The whole of weight loss surgery is complicated.
First, there is the period leading to the decision to have gastric bypass surgery at all. There are years of emotional testing, fractured self-esteem, barbs from cohorts, silent rejections at job interviews, and hushed critiques by the general public. There is the loneliness.
There is the poor health and risk factors that accompany obesity: high blood pressure, diabetes, heart disease, joint problems, sleep apnea, respiratory problems, cancer, metabolic syndrome, and psychosocial effects.
There are the failed diets and exercise programs accompanied by a desperate certainty that there is no hope. Obese forever, and forever is limited. An early demise because there is no resolution; nothing will be successful.
Then comes a spark. Weight loss surgery. Bariatric surgery. Gastric bypass. Gastric sleeve. Gastric band. Duodenal switch. All of them seem viable, and the level of success is good. Maybe there is hope after all.
Here come the doctors, the surgeons, the dieticians, the nutritionists, the counselors. Everything is set, but your insurance denies your request for surgery. You appeal… and appeal… and appeal. Eventually your insurance carrier concedes or you find some other method for payment.
The surgery takes place. You are in recovery, and there is some discomfort. There are pain meds, the liquid diet, the soft food diet, the supplements, the exercise. And then, one year or so later…you have regained most of the weight you had lost. That’s right, you have regained most of the weight you had lost.
Is that really what you had in mind?
Predictors for Weight Gain Following Weight Loss Surgery
There are a number of reasons the bariatric patient might regain weight. They are well-documented and can be evaluated by the weight loss patient prior to gastric bypass surgery.
Losing weight prior to bariatric surgery will impact how much weight is lost after the gastric bypass surgery is performed. It also decreases the possibility of weight gain afterward.
A history of alcohol and drug abuse is another indicator that regaining lost weight might happen. Substance abuse are more likely to engage old habits following bariatric surgery.
The psychological state of the patient after bariatric surgery can also be a determinant for regaining weight. Obstructed feelings of well-being can lead to comfort eating.
What each of the above-mentioned examples have in common is the potential for a return to poor eating habits. That is the final line for much of the explanation as to why weight is regained after bariatric surgery: the patient returns to prior inappropriate eating habits.
Surgical Complications as a Cause for Regaining Weight
More overlooked but equally important are the medical factors for regaining weight. The bariatric patient can comply with all suggestions and regulate herself accordingly but still suffer weight regain as the result of surgical complications.
It has been discovered that 59% of patients who have had Roux-en-Y gastric bypass surgery have regained 20% or more of the weight that had been lost. An increase in the size of the stoma has been correlated to the weight regain.
When the stoma dilates, it causes the gastric pouch to empty prematurely. This, in turn, eliminates the sensation of feeling full that is usually experienced by the gastric bypass patient.
Stoma dilation as a cause for weight regain must be given as much consideration as any of the behavioral factors.
Bariatric Surgery Source http://www.bariatric-surgery-source.com/weight-gain-after-gastric-bypass.html - accessed 6/1/12
Stanford Hospital and Clinics http://stanfordhospital.org/clinicsmedServices/COE/surgicalServices/generalSurgery/bariatricsurgery/obesity/effects.html - accessed 6/1/12
The AGA Journals Blog http://agajournals.wordpress.com/2011/03/03/what-causes-weight-gain-after-gastric-bypass/ - accessed 6/1/12
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You can read about my decision to have weight loss surgery back in 2003 and my journey to maintain a lifetime of obesity disease management since that time. My wish is to help you on your own journey of lifetime obesity disease management with shareposts along the way to help you navigate that journey successfully.
Published On: June 10, 2012