Revisional Bariatric Surgery for Weight Regain
Weight regain after bariatric surgery can be shocking, however in most cases, it is perfectly normal and can be easily managed. Over the course of a couple years, our patients will lose a significant amount of weight, very quickly. This is as a result of significant dietary, exercise and lifestyle modifications, as well as a restricted food intake. This restriction may be combined with a modification to the small intestine, if the patient has a gastric bypass or duodenal switch. This significant weight loss, of course, can only last for a certain amount of time and patients will eventually plateau. The exact time it takes for their weight to stabilize will also depend on the degree to which the patient has changed their lifestyle and the procedure they have undergone.
Once the weight stabilizes, the patient’s lifestyle will have normalized and many changes will begin to occur in the body. One of these changes may include the stretching of the smaller stomach pouch if the patient liberalizes their diet and consumes more food. This means that patients may regain up to 5 to 10% of their excess body weight after stabilization.
Revising a Gastric Band
Most commonly, however, we revise the gastric band or Lap-Band because of relatively higher long-term complication rates. One of the original selling points of the gastric band, its reversibility, is helpful in that we can easily revise the procedure to a gastric sleeve or gastric bypass. Since no part of the gastrointestinal tract is modified during the gastric band procedure, a follow-up procedure is relatively straightforward.
Revising a Gastric Bypass or a Gastric Sleeve
Revising the gastric bypass or gastric sleeve is slightly more challenging and comes with a higher risk than the primary bariatric procedure. While we perform these revisions regularly, they are less common because patients typically maintain excellent weight loss and disease improvement results over the longer-term.
Whether your weight gain is mild or significant, it is important that you contact us to determine the root cause and learn how to manage the possibility of weight regain in the future.
When We Consider Revision Surgery
When patients come to our office worried about this type of weight gain, we usually evaluate their exercise and diet regimen and suggest ways to manage their weight more effectively. This may include consuming denser proteins that will keep them fuller longer, eating smaller portions more often, or consuming fewer high-sugar and high-fat foods.
If the weight gain is significant, or if there are wild fluctuations in weight, it may be a sign of unacceptable stretching of the stomach pouch; or, in gastric bypass patients, enlarging of the stoma – the opening from the stomach to the small intestine. In cases where the stomach has stretched too much or the stoma is not performing its job, relatively straightforward revision procedures are available to correct the issues. These are usually performed on an outpatient basis and return the stomach and/or the stoma to their original post-surgery size and effectiveness.