Weight Regain After Gastric Sleeve Surgery

4 Tips for Preventing Weight Regain After Gastric Sleeve Surgery

January 6, 2020

Many patients wonder if it’s possible to regain weight after having Gastric Sleeve Surgery (VSG). It’s a hard conversation, but as soon as the patient starts thinking about this surgery, or any bariatric procedure, it’s important to address this topic: the possibility of weight regain after Gastric Sleeve Surgery.

Gastric Sleeve Surgery undoubtedly helps patients lose weight since the surgery not only decreases the size of a patient’s stomach but also removes the portion of the stomach that produces Ghrelin, the hunger hormone. The surgery is incredibly effective, and most patients continuously lose weight for 12 to 24 months after the procedure, provided they follow their diet and lifestyle changes prescribed by their doctor.

The idea of losing weight at such an accelerated rate fills patients with hope and optimism. However, it’s equally important to discuss the possibility of gaining a substantial amount of weight years after surgery.

Is it Possible to Regain Weight After a Gastric Sleeve?

This is one of the most important topics patients need to learn about, particularly when discussing the long-term impact of Gastric Sleeve surgery. After Gastric Sleeve surgery, patients will:

  • Steadily lose weight for 12 months or longer
  • Have to learn how to adjust to their new body after shedding the extra weight
  • Think about the possibility of having cosmetic surgery to remove excess skin and tissue
  • Learn to feed and care for their new (small) stomach

To this list, every bariatric surgeon should advise a patient to watch what you eat because, just like any other person, you can gain weight. Bariatric patients are often more susceptible to accelerated weight gain if they fall back to old habits. It needs to be clear: it is possible to regain weight after bariatric surgery. In fact, patients can sometimes regain more weight than they lost after their procedure. Additionally, they should know that the person to help them overcome this is their bariatric surgeon.

Acknowledging and Preventing Weight Regain

Explaining to a patient how simple it is to regain weight after Gastric Sleeve surgery can be discouraging, but it is important to know that as a patient, the support from their bariatric surgeon and a certified nutritionist can also prevent this. Bariatric patients face a long battle against obesity, but they are not alone.

Many possible explanations can shed light on why patients regain the weight that puts them back in the obese or morbidly obese categories after Gastric Sleeve surgery. It isn’t 100% clear, and there isn’t a single thing bariatric patients do to regain weight, because everybody’s weight loss journey is different. However, there are simple steps that can prepare patients and help prevent significant weight regain after gastric sleeve surgery:

  1. Transparency. Many patients often forget to discuss this possibility with their bariatric surgeons. They are so focused on getting through the surgery and losing weight that the possibility of gaining it back is often forgotten. A bariatric surgeon must discuss long term benefits and lifestyle changes after having a Gastric Sleeve, including weight gain months or even years after the surgery.
  2. Rationality. It is often helpful for patients to understand how, after having a smaller stomach, it is possible to go back to their pre-surgery weight. For a lot of patients who fail to maintain a healthy BMI, weight regain is the result of overeating and unhealthy habits, which led them to be obese in the first place. Let’s not forget that the stomach is an elastic muscle. In simple terms, yes, after a Gastric Sleeve, the stomach is a small pouch, but it can grow again. The stomach expands and contracts in response to food intake. When a patient is frequently snacking, consuming large amounts of calories, and in general, not watching their diet, the stomach will permanently grow. Long term dietary changes are vital!
  3. Clear expectations. Gastric Sleeve surgery or any other weight loss surgery is never an a=b scenario. Weight loss surgery is not as simple as getting the surgery = losing weight, and patients need to be aware of that. The surgery, while a great jumpstart to beating obesity, is not enough. Every bariatric patient must understand that when they are having weight loss surgery, they are making a commitment to themselves to living a healthier lifestyle. The effort to maintain a healthy weight is something that needs to be done daily.
  4. Arranging long-term support. It’s completely understandable if patients do not know how and what they can do to prevent weight gain after Gastric Sleeve surgery. Talking about this with a bariatric surgeon, a nutritionist, and even a plastic surgeon will help patients set clear milestones. A discussion of the weeks, months, and years after the surgery will help patients understand how to make the most out of their bariatric procedure and maintain results for years.

Patients should not feel overwhelmed or intimidated by the possibility of gaining weight. They should instead remember that their bariatric surgeon, nurses, and nutritionist are there to guide and help them. Weight regain is possible, even normal, but manageable and preventable too.

Weight Regain After Gastric Sleeve Surgery



Alejandro Quiroz, MD, FACS is the chief plastic surgeon at COSMED Plastic Surgery Center in Mexico. Dr. Quiroz is a Board Certified, Bi-lingual, Bi-cultural International Surgeon, Licensed in both the U.S. and Mexico. He is member of the American Society of Aesthetic Plastic Surgery (ASAPS), American Society of Plastic Surgery (ASPS), International Society of Aesthetic Plastic Surgery (ISAPS), and the San Diego Plastic Surgery Society (SDPSS).

Read more articles from Dr. Quiroz