Weight Regain After Bariatric Surgery: Causes & What You Can Do

It is possible to naturally gain weight after a bariatric surgery. It is not caused only due to a lack of following lifestyle and dietary instructions from your end. However, you still need to talk to your doctors, identify its root cause, and treat it as soon as possible. Bariatric surgery in India is only recommended for patients who are at serious health risks due to uncontrollable obesity. In such cases, if you or your loved ones are regaining weight post-surgery, it creates long-term health risks if it is left unchecked.

The first and foremost requirement is to understand the weight regain objectively without letting it add to your stress or panic. It is important to note that obesity is a genetic, physiological, and chronic condition. So, a bariatric surgery does not inherently treat obesity; it only covers the symptoms and helps your body lose weight. Regaining weight after losing it or even after bariatric surgery can be caused by numerous factors. So, let’s take a detailed look at the various reasons for weight regain after bariatric surgery. We’ll also discuss steps you can take to manage the weight regain, while seeking medical help.

Read This Before Continuing

Losing and gaining weight are a part of your body’s natural process. 

As obesity is a chronic condition, it requires active management from your end; however, weight regain is not always caused by failure to maintain proper dietary and lifestyle habits, even after a bariatric surgery. 

Checking your weight at home is very easy nowadays, and it may sometimes make you feel down and depressed when you see the figures on a scale go up. It is important not to let it sway you from the healthy daily habits that you have built in order to beat obesity. 

Sometimes, weight gain can even be caused by underlying health problems, without any interference or lack of trying on your end. With that being said, let’s review why you can regain weight after a bariatric surgery.

Understanding Why Weight Regain Happens After Bariatric Surgery

Top bariatric surgeons like Dr Sachin Ambekar remark on this phenomenon with two different perspectives. First, doctors unanimously agree that weight regain after bariatric surgery is not akin to a personal failure of the patient. In fact, the weight regain is remarked as a disease progression. You can compare it to stages of cancer; seeking treatment does not guarantee that the cancer goes away permanently (even with surgeries). The weight regain after a bariatric surgery can be deemed as the progression of obesity or its underlying health conditions.

Secondly, you must wait and ask, “When was the weight regained?”

Any patient going through a bariatric surgery first loses weight, thanks to their active medical supervision. The patients are, in most cases, actively monitored until their comorbidities can be managed to a lower threat level. This process of losing weight after the surgery and managing comorbidities can take up to a year.

After that, over the years, patients often report (especially patients who underwent laparoscopic sleeve gastrectomy) slow but gradual weight regain. However, the regain in most cases doesn’t happen suddenly.

This is how doctors look at it: If a patient who weighed 200kgs before the bariatric surgery, undergoes the surgery and can go down to 90kgs of weight, even if they gain 60kgs of weight on top of 90kgs over the next 7 to 8 years, it would not be the same. Even at 150kgs of weight after 8 years of their bariatric surgery, the life-risk associated with their comorbidities, especially for chronic conditions like diabetes and sleep apnea, would be invariably much improved.

To summarise, it is important to understand and remember the goal of bariatric surgery. It does not cure or permanently treat obesity. It just takes away the life threat of underlying health problems in people with obesity. And that, the improvement in life expectancy remains true, even if you regain weight over the years after your bariatric surgery.

Common Causes Behind Weight Regain

The common causes behind weight regain after a bariatric surgery can be categorised into behavioural and psychological causes and underlying medical causes. Let’s review both categories.

Underlying Medical Causes

Numerous health conditions, both active or recently developed, can cause weight regain after a bariatric surgery. Here are the most common causes.

• Hormonal Imbalances: It can be caused by underlying health conditions like thyroid dysfunction or conditions like PCOS/PCOD. Hormonal imbalances can slow metabolism and increase fat storage in your body, making it harder to lose weight and leading to weight gain, even when you’re trying to stick with your dietary and lifestyle strategies.
• Metabolic Adaptation: When you lose weight drastically, it doesn’t sit right with your body. So, it tries to burn fewer calories at rest. This gradual metabolic shift can lead to higher chances of weight regain.
• Insulin Resistance: Blood sugar levels can plateau after a bariatric surgery, and it can even reverse, leading to weight gain again, despite best efforts.
• Anatomical Changes: When you have bariatric surgery, the stomach pouch or sleeve can stretch and expand. This is a known and common medical possibility.
• Medications: Some medications prescribed for mental health or diabetes can sometimes lead to a risk of weight gain.

Behavioural & Psychological Causes

While underlying medical conditions are an important cause of weight regain after bariatric surgery, it is also important to acknowledge the effect of behavioural and psychological causes.

