Is Weight Regain After Bariatric Surgery Normal

October 11, 2021

Is Weight Regain After Bariatric Surgery Normal? This is another common question, and the short answer is YES with a BUT! Generally, there is about 5-10% weight regain after you reach your lowest weight. So, if you lost 75-80 pounds, expect to gain back about 7-10 pounds. The weight regain is normal and probably needed by your body. The initial phase of weight loss is fairly rapid, and the body doesn’t get an appropriate opportunity to make adjustments to the new you.

The challenge with obesity is the recurrent and relapsing nature of the disease. As soon as one starts losing weight, the body initiates a counteraction and tries to halt the weight loss and even pushes your body in the other direction, weight gain.

Remember, the body doesn’t see an ideal body weight; it only sees the fact that you lost weight, and that signals starvation period to your brain. The body feels threatened and thinks, this must be fought to preserve the body; lack of energy means withering away the tissues!

Weight Regain After Bariatric Surgery

Weight regain usually occurs between 9-15 months after your procedure and there are multiple influencing factors. Your body will recover from an energy deficit to an energy equilibrium where energy consumption is matched by your body's energy utilization. As your ability to eat more, which translates into more available calories for the body to use. The energy stores which are usually in the form of muscle and fat are replenished.

Remember, when you have bariatric surgery it triggers a cascade of metabolic effects which ultimately leads to weight loss and, unlike dieting, doesn’t allow the body to gain the lost weight fast.

Another major factor that plays an important role in how and where these calories are directed is the level of physical activity, both aerobic (such as walking, jogging, running, etc.) and resistance (such as weight lifting, functional body movements, etc.).

The more active you are, the more likely you will be able to maintain your lean muscle mass and allow your body to keep the lost pounds away.

One of the challenging problems arises when the weight regain continues, and we are unable to slow or stop it. Obesity is a complex disease as such; it has multiple contributing factors, and when we are faced with weight regain, we have to approach it from multiple angles.

In my practice, we institute dietary, exercise, and medical therapies to ensure we are successful in reversing that weight regain process.  One must not get discouraged or scared by weight regain. As mentioned above, some weight regain is normal and inevitable. The problem occurs when it gets out of hand, and we can’t control it.

Start by Keeping a Food Journal

Start by keeping a food journal. You must record everything you eat. We always underestimate the number of calories we consume and have a skewed understanding of how much we should be eating. Unfortunately, as our plate sizes have artificially increased in size, we have developed an eye and an appetite for filling larger plates. The random size of the plate shouldn’t dictate how much food we have to eat.

Some of the most active and longest healthy aging populations in the world consume very small amounts of food. In fact, we have found that if we can live with a slight caloric deficit, we will live healthier and longer.

Don’t eat until you are full! This might be a new premise for some people. The sensation of fullness is the upper limit of the stomach’s ability to handle food. So, when you are full, you have over-filled the stomach and definitely consumed too much food. To get used to the appropriate amount of food we need to consume, we have to measure it initially and then get used to seeing it. Developing an eye for how much is appropriate will take discipline and time to develop.

Sometimes despite all of the interventions above, we are unable to reverse the process. In these cases, we have to consider revisional bariatric surgery. There are many options available for patients that are gaining weight after bariatric surgery, which can not be reversed with other conservative therapies.

ABOUT THE AUTHOR Dr. Husain Abbas of Memorial Advanced Surgery, is a Board Certified surgeon trained in Minimally Invasive Surgery. After his surgical residency at St. Mary's, a Yale University affiliated hospital, Dr. Abbas completed a fellowship in Minimally Invasive Gastroesophageal & Bariatric Surgery at the University of Florida, Gainesville. Dr. Abbas' expertise extends to a wide array of gastroesophageal disorders, anti-reflux surgery, complex hernia repairs, endocrine, oncology and bariatric procedures. Read more articles from Dr. Abbas!

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