Why Patients Regain Weight After Bariatric Surgery — and How Dietitian - Rational Foods
Why Patients Regain Weight After Bariatric Surgery — and How Dietitians Can Help

Why Patients Regain Weight After Bariatric Surgery — and How Dietitians Can Help

October 30, 2018

Up to 50 percent of weight loss surgery patients regain weight two or more years after undergoing the procedure, according to the American Society for Metabolic and Bariatric Surgery. While this weight gain may be classified as “small,” even a few pounds a year can add up to big problems for weight loss patients.

The good news: Educating patients about the factors that lead to weight gain can help them avoid this pitfall. Here’s a closer look at four behaviors that lead to weight regain, along with tactics for overcoming them.

1. Limited knowledge of basic nutrition

Obesity is a complex disease with many causes. Perhaps the most elemental of these causes is a lack of knowledge about nutrition. Research published in the Journal of Community Health has determined a link between greater nutrition knowledge and “higher odds of engaging in healthy weight loss behaviors,” such as eating less food; eating foods with fewer calories; and eating more fruits, vegetables and salads and less sugar, candy and sweets. The conclusion, according to researchers: “An increase in nutrition knowledge may promote healthy weight loss behaviors.”

But different individuals go into bariatric surgery with different levels of nutrition knowledge. Establishing a baseline and educating patients according to their individual levels of nutrition knowledge ensures that they have the information they need reach their weight loss goals.

2. Environmental impediments

While weight loss surgery may change how the body responds to food, it does nothing to change the daily demands on patients. In other words, post-op patients return to the same schedules and demands they faced before surgery.

Unfortunately, this can also lead to the return of bad habits. Dietitians can help patients avoid falling back on these behaviors by making them aware of meal planning as a time management skill, as well as by providing them with recipes and cooking tips.

Furthermore, research has also shown that “support from family members may result in improved weight loss maintenance,” according to a paper published in the International Journal of Qualitative Studies on Health and Well-being.

Weight loss patients can be encouraged to invite their loved ones to participate in healthy new behaviors alongside them. Additionally, in-person and online support groups can also help patients stay on track.

3. Emotional triggers

People don’t become obese just because they eat too much. In fact, obesity is as much an emotional and psychological condition as it is a physical one. Research published in The Scientific World Journal determines emotional eating to be a “virtually untreated risk factor for outcome following bariatric surgery.”

It continues: “Uncontrolled eaters and those who engaged in both postoperative uncontrolled eating and grazing, however, ate in response to emotional distress emanating from both multiple negative moods and losing control of eating.”

Dietitians can help patients avoid weight gain after bariatric surgery by working with them to identify their triggers. Additionally, cognitive behavioral therapy (CBT) has been discovered to be an effective intervention.

4. Lack of physical activity

We all know that diet and exercise are two sides of the weight loss coin. However, many bariatric patients overlook the importance of exercise. Says research published in the journal, Diabetes, Obesity and Metabolism: “Bariatric surgery is the most effective treatment option for many but the benefits are not universal to all patients….Exercise clearly elicits a multitude of beneficial health effects. We now have objective evidence that bariatric surgery patients are not very physically active and thus represent a patient population who may benefit greatly from exercise.”

Dietitians can help patients embrace the many weight loss-boosting benefits of exercise by suggesting practical exercise tips, such as making working out a social activity, moving as much as possible in their day-to-day lives, choosing activities they like, and setting realistic goals.

Ultimately, while bariatric patients go into weight loss surgery with high hopes, success depends on much more than mere optimism. Dietitians who guide their clients in the direction of real strategies designed to overcome these obstacles are best positioned to facilitate sustainable weight loss and weight management following bariatric surgery.