Nov - Dec 2017

Why You Need to See Your Doctor If Your Weight Loss Is Failing

By Alex Barkan, MD FACS


Weight loss is a challenge, but not impossible. So if you’re following your weight loss regimen by the numbers and the scale still won’t budge, you may want to call your doctor right away. What you might think is only a harmless 20-pound weight gain, it may be a sign of something more serious. You shouldn’t panic, but you should go to see your doctor immediately.


Causes of weight regain can be the obvious reasons like overeating, defined as eating more calories in a day than you burn. If so, you are not in caloric balance. You are consuming too many calories and have not expended enough energy through movement and exercise to burn those calories off. Doing this day after day causes these excess calories to get stored up as fat pounds. The only way to get them off is to lower the calorie intake and burn more calories per day with movement and exercise. Poor food choices contribute to this caloric imbalance. When your food choice is full of calories and low on fiber or protein, both of which are filling, it’s easy to overeat. If the food melts quickly in your mouth it is unlikely to give a feeling of satiety because it does not fill the stomach and move through the intestines like protein and fiber do to make the digestive system work to expend energy.


Patients who are post bariatric surgery are also susceptible to a few surgical complications of which they need to be aware. The first is the stretching of the pouch which can happen with the gastric bypass and the gastric sleeve. The stomach can accommodate larger amounts of food at a sitting and the patient can eat larger portions thereby consuming larger amounts of calories. This can be evaluated by the doctor with a few simple tests and there are some ways to fix it. There can also be stretching of the anastomosis, which is the connection of the pouch and the intestine in the gastric bypass. This is checked with a radiology exam and an endoscopy. This too can sometimes be tightened by the right surgeon. There are also complications known as gastro gastric fistulas which can develop between the gastric bypass pouch and the remnant stomach. This allows the bypassed stomach to act as a second depository for food allowing the patient to take more calories in at one sitting. These too can be surgically repaired.


Regardless of whether your weight gain is due to overeating, poor food choices, grazing or some issue with the altered surgical anatomy, you must be aware of it and make sure that you follow up with your doctor. Weight regain can be a sign that there may be a serious problem. Take action by contacting your bariatric program so you can resume your weight loss journey.