Avoiding Weight Regain After Bariatric Surgery

Bariatric Surgery is Not a Quick Fix

Weight loss can sometimes feel like a never-ending battle. If you are considering bariatric surgery or have already undergone surgery, it is important to remember that the surgery isn’t a quick fix and you may still experience some setbacks.

Statistics reveal that the range of weight loss for people who undergo bariatric surgery is 12% to 39% of presurgical body weight or 40% to 71% of excess weight. Moreover, bariatric surgery results in the most significant and sustained weight loss as well as reversal of type 2 diabetes mellitus.*

When you regularly eat more calories than you burn, your weight increases but aside from caloric consumption, there are other reasons why people gain weight. Medications, some medical conditions, hormonal imbalance, toxins, stress, depression and slow metabolism are also contributing factors to weight gain. These factors have to be taken into consideration even when you choose bariatric surgery as an option.

Bariatric surgery may be a solution to obesity for some individuals, but without proper care, it can lose its effectiveness, leading to weight regain.

A recent research published in the American Medical Association’s journal JAMA Surgery found that nearly half of patients experience significant weight gain after five years following laparoscopic sleeve gastrectomy.**

Why You May Gain Weight Following Bariatric Surgery

1. Mental Health

Studies reveal that Binge Eating Disorder (BED) impairs weight loss following bariatric surgery. Based on these studies, some investigators recommend that patients be treated first for this condition before undergoing surgery. ***

Binge eating is related to stress, depression, anxiety, low self-esteem and other negative feelings. Even stressful thoughts can activate metabolic pathways that cause weight gain.

2. Poor Nutritional Habits

Problematic eating behaviors can lead to weight regain. Chaotic eating, skipping meals (which can result in overeating), poor choice of food, grazing, night eating, alcohol - all these may stretch the capacity of the stomach and thus lead to weight gain.

3. Lack of exercise

Regular exercise, even just walking, is important for long term weight maintenance. This is particularly important for peri and post menopausal women.

How to Avoid Regaining Weight After Bariatric Surgery

The key to avoid regaining weight after surgery is education and counseling in diet, health behaviors and exercise. Here’s how to avoid regaining weight after surgery.

1. Attend follow up appointments with your surgeon, dietitian and psychologist

Professionals can help you identify the emotional triggers and underlying issues that may lead to regaining weight and manage them effectively.

2. Stick to your prescribed diet

Closely following your prescribed diet helps you lose weight safely and avoid regaining weight.

Your doctor or dietitian will explain to you the types of food you'll need to follow after surgery, and how much food you can eat per meal. Your doctor may recommend:

- Eating and drinking slowly

Consuming your meals in at least 30 minutes will avoid dumping syndrome. It should also take you 30 to 60 minutes to drink 1 cup of liquid. You should also observe a 30 minute interval between meals and liquids.

- Eating small meals

You will be required to eat smaller meals - about a half-cup each meal to start with, but you can eat several meals a day, up to a maximum of six times. This will vary from patient to patient so it is important to follow the advice of your dietitian.

- Drinking between meals

Drinking too much liquid at or around mealtime can make you feel full, thus preventing you from consuming enough nutritious food.

- Chewing your food properly

Large pieces of food can get stuck in the very narrow passage between your stomach and intestine and block the passing of food. Blockages can cause vomiting, nausea and stomach aches.

- Choosing high-protein foods over fatty and sugary foods

Protein can help you maintain muscle mass. Fatty foods and sugar can cause dumping syndrome.

- Avoiding alcohol

Alcohol causes disinhibited eating (which involves a lack of restraint over food intake) and lack of satiety. It is also a source of easy calories.

- Taking supplements

Because you will be eating less, you may not be getting enough nutrients from your food, so you may require supplements.

3. Make fitness a priority

Increase your daily physical activity. You can start slow and progress gradually. Progressive resistance training decreases abdominal fat.

4. Enlist the support of your family and friends

People who care for you can help you stick to healthy eating and fitness habits, as well as help you overcome emotional issues.

Our Multidisciplinary Approach

A very common misconception is that it's very easy to lose weight - it's just a matter of eating less and moving more. But what most people don't understand is that there are secondary considerations and complications that need to be dealt with when it comes to obesity.

Long term weight management is a difficult task and it takes a multidisciplinary team consisting of a psychologist, dietitian, exercise physiologist and a surgeon to ensure we get the best results for our patients.

Each intervention is an individual one, so unless there is a multidisciplinary approach, you run the risk of missing key areas where you may need extra support. That makes a multidisciplinary approach a must.

At Dr. Phil Lockie, we also run a support group which includes talks on a wide range of pre and post surgery topics. Individuals can choose the sessions they wish to attend.

The support group is a wonderful avenue for giving and receiving support. It's also a great occasion for talking and sharing with each other, as well as learning a little bit more about the journey. If you are struggling to keep healthy habits, contact us today:

https://www.drphillockie.com.au/infopage/request-a-free-consultation-with-shirley-lockie

*https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3208891/

**https://jamanetwork.com/journals/jamasurgery/fullarticle/2422341

***https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3085093/