How to Avoid Weight Re-Gain After Bariatric Surgery

After bariatric surgery, most people can achieve their goal weight with proper dieting and exercise. However, after you get used to your life after weight loss surgery, it can be easy to regain the weight you initially lost.

At ProCare Health, we have all the tips you need to avoid weight gain after bariatric surgery.

What Causes Weight Gain After Bariatric Surgery?

While every patient is different, there are several factors that lead to weight gain after bariatric surgery.

Eating Habits

In the first year after bariatric surgery, most patients follow a strict diet and exercise every day. However, as they begin to tolerate a wider variety of foods, they may start to eat more and exercise less.

Most weight gain after weight loss surgery is associated with eating habits:

• Binge or emotional eating
• Eating when feeling full
• Eating continuously throughout the day
• Out-of-control eating
• Eating fast food or unhealthy food

Surgical Complications

Rather than eating habits, surgical complications – or anatomic issues – can also lead to weight gain in post-bariatric patients.

If a patient experiences an increased frequency in hunger sensations or develops recurring acid reflux, they may have developed anatomical issues after surgery. Anatomic problems are generally diagnosed with an upper GI series or an upper endoscopy.

Anatomic issues can also depend on the type of bariatric surgery you undergo. Some of the most common anatomic causes of weight regain are:

• Pouch dilatation happens when the stomach pouch stretches and becomes larger because of overeating or eating and drinking at the same time.
• Band slippage.
• Anastomic dilatation occurs when the connection between the stomach pouch and the entrance to the intestines becomes stretched. Common causes are not following dietary recommendations, increased food intake, and eating and drinking at the same time.
• Adjustable gastric band system problems (balloon leaks, holes in tubing, and port disconnection).

Medical Conditions

Medical conditions can also lead to weight gain after weight loss surgery. Some of these conditions include:

• Pregnancy
• Thyroid issues
• Adrenal issues
• New medications
• Kidney problems
• Heart problems

If you find that you are slipping back into old eating habits or suspect that you are gaining weight because of a surgical or medical condition, reach out to your bariatric healthcare team for advice.

How to Prevent Weight Gain After Bariatric Surgery

The key to preventing post-bariatric weight gain is educating yourself, following a healthy diet plan and lifestyle changes, and communicating with your bariatric surgeon. While weight gain can happen, it is not inevitable. Here are some tips for avoiding weight gain after bariatric surgery:

• Schedule regular visits with your bariatric surgeon to keep your weight loss on track.
• Follow your recommended nutrition plan to ensure you receive adequate nutrition and muscle mass.
• Eat lean proteins, whole grains, low-fat dairy, fruits, and vegetables.
• Eat foods low in fat.
• Avoid foods containing more than 15 grams of sugar per serving.
• Avoid snacking or grazing of any kind. This will prevent you from feeling full, and the extra calories can cause weight gain.
• Track your daily protein intake. You should aim for at least 60 to 80 grams of protein per day, depending on your type of surgery. Your bariatric healthcare team or dietitian can offer you advice if you have questions.
• Eat at least three meals every day.
• Spend at least 20 to 30 minutes of eating every meal. Be sure to chew your food slowly and thoroughly.
• Drink 65 ounces (eight cups) of low or non-calorie beverages.
• Separate eating and drinking by 30 minutes.
• Incorporate once-daily multivitamins and mineral supplements into your everyday routine.

Additionally, there are also specific foods you should avoid after weight loss surgery. These types of foods are high in fat or sugar, which can lead to weight regain:

• High-calorie or high-sugar beverages such as sports drinks, some juices, and soda
• Milkshakes or malt drinks
• Cakes and pastries
• Fried foods
• Chips and other high fat snack foods
• Ice cream
• Candy

Following a regular exercise regimen will also help keep unwanted pounds away. Remember that exercise needs to increase your heart rate. Be sure to incorporate strength training to build and maintain lean muscle mass. If you find that your exercise routine is lagging, consider some of the following to kick it back into high gear:

• Find an exercise partner who will help hold you accountable
• Join an exercise club, gym, or class
• Walk as often as you can
• Adopt – or refresh – your weekly plan with a commitment to fit physical activity into your schedule every day
• Find exercise clothes that you feel good in

Besides helping to keep the weight off and build muscle, exercise also helps to improve your coordination, boosts your physical health, and provides you with the goals you have set.

For other tips, read Keeping Up with Exercise, Nutrition, and Vitamins After Weight Loss Surgery.

Should You Undergo Bariatric Surgery Again?

If you experience weight gain after bariatric surgery, you may be considering a revision or conversion of the first surgery – especially if you have post-surgery complications.

In some cases, a second bariatric surgery can successfully repair or redo your previous procedure. You may consider a second surgery if the anatomy of your stomach and small intestine have changed.

However, there is an increased risk of complications associated with a second bariatric surgery, including infections and bleeding of the gastrointestinal tract.

Because of these risks, you should not consider another round of bariatric surgery if you regain weight because of eating habits or lack of exercise. If these are the reasons you gained weight, you may want to consider another option: the pouch reset diet.

What is the Pouch Reset Diet?

A pouch reset diet is a popular option for patients who experience weight gain after bariatric surgery. It can help you kickstart your weight loss and help you get back on track.

Similar to the post-bariatric diet, the pouch reset diet is made up of specific phases:

• Day 1 – On the first day, you will only be allowed to drink clear liquids such as broth, sugar-free jello, or fruit juice.
• Day 2 to 3 – Next, you can transition to full liquids such as protein drinks, non-fat Greek yogurt, cream soup, or sugar-free pudding. You will also need 90 grams of protein per day.
• Day 4 to 6 – During this phase, you should only eat pureed foods, which have a consistency of a smooth paste or a thick liquid without solid pieces of food. Acceptable foods include protein drinks, mashed potatoes, scrambled eggs, low-fat cottage cheese, or hummus.
• Day 7 to 9 – Then, you can transition to soft foods for two days. Soft foods include soft vegetables, steamed or grilled fish, low-fat cheese, and scrambled eggs.
• Day 10 and beyond – From the tenth day and onward, you should only eat whole foods. You should slowly incorporate these foods back into your diet and focus on eating lean proteins.

Lasting only 10 days, the pouch reset mimics your post-surgery diet with restricted food intake. When you overeat, your stomach stretches to make room for larger and larger amounts of food. The weight you lost, may be quick to return. With a pouch reset, you help return your stomach back to its normal size.

While you can do your own pouch reset, it is recommended to seek the support of your weight loss surgeon and dietitian.