Medically Reviewed by:John Rabkin, MD, FACSBoard Certified Bariatric Surgeon
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
- 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
- AspireAssist results in zero pounds being regained, but overall results 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
- Duodenal switch (70%+ excess weight loss (EWL) after 3 years)
High long-term weight loss, even though 8 to 10% weight regain
- Gastric sleeve (60% EWL after 3 years)
- Gastric bypass (60% EWL after 3 years)
- Lap-Band (55% EWL after 3 years, but highly variable from patient to patient)
Moderate long-term weight loss and no weight regain
- AspireAssist (20 – 30% EWL assumed but not confirmed)
AspireAssist relies on a device to control the patient’s weight. While there is no long-term weight regain research on AspireAssist, the nature of the device indicates that patients will reach a weight loss plateau and stay there as long as it’s used properly.
Moderate short-term weight loss
- Gastric balloon (30% EWL in 6 months, then must be removed)
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)
- 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…
- Bariatric Diet – learn the proper diet before and after surgery and tips to stay on track
- Bariatric eating – how you eat vs what you eat
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…
- Bariatric Doctors – how to find, interview and choose the best surgeon
- Life After Weight Loss Surgery – what to expect in every area of your life
- Exercise for Bariatric Surgery Patients
- In-person weight loss surgery support groups and online weight loss support – finding and participating in the right support groups has been proven to lead to better weight loss
See the pages below for weight regain questions and answers from other patients:
- 50 Lb Regain 5 Years After Gastric Bypass Surgery
- Bitter disappointment – why I gained back 40 pounds after weight loss surgery
- Breast Cancer After Gastric Sleeve Followed By Weight Regain
- Dealing with Loss and Weight Gain After Lap Band Surgery
- Patient Experience: Gastric Sleeve Weight Regain
- Weight regain 3 years after bariatric surgery… I eat right!
- 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 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