Weight Gain After Bariatric Surgery & How to Avoid or Reverse It

Reviewed by: John Rabkin, MD

Are you likely to experience weight gain after bariatric surgery? It depends on factors both in and out of your control.

How much weight gain after bariatric surgery should you expect?

weight gain after bariatric surgeryThe procedure you choose will play a large part in determining how much weight you will gain back after you hit your low point.

Patients who undergo primarily restrictive procedures (i.e. procedures that are not calorie malabsorptive, including gastric bypass surgery, mini gastric bypass surgery, gastric sleeve surgery and lap band surgery) usually gain around 8 to 10% of their weight back.

Malabsorptive procedures such as duodenal switch surgery have been shown to result in greater maintained excess weight loss over the long-term. After any weight regain, patients who undergo malabsorptive procedures experience at least 10% to 15% greater excess weight loss than restrictive procedures.

Regardless of which procedure you choose (or chose), the possibility for weight gain after a bariatric procedure will remain present throughout your life.

Remember… bariatric surgery is only a tool. You’ll need to continue doing the right things and making the right choices for the surgery to be effective over the long run…

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7 ways to minimize weight gain after bariatric surgery

YOUR Weight Loss Journey

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The key to preventing long term weight regain and reducing your risk of baratric surgery complications is to learn and address potential pitfalls early on.

Seven behaviors have been proven to reduce the chance of weight gain after bariatric surgery:

  1. Stop binge eating well before surgery – Patients with binge eating disorder (BED) tend to lose less weight after surgery.  Receiving treatment for BED prior to surgery will lead to less weight gain after bariatric surgery.1
  2. Lose as much weight as possible prior to surgery - Your body mass index (BMI) prior to surgery directly relates to how much weight you'll lose and keep off.  For example, one study showed that morbidly obese patients (BMI between 40 and 49.9) had a 15% higher liklihood than super obese patients (BMI of 50 or more) to keep off at least half of their excess weight 10 years after surgery.2
  3. Address alcohol and drug abuse problems as they will cause weight gain after bariatric surgery and potentially lead to bariatric surgery complications.  Your surgeon and bariatric surgery insurance company will both require a psychological evaluation before they approve surgery and the evaluation will include this topic.  Be prepared to be honest with your psychologist and work with them to get any problems under control.
  4. Follow your bariatric doctors’ advice to the letter – this may sound obvious, but you’d be surprised how many patients follow their doctors’ orders for the first year or two and then slowly begin to slip back into their old habits.  The best bariatric doctors are not only good in the operating room but are also trained and experienced in helping patients keep the weight off long-term.
  5. Join and participate in a good weight loss surgery support group – weight loss surgery patients who actively participate in support groups have roughly a 10% lower body mass index than patients who do not.3
  6. Address food urges and lack of well being if you start to experience them after surgery - If you begin to experience increased food urges, depression or other emotional problems following surgery, talk with your bariatric doctors right away and bring these issues out in the open with your family and support group.  Patients who experience these feelings and don’t address them usually gain more weight back.  
  7. Continue to get nutritional counseling – patients who continue to monitor their diet with the help of a professional (your surgeon-referred dietitian or nutritionist) have better long-term results.4   Good bariatric doctors partner with or will refer you to a nutritionist or dietitian, so you should not need to find one on your own.  The key is to never stop seeing them.  For DS patients, diet and exercise works especially well and is very effective towards losing weight after any weight regain.

    Review the following pages for more about proper diet and eating habits…

In addition to the above, the following pages will set you up for success, both reducing your risk of complications and minimizing your weight gain after bariatric surgery…

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Surgical options for reversing weight gain after bariatric surgery

The first path your doctor will have you take to reverse weight gain after bariatric surgery is good old-fashioned diet and exercise.

If these are not effective towards keeping the weight off after surgery, it may be because your new stomach (and possibly the digestive openings made during surgery) has stretched which allows you to eat more before feeling full.

See our Gastric Bypass Revision Surgery page for more information.

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Did you experience weight gain after bariatric surgery?

- How much weight did you lose before the weight regain started?

- How long after surgery did it begin?

- Which type of weight loss surgery did you have?

- What diet, exercise or other factors caused your weight regain?

- What did you do to stop or reverse it?

- If you haven't experienced weight regain, give us your advice about how you've been able to avoid it.

Please share your experiences to help other bariatric surgery patients avoid pitfalls, keep their weight off and reverse weight regain if necessary...

Enter a title for your experience (i.e. your key advice, how much you gained back, how you reversed it, etc.)

Other visitors' experiences with weight gain after bariatric surgery

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Why would I have stopped losing weight 4 1/2 months after my duodenal switch? 
I had my duodenal switch on 3/10/11 and started out at 275. For the last 2 weeks, I have not lost any weight so I am stuck at 206. I am really getting …

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References

  1. Sallet PC, et al. Eating Behavior as a Prognostic Factor for Weight Loss after Gastric Bypass. Obesity Surgery Volume 17, Number 4 / April, 2007 Pages 445-451.
  2. Christou NV, et al. Weight Gain After Short- and Long-Limb Gastric Bypass in Patients Followed for Longer Than 10 Years. Ann Surg. 2006 November; 244(5): 734–740.
    doi: 10.1097/01.sla.0000217592.04061.d5.
  3. Orth WS, et al.  Support Group Meeting Attendance is Associated with Better Weight Loss. Obesity Surgery Volume 18, Number 4 / April, 2008 pgs 391-394.
  4. Faria SL, et al.  Nutritional Management of Weight Regain After Bariatric Surgery
    Obesity Surgery. Available at: http://www.springerlink.com/content/w716724l2u68l31u/
    ?p=6d029e9052c048d9beab73c0b56c2ce0&pi=3
  5. Weight gain after bariatric surgery as a result of a large gastric stoma: endotherapy with sodium morrhuate may prevent the need for surgical revision
    Marc F. Catalano, Goran Rudic, Alfred J. Anderson, Thomas Y. Chua
    Gastrointestinal Endoscopy - August 2007 (Vol. 66, Issue 2, Pages 240-245, DOI: 10.1016/j.gie.2006.06.061)
  6. Treatment of weight regain after gastric bypass surgery when using a new endoscopic platform: initial experience and early outcomes (with video)
    Daniel K. Mullady, David B. Lautz, Christopher C. Thompson
    Gastrointestinal Endoscopy - September 2009 (Vol. 70, Issue 3, Pages 440-444, DOI: 10.1016/j.gie.2009.01.042)
  7. UC San Diego Medical Center Press Release: Data Shows Incision-free Procedure Reverses Weight Regain after Gastric Bypass Surgery. June 2009.  Available at: http://health.ucsd.edu/news/2009/6-29-rose-procedure.htm.
  8. Thompson, C.1; Slattery, J.; Bundga, M.; Lautz, D. Peroral endoscopic reduction of dilated gastrojejunal anastomosis after Roux-en-Y gastric bypass: a possible new option for patients with weight regain. Surgical Endoscopy, Volume 20, Number 11, November 2006 , pp. 1744-1748(5)
  9. Dapri G, et al.  Laparoscopic Placement of Non-Adjustable Silicone Ring for Weight Regain After Roux-en-Y Gastric Bypass. Obesity Surgery Volume 19, Number 5 / May, 2009 Pages 650-654.

[Last editorial review/modification of this page: 2/17/2011]

Disclaimer: The information contained in this web site is provided for general informational purposes only. It is not intended as nor should be relied upon as medical advice. Rather, it is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her existing physician(s). Before you use any of the information provided in the site, you should seek the advice of a qualified medical, dietary, fitness or other appropriate professional. Read More