Weight Gain After Gastric Bypass Surgery & 7 Ways to Avoid/Reverse It

Reviewed by:  

Peter F. Rovito, MD, FACS

Last Updated:  

06/14/2017

Weight gain after gastric bypass surgery occurs in about half of all patients within 2 years (1). Despite the weight regain, the average patient still keeps off over 60% of their excess weight after 5 years (2).

Read and click the sections below for everything you need to know about gastric bypass weight regain.

01Average Weight Regain
  • About half of all patients regain weight after 2 years
  • Average regain is about 8% after reaching low point
  • Total 10-year excess weight loss is still over 50%

The average excess weight lost following laparoscopic gastric bypass surgery is about 65% (in other words, at 100 pounds overweight the average patient loses almost 70 pounds). Many patients have seen results of well over 80%.

“Most patients keep at least 50% of their excess weight off after 10 years.”

About 50% of patients eventually gain a little weight back after hitting their low point (also called their “nadir”) (3). In addition, the more time that passes following surgery, the more likely patients are to gain some weight back (4).

On average, patients who gain weight back see about 8% of their old weight return within 5 years of surgery (5). So if a patient is one of the 50% who gains weight back, was 100 pounds overweight and lost 70 pounds from surgery, on average she can expect to gain back about 8 pounds.

The good news is that most patients (about 80% of morbidly obese and 65% of super obese) keep at least 50% of their excess weight off after 10 years (6).

024 Reasons for Regain
  • Weight prior to surgery
  • Alcohol or drug abuse
  • Lack of a support system
  • Psychological state or food addiction

Several factors make you more likely to lose less weight or gain weight back following gastric bypass surgery. Addressing and preparing for these factors ahead of time can make all the difference…

  1. Your weight prior to surgery – losing weight before gastric bypass surgery sounds pointless… after all, isn’t that what the surgery is for?

    The fact is that shedding some extra pounds before surgery can have a significant impact. Not only will it reduce the risk of gastric bypass complications, but the lower your body mass index (BMI) prior to surgery the more weight you are likely to lose and the less likely you will be to experience weight gain after gastric bypass surgery.
  2. Alcohol or drug abuse – not surprisingly, substance abusers are more likely to revert back to their old habits following surgery. Plus, some patients begin to abuse alcohol and drugs after bariatric surgery, in effect, replacing one addition with another. In addition, drinking alcohol and taking certain drugs can lead to significant bariatric surgery complications.
  3. Lack of a support system among family, friends and a weight loss surgery support group and lack of ongoing lifestyle counseling through a hospital or doctor based support group.
  4. Psychological state following surgery – Increased food urges and decreased feelings of well-being following surgery are directly correlated with weight gain after gastric bypass surgery (7). Food addiction is also a big (and under-reported) reason for gastric bypass weight regain. See our Food Addiction Treatment page to learn more.
Advertisement

037 Ways to Avoid or Reverse Regain
  • Pre-surgery behaviors
  • Diet guidelines
  • Good support system
  • Follow surgeon’s advice

While a little bit of weight gain after gastric bypass surgery is likely to occur after hitting your nadir (lowest weight), there are many things you can do to keep the weight regain to a minimum…

  1. 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 (8).
  2. Stop binge eating well before surgery – Research suggests that patients with binge eating disorder (BED) tend to lose less weight after surgery. Seeking treatment for BED prior to surgery will make you less likely to experience weight gain after gastric bypass surgery (9).
  3. Lose as much weight as possible prior to surgery – The percentage of patients who keep off at least half of their excess weight 10 years after surgery is almost 15% higher for the morbidly obese (BMI between 40 and 49.9) than for the super obese (BMI of 50 or more) (10).
  4. Address alcohol and drug abuse problems to prevent weight gain after gastric bypass surgery and avoid gastric bypass complications. The topic of alcohol and drug use will come up in your psychological evaluation prior to surgery approval, so be prepared to be honest with your psychologist and work with him or her to get any problems under control.
  5. 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 then slowly start to falter. Effective surgeons are not only good in the operating room but are also trained and experienced in helping patients keep the weight off long-term.
  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 or your mental state becomes unstable following surgery, talk with your bariatric doctors immediately. Patients who experience these feelings and don’t address them usually gain more weight back. Between meetings with your surgeon and psychologist along with regular discussions with your weight loss surgery support group, you will overcome these issues.
  7. “Patients who actively participate in support groups have about a 10% lower body mass index than patients who go it alone.”

