One of the most frequently asked questions from patients in the office is “Doctor, can I gain weight after bariatric surgery?” Yes you can. There is no miracle when talking about bariatric surgery and in any technique the patient is subject to recovering the lost weight.

In the first 18 months after the surgery, the phase is popularly known as the “Honeymoon”, where most of the time the patient is extremely motivated, faithfully following all the nutritionist’s guidelines, reduced appetite, daily receiving many compliments about his appearance, enthusiastic about physical activity and changing his life. Over time, appetite increases, weight stabilizes, and emotional problems can return, bringing with them the old habits that caused excess weight.

It is estimated that more than 50% of patients will have some degree of weight regain and it is important to assess what is considered normal, acceptable and even expected from what is not normal and can be harmful. Recovering approximately 5-10% of the reduced excess weight after 24 months of surgery, slowly and without clinical repercussions, can be considered normal and does not require any clinical treatment.

For example: a 49-year-old female patient, operated on 5 years ago, weighed 120 kg and was 1.65 m tall preoperatively (overweight 52 kg); 24 months after surgery, he had lost 56 kg, was 64 kg (loss of 107% of excess weight, well above expectations) and currently weighs 72 kg. Despite having regained 8 kg of weight, she has lost 92% of her excess weight, which is an excellent result. This patient should review habits and diet with the nutritionist, reinforce physical activity and maintain control with her team.

If weight regain begins in the first postoperative year, or occurs quickly and is associated with bad habits, if some of the comorbidities such as diabetes, steatosis (fat in the liver), sleep apnea, high cholesterol and triglycerides return, or if the reduction in excess weight is less than 50%, this is not normal, it must be evaluated and, whenever possible, treated. For example, the same 49-year-old patient operated on 5 years ago, weighing 120 kg and 1.65 m tall, who had reduced to 84 kg 24 months after the operation (69% loss of excess weight) and currently weighs 98 kg (42% loss of excess weight), in addition to being again hypertensive and with hepatic steatosis, shows a significant re-weight and with significant damage to health.

In this case, the patient should preferably seek out the multidisciplinary team that performed the bariatric surgery. The patient must undergo clinical, nutritional and psychological evaluations, through specific tests as the clinical investigation shows to be necessary. Answer some questions:

1. How many meals do you have a day?

2. Are you hungry? How long after the meal?

3. Do you feel full after eating? With what foods?

4. How big a portion of food can you eat?

5. Do you experience heartburn or reflux?

6. Have you started any new medication in the last few months?

7. Are you doing physical activity? What kind of activity and how often?

8. Do you drink alcoholic beverages?

9. Are you drinking sodas and sugar-sweetened beverages?

10. Do you feel guilty or depressed?

11. Do you know why you are regaining your weight?

Based on this information and with a dietary and habit recall, the patient can be helped to discover the causes of weight gain and seek appropriate treatment. In most cases, weight gain is due to a return to bad eating habits, a biting pattern (eating cookies, sweets, snacks, and other high-calorie foods with low satiety power in small, frequent portions), consumption of alcohol and sweetened drinks, and physical inactivity. In these cases, you should reorganize your diet, start physical activity or intensify it, review healthy habits and, if necessary, psychological or psychiatric follow-up.
Obesity is a serious disease. And more and more studies show that curing obesity is not just about surgery, on the contrary, it is the beginning of a period of one to two years of changes that must be associated with auxiliary therapies such as nutritional education, programmed physical activity and changes in lifestyle. Take care, your health is priceless.

Through all that has been said, we can conclude that obesity is a multifactorial disease and we reiterate that only Bariatric Surgery does not perform miracles. The patient has to do his part and be aware that obesity is a disease that is difficult to control, even after bariatric surgery. Take care, your health is priceless.

One of the most frequently asked questions from patients in the office is “Doctor, can I gain weight after bariatric surgery?” Yes you can. There is no miracle when talking about bariatric surgery and in any technique the patient is subject to recovering the lost weight.

In the first 18 months after the surgery, the phase is popularly known as the “Honeymoon”, where most of the time the patient is extremely motivated, faithfully following all the nutritionist’s guidelines, reduced appetite, daily receiving many compliments about his appearance, enthusiastic about physical activity and changing his life. Over time, appetite increases, weight stabilizes, and emotional problems can return, bringing with them the old habits that caused excess weight.

It is estimated that more than 50% of patients will have some degree of weight regain and it is important to assess what is considered normal, acceptable and even expected from what is not normal and can be harmful. Recovering approximately 5-10% of the reduced excess weight after 24 months of surgery, slowly and without clinical repercussions, can be considered normal and does not require any clinical treatment.

For example: a 49-year-old female patient, operated on 5 years ago, weighed 120 kg and was 1.65 m tall preoperatively (overweight 52 kg); 24 months after surgery, he had lost 56 kg, was 64 kg (loss of 107% of excess weight, well above expectations) and currently weighs 72 kg. Despite having regained 8 kg of weight, she has lost 92% of her excess weight, which is an excellent result. This patient should review habits and diet with the nutritionist, reinforce physical activity and maintain control with her team.

If weight regain begins in the first postoperative year, or occurs quickly and is associated with bad habits, if some of the comorbidities such as diabetes, steatosis (fat in the liver), sleep apnea, high cholesterol and triglycerides return, or if the reduction in excess weight is less than 50%, this is not normal, it must be evaluated and, whenever possible, treated. For example, the same 49-year-old patient operated on 5 years ago, weighing 120 kg and 1.65 m tall, who had reduced to 84 kg 24 months after the operation (69% loss of excess weight) and currently weighs 98 kg (42% loss of excess weight), in addition to being again hypertensive and with hepatic steatosis, shows a significant re-weight and with significant damage to health.

In this case, the patient should preferably seek out the multidisciplinary team that performed the bariatric surgery. The patient must undergo clinical, nutritional and psychological evaluations, through specific tests as the clinical investigation shows to be necessary. Answer some questions:

1. How many meals do you have a day?

2. Are you hungry? How long after the meal?

3. Do you feel full after eating? With what foods?

4. How big a portion of food can you eat?

5. Do you experience heartburn or reflux?

6. Have you started any new medication in the last few months?

7. Are you doing physical activity? What kind of activity and how often?

8. Do you drink alcoholic beverages?

9. Are you drinking sodas and sugar-sweetened beverages?

10. Do you feel guilty or depressed?

11. Do you know why you are regaining your weight?

Based on this information and with a dietary and habit recall, the patient can be helped to discover the causes of weight gain and seek appropriate treatment. In most cases, weight gain is due to a return to bad eating habits, a biting pattern (eating cookies, sweets, snacks, and other high-calorie foods with low satiety power in small, frequent portions), consumption of alcohol and sweetened drinks, and physical inactivity. In these cases, you should reorganize your diet, start physical activity or intensify it, review healthy habits and, if necessary, psychological or psychiatric follow-up.
Obesity is a serious disease. And more and more studies show that curing obesity is not just about surgery, on the contrary, it is the beginning of a period of one to two years of changes that must be associated with auxiliary therapies such as nutritional education, programmed physical activity and changes in lifestyle. Take care, your health is priceless.

Through all that has been said, we can conclude that obesity is a multifactorial disease and we reiterate that only Bariatric Surgery does not perform miracles. The patient has to do his part and be aware that obesity is a disease that is difficult to control, even after bariatric surgery. Take care, your health is priceless.