Weight Regain

Weight Gain After Bariatric Surgery – 7 Ways to Get Back to Your Low Point

The average bariatric surgery patient regains from 0 to 10% of the weight they lost, depending on their eating and drinking habits and which surgical weight loss procedure they had.

There are several non-surgical measures to prevent or reverse weight regain, although revision surgery may also be an option.

Read the page below to learn how all about weight regain after weight loss surgery.

TABLE OF CONTENTS

Click on any of the topics below to jump directly to that section

  1. Regain by Procedure
  2. How to Avoid Regain
  3. Revision Surgery Options
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01.

Weight Regain by Procedure

SECTION SUMMARY:

  • The Duodenal Switch results in little to no weight regained and has the highest long-term weight loss

  • The Gastric Sleeve, Gastric Bypass, Lap-Band result in very low weight regained (8 – 10%), but still have a high long-term weight loss

  • vBloc Therapy and AspireAssist result in zero pounds being regained, but overall result in a much lower amount of weight loss

  • The Gastric Balloon results in 100% of the weight lost being regained after the balloon is removed in 6 months, unless you change your eating and drinking habits

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

Following is a list of all widely performed procedures sorted by amount of long-term weight loss and average weight regain.

Highest long-term weight loss and little to no weight regain

High long-term weight loss, even though 8 to 10% weight regain

Moderate long-term weight loss and no weight regain

vBloc and AspireAssist each rely on devices to control the patient’s weight. While neither has long-term weight regain research, their nature indicates that patients will reach a weight loss plateau and stay there as long as the devices are used properly.

Moderate short-term weight loss

If the patient does not receive another gastric balloon after their balloon is removed or have one of the more involved procedures listed above, 100% weight regain is likely.

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.

References for Weight Regain After Weight Loss Surgery: (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18) (19) (20) (21) (22) (23) (24) (25) (26) (27) (28) (29) (30)

02.

How to Avoid Regaining Weight after Bariatric Surgery

SECTION SUMMARY:

  • 7 actions to help you keep the weight off (read below)

The key to preventing long term weight regain and reducing your risk of bariatric 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. 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 (1).

2. 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 (2).

3. 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 likelihood than super obese patients (BMI of 50 or more) to keep off at least half of their excess weight 10 years after surgery (3).

4. Address alcohol and drug abuse problems

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.

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 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.

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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03.

Revision Surgery Options

SECTION SUMMARY:

  • It's possible to undergo a revision procedure if you had gastric sleeve, gastric bypass, or Lap-Band

Due to its inherent risks and high price tag, surgery to address weight regain should be your last resort.

If you have not done so already, please review the non-surgical options listed above, especially support groups. If you’re not actively participating in one now, you’ll be pleasantly surprised at how effective they can be.

If you’ve already tried everything else, contact a top surgeon’s office to discuss your options.

See the following pages depending on which procedure you had:

Gastric Sleeve Revision Surgery Options

  • Have another sleeve procedure, sometimes called a “re-sleeve”
  • Convert to a duodenal switch (DS)
  • Convert to Lap-Band (“band over sleeve”) or gastric bypass

Gastric Bypass Revision Surgery Options

  • Shrink stoma by injecting a sclerosant
  • Add an adjustable gastric band (Lap-Band)
  • Lengthen the Roux limb of the intestine
  • Convert to a duodenal switch

Lap-Band Revision Surgery Options

  • Rebanding (remove band and add another)
  • Convert to a gastric sleeve
  • Convert to a gastric bypass
  • Convert to a duodenal switch

Click here to find a surgeon that specializes in weight loss surgery revisions.

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References

  • 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.
  • 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.
  • 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.
  • 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
  • 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)
  • 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)
  • 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.
  • 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)
  • 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.

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