• Unintentional Grazing: Small bites that you eat over the course of the day add up to the calorie intake, especially when you’re on calorie-restrictive diets. This leads to an increased risk of weight gain over time.
• Routine Loss: When you start a new routine, it is easy to stay on track with it with all your motivation. However, it is only human to lose focus over time as time passes. These small lapses can lead to gradual weight gain over time.
• Sedentary Lifestyle: Work schedules and declining energy levels with age make activity harder and force people to take on a sedentary lifestyle. This improves your risk of weight gain.
• Struggle With Food: Many people associate food and eating with comfort. This leads to habits like overeating or binge eating at times of emotional distress. These practices can increase your risk of weight gain post-bariatric surgery.

What You Can Do to Prevent & Manage Weight Regain

Here’s a clear stepwise structure that you can use to prevent and manage weight regain while seeking medical care.

Reimagine Your Relationship with Eating

Following a ‘diet’, unfortunately, comes with a negative connotation for many people. This creates an unhealthy relationship with food, one that you want to desperately escape at any chance you can get. This needs to change. You should focus on eating without distractions, and specifically, food that you like reimagined in a way that helps you meet your nutritional requirements. This is one of the best and most sustainable ways to maintain and reverse weight regain.

Don’t Count Calories, Make The Calories Count

In direct succession to the previous point, you have to learn about food substitutions that allow you to enjoy the food you like without making following the diet feel like a chore. Balanced meals that you consume regularly can help you improve your health and make you feel better both emotionally and physically.

Create Sustainable Fitness Habits

If you can run 1km once a year, it doesn’t have any long-term health benefits. If you can walk for five minutes every day, it has long-term benefits. The key is to be consistent, which is difficult considering everyone has packed schedules on a daily basis. So, this is why it is important to create sustainable fitness habits, which can be something as simple as walking to the market every day or going for an evening walk. It is important to set goals that you cannot only do today but also a year later, without feeling overwhelmed or angry.

Don’t Ignore Your Psychological Support Needs

Body weight, the stigma around obesity, and a difficult relationship with food are things you should never go through alone. There are dedicated avenues in India for people going through similar experiences to help you feel seen and receive support. You must focus on your emotional well-being to maintain your weight after bariatric surgery.

Stay Connected With Your Bariatric Care Team

Your bariatric care team can help you navigate weight changes and understand how to manage your weight over time. There are medical interventions that the team can recommend for you, with oral medications and injections that can help you manage your weight regain and even reverse it.

Why Choose MAASH Hospital For Your Bariatric Surgery & Post-Operative Care?

MASSH Hospital goes beyond just medical care; it cares about holistic medical support and overall well-being. MASSH provides excellent post-surgical care to help you recover and manage your body weight. Even after the initial recovery phase, we offer long-term medical assistance for patients in case they experience weight regain. From lifestyle management to mental-health check-ups, MASSH offers dedicated services aimed at helping our patients live life on their terms without compromising their health. For more information, feel free to learn more about bariatric surgery at MASSH by visiting us and setting up a consultation with our specialists.

FAQs

1. Is weight regain normal after bariatric surgery?

Yes, weight regain is normal after bariatric surgery over time. However, even though it is normal, you must communicate weight changes with your bariatric support team to prevent any health complications resulting from weight changes.

2. Why do some people regain weight years after bariatric surgery?

Over time, multiple factors like an unhealthy relationship with following a diet and regular exercising, paired with underlying health problems, can lead to weight gain years after bariatric surgery. 

3. Does snacking lead to weight regain after bariatric surgery?

Yes, snacking that doesn’t contribute to your nutritional requirements can lead to additional calorie intake beyond your daily requirements. These small additions can, over time, lead to weight regain after bariatric surgery.

4. Can hormonal changes cause weight regain after bariatric surgery?

Yes, hormonal changes can cause weight regain after bariatric surgery. In most cases, hormonal changes can be influenced by thyroid disorders or conditions like PCOD/PCOS.

5. Can emotional eating cause weight regain after bariatric surgery?

Yes, emotional eating can cause weight regain after bariatric surgery because it leads to overeating, which can directly lead to weight gain.

6. How can I prevent weight regain after bariatric surgery?

Preventing weight regain after bariatric surgery requires maintaining a healthy diet and lifestyle routines. It also requires focusing on your emotional well-being and overall health to ensure holistic well-being.

7. Is weight regain more common after a gastric sleeve or a gastric bypass?

Weight regain is more common after a gastric sleeve compared to a gastric bypass surgery. Set up a consultation with our specialists at MASSH to learn more about the underlying cause for this statistic.