Weight Regain, and What You Can Do
By: Dr. Steven C. Simper, MD, FACS
“It is the will and ambition of our patients who ultimately make their weight loss possible. Treating the whole person is a critical part of the care given to my patients.”
Question: I’m starting to regain weight. What can I do?
Dr. Simper’s Answer: This is a difficult but common problem. To some extent, weight regain occurs with most patients. The natural history of weight loss surgery is that most patients will lose almost all of the weight that they are going to lose within the first two years. Over the following five years or so, patients often regain some weight. But if things do not stabilize, then you are in trouble.
Remember that all bariatric surgery procedures are tools and not the solution. They require a lifetime commitment of exercise and a good diet to keep the weight off. The book that you received prior to your surgery details information regarding a good diet and exercise to help you keep your weight off. Additionally, RMAP support groups, our Facebook page, and newsletters are also meant to be a continual reminder. They reinforce the principles that will help you be successful.
With time, you may find yourself eating more, cheating on your diet, and allowing old habits to creep back into your life. Snacking, grazing, eating high calorie, high carbohydrate foods and drinking sodas will sabotage all bariatric procedures. As one surgeon that I know has said, “There is no operation as strong as the potato chip,” and he’s right.
If you don’t eat right and exercise, no operation will be able to keep you from gaining weight. The first thing to do is get back to the basics.
Weigh yourself frequently. Your metabolism, activity level, and basic energy expenditure changes gradually with time. Weighing yourself will help you stay on top of what’s happening to you and take action before it gets out of hand.
If you have lost your way and regained much of your weight back, identify your particular weakness. It still might be very difficult to lose much of the weight that you have gained. We may be able to help you here. In selected patients, doing revision surgery for weight regain may be helpful.
For Lap Band patients, converting their surgery to a gastric bypass or duodenal switch (DS) can be helpful. Gastric bypass patients are a more difficult problem. There has been some success with placing lap bands on selected gastric bypass patients or converting them to a duodenal switch. For DS patients, the problem is even more difficult, as this is our most powerful bariatric procedure.
Revision surgery is a controversial and difficult area of bariatric surgery and therefore takes careful evaluation, education and consideration before proceeding. We require patients to take our six month medical weight loss program before undergoing revision surgery. We believe that this extensive personal education has contributed to our success.
The best treatment is prevention! Stick to the rules and avoid the weight regain in the first place. If you believe that you might be a candidate for revision surgery, please contact our office for an appointment.
About the Author:
Dr. Steven Simper, MD, FACS, performed his first bariatric procedures in 1984 at Wilford Hall Medical Center, in Texas. Currently, he performs laparoscopic gastric bypass, sleeve gastrectomy, duodenal switch, and revisional surgery. In addition to general surgery procedures. He joined Rocky Mountain Associated Physicians in 2001, and began performing laparoscopic gastric bypass. Since 2008, he has developed his skill and expertise with the powerful biliopancreatic diversion with duodenal switch (DS). He is among a handful of surgeons who perform this procedure. He both proctors other surgeons and is a speaker at bariatric conferences in regards to the duodenal switch procedure. In following his patients, and witnessing results, he has become a strong advocate for this procedure in the select individual who needs a powerful surgery.