Preventing Weight Regain After Bariatric Surgery: An Overview of Lifestyle and Psychosocial Modulators

Abstract

Bariatric surgery is being increasingly used as a treatment for obesity. With this weight loss intervention, obesity-specific disease remission and mortality reduction benefits are undeniable. After surgical weight loss is complete, one of the greatest challenges becomes long-term weight loss maintenance, which is largely behaviorally based. The fundamental behavioral components to maintaining surgical weight loss include dietary control, commitment to regular physical activity, and behavior modification. Changing these longstanding lifestyle habits, however, is a serious challenge and, unfortunately, many formerly obese individuals ultimately experience weight regain due to noncompliance. Further research is needed to identify optimal treatment strategies for postoperative bariatric surgery patients to minimize weight regain.Adapted from Vogel JA, Franklin BA, Zalesin KC, et al. Reduction in predicted coronary heart disease risk after substantial weight reduction after bariatric surgery.

Interventions for treating children and adolescents with overweight and obesity: an overview of Cochrane reviews

“…The restrictive or mal-absorptive nature of some forms of bariatric surgery presents an additional consideration in growing children. Psychological maturity, ability to provide informed consent, the availability of family support, and provision of ongoing post-operative lifestyle support [63] should be considered. Drug interventions are also not without adverse events, which depending on the drug prescribed, include a variety of gastrointestinal and cardiovascular conditions.…”

Weight regain after gastric bypass: etiology and treatment options

“…General postoperative nutritional recommendations include higher daily protein intake (1.0-1.5 g/kg of ideal body weight), limitation of sugar (<5 g per serving) and less than 30% of daily calories from fat. Foods with low glycemic index and prolonged absorption such as fruits and vegetables should be preferred and eating regimen should include 4-6 meals per day (14,15).…”

“…Return of appetite and increased food intake were observed after inhibition of gut hormones responses by octreotide (33). Thus, hormonal alterations may facilitate portion control and decrease intake of highcaloric food reducing the likelihood of WR (15).…”

The experience of regaining weight following weight loss surgery: A narrative-phenomenological exploration

“…It also helps normalize blood lipid, glucose, cholesterol profiles and type 2 diabetes and contributes to lower rates of depression, anxiety and related mental illnesses (Colquitt et al, 2014;Puzziferri, Roshek, Mayo, Gallagher, Belle & Livington, 2014;Zalesin et al, 2010) Not all responses to WLS are positive, however. Scholars have documented how excess skin, malnutrition, diarrhea, hypoglycemia, and dumping syndrome can impact patients" health-related quality of life, eating habits, and psycho-social functioning in the first two or three years following WLS (Hadam, Somers, & Chand, 2011;Author, 2015;Natvik, 2015;Mala & Kristinsson, 2013;Ikramuddin, 2013).…”

“…To qualify for bariatric surgery (according to the guidelines to which the majority of clinics adhere), a person must have a body mass index (BMI) of 40 or above, or a BMI of 35 together with at least one significant, obesity-related health problem (Zalesin, Franklin, Miller, Janosz, Veri, Odom, McCullough, 2010;Natvik 2015;National Institutes of Health, 2012).…”