Unfortunately, weight regain is a possibility after bariatric surgery. As we mentioned elsewhere, weight loss surgery is not a magic bullet and a lot of the success, especially over the long term, is patient dependent. Many patients maintain significant weight loss for decades or even the rest of their lives, but some can regain weight, or at very least plateau, throughout the weight loss journey. Before we get into concerning weight regain, we have to discuss when weight gain is not an issue.
First, you will experience plateaus and maybe even some mild weight gain throughout the journey. This usually happens when your body becomes accustomed to your diet and exercise regimen. The best way to restart your weight loss during a plateau is to change up what you’re eating and how you’re exercising. You may consume the same number of calories or exercise just as much, but different exercises work different muscles and new diets can restart the body‘s natural internal furnace.
Another cause of normal and natural weight gain is the muscle building process. Once you have recovered from surgery, you will begin a strength training program. As muscle begins to replace fat, you may actually see your weight increase slightly. This is normal because muscle is denser than fat and consequently weighs more. Don’t get discouraged during this time. Rather, take a look at your waistline as a better way to see your progress.
When Weight Gain Is Concerning
Most patients lose a consistent amount of weight over the first six months to a year after surgery, unless they are not compliant with their diet and exercise program. However, as we normalize our diets and get back into regular life, it becomes harder and harder to maintain the focus that we had soon after surgery. For most, weight gain involves simply straying from the diet and can be easily corrected by redoubling your effort to get back on track. Sometimes this requires a bit of support from your medical team at our office or support group buddies. Everybody has gone through this and it is quite normal.
If your weight is increasing drastically or if your weight is yo-yoing by 10 or 20 pounds at a time, this may be a sign of a larger issue. We strongly encourage you to make an appointment with Dr. Higa to follow up on this and give him a very candid report on your diet and exercise progress in the recent past. Keeping a journal of what you’ve eaten and how much you’ve exercised will be very helpful in diagnosing the issue.
Has the Procedure Failed?
More often than not, weight regain is due to patient non-compliance with the postoperative program. However, there are times where the procedure itself does not offer the expected weight loss. This is especially true with the Lap-Band and other gastric bands that were first placed over a decade ago and now have created a number of longer-term complications. These Lap-Bands are now being converted to stapled procedures such as the gastric sleeve or the gastric bypass to allow the patient to restart their weight loss and even lose more weight than they would have previously. Stapled procedures are also more effective when dealing with the diseases associated with obesity including type 2 diabetes, acid reflux, sleep apnea, high blood pressure and high cholesterol.
There is always a solution to a procedure that has failed. However, before we consider a revisional surgery, we always look at your lifestyle including diet and exercise to make sure that it is not something that can be addressed non-surgically. Revisional and conversion surgery requires more risk due to the scar tissue in the area, however even those procedures are very safe.