Weight Gain After Bariatric Surgery: Experts Explain

Written by Heather Smith, B.S. and medically reviewed by Dr. Stephen Boyce, MD

Key Takeaways

  • About 25% of people who have bariatric surgery experience some weight regain during their weight management journey.
  • Achieving and maintaining weight loss after bariatric surgery requires ongoing dedication to healthy eating, regular physical activity, and mindful habits. 
  • Getting back on track can involve consistent follow-up with your healthcare team, sticking to the recommended eating plan, managing stress, and changing up your physical activity.

Most people lose a lot of weight and improve their health after bariatric surgery. However, some individuals struggle and regain some of that weight.

Over time, your digestive system may allow for more food intake. Some behavioral and psychological factors are hard to overcome. These challenges make it important to incorporate bariatric vitamins into your routine to ensure proper nutrition and manage cravings effectively.

This can be frustrating. It’s a common challenge. But, you can take steps to resume or maintain your weight loss. 

We wrote this article to help you. It explains the common causes of weight regain after bariatric surgery. It also gives you strategies to maintain your hard-earned weight loss.

Why Gaining Weight after Bariatric Surgery?

There are several reasons why you may be seeing the numbers on the scale increase rather than decrease after bariatric surgery. 

Over time, the pouch your surgeon created during surgery can stretch, or the connection between your stomach and the intestines may enlarge. These changes allow you to comfortably eat more food than before, which can gradually lead to weight regain. 

Changes to your digestive system hormones may also play a role in weight regain. After surgery, your hormones may tell you that you are full and satiated after eating only a small amount of food. Over time, your hormones may adjust, and you may not feel quite as full and satisfied as before, causing you to want to eat more. 

Also, old habits are hard to break. It’s easy to fall back into unhealthy habits. We might snack all day or choose high-calorie comfort foods instead of lean proteins and fiber-rich foods. Slipping back into familiar routines is especially easy when life gets too busy or stressful. However, returning to these old habits can slowly undo the progress you’ve made after surgery. 

There are also psychological factors. Emotional eating is a big culprit for weight regain. If you don’t address issues like stress or anxiety, it’s easy to turn to food for comfort. You must learn to manage them.

Bariatric surgery changes your stomach, but can’t change your relationship with food. This is why it’s crucial for you to address psychological matters for long-term success. 

How Common is Weight Regain After Bariatric Surgery?

Regaining weight after bariatric surgery is more common than you’d think. In fact, studies show that around 20-25% of people experience significant weight regain at some point after surgery.

The typical timeline for weight regain usually starts between 12 to 18 months after surgery. At this time, you can typically eat a broader range of food, your body is done healing, and you may be feeling pretty good. But beware, this is when it’s easy to slip back into old eating habits, including less nutritious options and skipping essential supplements like a bariatric multivitamin with iron.

According to another study, about 53% of people experienced significant weight regain (defined as gaining back 25% or more of the weight lost from the lowest point post-surgery) six years after surgery. Males generally regain weight slightly earlier than females, but by year six after surgery, both genders have similar weight regain patterns. 

Proactive Health Measures to Prevent Regain

Being proactive with your health and weight management can help you stay on track, prevent weight regain after bariatric surgery and other challenges like a weight stall after bariatric surgery. Here are some key factors to keep in mind.

  • Regular monitoring: Schedule consistent follow-up appointments with your bariatric team to check progress, address potential issues, and make necessary adjustments. It’s better to spot a shift in weight gain early on than letting it go unnoticed for too long.
  • Adhere to dietary guidelines: Stick to your recommended eating plan, focusing on portion control, lean proteins, bariatric snacks and fiber-rich foods. Avoid the temptation to slip back into old habits; remember, those extra bites can add up quickly.
  • Physical activity: Incorporate regular exercise and resistance training into your routine to help maintain weight loss and boost overall health. Building muscle supports better metabolism and helps you burn more calories throughout the day. 
  • Sleep quality: Aim for at least 7-8 hours of sleep each night. Poor sleep can throw off your hormones, making you naturally hungrier, and it’s harder to resist cravings and control your appetite when you are tired. 
  • Stress management: Practice stress-reducing activities like meditation, yoga, or even taking a walk. High-stress levels can lead to emotional eating, which might undo all your hard work. 

How To Stop Gaining Weight after Bariatric Surgery?

Don’t panic if you notice the numbers on the scale creeping up after bariatric surgery. There are several effective ways to get back on track.

