One of the greatest fears of many bariatric surgery patients is not the procedure itself, but the weight regain that may occur months or years after the surgery.

Many patients see a significant weight loss immediately after surgery until around two years at most. But it’s not exactly easy to maintain a healthy weight in the long run due to several factors. And this can be extremely discouraging for people who have had a hard time losing weight in the past. 

While weight regain is a common scenario, our team at Beltline Heath can help you prevent it by having the proper medical guidance, a steady support system, and a consistently healthy lifestyle.

In fact, many bariatric surgeons say that weight regain is the number one long-term complication of bariatric surgery. It usually occurs two years following surgery, and according to the American Society for Metabolic and Bariatric Surgery, more than half of patients regain 5 to 10% of their body weight within two years. But on a positive note, about 80% of morbidly obese and 65% of super obese patients can still hold off at least 50% of their excess weight after 10 years.

In this post, we will discuss how bariatric surgery works, reasons for weight regain after surgery, and the steps you need to take in case it happens to you.

What is bariatric surgery?

Bariatric surgery, also known as weight loss surgery, is a medical metabolic procedure that aims to provide sustainable weight loss to help patients with extreme obesity as well as those who have been suffering from obesity-related health problems. The ultimate goals of common bariatric procedures today are:

• reduce the stomach’s natural capacity to limit the amount of food you can eat or your food intake
• alter your digestive tract to control how food is digested after being consumed
• or both.

These procedures allow to induce weight loss and control obesity-related conditions, and when done correctly, a patient can experience a significant weight loss of up to 80% of excess weight.

What are the reasons for weight regain after bariatric surgery?

Let’s be clear. Regaining weight isn’t a clear indication that your surgery didn’t work. According to Dr. Charles Procter, a leading bariatric surgeon in the country and a founding member of Beltline Health, the effects of bariatric surgery come into play within two years after having the procedure.

So if you’re already five years post-surgery, the weight loss surgery you had does nothing for you anymore. It means that your metabolism is likely normal or at least, back to what it was before surgery.

During those years, there are several reasons that may make you gain the weight you lost. It’s important to know these factors to increase your chances of having sustained weight loss.

Prior Weight

Patients are typically encouraged to lose weight before the surgery, mainly because it can reduce the chances of surgical complications which makes recovery easier for the patient after the bariatric procedure. Based on thousands of bariatric surgeries performed, experts are convinced that a patient’s body mass index (BMI) during the procedure is associated with a higher possibility of weight gain later on. This means that patients with a lower body mass index (BMI) prior to surgery are more likely to lose weight and less likely to regain weight years following surgery.

Eating Habits

During the first two years following bariatric surgery, most patients still follow the recommended diet guidelines and exercise routine to get the best results.

But as they start to adjust and tolerate a wider variety of foods, some tend to eat more food than usual and just set aside regular exercise. At this time, patients start to lose weight at a slower rate before their weight rises again.

“If you’re starting to gain weight, it’s not about the quantity of food you’re eating, but the quality. Most bariatric patients will see about a 10% weight regain a few years down the road, but if you’re gaining most of the weight that you lost, it’s generally because you have had some bad eating habits,” says Dr. Procter.

Mental Health

While there are physical health concerns associated with bariatric surgery, it also includes several psychological and emotional components that should be considered and taken care of to have a better and healthier lifestyle.

For instance, a patient diagnosed with depression who fails to maintain his weight may struggle to manage his condition, revisit some old habits, develop binge eating disorder, food addiction, or drug abuse, and experience weight gain as a result. Without support groups and ongoing lifestyle counseling, patients are more likely to have lower self-esteem and sense of well-being and develop bad lifestyle and eating habits that may affect both physical and mental health.

Surgical Complications

It’s uncommon for surgical complications to become the cause of weight regain, but some of the possible issues that may arise are:

• pouch enlargement (the gastric or stomach pouch itself stretches out over time which increases stomach capacity)
• gastrogastric fistula (food materials may leak from the gastric pouch to the gastric remnant which allows more food to be digested by the body)
• stomal dilatation (the new connection between the gastric pouch and the small intestine may dilate which allows more food to pass through)re