Weight Gain After Gastric Sleeve & How to Reverse It

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Weight gain after gastric sleeve surgery:

  • Happens for as many as 30% of patients
  • Starts anywhere from 18 months to 6 years after surgery
  • Ranges from a regaining a small amount of weight to all of the excess weight lost
  • Is usually caused by the stomach stretching back out as the result of poor diet choices

Read and click below for more information.

Gastric sleeve surgery works by making the patient feel full sooner while eating and by reducing the amount of hunger-causing hormones secreted by the stomach. As a result, patients lose up to 70% of their excess body weight within 18 months to 2 years.

However, up to 3 out of 10 gastric sleeve patients gain weight after reaching their low weight (1)(2). The amount varies widely by patient, ranging from only a small amount of weight to all of it (3)(4).

Can a gastric sleeve stretch?

Yes. If you lost weight initially and then gained some back, it was most likely caused by your smaller sleeve stomach stretching out as a result of poor diet choices or lifestyle habits, including (5):

  • Eating or drinking the wrong things
  • Not exercising enough
  • Overeating during meals
  • Drinking within 30 minutes of your meals (before or after)

However, the sleeve stomach may also stretch for patients with perfect diets and eating habits.

Gastric sleeve stretching causes weight regain by allowing patients to eat more during meals and by increasing the amount of hunger-causing hormones secreted by your stomach.

There are 5 options for reversing weight gain after gastric sleeve surgery:

  • Change your diet & lifestyle
  • Ask for more support
  • Ask about medication
  • Have a gastric sleeve revision surgery (last resort)
  • If food addiction is present, seek treatment

Click below for more information about each option.

Change your diet & lifestyle

Two of the most common reasons for gastric sleeve weight gain are (6)(7):

  • Consuming the wrong foods/liquids or too much foods/liquids
  • Not exercising enough

Review our Gastric Sleeve Diet Guidelines and Exercise Guidelines and compare them to your current habits. If you’ve let yourself slip, make a concerted effort to get back on track before considering surgery.

Talk with your surgeon and dietitian about helping you get on a strict dietary regimen to get back on track.

Start & Maintain a Diet Journal

Diet journals are directly associated with more weight loss (8). If you reach your low point then gain weight after gastric sleeve, a well-kept journal will help you to:

  • Set goals and record progress
  • Plan your meals ahead of time
  • Prevent “cheating” on your meal plans
  • Shop smartly – take your journal with you to the grocery store and only buy the foods that you have planned

If you haven’t been journaling, give it a try before exploring more aggressive options like revision surgery.

Ask for more support

It’s so much more difficult to succeed on your own. If haven’t done so already, talk with your surgeon about specialists and local support groups.

Talk with a Specialist

Your surgeon should have several gastric sleeve specialists either in-house or nearby who are experts at helping patients experiencing weight gain after gastric sleeve surgery, including:

  • Dietitian
  • Psychologist
  • Personal Trainer

Set up an appointment with your surgeon to discuss your options.

Join a Gastric Sleeve Support Group

If you’re having a tough time sticking to your diet and exercise goals on your own, join a local support group of other gastric sleeve patients. Odds are, at least a few people in the group will have struggled with gastric sleeve weight gain.

Your surgeon’s office should be able to refer you to a good group.

In addition to the invaluable encouragement and support you’ll receive from others who know your challenges, support groups also result in more weight loss. Several studies have shown that regular weight loss support group attendees lose as much as 12% more excess weight than patients who do not attend (9).

See our Weight Loss Surgery Support Group page for more information.

Ask about medication

Medication is usually not effective for weight regain after gastric sleeve surgery, but it’s worth discussing with your surgeon.

For example, one study of gastric bypass and gastric sleeve patients undergoing revision surgery for weight regain or inadequate weight loss found that the medication Topiramate made patients more likely to lose weight (10).

Have a gastric sleeve revision surgery

Revision surgery should only be considered as a last resort for addressing weight gain after gastric sleeve surgery. Just like your initial surgery, it’s time consuming, costs money, carries risk, and isn’t guaranteed to work long-term.

Following are the 4 gastric sleeve revision surgery options in order of the most long-term weight loss:

  1. Convert to duodenal switch
  2. Convert to gastric bypass
  3. Re-sleeve (having another gastric sleeve surgery)
  4. Convert to Lap-Band (“band over sleeve”)

See our Gastric Sleeve Revision Surgery Guide for more information about each option, including expected weight loss, risks, and cost.

Address Food Addiction

Gastric sleeve patients with food addiction are at high risk of weight regain after surgery. If you think you may have a food addiction, you are strongly encouraged to meet with a therapist and discuss this further. Food addiction symptoms include:

  • Eating due to stress
  • Food cravings despite being full
  • Feeling guilty about what or how much you ate
  • Prioritizing food over work, friends, family
  • Justifying unhealthy food choices (making excuses)

Meeting with a therapist to address food addiction can lead to weight loss. Therapist are trained to uncover the root cause of your eating, and working with one might be the missing link to lose the weight you gained back.

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Have you experienced weight gain after gastric sleeve surgery? Have you been successful at reversing your weight regain?

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