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Vital Signs: Weight Gain After Weight Loss Surgery When You Don’t Follow The Rules


As with dieters in general, it’s not uncommon for people who undergo weight loss surgery to gain back the pounds they lost. In the search for a reason why, a study from U-T Southwestern Medical Center found that even after three months of nutritional counseling, many patients failed to follow guidelines after surgery. Dr. Abhimanyu Garg explains in the week’s Vital Signs.

Pros and Cons of Weight Loss Surgery

According to, As a treatment for severe obesity, the popularity of bariatric weight loss surgery is growing. For some people considered obese, surgery can literally be lifesaving.

But it isn’t for everyone. While generally safe, bariatric weight loss surgery has risks. And losing weight after bariatric surgery is far from automatic; it takes commitment to lifelong changes in eating patterns and lifestyle.

According to the National Institutes of Health, weight loss surgery might be a choice for you if you meet the first or second of the following criteria and criteria three, four, and five:

1. A body mass index (BMI) greater than 40. For example:

  • Five feet six inches tall and weigh more than 248 pounds.
  • Five feet nine inches tall and weigh more than 270 pounds, or
  • Six feet tall and weigh more than 295 pounds.

2. Your BMI is greater than 35, and you have obesity-related health problems that may improve with weight loss.
Obstructive sleep apnea, severe arthritis, and diabetes are several conditions that may benefit from even a small weight loss. Weight loss surgery can dramatically reverse these health problems when caused by obesity.

3. You can demonstrate that traditional weight loss programs like diet and exercise haven’t worked.

It’s by far preferable to lose weight without surgery’s risks. Weight loss surgery should be considered a last resort after traditional methods fail. Some centers may require you to show you have made serious efforts to lose weight.

4. You are ready to commit to permanent lifestyle changes after surgery.

Weight loss surgery is no quick fix. Ideally, surgery is only the beginning of a new healthy lifestyle.

5. You understand the risks and benefits of weight loss surgery.

As with any surgical procedure, it’s essential to be well-informed before considering weight loss surgery — knowing and accepting the risks as well as the benefits.

Benefits of Weight Loss Surgery

The primary benefit of weight loss surgery is easy to understand: weight loss!

  • Gastric bypass surgery causes an average loss of 61 percent of excess weight.
  • Gastric banding surgery causes slightly less — an average of 47 percent of excess weight lost.

Improvements in general health are also common. Obesity-related medical conditions usually improve or even go away after weight loss surgery, including:

  • Diabetes
  • Severe arthritis
  • Obstructive sleep apnea
  • High blood pressure

About 95 percent of people report improved quality of life after weight loss surgery. Some studies also suggest people live longer after weight loss surgery, compared to equally obese people who do not have surgery.
Risks of Weight Loss Surgery

Weight loss surgery carries real risks. As many as 10% of people have complications afterward. Usually problems are only unpleasant or inconvenient, and might cause some pain and discomfort, or require additional surgeries, including:

  • Nausea, vomiting, and diarrhea
  • Wound infections
  • Abdominal hernias

Serious complications do occur after weight loss surgery. Although rare — happening about 3 percent of the time — they can sometimes be life-threatening:

  • Blood clot to the lungs (pulmonary embolism)
  • Leaks in the new surgical gut connections
  • Bleeding ulcers
  • Heart attacks

About one in 400 people die from weight loss surgery complications in the first thirty days. The risk is higher for people over age 60. Having bariatric surgery at a center with very experienced surgeons reduces this risk.
Even after successful weight loss surgery, other problems are common:

  • Gallstones, often requiring gallbladder removal
  • Vitamin deficiencies or malnutrition, from poor absorption
  • Excess skin, requiring surgical removal (body contouring)

After Weight Loss Surgery

Weight loss surgery should be the beginning of a new and healthy lifestyle. To make the most of the surgery and to maximize results, people need to:

  • Break the binge habit
  • Eat healthy and take vitamins
  • Exercise
Sam Baker is KERA's senior editor and local host for Morning Edition. The native of Beaumont, Texas, also edits and produces radio commentaries and Vital Signs, a series that's part of the station's Breakthroughs initiative. He also was the longtime host of KERA 13’s Emmy Award-winning public affairs program On the Record. He also won an Emmy in 2008 for KERA’s Sharing the Power: A Voter’s Voice Special, and has earned honors from the Associated Press and the Public Radio News Directors Inc.