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Post-Bariatric Weight Gain: Understanding the reasons behind weight gain in bariatric patients after surgery.
Post-Bariatric Weight Gain: Understanding the reasons behind weight gain in bariatric patients after surgery.

Weight loss medications after bariatric surgeries like the laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass let you finally lose weight after years of trying. This is the experience of millions of Americans who struggle with obesity and eventually turn to bariatric surgery to drop the stubborn weight.

Bariatric or weight loss surgery is considered a last resort. It usually gets recommended by your doctor or bariatric surgeon after you’ve tried everything to drop those excess pounds. Conventional weight loss methods like diet and exercise do work for some. But when you’ve struggled with obesity for life, a slowed metabolism, psychological issues, food addiction, and other factors can keep you from losing weight even through traditional methods.

Bariatric surgery tends to be the saving grace for these men and women who can finally lose excess body mass to boost their quality of life significantly.

Does bariatric surgery work? You bet. Millions have already turned to these procedures to lose 50% or more of their excess weight. Many bariatric patients manage to keep the weight off for the long term.

However, there is a phenomenon known as post-bariatric weight gain, and the very thought of it strikes fear in the hearts of those who have undergone weight loss surgery.

If you fear post-bariatric weight gain, there are signs you should look out for and ways to guard against the condition. At Healthy Life Bariatrics, we aim to help you lose excess weight and keep it off for life. That’s why we instruct all our patients on achieving weight loss greatness without post-bariatric weight gain getting in the way. Here is some of that advice.

Before we get to ways to guard against weight gain following bariatric surgery, let’s delve into reasons why a bariatric patient may regain weight in the first place.

Common Reasons for Post-Bariatric Weight Gain

Healthy Habits Have Slipped

Popular weight-loss surgeries like the gastric sleeve and bypass help you lose weight by restricting how much food you can consume. With both surgeries, up to a third of your stomach is removed. The remaining space is converted into a pouch where you process the food you eat. You can only eat so much with a smaller stomach, leading to safe and rapid weight loss.

However, even with these changes, you must still live a healthy lifestyle. Because your space for food is limited, you must fill your allotment with healthy food options. We’re talking dense protein sources, good carbohydrates, and healthy fats like Omega-3s. You are even instructed to drink water and other liquids apart from eating so you don’t inadvertently stuff yourself with non-caloric options.

The digestive changes with the gastric bypass go beyond the changes made during the gastric sleeve. With the Roux-en-Y gastric bypass, your smaller stomach is rerouted to your small intestine. This limits the number of calories and nutrients your body can absorb.

And yet, even with all that, you can still eat terribly unless you commit to healthier ways of eating. Committing to a healthy lifestyle to succeed with bariatric surgery over the long term would be best. If you can eat right regularly, you can keep post-bariatric weight gain at bay.

But fill your plate with too many unhealthy foods and fail to exercise, and you could experience a regain of some of the weight you lost.

Changes to Your Internal Organs

Though it is rare, in some cases, changes can occur in your stomach and intestine, allowing you to consume more food and take in more calories. These changes can sometimes occur after weight loss surgery. The result can be weight regain.

To guard against this, your surgeon may recommend a second bariatric surgery, called revision surgery, to redo the gastric bypass surgery. One common ailment that can lead to bariatric revision surgery is when a fistula forms. A fistula is when an additional connection forms between the stomach and intestine.

Speak to your bariatric surgeon about the prospects of having revision bariatric surgery if weight regain has affected you. Your doctor will inform you that you are having a second surgery. At the same time, the outcome can be successful, but it puts you at greater risk of complications, such as bleeding, gastrointestinal leaks, and infection.

How to Guard Against Post-Bariatric Weight Gain

Those are the two main problems with weight regain. Second revision surgery may be for you if you have developed a fistula after a gastric bypass or have other changes to your body and internal organs. However, in most cases, weight regain comes down to a choice of habits.

Common Habits That Lead to Post-Bariatric Weight Gain

If you want to know if your habits are causing you to gain back some or all your excess weight, keep a food and exercise diary. Keep accurate records for a week or two, then check your results. Pay attention to the following weight-gaining habits.

