Stuck at Half-Mast
By Ronda L. Hart, MSN APRN-BC CBN
Is this happening to you?
You made it through surgery just fine. The weight was coming off as anticipated and you were cruising along. But a couple of years later you pulled out your scale and suddenly discovered you gained weight.
For many patients after surgery, there is a certain amount of weight regain that can occur. In one study, weight regain was observed within 24 months after surgery in approximately 50% of patients (Magro et al., 2008). In another study, 59% of the patients regained 20% or more of the weight they lost after gastric bypass surgery (Barham, 2011).
It is important to be aware that there is a possibility of gaining all of your weight back after bariatric surgery and possibly even more. Why does this happen? Here are several common causes:
- Gastro-gastric fistula formation can occur in up to 6% of post gastric bypass patients. Weight gain can be a sign of this condition (Filho, 2006).
- Progressive dilatation of the gastro-jejunal stoma after gastric bypass surgery is thought to cause early emptying of the gastric pouch and loss of post-prandial satiety, resulting in weight regain (Barham, 2011, Heneghan et.al, 2011).
- Pouch enlargement can occur after gastric bypass surgery although a wide variety of pouch sizes still provide acceptable weight loss.
- Excessive consumption of snacks, sweets, and fatty foods was considerably higher among those who regained weight (Freire, 2011).
- Lack of both nutritional counseling and exercise was associated with weight gain (Freire, 2011).
- Grazing is when one consumes small quantities of food throughout the day. This behavior typically does not fill you up and therefore, one will consume more resulting in an excess of calories which can lead to weight regain (Freire, 2011).
Most people do lose weight after their procedure. The risk of weight regain can be minimized if you are committed to your nutrition, behavior and fitness goals. If you find you are gaining weight, schedule an appointment with your bariatric program to get back on track as well as rule out any physical causes that may be contributing to your weight regain.
Barham, K., Lautz, D.B., & Thompson, C.C., (2011). Gastrojejunal stoma diameter predicts weight regain after Roux-en-Y gastric bypass. Clinical Gastroenterology and Hepatology, 9(3), 228-233.
Filho, A., Kondo, W., Nassif, L., Garcia,M., Tirapelle, R., & Dotti, C. (2006). Gastrogastric fistula: A possible complication of Roux-en-Y gastric bypass. Journal of the Society of Laparoendoscopic Surgeons, 10(3), 326-331.
Freire, R., Borges, M., Alvarez-Leite, J., Touslon, D., & Correia, M. (2011). Food quality, physical activity, and nutritional follow-up as determinant of weight regain after Roux-en-Y gastric bypass. Nutrition, Aug 30 [Epub ahead of print].
Heneghan, H., Yimcharoen, P., Brethauer, S., Kroh, M., & Chand, B. (2011). Influence of stoma size on weight loss after gastric bypass. Surgery for Obesity and Related Diseases, Sept, [EPub ahead of print].
Magro, D.O., Geloneze, B., Delfini, R., Pareja, B.C., Callejas, F.,& Pareja JC. (2008). Long-term weight regain after gastric bypass: A 5-year prospective study. Obesity Surgery, 18(6), 648-651.