Weight Regain After Bariatric Surgery

Preparing and enduring bariatric surgery is no easy feat. This takes a lot of discipline and hard work to achieve the result and weight loss that is promoted with the surgery. However, some patients do experience the dreaded weight regain after having the surgery. Below are the leading causes of weight regain following bariatric surgery and what the risk factors are to look for so that it can be prevented with future patients. 

The Leading Causes of Weight Gain After Bariatric Surgery

With bariatric surgery comes significant changes to the stomach of the patient. Because of this restructuring, several types of conditions can develop anatomically causing the patients to begin regaining their weight. 

Anatomic Conditions

weight regain

  • Pouch dilatation
  • Anastomotic dilatation
  • Adjustable gastric band system problem 
  • Gastric-gastric fistula due to staple line breakdown
  • Pregnancy
  • Thyroid disorders
  • Adrenal Issues
  • New Medications
  • Kidney problems
  • Heart Problems

Pouch Dilatation

This condition does not show up immediately, but rather a few weeks following bariatric surgery when the band inserted was done so improperly and the pouch made for the patient is too large, allowing weight regain.

Anastomotic Dilatation

The connection between the stomach and the small intestine now has a smaller area following bariatric surgery. With this anastomotic dilatation condition, however, through the use of staples or minimal blood flow, this connection may narrow completely, causing the stomach to not properly disperse into the small intestine.

Adjustable Gastric Band System Problem

Whether the patient has used the balloon or band, any damage to the tubing or port could cause room for error when eating, and allow the patient to add additional weight following the surgery. 

Gastric-Gastric Fistula Due to Staple Line Breakdown

For patients who have bariatric surgery, there could be a condition where the stomach was not properly divided by the surgeon, leaving more room for the patient to hold food and allow weight regain. 


It is not recommended to become pregnant immediately following bariatric surgery. However, some patients find themselves in this situation and their weight will begin to increase throughout the term of the pregnancy. 

Thyroid Disorders

For the patients who may have had unknown thyroid disorders before the surgery, they tend to flare post-bariatric surgery due to the changes happening within the body and the thyroid and hormones respond with unwanted weight gain when the patient is trying to lose the weight. 

Adrenal Issues

Like the thyroid, some patients have underlying adrenal issues within their bodies that they were unaware of before surgery. Following surgery, these issues cause patients to be tired and fatigued regularly, preventing them from getting the required movement and exercise to promote a healthy weight loss after the surgery. 

New Medications

gain weight medicationsReacting to new medications is not a new concept in the medical field. Patients of bariatric surgery are capable of also suffering from side effects of this new medication that alters their hormones, with weight gain as a side effect.

Kidney Problems

While the kidneys are often relieved following bariatric surgery, some long-term effects could cause kidney problems from the surgery. This pain and imbalance can cause patients to forego their bariatric diets and plans, reverting to poor habits and gaining unwanted weight.

Heart Problems

Heart problems are another underlying condition that several of bariatric patients were not aware of. Because of the type of medication and physical restrictions placed on these patients following the surgery and the diagnosis, they are at a risk for weight regain.

Behavioral Conditions

  • Binge Eating
  • Grazing
  • Night Eating
  • Other Maladaptive Eating Behaviors

Binge Eating

Many patients following the bariatric surgery will have periods where they are doing very well with the plan and diet to continue losing weight. However, if they suffered from binge eating before the surgery, the potential for them to fall back into former patterns arise and binge eating will cause them to overeat and begin the weight gain process. 


This behavior refers to eating small portions around the clock, constantly having something nearby and is a dangerous form of overeating. While the patient may feel that the food amount is too small to matter, the constant grazing return and having another portion of the same size add up. This can cause a patient who thinks they are on the right track to make a harmful decision and begin regaining the weight. 

Night Eating

It is recommended that bariatric patients cut their eating off daily at a certain time each evening. This gives these patients accountability and control with what they are eating each day. For those who were night eaters, requiring a snack following dinner or while watching television, this behavior is easy to repeat and pick up when they shift back into a routine that is similar to what they had before surgery.

Other Maladaptive Eating Behaviors

The bariatric surgery does not eliminate maladaptive eating behaviors that these patients may have had before bariatric surgery. No matter what that behavior may be, it is essential to recognize it and ensure that it is not present following the surgery. This could range from the number of foods to types of food when it is consumed and the environment in which the patient is comfortable to consume it. 

  1. Psychological Factors
  • Minimal Support
  • Emotional Distress

Minimal Support

 Undergoing bariatric surgery is something that requires strength and discipline from the patient, but the most successful patients are those who have a support system at home with family and friends. Maintaining positive psychological health is essential for these patients to move forward and continue progressing with their weight loss. If they do not have the support from friends and family that encourage them to keep going, even when it becomes difficult to continue pursuing this lifestyle, these patients will be at risk for weight regain. 

Emotional Distress

Because so many patients link their eating with their emotions, a stressful situation that harbors on their emotions has the potential to force their hand with poor eating habits as a way to deal with the emotional distress. Unhealthy emotions increase the risk of overeating, which leads to complications of the surgery and then to increasing weight as opposed to decreasing it. 

What Are the Risk Factors?

Any time a patient undergoes bariatric surgery, it is critical that they understand this is the first step in changing their lives. Risk factors are known to cause these patients to fall off the wagon and revert to poor habits that lead to weight gain. 

  • Returning to former environments
  • Pressure and lack of supportunhealthy habits

One of the biggest risk factors for bariatric surgery patients to have weight regain following their surgery is returning to previous habits. Eating foods that are not recommended because they are convenient or engaging in behavior that is not beneficial to their health will encourage them to revert to their previous actions. Returning to these environments and actions will cause these patients to have weight regain following bariatric surgery as opposed to losing the weight. 

It is so critical for these patients to have a supportive environment before and after bariatric surgery. If they return to an environment that is not encouraging of their new lifestyle, either by being negative verbally or pressuring poor eating habits on the patient, they are increasing their risk for weight gain and negating their actions moving forward after the surgery. While some family members may want them to do well after the surgery, allowing them to give in to their desires and go against the diet plan is considered enabling and not a positive environment for weight loss. 

Preventing Weight Gain Following the Surgery

  • Follow the outlined diet and exercise plan
  • Have a support team that keeps you accountable

The biggest way for a patient to prevent weight gain following the surgery is to stick strictly to the diet and plan outlined by the bariatric physician. Sticking to this diet keeps them from overeating and allows their stomach to safely process their food while their body is changing and adapting to the smaller portions. 

To keep these patients from regaining weight, it is recommended that they have a support team in place to keep them accountable for their plan. Having an understanding of what they should be doing and making sure to support that plan at every chance is critical for their success. If they do make a mistake and fall off the plan, this support system needs to give them the encouragement to get back on to the diet and continue moving forward for success. 

Is Bariatric Surgery Right for You?

If you are interested in weight loss and pursuing bariatric surgery, give us a call at My New Beginning today for more information and to schedule your consultation. We look forward to hearing from you soon!

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