Binge Eating:

When recording your eating habits, don’t just pay attention to what you eat and how much. Also, record the environment and circumstances, as well as the ways you feel. Sometimes, we can get caught up in emotional eating and not know it. Tend to overeat when stressed, or social eating is your emotional crutch. Your food diary will make your bad habits more apparent, allowing you to follow healthier habits to reinvigorate your weight loss.

Eating After You’re Full:

When eating meals, try to eat on smaller plates. Sometimes, we feel the need to eat everything we’re presented with. If you are used to large plates, you may feel you have to consume the entire serving, even if you’re already full. Instead of eating with your eyes, pay attention to your stomach to stop eating when you feel satiated.

Continuous Eating:

Do you ever find yourself in a food loop, where you find yourself consuming meals and snacks all day long? This usually happens when food is readily available. Try removing food from your immediate environment or setting a timer and allowing yourself to eat small amounts only once every three or four hours. These tactics can help with continuous eating, which can pack on the pounds without you noticing.

Uncontrollable Eating:

Eating a box, carton, or container is unhealthy for weight loss. If you can’t control yourself around certain types of foods, get them out of your house. Remove them from your environment and stuff your pantries and fridge with healthier options. Stick to foods high in fiber and protein so you feel fuller longer and won’t be so apt to overeat.

Regular Fast Food:

Fast food is convenient, but that’s all it’s good for. For best results and to keep weight regain at bay, strive to eat fast food sparingly. Use it as a treat occasionally, and stick with home-cooked options for much of your dietary intake.

How to Treat Weight Regain as a Bariatric Patient

There are five steps to handling weight regain after a bariatric procedure.

Recognize That Obesity is a Disease

The entire reason you underwent bariatric surgery was that you could not lose the weight on your own. That’s to be commended. You finally took a stand and stood up to obesity, and you chose health! Just because you had bariatric surgery doesn’t mean the fight against obesity was won. It will be a long, arduous battle, but you can win…if you don’t let minor setbacks like weight regain derail your motivation for wanting to lose weight. Keep your eyes on the prize and envision yourself in a new body and wearing a new wardrobe. Even when a few pounds have crept back, envisioning success is sometimes all it takes to revive your motivation and your weight loss efforts.

Follow Your Bariatric Surgeon’s Advice

Your weight loss surgeon gave you instructions for following a healthy lifestyle. This advice is part of every patient’s bariatric treatment. Follow that advice to the letter, and you’ll likely succeed along your weight loss journey, even with minor setbacks.

Your surgeon will tell you which foods to fill your plate with. You’ll learn exactly how much of each type of food to eat and how much exercise you should get each day. Don’t feel like you must become a dietary and fitness expert right out of the gate. Living a healthy lifestyle isn’t a speed race; it’s a slow-to-the-win marathon. Treat it as such and try to have some fun along the way. Eating right and exercising don’t have to be boring, after all.

Avoid Snacking or Grazing

Changing your eating habits is never easy. Grabbing a handy snack keeps you full all day long. Fullness represents comfort, so maybe you’ve become used to snacking all day to comfort yourself. You can try replacing more harmful snacks with healthier ones, such as carrot sticks instead of cookies or fruit, instead of digging into the cereal box. Eventually, it would be best to strive to go without snacking entirely. Try drinking more water between meals and getting some exercise to eliminate boredom. Keeping a food diary can also help you avoid mindless snacking. It’s amazing seeing just how much you eat daily when you’re writing down every morsel.

Seek Support

You should never feel forced to undergo your weight loss journey alone. For one, your bariatric surgeon will keep up with your aftercare with regular follow-up visits. It would be best if you directed any questions or concerns about post-bariatric weight gain to your surgeon, who may have customized answers you can benefit from.

You can support your surgeon by seeking a support group or starting your own. Having like-minded people to bounce ideas off of can be extremely beneficial. That’s especially true when you’re all going through the same post-bariatric experience.

Schedule a Follow-Up Visit with Your Bariatric Surgeon

Post-bariatric weight gain is sometimes part of the weight loss surgery following bariatric surgery. It doesn’t happen to everyone, and it’s not inevitable. You can now recognize the signs and habits that may be leading to a few pounds creeping up here and there. Your weight loss journey won’t always be downhill. There will be struggles. But by choosing a skilled bariatric surgeon like Dr. Babak Moeinolmolki of Healthy Life Bariatrics, you can further ensure your success as a bariatric surgery patient.

Dr. Babak Moeinolmolki
August 23, 2021