Weight Gain After Bariatric Surgery

I think it's important to determine the cause of your weight gain when deciding the best approach to weight loss. Are you taking in too many calories? Not exercising enough? Is there a problem with the gastric pouch? I suggest you consult with your bariatric surgeon first to rule out any complications from surgery. If the gastric pouch has expanded, a second surgery may be needed to make the pouch smaller and decrease nutritional absorption. If this is not the case, perhaps consult with a nutritionist or behavioral therapist to modify your eating habits and exercise routine. Best of luck!

Weight regain after bariatric surgery could be a sign of fail procedure and is both disappointing and a major health issue. Fail procedure is a challenge not only for assessing the patient correctly and deciding the best surgical therapy but the technical difficulty of performing a revision procedure. For a number of reasons, a weight loss procedure can fail to allow the patient to reach his or her goals. TECHNICAL: The surgery was not executed optimally, this is very rare, but unfortunately occurs.MECHANICAL: This could be an alteration of the procedure due to the transit of the food o pressure from the body.ADAPTATIVE: The body has adapted to the modifications made by the surgery, in the case of gastric sleeve, increase elasticity making the gastric reservoir larger.A complete evaluation is necessary, a food log, imaging studies, to assess your case. You should seek a consult with a bariatric surgeon with experience in revision surgeries, to assess your case and give you the options for your case specifically.

Hello,
Thank you for your question.
All bariatric surgeries require a diet period. The surgery essentially facilitates the diet for patients; however, they shouldn’t be regarded as a sole means of losing weight. If the patient reverts to their former eating habits, the risk of weight-gain will persist in the long run.
Make sure you follow your dietary plan provided by your nutritionist. 
I hope this answer helps you
Dr HE

Hello,
Thank you for your question. Congratulations on your surgery, I am sorry you are not getting the results you expected. In my experience, patients tend to lose 20-30 pounds in the first month and average 10 a month thereafter, reaching a stable weight at 12-18 months. Factors that influence the rate and total weight loss include gender, age, starting BMI, and extent of lifestyle changes. 
Generally, to be successful, patients need the support of a multidisciplinary team, including their surgeon, a nutritionist, and psychologist. It is essential to maintain the health lifestyle changes expected after surgery. I also caution you to avoid puréed and soft foods and be careful you do not consume too many liquid calories. It is much easier for sleeve patients to consume too many calories through liquids than with solid food. This is because the liquids are digested more quickly than the solids, allowing the patient to more easily "overeat" if consuming high-calorie liquids. Excessive liquid calories can stall and even reverse weight loss. It’s also important not to consume liquids with solids since it can push the food more quickly through your stomach. 
Regular exercise is also essential. At this point the goal is 45 minutes of daily exercise. 
It is also possible there are mechanical issues with your pouch that are leading to your weight gain. In rare cases, revisional surgery may be necessary to maintain weight loss. It is essential you follow up with your surgeon to help you determine the underlying cause of your weight gain; it's important not to feel discouraged during these times and to look to your care team and support network for guidance and encouragement.
Kind regards,
Dr. Moein

Patients who have undergone gastric bypass surgery are able to metabolize calories in a manner similar to individuals who have not undergone the surgery. The difference is the size of the neo-stomach and the feeling of early satiety, or feeling of fullness after surgery.
Patients who have undergone gastric bypass may continue to gain weight if they consume foods with a high calorie to volume ratio. Examples include protein shakes, milkshakes, or other foods with high calories without a lot of bulk or fiber.
If you are continuing to gain weight without feeling full, you may alter your foods with increased amounts of bulk or fiber in order to consume less calories before feeling full.
If you are considering plastic surgery, most surgeons will delay surgery until you have reached a plateau weight for 6 months to one year.