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WHY DO PEOPLE REGAIN WEIGHT AFTER BARIATRIC SURGERY?
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50% of weight loss surgery patients regain the weight they lose after weight loss surgery (1). Bariatric surgery is a tool associated with successful weight loss, but there are some who find that weight regain can occur in the long term. This weight regain can have a significant impact on their health, undoing a lot of the hard work they have put in to lose the weight in the first place, and can have a detrimental impact not just on physical health, but mental health and body confidence.
So why do people regain weight after bariatric surgery?
They don’t look at the big picture
When patients initially discuss weight loss surgery with a surgeon it is difficult to not just look at the positive aspects that can come from the procedure and the weight loss results of previous patients. However, not everyone looks at the hard work involved not just before and during bariatric surgery, but the change in mindset and lifestyle that is required to not just lose weight, but to keep the weight off for good. Patients get caught up in the how and what and forget to focus on their core values, WHY they want to lose weight, something I remind my clients during support sessions, to get good results.
I like to compare this to a diamond - when people look at a diamond they see the end result and don’t consider how much work has gone into creating such a beautiful and polished stone. Weight loss is the same - many see the end result of successful weight loss but don’t consider just how much time and effort has gone into achieving those results. It’s taken many years to gain the weight, however most expect the weight to be lost in a short period of time.
There is a lack of support
People who have bariatric surgery without any support and aftercare are more likely to regain the weight that they lose. One of the biggest problems after bariatric surgery is that patients don’t work with the surgery correctly because they don’t know how to. Surgery isn’t the quick fix or easy option and there are lots of different changes in lifestyle and habits that need to be made, to make weight loss not just effective, but permanent, and with a lack of support it is easy to revert back to old habits that will cause weight regain.
They become overwhelmed with all the changes
As discussed above, having a bariatric procedure is only a very small part of weight loss. The hard work is really found within the changes involved - dealing with emotional connections to food and triggers, meal planning, making sure that you take the right vitamins and minerals and developing an exercise routine is all part of a weight loss journey. After a few months some can find this overwhelming and slip back into old habits because it is easy to do so.
They are stuck in the dieting mindset
Yes, following a pre-op diet is necessary to shrink your liver, and immediately after surgery there are different stages that need to be followed to introduce textures while your stomach is healing, but many find it difficult to get out of the “all or nothing” dieting mindset of weighing their food and counting calories that is associated with weight loss. I am not a believer in the concept of a “diet.” One of the most detrimental things that anyone can do when changing their eating habits is to restrict and remove the foods that they really enjoy as this can lead to an unhealthy binge / restrict cycle, a negative mindset and weight regain.
They haven’t dealt with their emotional hunger
Emotional hunger is often referred to as “head hunger”- habitual and mindless eating which can be triggered by stress and tiredness and can result in someone turning to “slider” foods for comfort. It’s really important to remember that weight loss surgery is a tool and does approximately 30% of the work in controlling
real hunger, but it doesn’t control emotional eating or change thoughts and feelings about food. It may feel that this is under control during the “honeymoon” phase immediately following bariatric surgery, but it is likely to reappear in the long term. Emotional hunger needs to be managed with support.
There could be a surgical problem
In rare cases weight regain could be the result of a surgical problem. Make sure that you consult your aftercare team, dietitian and surgeon to make sure that there aren’t any surgical issues that may be the result of weight regain. Assessment may require a procedure under x-ray called a barium swallow to check the anatomy of your stomach and how quickly food empties into the small bowel. Surgical problems are rare, however patients immediately feel frustrated and will feel there is a problem with the surgery rather than their diet,habits and lifestyle when it comes to weight regain.
Are you concerned about weight regain following bariatric surgery? Want to know more about how I can help you change your relationship with food? Why not book a discovery call? Contact me via my website here:
https://www.thedietologist.co.uk/#CONTACT
Obes Surg
Obesity Journal 2008 Jun;18(6):648-51. doi: 10.1007/s11695-007-9265-1. Epub 2008 Apr 8.
