Bariatric Surgery has evolved as one of the most reliable medical treatments to resolve obesity and related issues. It is equally important to understand that the patient can maintain a healthy weight after bariatric surgery with positive results. But there have been instances of people gaining weight a few years after their bariatric surgery.

Considered as the best bariatric surgeon in Mumbai, Dr. Harsh Sheth says that regaining weight after bariatric surgery does happen, especially after a couple of years. He states, 'There is a possibility, but then it depends upon a variety of reasons such as distension of the sleeve pouch, formation of a gastro-gastric fistula, or an unsuitable primary procedure.'

If required a second surgery is performed to assist with losing the gained weight. The bariatric surgeon will give a serious consideration if there has been a visible change in the anatomy of the stomach and/or small. There is a higher risk of complications such as bleeding, leak, or infection in the gastrointestinal tract if the procedure is redone, especially if not done by an experienced surgeon.

He also states the weight regain is associated with the food intake of the patients. He has observed that patients are quite serious about their diet and exercise regimen for a year after surgery. They restrict their food consumption to the suggested intake of 3 to 6 ounces per meal; as their health stabilizes, their food intake increases while they reduce exercising for various reasons, which slows down their weight loss journey.

He shares stories of his two challenging cases of weight regain which he was able to resolve successfully. Recently, a female patient weighing 110 kg, consulted Dr. Harsh Sheth to resolve her weight gain issue nearly six years after her laparoscopic sleeve gastrectomy procedure.

Upon extensive work up to identify the cause of the weight regain, Dr. Harsh concluded that the patient had taken less than the required efforts to maintain her weight loss. She weighed 140kg before the surgery, while her lowest weight after the surgery was 75kg. Along with serious counseling, she had to undergo a strict diet and exercise regimen. An appetite suppressant drug was also prescribed. Fortunately, she was successful in reducing her weight to 80kg. Dr. Harsh Sheth counselled her to continue with the diet and exercise interventions

In yet another similar case, a patient who had undergone laparoscopic sleeve gastrectomy four years ago consulted Dr. Harsh Sheth as he had regained weight. When consulting the doctor, he weighed 156 kg along with a recurrence of diabetes, hypertension, and hypercholesterolemia. Further clinical diagnoses revealed that his stomach had increased due to its inherent elasticity, which led to weight gain.

Dr. Harsh Sheth recommended a revision bariatric surgery, to which the patient agreed. Dr. Harsh performed the revision bariatric surgery, which is also known as sleeve-DJB (duodenojejunal bypass). In this procedure, the sleeve is trimmed, and a part of the intestines are bypassed and joined just beyond the sleeve. The patient recovered well from the surgery and reduced nearly 65 kg over the next two years. Also, he does not require to take medications for diabetes, hypertension, and hypercholesterolemia anymore.

The other important factors influencing weight gain post-bariatric surgery include weight before the surgery, alcohol or drug abuse, lack of a support system, and psychological state following surgery. Hence, he cautions patients on the likelihood of recurrence of weight gain if any of these factors are not attended to properly.

He firmly believes that patients can maintain ideal weight after knocking off 50% of their excess weight even ten years after their bariatric surgery. But they have to be very disciplined in their food intake and diet, as well as being strict about exercising to burn the extra calories. Routine follow up with the bariatric team will also ensure that there is constant motivation to maintain weight.

Dr. Harsh Sheth is a consultant in advanced laparoscopic and bariatric surgery at the Saifee Hospital, Bhatia Hospital, ACI Cumballa Hill Hospital, Apollo Spectra Hospital (Tardeo),Wockhardt Hospital, Mumbai Central, and Conwest & Manjula S Badani Jain Charitable Hospital.

Over his decade plus real-time experience in bariatric surgery in Mumbai, Dr. Harsh Sheth has performed bariatric procedures such as sleeve gastrectomy, Roux-en-Y gastric bypass, mini-gastric bypass, revision bariatric surgeries, and endoscopic sleeve gastroplasty. He is an expert in advanced laparoscopic GI, hernia, HPB, splenectomy, and Abdominal Wall Reconstruction surgery.

In conversation in Clinicspots, an online healthcare Q and Ans portal, Dr. Harsh Sheth offers few guidelines for bariatric surgery patients who are aware of the feasibility of weight regain -

Keep a regular follow up with your bariatric team to ensure best possible post-operative results and maintain motivation.

Stay connected with fellow patients who have had similar bariatric surgery. Keep sharing experiences, ideas and, suggestions to stay motivated to lose weight and achieve the ideal weight.

Cultivating healthy eating habits before surgery is essential. Patients suffering from binge eating disorders are less likely to reduce weight after surgery if they cannot overcome the binging addiction.

As suggested by their doctor, patients who have lost weight before their surgery are likely to make most of their bariatric surgery. They will be able to experience healthy weight loss even years after their surgery.

Overcoming alcoholism and drug addiction is a must to avoid surgical as well as post-surgical complications. In addition, these habits could likely interfere in the recovery process leading to further health issues.

Locating and choosing the right bariatric surgeon is very important. Apart from performing the surgery, the doctor has to guide, mentor, and motivate the patients towards a healthier lifestyle and maintaining active health. Lastly, it becomes more important to have a good and positive mental state which is the first requisite before proceeding with bariatric surgery.

This is a sponsored article for Dr. Harsh Sheth. He can be consulted at Saifee hospital or Bhatia Hospital in Mumbai and can be contacted at +91-9819388836