How to Keep the Weight Off After Bariatric Surgery – Health Essentials from Cleveland Clinic

If youve had bariatric surgery, one of your greatest fears may be that youll regain the weight.

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Unfortunately, the truth is its easyto regain weight. People typically start gaining weight 12 to 18 months aftertheir surgery. And it can happen for a variety of reasons.

Maybe they didnt choose the right procedure, says bariatric dietitian and support group coordinator Lilian Craggs, DHA, RDN, LDN. PhD. Or they had the gastric bypass and developed a fistula (an abnormal opening) that allowed food to enter the bigger stomach. Or the sleeve or pouch got stretched.

However, Dr. Craggs says those areexceptions. In the majority of cases, weight regain is diet-related.

In the first year after surgery, most patients are diligent with diet and exercise. They eat proper portions of 3 to 6 ounces. If they eat out, they bring most of their meal home with them. But as they start to tolerate a wider variety of foods, many begin to eat more and exercise less. Their weight loss slows down and plateaus before beginning to climb.

When you weigh more, you require morecalories to function, Dr. Craggs explains. After bariatric surgery, yourmetabolism decreases, and your need for calories drops as you lose weight. Youcant eat the same number of calories at 150 pounds that you did at 300 pounds,or youll gain weight.

Most weight regain boils down to eating habits. Researchers recently reported five of 13 eating behaviors were largely responsible for a greater-than-normal amount of weight loss:

While weight gain is common, its notinevitable. Here are 8 tips for maintaining your weight loss:

These findings underscore thatbariatric surgery alone isnt a permanent solution to obesity. Its a tool forlosing weight. Once it occurs, you need to exercise and eat smart to stay slim.

Its not a magic wand, Dr. Craggssays. You have to eat healthy foods, follow the bariatric protocol fornutrition and stay active, or the disease and its comorbidities will recur.

Bariatric procedures produce rapid andsubstantial weight loss. The result? Diabetes, hypertension, high cholesterol,sleep apnea and other medical issues linked to obesity may disappear, loweringthe risk of heart disease, stroke, premature death and many forms of cancer.

In some ways, bariatric surgeryreverses the clock.

We found that detrimental changes to the heart reverse themselves with rapid weight loss, Dr. Rosenthal explains. This dramatically lowers the risk of cardiac arrhythmias and heart attack.

So as weight climbs again after weightloss surgery, so do the risksof developing cardiovascular disease and cancer.

The health risks associated with weightregain are proportional to the amount of weight regained. In this respect, mostbariatric procedures are successful.

Success is defined as retaining 50% ofyour weight loss five years after the initial procedure was performed, Dr.Rosenthal says. Rarely do patients gain all their weight back.

Although bariatric surgery isconsidered the only route to permanent weight loss, variability in the surgicalprocedures themselves can affect success.

The procedures are still evolving, and there is no standardization, Dr. Rosenthal says. We are still learning what matters and contributes to success. Also, some patients choose, or are advised to undergo, the wrong procedure and do not realize the same benefits as he or she would have realized with a different bariatric procedure.

This article was adapted from ClevelandClinic Heart Advisor.

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How to Keep the Weight Off After Bariatric Surgery - Health Essentials from Cleveland Clinic