that will need to be corrected. Bariatric surgical patients can prevent this by taking high quality Bariatric vitamins as directed along with adequate protein intake – for life! Non-surgical weight loss should be slow and steady and one that does NOT involve restriction or elimination of food groups and essential nutrients.

Kathleen Baskett, MD is the Medical Director of Weight Management at St. Vincent Healthcare. She is a graduate of the University of Maryland School of Medicine, and the author of “Moving Forward: The Weigh to a Healthier Weight”.