Weight Regain after Bariatric Surgery

Weight regain is known as one of the most impactful long-term complications after bariatric surgery. What is it, why does it happen and what can you do about it?

What is it?

Weight regain is known as one of the most impactful long-term complications after bariatric surgery, although there is currently no clear definition of what exactly weight regain means. A poll by the International Bariatric Club, a group of experts in bariatrics, found that the two most favoured definitions are:

• regaining weight to a BMI above 35; and/or
• an increase in weight of more than 10 kg from the patient's lowest post-operative weight.

Whatever the definition, if you are a post-bariatric surgery patient experiencing weight regain, there is no denying it is frustrating, and it can sometimes lead to feelings of defeat, anger or even depression.

Why does it happen?

It is nearly impossible to pinpoint exactly what causes weight regain. The mechanisms stem from lifestyle, mental health, hormonal changes, surgical factors or any combination of these. Behavioural drift – the slow movement away from a behaviour or skill – is also common among patients experiencing weight regain after surgery.

What can you do?

If this is happening to you, your first thought might be "I failed". Rest assured, this is far from the truth. According to the American Society for Metabolic and Bariatric Surgery, as many as 50 percent of patients may regain a small amount of weight (approximately 5 percent) two years or more after their surgery. While some weight regain may be tolerable, if you feel your weight regain is getting out of control, here are 5 recommendations to help you get back on track.

1. Go back to the basics

• Follow a balanced meal plan focusing on protein, with an adequate intake of vegetables, fruit and healthy fats.
• Drink at least 1.5 litres of fluids each day, avoiding high-calorie drinks.
• Increase movement throughout your day and include a weekly exercise regimen with some resistance training and aerobic exercise.

2. Take your vitamins

• Stick to the vitamin/mineral regimen set by your bariatric team.
• Have your nutrition-related laboratory values checked annually.

3. Control life stressors

• Stress plays a huge role in our hormone balance and eating patterns, and can therefore lead to weight regain.
• Find healthy ways to deal with stress: see a counsellor, keep a journal, go for a walk, read a book or confide in a trusted family member or friend.

4. Set small, attainable goals

• Trying to take on too much at once can be overwhelming.
• Identify behaviours or skills that helped you lose weight in the beginning (for example food tracking, meal prepping, step counting or journaling). Reintroduce them one or two at a time so it stays manageable.

5. Go back to your bariatric clinic!

• Weight regain is common, and your bariatric team is there to help you, for life. Attending support groups is a great way to stay involved in the community.
• If you cannot go back to your original clinic, do not hesitate to find a new one. Other practices will be more than happy to continue your care!

This article is for general information only and does not replace personal medical advice. Always discuss your situation, blood test results and supplementation with your bariatric team or healthcare provider.