Here are some strategies to help stop weight regain:

  • Behavioral interventions: Consider participating in cognitive behavioral therapy (CBT) or joining a support group. These can help you identify and change unhelpful eating behaviors and emotional triggers. 
  • Nutritional counseling: Schedule an appointment with a registered dietitian who specializes in bariatric care. They can help you fine-tune your eating habits, ensuring you’re sticking to the post-surgery guidelines and getting the nutrients you need. Many dietitians are available to meet virtually, which can be very convenient.
  • Medical evaluation: Check in with your healthcare provider to rule out any physical changes or medical issues that might be causing weight gain, like an enlarged stomach pouch or a new medical condition. It’s better to catch these issues early on and deal with them rather than work against them.
  • Mindful eating practices: Focus on eating slowly, savoring each bite, and listening to your body’s hunger and fullness cues. This helps prevent overeating and can make mealtime a more enjoyable experience. Plus, it’s a great excuse to slow down, destress, and really enjoy that tasty meal.
  • Hydration check: Make sure you’re drinking enough water throughout the day. Sometimes, your body can confuse thirst for hunger, leading to unnecessary snacking when all you really need is some water. Try getting a refillable water bottle so you can see if you are keeping up with your water intake goals. 
  • Set realistic goals: Establish small, attainable goals to keep yourself motivated. Whether it’s walking an extra 10 minutes each day or adding more veggies to your meals, these little changes can add up over time. Remember, slow and steady wins the race.

Role of Pharmacotherapy in Weight Management

Taking weight loss medication can be a helpful tool in managing your weight regain after bariatric surgery. 

Healthcare providers often prescribe these medications as an adjunctive treatment, meaning they work best when combined with lifestyle changes like healthy eating and regular exercise. 

Think of them as the extra boost you might need when your body gets a little too comfortable with its current weight. 

Several options have been approved for long-term use:

  • Orlistat: This medication blocks the enzyme that breaks down fats in your diet, helping decrease the amount of fat you absorb.
  • Phentermine-topiramate: This medication helps reduce your appetite and keep you feeling full for longer.
  • Liraglutide: This injection medication helps reduce appetite and keep blood sugar levels steady, reducing cravings throughout the day.

Choosing the right medication is not a one-size-fits-all approach. It’s important to talk with your healthcare professionals about your medical history, the potential side effects of each medication, and your weight loss goals. 

Taking these considerations in mind, your healthcare provider can help you determine which medication is best for your needs. 

The Role of Follow-Up Care in Weight Management

Your follow-up care is crucial for long-term weight control after bariatric surgery. Regular check-ins with your healthcare team are vital. They provide support and accountability. They help you stick to the lifestyle changes needed for success. These appointments can also assess whether additional supplements, like bariatric multivitamins or bariatric vitamins chewable, are needed to support your journey.

These visits are not just about your weight. They also check your health. This includes your nutrition, post-surgery healing, vital signs, and lab work. Catching issues early can prevent small problems from growing. 

Follow-up care also helps you stick to those new healthy habits. Knowing you have an appointment on the calendar can be a great motivator to stay on track. It’s like a friendly nudge reminding you why you started this journey in the first place. 

Your healthcare team wants to help keep you accountable. They also want to celebrate your wins, no matter how small.

Conclusion

Commitment is the key to long-term success after bariatric surgery. The surgery is not a one-and-done deal. It’s a lifelong journey of maintaining healthy habits.

Healthy weight management needs a broad approach, beyond diet and exercise. You’ll also need to change your relationship with food. You must overcome unhealthy habits that may cause weight gain. 

It’s best to have regular check-ins with your healthcare team. You may also want to work with a registered dietitian who specializes in bariatric surgery. If you have anxiety, stress, or depression, find healthier ways to cope. Don’t turn to comfort foods.

Remember that each person’s pack is unique to them. What works for one person may not work for another. For this reason, personalized guidance is key to your health after bariatric surgery.

If you want to learn more, why not check out these articles below: 

Resources

Alfadda, A. A., et al. (2021). Long-Term Weight Outcomes after Bariatric Surgery: A Single Center Saudi Arabian Cohort Experience. Journal of Clinical Medicine.

Ansari, W. E., & Elhag, W. (2021). Weight Regain and Insufficient Weight Loss After Bariatric Surgery: Definitions, Prevalence, Mechanisms, Predictors, Prevention and Management Strategies, and Knowledge Gaps—A Scoping Review. Obesity Surgery.

Baratte, C., & Poghosyan, T. (2023). Weight Regain after Bariatric Surgery. Journal of Clinical Medicine. 

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