What Can I Do If I Gain Weight After My Bariatric Surgery?

Many people decide to have weight loss surgery each year, in fact over 558,000 people have either gastric sleeve or gastric bypass surgery worldwide every single year.  A large portion of those people choose to go to Mexico for weight loss surgery, and one of the leading destinations is Puerto Vallarta Mexico.

The Gastric Sleeve surgery is a very popular weight loss surgery where the patient has their stomach reduced by about 80% causing weight loss by helping the patient eat less and feel fuller quickly.  The gastric sleeve is a perfect option for patients that have a BMI over 30 and under 45 or have less than 130 pounds to lose. 

The Gastric Bypass is a little more invasive but designed for more significant weight loss, typically 130 or more pounds can be lost with a gastric bypass.  With the gastric bypass the surgeon creates a pouch in the stomach and then removes about 1 and half meters of the small intestine which triggers malabsorption and significant amount of weight loss.

Of course, both surgery options are just tools, and the patient needs to follow their doctors’ nutritional guidelines and diet for ultimate success.  Many patients with both surgeries have very good weight loss and in fact many have success for many years after surgery.

That said however, after year 3 postop many patients slowly start to gain weight.  The weight loss starts creeping on 15 pounds here 10 pounds there, and suddenly, the patient that had lost all their weight, has now gained about 30-40 pounds without even really understanding why.

Gastric Bypass patients have about a year and a half where the body can benefit from the malabsorption effect on the body and lose weight, after that the body starts absorbing again and if the patient has not changed their habits, then weight regain is a certain outcome.  Gastric Bypass patients, lose the most amount of weight but also tend to gain the most back years after surgery because they do not change the habits that caused them to be obese in the first place.

Gastric Sleeve patients also have about a year and a half where the metabolism does not realize what is happening and the body burns fat faster as the metabolism kicks into hyperdrive for this period.  At Weight Loss Team in Puerto Vallarta, Dr. Parra explains this as the “Advantage Window” where if the patient follows a strict diet the most amount of weight is lost in those first 18 months.  After that, the metabolism locks back into a regular routine and weight loss slows down.

So basically, after a year and a half for the bypass and sleeve patients the true benefit of the surgery shuts down and weight loss can still be achieved at a slower rate.  After that also if the patients do not eat right, weight gain is very possible.

What options do I have if I gain weight after my weight loss surgery?

In Puerto Vallarta at Weight Loss Team, Dr. Jorge Arturo Parra and the team of trained bariatric specialist evaluate each surgery candidate individually and typically provide the best possible surgical option for each candidate.

That said however if you have had a Gastric Sleeve surgery some patients think they can have a surgery called the Re-Sleeve, this is a surgery applied by shady doctors in the Tijuana area that are out to just take the patients money.  With a re-sleeve, supposedly the doctor goes in and fixes the size of the sleeve when in fact they do not do anything other than charge the patient and literally do nothing.  These are the same doctors that have very high hiatal hernia rates and are not honest surgeons.  The famous Re-Sleeve was created as a revision surgery if and only if the patient recently had surgery but is not losing weight, a sign that something was not done correctly from the very beginning and something that can be fixed so that the patient loses weight by recalibrating a poorly done sleeve.  If the patient at one time has reached their weight loss goal, then the Re-Sleeve is a fraud and does not work, for these patients the only real option to consider is a Bypass surgery.

But what type of Bypass surgery is best?

If the patient has less than 100 pounds to lose and no reflux, you may want to consider the SASI S Bypass, this is a newer bypass that has been available for the last 2 years.  Dr. Parra and Weight Loss Team is the leading bariatric surgery center in Puerto Vallarta and was the very first surgical team to offer this surgery in Puerto Vallarta Mexico. The Sasi S Bypass is a little less aggressive than the RNY Bypass and only has one anastomosis.  That said it is not as effective for large amounts of weight loss such as the RNY, but the results are very good for 75 pounds or less.  Also, with the SASI S the patient maintains the digestive tract so future endoscopies are not an issue and there is about 25-30% absorption of the nutrients that they eat.

The RNY is ideal if the sleeve patient has reflux of if the sleeve patient has gained more than 75 pounds.  Here in this instance the RNY will give the patient the full benefit of a malabsorptive surgery, and this will help the patient lose the weight they regained.  Of course, all these options need to be applied with a strict diet and following the post-surgery nutritional guidelines of the surgeon for ultimate success.

For patients who had a Bypass surgery first, then your options of a revision are much more restricted and for these patients the key factor they need to realize is weight loss will be substantially slower and there may even be no positive outcome after Bypass revision surgery post Bypass surgery.  Why?  The main reason is if your Bypass was originally successful, then they metabolic benefits to the malabsorption have been used up.  What the surgeon tries to do in a Bypass Revision is remove an additional ½ meter of the small intestine.  The concept is that this may retrigger malabsorption and sometimes it does and other times it does not.  When it does, the revision typically works well, and the patient loses weight slowly while maintain a strict diet.  When the malabsorption does not kick in, then the patient needs to work even harder, and diet and exercise is the option that will help them achieve their weight loss success.

To summarize the bypass revision either SASI S or RNY is a very good option for post Gastric Sleeve surgery regain, but post Bypass surgery, the Bypass revision does not always provide the patient with the results they are hoping for.  If you have any specific questions you may reach out to Weight Loss Team in Puerto Vallarta at +1(800) 404-9064 or via email at info@weightlossteam.com  or visit the site online at www.weightlossteam.com