When Is Weight Regain Normal? When Is It Problematic? After Bariatric Surgery
You may have had bariatric surgery after years if not decades of yo-yo dieting – losing a significant amount of weight only to gain it right back – sometimes even reaching higher weight heights than you had before. Weight regain, sadly, is a very normal part of an obese person‘s life.
It may also be the case that after bariatric surgery, you saw several months or even a couple years of consistent weight loss allowing you to reach your ultimate body weight goals. When you finally hit that number, it can be a thrilling experience and the culmination of years of hard work and difficult decisions. However, once you hit your goal weight, you’ve only just begun your journey. Staying at your new lower weight requires as much dedication as the weight-loss leading to that point. It is at this point where many patients begin to regain some weight.
Obviously, regaining any weight after losing so much and working so hard can be scary and frustrating. However, it is important to understand what kind of weight regain his normal and when you should be concerned.
Normal Hormonal and Metabolic Fluctuations
Everybody’s weight fluctuates over time. Our weight fluctuates during the day and over the course of weeks or months. This can be particularly true for patients with changing hormones, for example menstruating women. This kind of weight gain and subsequent loss is very normal and should not be construed as a problem.
Normal Post-Op Weight Gain
Further, postoperative bariatric patients should expect to regain approximately 5 to 10% of their excess body weight lost after they have stabilized at their new lower target weight. This is as a result of the stomach adjusting to the new food reality and the inevitable liberalization of dietary habits. The stomach is a very adaptable organ and will stretch over time.
When We Get Concerned
We begin to worry about weight regain and weight loss when the regain consist of more than 10% of the excess body weight loss. Also, it is concerning when patients gain significant amount of weight very quickly. Even if they lose it shortly thereafter, we prefer to investigate what the causes of those ups and downs might be.
How We Manage Concerning Weight Regain
First, it is incredibly important that bariatric patients are honest during their follow up consultations with their surgeon. While it may be embarrassing or nerve-racking to tell your surgeon that you had difficulty maintaining your weight, it is also an opportunity to find out the root cause and fix it.
Typically, weight gain revolves around the liberalization of diet and a slowing of the exercise regimen. Life gets in the way. These will be the first questions that we will. However, if there is no obvious reason for the weight regain or significant fluctuation, we may start to consider the possibility that the procedure has failed to offer the results that we expected. This is especially common in patients who had a gastric band and are no longer receiving its benefit.
Only then will we consider a revision of the primary bariatric procedure, which involves changing the primary bariatric procedure into something new. Typically, we convert gastric bands that often fail after several years, to a gastric bypass or gastric sleeve. We find that these revisions, while more complex and with somewhat higher risk, offer a much greater degree of weight loss potential and typically the patient is much happier with the results.
The bottom line is that you should always report concerning weight regain to Dr. Tsuda, Dr. Ryan, and Brian Grace our PA or your support team. Figuring out whether the weight regain is problematic is the first step to correcting and stabilizing it. In most cases, weight gain can be well managed by refocusing on proper dietary and exercise habits. In some cases, with the advice of your surgeon, other medical and/or surgical options may be appropriate.