According to health experts, bariatric surgery is one of the best treatment options to “control” obesity, as it helps patients lose a lot of weight and also maintain it for a much longer period. compared to other weight loss methods like weight loss. diets, etc. However, obesity is a chronic medical condition just like type 2 diabetes or hypertension, which needs long-term management, so regular follow-up is crucial to getting good long-term results.
Weight recovery is one of the main concerns of patients before undergoing bariatric surgery. Weight loss is associated with improved quality of life, associated comorbidities, and overall confidence, but weight recovery, on the other hand, can lead to a drop in all of the above.
In an interview with HT Lifestyle, Dr. Aparna Govil Bhasker, a laparoscopic and bariatric surgeon at Saifee, Apollo Spectra, Namaha and Currae Hospitals in Bombay, shared: “Bariatric surgery is currently the most effective method for sustained weight loss. “However, many patients tend to regain some degree of weight after 2 or 3 years of bariatric surgery. The amount of weight gain is variable and depends on many factors.”
He listed some of these factors as:
1. Hormonal and metabolic factors – Bariatric surgery procedures cause an increase in certain gastrointestinal hormones such as GLP-1, PYY, GIP, etc. which increase satiety and reduce appetite. The appetite hormone called ghrelin also decreases, causing a decrease in food intake. However, over time, the effects of these alterations diminish, leading to a degree of weight recovery.
2. Non-adherence to dietary guidelines – People with obesity are more likely to gain weight compared to people with normal weight. Therefore, the quality of the diet after bariatric surgery is very important. It is essential to eat a moderately healthy diet and avoid high-calorie foods, snacks, junk food, sweets and sugary drinks, alcohol, and so on. Nutritional counseling and regular follow-up help guide patients toward a healthier lifestyle.
3. Physical inactivity – Patients who are physically active tend to maintain weight loss for a much longer period of time. Improper activity and a sedentary lifestyle after bariatric surgery can contribute to weight recovery. In some cases, there may be joint problems or other mobility problems that can lead to insufficient activity levels. These patients are also more prone to weight recovery.
4. Mental health conditions – Patients with mental health problems may have psychological problems that can slow down weight loss. Lack of motivation, depression and some antidepressant medications can also contribute to inadequate weight loss and weight recovery. Eating disorders such as binge eating may persist or resurface after surgery and may be a contributing factor in weight recovery.
5. Factors Related to Surgery – Body tissues are elastic in nature and can increase over a period of time. This varies from patient to patient. It also depends on the initial size of the stomach pouch, the degree of malabsorption, and the size of the anastomosis in bypass surgeries. Rarely, there may be a gastrogastric fistula that may be the cause of weight recovery.
6. Medications – Some patients may need to take certain medications such as antidepressants, oral contraceptives, immunosuppressants, steroids, and so on. and can contribute to weight recovery.
Can we manage weight recovery after bariatric surgery?
Dr. Aparna Govil Bhasker revealed some strategies that help control weight recovery after bariatric surgery. This includes:
1. Regular follow-up – A biannual or annual follow-up is essential after bariatric surgery. It helps to control nutritional deficiencies and also helps to maintain the lost weight. Frequent contact with bariatric equipment also helps motivate patients to keep up with a healthy diet and lifestyle.
2. Attendance at support group meetings – Most bariatric teams hold regular support group meetings for post-bariatric surgery patients. In these meetings, patients are able to interact with each other, which generates motivation, inspiration, and increased enthusiasm for initiating or maintaining healthy habits.
3. Self-weight control – Patients should be encouraged to control their weight at home once every 15 days. They should be made aware of weight recovery and if the weight shows an upward trend with respect to the reference weight achieved, they should contact the bariatric team immediately.
4. Diet and Physical Activity – For a small degree of weight recovery, diet modification and a greater emphasis on physical activity can help to regain the lower weight achieved. This should be done under supervision and with the help of a qualified dietitian and exercise specialist.
5. Weight Loss Medications – If only diet and lifestyle modification are not working effectively, certain medications can be added to help you lose weight. Medications can be advised by the bariatric team and can help you lose up to 10 to 15 kg of weight in a few months. Weight loss medications should always be accompanied by a healthy diet and lifestyle for optimal results.
6. Endoscopic Measurements – In case of anatomical problems related to surgery, endoscopic measures can be used to resize the stomach bag or anastomosis.
7. Bariatric Revision Surgery – This can be considered for a greater degree of weight recovery and also if there is a recurrence of comorbidities such as type 2 diabetes. In revision surgeries, the existing bariatric procedure usually becomes a another more powerful operation.
Dr. Aparna Govil Bhasker stressed: “Obesity can be controlled effectively, but the key is to understand that people with obesity need lifelong support. Bariatric surgery is just a cog in the wheel of weight loss. Weight recovery is a reality, but it can be managed using the above-mentioned methods that are commonly used in combination with each other.Regular follow-up and good compliance are the key to long-term success after surgery. bariatric “.