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3 Reasons Why You Will Regain Weight After Bariatric Surgery

OC Staff After Surgery, Obesity Coverage

Bariatric Surgery Gets a Bad Rap

Bariatric surgery gets a bad rap. And it makes sense.

Tell your friends or family members that you are considering bariatric surgery and you usually get a response like this; ‘You don’t need surgery. You’re not that fat. You can do it the natural way.’

Your friends and family members care about you. But they are scared, misinformed and sometimes even a tad bit jealous. They aren’t trying to make you feel bad. But they’ve heard stories.

‘Ann had bariatric surgery and lost 150 pounds. She completely got off all her meds and she no longer has diabetes.’ That’s a true but very boring story.

Here’s the story that you’re more likely to hear about bariatric surgery; ‘Jane tried to lose weight the ‘easy way.’ Yep, she had that Lap Band thing. Well she almost died on the operating table. For an entire year, she could only drink water and eat baby food. Then she gained it all back! I just saw her drinking a coke and eating a donut. Man, people just want the easy way out.’

It’s stories like these that give all of bariatric surgery a bad rap. And while some of those scary stories are true, most of them are embellished, changed, or outright gossip.

Some patients do regain weight years after bariatric surgery. In those cases, it’s typically not the surgery that failed, but instead the patient or bariatric program that failed. Failure (inadequate weight loss) typically happens for two reasons:

  • Lack of pre and post-operative education and support (the bariatric program’s fault if these weren’t offered) or…
  • Lack of implementation (the patient never changed their lifestyle by not taking advantage of the education and support offered).

The scary bariatric surgery stories that you hear are shared because they’re ‘share-worthy.’ And while some stories may be true or have a kernel of truth, the data (the clinical studies) tells us that those are the exceptions.

Lap Band Success Rate
Gastric Sleeve Success Rate
Gastric Bypass Success Rate
Duodenal Switch Success Rate

Data Sources: PubMed: Quick fix or long-term cure? Pros and cons of bariatric surgery and International Journal of Surgery: Long term predictors of success after laparoscopic sleeve gastrectomy

The line graphs above show patients who have lost more than 50% of their excess weight and managed to keep it off for more than 5 years. The popularity of the Lap Band has dropped significantly due to the long-term complication rate and low success rate.

Bariatric surgery is a life changing procedure that is the opposite of easy. It is hard, it is abrupt, and it is major surgery. And, as pointed out, if you don’t change your lifestyle, there is a chance you will fail (inadequate weight loss).

What is the Point of Bariatric Surgery?

So what then, is the point of surgery if you have to change your lifestyle anyway? Couldn’t you do that without surgery?

  • Bariatric surgery forces a reduction in calories or minimizes the absorption of calories or both (depending on the type of surgery).
    • Procedures that are restrictive in nature (your stomach size is reduced) allow patients to feel full after a small amount of food. This forces patients to eat less.
    • Procedures that are malapsortive create a smaller intestinal tract for the body to absorb calories. This forces lower calorie absorption.
  • And in some procedures, ghrelin production (the ‘hunger hormone’) is reduced leading to a reduction of hunger.
  • Most bariatric procedures also create a feeling of nausea after consuming foods high in carbohydrates or sugar. This ‘helps’ many patients choose nutrient dense foods that are low in sugar and low in simple carbohydrates.
  • Bariatric surgery forces patients to re-learn how to eat. It forces patients to choose better foods. It forces patients to think about how much and when they eat.
  • Bariatric surgery patients are able to lose a lot of weight in a short amount of time.

How Do Some People Gain Weight Back?

If bariatric surgery forces you into a new diet, and it forces you to eat less, and it forces you to not eat unhealthy foods, then how do people regain the weight?

Reason #1 – Rationalizing

People are smart. And, as with any bad habit, our minds can rationalize a little bit of something because a little bit is ‘ok.’ And then a little bit more the following day. And a week later, that Sugar Free Caramel Frappuccino that was just a one-time thing now has whip on it and your buying it every day on the way to work.

Reason #2 – Comfort

Life is tough. For many bariatric surgery patients, food was a shoulder to lean on. Food was a support system and food made those bad days a little bit better.

You had a family member die. You lost your job. You are stressed. That pizza and ice cream makes you feel a little bit better while you eat it. Then regret. Then you decide the entire week is ruined and you eat poorly the next day. Then something else happens in your life and you’re sad. So you eat more. Then you feel bad again and you’ve started to gain weight. Now you’re depressed and who cares, right?

And slowly but surely, as you snack more and your meals get a little bit larger and more simple carbohydrates find their way to your plate, your body adjusts and allows the gradual introduction of bad foods.

Reason #3 – You’re tired

When you don’t sleep you make poor decisions. This seems simple and maybe obvious but it’s not that obvious. You are working long hours at work and you’re tired. You need something quick. You got 4 hours of sleep last night and you already feel like crap, fast food works.

These are bad decisions, that have multiplier effects. When you slip, you end up slipping more. Choosing the quick food option. Choosing simple carbs over protein and veggies.

A single slice of pizza doesn’t make you feel sick anymore. A small piece of cake is ok. And you found those sweet potato chips that don’t seem to upset your new stomach so you eat a bag a day at your desk.

Slowly but surely, the weight comes back.  Habits are hard to break.

Again, what is the point of bariatric surgery?

You are probably saying to yourself, well I still have to change my lifestyle. I can do that without bariatric surgery. Why go through the hassle of surgery?

You have tried the ‘natural’ way. You have likely tried to lose weight for most of your adult life. You are here because, for you, nothing else has worked. And the data shows that, for most people, nothing else will work.

Bariatric surgery forces you to lose weight while you learn how to eat healthy. And a successful bariatric patient will know how to recognize when they have fallen off the wagon. Because you will. Everyone does.

The key is recognition. Successful bariatric patients recognize bad habit creep and quickly address the issue. This can be done by food journaling, by attending regular support groups, by getting friends and family to support your journey.

Every patient has different triggers and different emotional ties with food. Understanding your relationship with food during the pre-operative psychological counseling, the pre-operative physician supervised weight loss program, the post-operative dietitian consults and monthly support group meetings will better prepare you for bad habit creep.

And as the weight comes off, it becomes easier to exercise. Medication is often reduced. Cholesterol and sleep apnea are better controlled. More energy and a visible physical change can be powerful motivators.

Bariatric surgery creates such a drastic physical change that the weight loss itself becomes a strong motivator to continue to lose more and keep it off.

So why choose bariatric surgery?

Because the drastic weight loss will motivate you to continue your journey to better health while your pre and post-operative education helps you implement healthy habits that last. 

And how do you implement healthy habits that last? The success is in the habit. Check out our 5 Habits to Weight Loss Success article to set you on the right track.


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