Struggling with weight gain after gastric bypass surgery? The roux-en-y gastric bypass has long been one of the premier weight loss surgery options to treat obesity. Bypass procedure has a very high weight loss success rate, along with excellent health outcomes that can lead to partial or complete cures for diabetes, sleep apnea, and other obesity-related diseases.

Gastric Bypass Surgery Roux en Y Diagram

RNY bypass surgery creates a restriction, like gastric sleeve, so you feel full faster. The procedure also has a malabsorption component so patients can eat more and absorb fewer calories.

Unfortunately, no bariatric procedure, including gastric bypass, is perfect for everyone. Some people end up gaining a portion of the excess weight back sometime after. Weight regain after RNY gastric bypass can be due to a lack of a solid support system, food addiction, or not staying active.

Weight Gain After Gastric Bypass Surgery

As effective as Roux-en-Y gastric bypass is, it is not magic. About 50% of bariatric patients regain some of the excess weight after two years following the operation. However, only a small percentage (5%) of individuals that undergo gastric bypass surgery “gained a lot of it back.” When this happens, it can be both disheartening – and potentially dangerous – for the patient.

What Causes Weight Regain After Gastric Bypass Bariatric Surgery

What Causes Weight Gain After Roux-en-Y Gastric Bypass?

Weight gain after gastric bypass surgery is not common, but it happens. Procedures like gastric bypass or gastric sleeve surgery are known as two of the safest and most effective weight loss procedures. Often the most common reasons for weight gain after gastric bypass roux-en-y include:

  • High-Calorie Diet
  • Lack of Exercise
  • Stretching of Stomach Pouch (Allowing More Food)

Most of the time, the primary cause of weight gain after weight loss surgery is not engaging in the lifestyle changes necessary to continue to lose weight or maintain your weight loss.

Bariatric surgery is the first step towards lifelong changes that are all meant to help you lose weight. If you start to slip on these changes, weight regain is possible.

Treatments for Weight Gain After Gastric Bypass Surgery

If the weight-gain after gastric bypass surgery is minor, no treatment may be necessary. Most patients begin weight gain from either a stall or plateau after losing as much as 60% of their excess body weight following surgery. This small percentage of weight gain is simply because they have hit their floor.

But when the weight-gain is more significant, that can quickly become a problem and something that should be dealt with quickly to avoid complications and health challenges. Your treatment choices include:

1. Therapy/Counseling

Depending on the severity of the weight gain after gastric bypass roux-en-y, it may be important to seek therapy and determine if and why you are struggling with eating, exercise, and other necessary health changes. Often it is an underlying issue that can be controlled with the right counselor and program. Nutrition counseling may also be helpful.

2. Pouch Reset

Another option is known as a “pouch reset.” This is where patients go back to the diet that they had immediately after surgery in order to “shrink” their pouch and bring it back to normal. There is no medical evidence that a pouch reset exists, or is anything more than a crash diet to lose some weight quickly. It appears to be a bit more of a myth but anecdotally some people find it is very helpful. If you decide to go this route, only do so under a doctor’s supervision.

3. Revision Surgery

If changes have occurred in your stomach or intestines that have led to a decrease in the effectiveness of your gastric bypass surgery, a gastric bypass revision may be necessary. Revisions for gastric bypass do come with an increased risk of complications, so it is only used as a last resort. Learn about the gastric bypass revision procedures.


If you’re struggling with gaining weight after gastric bypass, the first issue you should evaluate is your diet and exercise. If you have not been keeping to either, then your first step should be immediately speaking with a nutrition counselor, psychologist, personal trainer, and other experts that can lead you in a healthier direction.

But if the issue is more severe, a revision gastric bypass may be necessary, as well as continued counseling to help you change your lifestyle in a way that contributes to weight loss.