Many patients that have bariatric surgery experience significant weight loss and often their weight-related illnesses go into remission. About one-half of the patients who have lost weight with the help of bariatric surgery are able to maintain their weight loss results but statistics show that the other half experience weight regain within two to five years. When weight loss stalls or patients begin to regain weight after a weight loss procedure, bariatric revision surgery may be the answer.
Let’s look at some factors that can cause weight regain and how bariatric surgery revision can be used to correct it.
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Why Do Patients Regain Weight After Bariatric Surgery?
There are several reasons why a patient may regain weight after they have had a weight loss procedure and some, are beyond the patient’s control. When we think about someone regaining weight after losing it, our immediate thought is that they've somehow messed up or they don't have any willpower.
Sometimes this is true and their regained weight or the stall in their weight loss is because they are not following their recommended low-calorie diet and exercise program. But this is not always the case.
Your Body Could Be Sabotaging Your Weight Loss Efforts
The human body is miraculous in the fact that it can do amazing things such as heal itself like when we get a minor cut or scrape. We slap on some antibacterial ointment and a bandaid and that is the extent of our interference. Our body does the rest. It creates new skin and in a few weeks, there is no evidence of the cut or scrape.
In that same way, our body was designed to keep us alive by regulating our energy levels vs our sources of energy. When we eat food we are fueling our bodies with energy and when we have given our body all it needs at that moment the excess is stored for use later (as fat)
Metabolism Speed
Our metabolism is the system that is in charge of how much and how fast this fuel energy is used and/or stored and it has a mind of its own. If we drastically reduce our calorie intake our metabolism will slow down a crawl to preserve energy in case we need it later (maybe to hunt for our dinner - on foot - in the woods). Our metabolism does not know that we can get in the car and easily pick up groceries at the market so in its effort to help us, it is actually hindering our weight loss efforts.
Individuals who have had weight loss surgery can be doing everything they're supposed to and can still experience weight plateaus or regain some of the weight they lost.
Anatomical Changes
Another thing that can happen to cause weight regain is the body can spontaneously make anatomical changes that alter some of the results of the previously performed bariatric surgery. The most common is the enlargement of the gastrojejunal stoma where the stomach connects to the small intestine. This speeds up the process of stomach emptying and patients do not stay feeling full as long.
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The Bariatric Surgery They Had Was Not Ideal For Them
Not every individual is going to respond positively to every bariatric procedure. Sometimes the procedure or surgery that was used on the patient initially was not the best choice or fit for that patient.
The procedure may not have been a good fit for the patient's lifestyle or sometimes a bariatric procedure can create chronic side effects that the patient cannot live with comfortably. One such side effect is severe acid reflux which may cause a patient to desire relief and to seek a bariatric revision.
This patient needs to be re-evaluated to determine which procedure or changes are needed for them to achieve effective weight loss without debilitating side effects.
Self-Sabotaging Choices
Let’s be honest. life happens and sometimes patients choose to sabotage their weight loss efforts by eating things they are not supposed to eat or eating when they are not supposed to eat (between meals) overeating, choosing not to exercise, etc.
They can also accidentally sabotage their weight-loss efforts by eating just a little bit too much during every meal and gradually stretching out their stomach. This stretching out of their stomach may be subtle and something they may not notice, but it allows them to eat more and more during meal times resulting in weight gain.
Mismanagement of Stress
When we undergo stress our bodies produce a hormone called cortisol which instructs our bodies to retain excess fat. This is another example of our body trying to protect us but giving us the kind of help we could do without. Stress can inhibit even our greatest weight loss efforts.
It is a disservice to us all that they do not teach us how to manage stress as a course in high school. Stress is inevitable and no one can get through life and avoid it. Understanding the side effects of stress and learning strategies to alleviate it would benefit all of us, especially during our teenage years!
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What To Do If You Start To Gain Weight After Bariatric Surgery
If despite following your diet and exercise plan, you stop losing weight or begin to gain weight, or if you are having issues following your plan, contact your doctor before the situation progresses and becomes worse.
Your bariatric surgeon and the team of medical professionals at your weight loss clinic are there to help you succeed. They do not want their patients to become discouraged or overwhelmed and desire for them to reach out if they have concerns or need help. They are there to help you get back on track, free from judgment, no matter the reason for the regain. One of the options they may offer is bariatric revision surgery.