  1. Continue to get nutritional counseling – patients who continue to monitor their diet with the help of a professional have better long-term results (11).  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. The importance of this cannot be understated and needs to be repeated: the key is to never stop seeing them.

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

04Revision Surgery
  • Reduce “stoma” size
  • Resize or tighten stomach pouch

Even if you stay on top of the points above, there’s still a chance that you could experience weight gain after gastric bypass surgery. Discuss the following two options with your surgeon if you’re doing all the right things and the pounds continue to come back…

Finding a Surgeon

Not all bariatric surgeons perform these corrective procedures.

If your surgeon does not and recommends surgical intervention, ask for a referral to a bariatric surgeon who has experience with these specific procedures.

You can also click here to access our directory of qualified surgeons in your area. Give the surgeon(s) in your area a call to find out if they perform any of these procedures. If they do, schedule a free one-on-one consultation to discuss.

  1. Reduce “stoma” size – The connection between your pouch and small intestines (also called the “gastrojejunal anastomoses” or "stoma") gets bigger following surgery for some patients.

    If your surgeon determines that this has happened to you, having the connection tightened can get you back on the right track (12).
  2. Resize or tighten stomach pouch – if your pouch has stretched over time, having it reduced can also improve weight loss (13). For example:
    • Endoscopic injection of a “sclerosant” (sodium morrhuate) to shrink the stomach. Your surgeon may need to administer the injections 2 to 3 times before determining whether the process was a success.

      One study showed that 64% of patients lost at least 75% of their weight regain after their injections. The only complication that occurred was symptoms of stomal stenosis that required the stomach to be stretched back out with the use of a special balloon (14).

      Another study revealed that out of 231 patients who underwent 575 sclerotherapy sessions (15):
      • 12 months from the last sclerotherapy session, weight regain stabilized in 78% of the patients
      • Patients who underwent two or three sclerotherapy sessions had much higher rates of weight regain stabilization than those who underwent a single session
      • The average sclerotherapy patient lost 10 pounds in six months
      • There were ‘high responders’ who lost an average of 26 pounds, which was 61% of the weight regain
      • Those who had higher regain after bariatric surgery responded better to sclerotherapy
      The procedure does carry a low risk of minor complications including bleeding (2.5% of patients), abdominal pain (0.5%) and small ulcers (1%) along with a relatively high risk of blood pressure elevation (11%). Due to the risk of blood pressure elevation, patients with cardiac risk factors should most likely stay away from this procedure.

For more information, see our Gastric Bypass Revision Surgery page.

05Help & Support
  • Ask the expert
  • Patient experiences

Ask the Expert & Patient Experiences*

Please share your experiences with weight gain after gastric bypass surgery. Your insights are invaluable to making sure other people have the information they need to meet their goals.

We would also be happy to answer any questions you may have weight regain, such as:

  • 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 use the form below to submit your story or questions.

Close Help

Entering your question or experiences is easy to do. Just type!… Your comments and questions will appear on a Web page exactly the way you enter it here. You can wrap a word in square brackets to make it appear bold. For example [my story] would show as my story on the Web page containing your story. TIP: Since most people scan Web pages, include your best thoughts in your first paragraph.

Upload 1-4 Pictures or Graphics (optional)[ ? ]

Close Help

Do you have some pictures or graphics to add? Great! Click the button and find the first one on your computer. Select it and click on the button to choose it. Then click on the link if you want to upload up to 3 more images.

 

Click here to upload more images (optional)

Author Information (optional)


To receive credit as the author, enter your information below.

