Are My Bad Habits Leading to Weight Regain After Gastric Sleeve?

by Anne


Hello there,

My name is Anne, I am 4 years out from my Gastric Sleeve. The day of the surgery I was 5’4, and 254, BMI of 44 or so. I followed the diet and exercise guidelines just about as good as anyone can expect (I may have missed a day or two of exercise or ate something I wasn’t supposed to on Christmas, but never got into any bad habits) and I got down to about 165. It wasn’t quite my goal, but it was pretty darn close!

Here’s where the issue comes in, though. About 6 months ago I started to slowly tick up on the scale. Every month was a couple more pounds. I didn’t fundamentally change my exercise or diet habits, for good or for bad, so I’m at a loss as to why this is happening!

I mean, I guess it could be, heaven forbid, that I’m just getting older? Is there something that could be causing this?

Also, what can I do to stop this gain? I guess stop the cheating all together and try and up my exercise routine? Any other suggestions would be much appreciated!

Thanks in advance for the response! Stay strong everyone!

— Anne

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Surgeon Response to "Are My Bad Habits Leading to Weight Regain After Gastric Sleeve?"

by: John Rabkin, M.D., Pacific Laparoscopy


Gastric Sleeve surgery (VSG) is a very effective restrictive Weight Loss Surgery (WLS) procedure that has excellent short/intermediate term outcomes. Many patients enjoy better than a 70% excess weight loss (EWL) initially (18 month) after undergoing the VSG. It appears from your question that you did very well from that perspective after your VSG.

Unfortunately, despite every attempt to maintain that weight loss, many patients face longer term weight regain after the VSG which relies completely on the principle of restriction to accomplish the weight loss; there isn't any accompanying calorie mal-absorption. Consequently, over time, as that restriction lessens, many patients end up consuming more and more calories in a given time period to enjoy the sense of satiety that they formerly experienced with fewer calories ingested. Eventually, if more calories are consumed in a day than are 'burned off,' weight regain is the end result. The intermediate to longer term (five years and after) results after the VSG reflect the problem of weight regain and demonstrate that you aren't alone in facing this: EWL by five years after the VSG has decreased on average to approximately 50% from the 70% initial EWL.

Minimizing your caloric intake ('dieting') is your most effective tool to employ to confront this problem of weight regain following the VSG. Maintaining a rigorous food diary is often very beneficial to accomplishing this task. Maintaining a very active lifestyle incorporating a regular exercise program is also very helpful. If these strategies ultimately aren't effective in your case, you may want to consider revisional bariatric surgery. Keep in mind that the VSG as initially conceived was intended as the first part of a 'staged' (two part) Duodenal Switch (DS) and not as a stand-alone procedure. Should you seek revisional bariatric surgery, you may want to consider the option of 'completing' the DS as one of (perhaps even your best) choice.

Best regards,

John M. Rabkin, M.D.
Pacific Laparoscopy


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DISCLAIMER: This educational advice is based on the depth of your question and the details provided. The above should never replace the advice of your local physicians as they have the ability to evaluate you in person.

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