Weight Regain After Bariatric Surgery – when to be concerned

Plateau Pitstop

After bariatric surgery, the restrictive post-surgery diet and changes in appetite and capacity results in rapid weight loss for patients. We expect most patients to lose around 30% or more of their starting weight and have many strategies to help if someone struggles to meet their goals.  After surgery, following a new healthy diet and becoming more active will ensure a steady weight loss. Some people will achieve what they need quickly, others may need more help along the way, but weight generally settles at a much lower and far healthier level than before surgery (if lifestyle changes have been made and committed to). 

Plateaus are a normal part of weight loss. But if you have noticed that your weight has plateaued for an extended period and you’re no longer losing weight, it might be worth checking in with yourself… 

• Have some unhealthy habits returned, like mindless snacking? 
• Are you sticking to your post-surgery diet? 3 meals a day? Plenty of protein? 
• What are your activity levels like, could you be doing more or trying something different? 
• Should we be considering the addition of Anti-Obesity medications such as GLP-1 agonists to help you get to goal?

If you’re still unsure what’s causing it, it is time to make an appointment with your healthcare team or your doctor, who’ll be able to help steer you back on course if need be. 

Weight Regain After Bariatric Surgery – The Reality

Typically, some weight regain can be expected to occur after 12-24 months, and while in some the weight gain is minor, in others it is progressive which can be very disheartening. From our clinical experience, patients who attend regular follow-ups with their clinic tend to regain less weight than those who don’t come back for follow-ups.

While fluctuations are normal, a gradual and persistent weight gain over an extended period may signal the need for attention. We advise our patients to come in and see us if they have gained more than 3kg. If someone has regained > 20% of their lost weight (i.e, if they lose 40 kg and regain more than 8kg) then we would prioritise an appointment to discuss active therapies, as diet and lifestyle may not be sufficient to meet their needs. Furthermore, weight regain beyond this level is likely to create increasing risks of ill health. 

Getting Back on Track – 3 Ways to Tackle Weight Regain

1. The Importance of Checking In – regular follow-up appointments with your healthcare team are designed to monitor progress. If weight regain becomes evident or bad habits begin to resurface, these appointments are the ideal platform for discussion and intervention. It’s a team effort. 
2. Taking Responsibility – reflecting on your current lifestyle habits and identifying areas that may have contributed to weight regain can empower you to make positive changes. This may involve being more accountable for what you are eating, being honest about your physical activity levels (and if you can do better), as well as other areas of your life such as sleep quality and stress management. If reflecting on your lifestyle makes you feel uncomfortable or disappointed in yourself, pick up the phone!
3. Reclaiming the Journey – weight regain is a detour, not a dead-end. It’s an opportunity to reassess, realign and reclaim your journey toward health.