(first or full name)

(e.g., City, State, Country)

Submit Your Contribution

submission guidelines.

Submit Your Question or Contribution



Questions From Other Visitors*

Click below to see contributions from other visitors to this page…

17 Years After Gastric Bypass & Gained 60 Pounds Back*

In 1998, I had a Roux-en-Y Gastric Bypass done. I was 277 lbs the date of my surgery. I lost over the next 6 months down to 145 lbs, for…


Gastric Sleeve After Failed Gastric Bypass*

Can gastric sleeve surgery be done after a failed gastric bypass? My gastric bypass surgery was performed 9 years ago. I had decent weight loss but I am gaining again…


Weight Regain & Supplements Questions 13 Years After Gastric Bypass*

I was 310 lbs, in 2001, when I had my Roux En Y Gastric Bypass in South Florida. I got down to 160 and kept that off for many years…


Stopped Losing Weight 3 Years After Gastric Bypass Surgery*

I lost 100 lbs the first year after gastric bypass surgery, then I stopped losing weight. I was eating the wrong food, but now I am back on track and…


50 Lb Regain 5 Years After Gastric Bypass Surgery*

It began after 5 years. I thought I had it beat. I had gastric bypass. I joined a gym and thought I was doing it right. I started to regain…


Depressed and hopeless from weight gain after gastric bypass*

I had gastric bypass surgery in Birmingham, England about 5 years ago. I loved the weight that dropped off... I lost 9 stone (126 lbs) in total. But over the…


Trying to reverse the weight regain after gastric bypass surgery*

I was at 317 lbs when I had my surgery in 2001, and I was at 170 lbs when I finally quit losing weight about a year and a half…


8 years post-weight loss surgery and out of control!*

I had laparoscopic gastric bypass surgery 8 years ago and went from 300 ponds down to 160 pounds. I maintained a 140 pound weight loss for 5 years and had…


7 stones regained 3 years after gastric bypass surgery*

Well, as I approach my 3rd year since my gastric bypass operation I am fast regaining all the weight I lost, which at my lowest was 7 stones (98 lbs).…


9 stone lost, 2 and a half stone re-gained 2 years after gastric bypass surgery*

I was really happy with the weight loss following the gastric bypass, and I lost 9 stone in total. I decided against the banding because I needed to feel the…


Slow weight loss and weight regain after gastric bypass surgery*

I had weight loss surgery in 2004 and it took me 5 years to lose 100 lbs. When I had the surgery I weighed 342 lbs. I had gastric bypass…


Gained Back Weight After Gastric Bypass Surgery*

I had gastric bypass surgery on 3/2006 and lost close to 130lbs. Now almost 6 years later I have gained 20 pounds back in a year. I'm thinking about getting…


Worried About Weight Gain After Gastric Bypass Surgery*

I am very worried about weight gain after gastric bypass surgery. A lot of people I know have lost weight after surgery and then gained quite a bit back. I…


Post-op bariatric weight gain (after gastric bypass surgery)*

I had the laparoscopic gastric bypass when I was 38. I lost about 190 pounds in just a little over a year's time! I have been mainly eating proteins and…


Why would I gain weight only 4 months after gastric bypass?*

I am 4 and a half months out post-op from gastric bypass surgery. I had really speedy weight loss at first (90 pounds in 3 and a half months). Now,…


Regain of 35 lbs after gastric bypass - Getting back on track*

- How much weight did you lose before the weight regain started? 130lbs- How long after surgery did it begin? 5 years- Which type of weight loss surgery did you…


Gastric Bypass Weight Regain After 2 Children*

Hi, I had a gastric bypass in 2007 and lost 120lbs. I had gone from size 16 to size 0. In 2011 I had my first child and couldn't lose…


Years after Gastric Bypass weight gain*

Many years ago i had gastric bypass- no pre diet was mentioned. In fact i was out to lunch (salad only) when hospital called saying they had moved me up…


Advertisement

* Disclaimer: The information contained in this website is provided for general information purposes and your specific results may vary depending on a variety of circumstances. 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