What Is Bariatric Revision Surgery?
A revision of bariatric surgery is a procedure that is done to repair or make changes to a previous weight loss surgery that will promote future weight loss. Sometimes, this is as simple as adding a few sutures to tighten areas that have become lax or it may be a conversion from the original bariatric surgery to another. Bariatric revision can be performed through a surgical procedure or endoscopically. (non-surgical bariatric revision)
The sooner the patient lets the doctor know that they are having issues, the sooner the bariatric revision surgery can be done and get the patient’s weight loss back on track.
What Type Of Revision Will I Need?
The type of bariatric revision you will need will depend on several factors so a consultation with the bariatric surgeon is the best way to ascertain which technique will offer the best results. Factors such as the previous technique used, your current body mass index, and your general health will factor into the type of revision that will be used.
How Is Revisional Surgery Done?
Bariatric revisions can be done through additional surgery or through procedures that are performed endoscopically and require no surgery.
If the bariatric revision requires a conversion from one type of bariatric surgery to another such as a gastric sleeve to a gastric bypass, this will be done through surgery. If the patient’s stomach has become bigger and is no longer helping them with portion control, this can be corrected without surgery.
Endoscopic Bariaric Revision
Non-surgical bariatric revisions are done using a special hollow tube-like surgical instrument that is lowered down the patient’s throat called an endoscope.
This special tool has a tiny camera attached to it that projects a real-time image onto a video monitor and helps to guide the surgeon as they perform the corrections or revisions.
The surgeon will use a special suturing tool to easily repair areas that have become loose or to make a stretched-out stomach smaller. There are no incisions, no hospital stay, and no long recovery times.
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What Type Of Revision Would I Need If I Previously Had A Gastric Bypass?
If the patient’s gastric bypass surgery was no longer producing the weight loss results expected, the surgeon would have to determine the cause of the plateau or weight regain. Both, surgical and non-surgical techniques could be used depending on the circumstances.
1. Non-Surgical Bariatric Revision
Non-Surgical Sutures
If it is determined that the stoma (the opening between the stomach and the small intestine) or the patient’s stomach has stretched out, these can be repaired with a few sutures placed endoscopically and without surgery.
Non-Surgical Injections
Sclerotherapy is another bariatric revision procedure that does not require surgery and can be used to shrink the stoma or the stomach pouch. The surgeon uses an endoscope to strategically administer injections of Sodium Morrhuate in targeted areas that will reduce the capacity of the stomach pouch or shrink the stoma opening.
2. Surgical Bariatric Revision
Some bariatric revisions can only be performed through surgery. For example, If it is determined that the patient requires additional malabsorptive measures added to promote additional weight loss, then the surgeon may convert a previously performed gastric bypass to a duodenal switch through surgery.
Gastric sleeve surgery can be converted to gastric bypass surgery or duodenal switch surgery.
How Much Does Bariatric Revision Surgery Cost?
A bariatric revision will vary in cost depending on many factors such as the original procedure and the technique used to correct or revise it (surgical, non-surgical), and the type of revision or conversion being performed. Costs can also vary geographically and can also depend on the skill and expertise of the surgeon.
What Are The Qualifications For Revision Surgery?
Determining if you are a candidate for a revision of a previously performed bariatric surgery will require a consultation with a bariatric surgeon. Surgeons make decisions regarding revisions to bariatric surgery case by case and will consider factors such as:
- The bariatric procedure that is being corrected or revised;
- If complications from the original surgery prompted the patient to request the revision;
- The health and circumstances of the patient;
- They will try to pinpoint the cause of the insufficient weight loss or weight gain;
- Sometimes, patients need to undergo psychological and nutritional assessments before being approved for a revision of a bariatric procedure.
There are many reasons why a patient may be experiencing weight regain or weight plateaus after bariatric surgery. If you have had gastric sleeve surgery or gastric bypass surgery and have not reached your weight loss goals or are regaining weight, contact Batash Endoscopic Weight Loss Center today.
You may be a candidate for a non-surgical endoscopic procedure that can correct the problem and promote further weight loss. Our team of medical professionals is here to support your weight loss efforts and put you on the right track again. Contact us today!
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