Regain after weight loss surgery and what to do about it

Let’s talk about regain. One simple word that will strike fear into the hearts of most post-op weight loss surgery people. It’s the thing we all swear will never happen to us and by gosh do we mean it when we say it. It doesn’t help when the first story people want to tell you is about the person they know who had WLS and gained all the weight back, aren’t people so helpful, sigh. I wanted to talk about the reality of weight gain and regain after weight loss surgery, I hope we can figure it out.

So, regain. What is regain? Like anything it needs to be quantified and articulated so we’re all on the same page. It gets tricky though, what exactly do any of us mean by regain? I’m sure we all have a different perspective on it. Our bodies will do what they are going to do and although we can influence them with the choices we make, we cannot completely control our bodies with our mind or behaviour. I believe we have a ‘set point’ weight which is different after bariatric surgery than it was before, but that our bodies will figure that out and will stick around that with a consistent routine filled with good nutrition and exercise choices.

After any bariatric surgery you will lose weight. The journey I see often is someone loses a ton of weight, they get really skinny and gaunt and then their weight bounces back up a little bit and settles. I would not class this as regain. I think some people expect that when they will hit the lowest post-op weight they stay there and maintain that. I’m sure that happens very occasionally but it’s not the trend. I can’t stress enough that it is common and expected that we will regain a little bit, around 5-10% of what we have lost, after weight loss surgery. (I have read a lot online and spoken to a researcher and the values, depending on where you look, vary wildly. Please remember I’m not a doctor or anything fancy so I’m throwing out anecdotal numbers here.)

When does it turn into regain? I think the line is different for us all but I would say when you’re getting to 10-15% of your loss back. Say for example you lost 70kg all up. That gives you a range of 7-10.5kgs over your lowest weight where you could start calling it true regain. I think it’s important for us to define that range for ourselves, depending on our numbers and tolerance for regain, so that you have a point at which alarm bells should start ringing.

What causes regain and how do we fix it? Regain doesn’t happen for no reason. Sometimes there’s understandable reasons and sometimes it’s because we’ve let our habits slip a bit and we need to do something about it.  This is where it’s really important to keep being honest with ourselves. If you know you are making excuses and could be making better choices for your body and your wellness, then that’s what you need to start doing. I still, nearly five years out from surgery, slip back into old and unhelpful habits when things get tough. Stress is not a great friend of mine.

If you’re worried about your regain and don’t know where to start talk to your bariatric team or even your GP. You need to troubleshoot and make sure there’s not something else going on, for example a new health condition or medication that’s interfering with your weight. Please don’t let embarrassment or feelings like you haven’t done well enough stop you from talking to your team. They are there to support you and you’re not the first person this has happened to. They will have great advice and may give you the encouragement and motivation you need to start getting back on track.

If you know what’s going on and that it’s the snacking, not getting enough protein, not drinking enough water, not getting enough activity in, or eating chocolate bars everyday that’s doing it then get working on your habits. Our habits are incredibly powerful and can drive us to do stuff we know we probably shouldn’t without too much thought going into it. You have the power to change your habits. Start small, do everything at once, go cold turkey. Do whatever it is that’s worked in the past and helped you go in the right direction.

Drop the expectation that you will forever stay at your lowest weight post bariatric surgery. Figure out your body’s new set point in weight and make peace with it. Continue to do what you need to so you can maintain your helpful food and exercise habits. Please, for the love of kittens, if you’re newly post-op don’t get all judgemental and on your high horse about it when you see people in FB groups talking about regain. The, that’ll never happen to me attitude/how on earth did you let that happen, attitude is not cute and we need to be kind and supportive to each other when someone is struggling with it. The journey changes over time and it’s easy to lose focus on yourself and your weight as time goes on.

Have you experienced regain after your weight loss surgery? What helpful things did you do to combat it and not let it go too far? Comment below, I’d love to hear from you!

If you’re struggling with regain and need an accountability partner to help you make changes and get back on track I can help you. I am a professional bariatric coach and have a ‘Getting back on track’ package available. Head to my coaching website Bariatric Gold to get more info.