Gastric sleeve surgery makes patients eat less by reducing hunger-causing hormones as well as feel full faster by reducing stomach size and creating a restriction. Most overweight and obese people undergo weight loss surgery because diet and exercise aren’t maintaining any significant long-term results.

Sleeve surgery helps patients lose excess weight quickly, efficiently, and permanently. However, in about 30% of the cases, gastric sleeve patients have inadequate weight loss, weight regain or develop upper GI problems requiring revisional surgery [1].

The main reasons that sleeve patients regain excess weight are loss of restrictions and/or change in their eating habits.

weight regain after gastric sleeve surgery - jigsaw puzzle

So you’ve gained some weight and don’t know what to do to turn the scale around. It happens, and we’re here to help! Here we will go through EXACTLY what could be causing weight gain after gastric sleeve surgery – and how to fix it!

Whether you are one month, one year, or more years after surgery this article should help prevent weight gain from worsening.

Gastric Sleeve and Weight Gain

Regaining weight occurs in a small patient population starting anywhere from 18 months to 6 years after gastric sleeve surgery. Weight regains range from a small portion of excess weight to almost the entire weight loss.

There are a few main causes of weight gain after bariatric surgery, specifically Laparoscopic Sleeve Gastrectomy (LSG). It’s not a question of if the appetite will return, it’s about planning and preventing overeating when the body starts to increase food intake. So just remember, you are not alone.

I am gaining weight after gastric sleeve surgery

Another possible scenario for insufficient weight loss and regain is the surgeon’s technical errors, such as:

  • Incorrect calibration with a bougie
  • Incomplete dissection of the gastric fundus

The amount of weight you lose will eventually, or abruptly come to a halt. Gastric sleeve weight gain will occur eventually. Whether you reach your goal weight or not, it is bound to happen at one point in time or another.

Change your diet and lifestyle

How Your Appetite Increases Over Time

All patients progressively increase their capacity for food. Your body adapts to the new stomach size, neurohormonal changes occur and will adjust after gastric sleeve surgery.

For example, after gastric sleeve surgery, patient’s appetites tend to increase as shown below.

  • 1 month: 2 to 3 bites per meal
  • 6 month: 3-4 ounces of food per meal
  • 1 year: 6 ounces per meal
  • 3 year: 8 ounces per meal
  • 5+ year: 8+ ounces per meal

The goal is to avoid increasing your stomach’s capacity more than it will naturally. Remember, the slightest boost of eating more food can grow exponentially over the course of a few weeks and cause weight gain after gastric sleeve surgery.

Ask for support: dietitian, psychologist,  and personal trainer

What Causes Weight Gain After Gastric Sleeve?

  • Medications: It is important to do research on your current medications if you are facing gastric sleeve weight gain.
  • Processed Foods: Artificially sweetened or unnaturally sweetened foods.
  • Lack of Physical Activity or Injury: Being active isn’t always enough. Even if you are currently active, you may need to become more active through exercise or working out.
  • Liquid Calories: Drinks that have a high amount of calories without providing a feeling of fullness (such as soda and juice).

Other Potential Causes

  • Stress, Depression, and Anxiety
  • Genetics
  • YoYo Dieting
  • Lack of Sleep
  • Chronic Disease

Address food addiction

How to Restart Weight Loss After Gastric Sleeve Weight Regain

Here are eight options to help you reverse weight gain:

  1. Cut out all added sugar from your diet.
  2. Increase water intake to a minimum of 64 ounces.
  3. Find a healthy meal plan that will help give you guidance.
  4. Try out the 5-day pouch reset diet or the 10-day pouch reset diet.
  5. Speak with your nutritionist.
  6. Be open and honest.
  7. Join a support group.
  8. Start a food journal to fully understand your eating habits and what types of food are causing weight regain after gastric sleeve surgery.

Ask about the medications you take

Strategy to Overcome Weight Gain

Some patients have to work a lot harder to lose weight and keep the weight off. Gastric sleeve surgery is not a perfect “fix-all” solution. It is a tool, and you can work with the tool or work against it.

  • Nutrition: What are your current eating habits?
  • Support: Seek support and join a gastric sleeve support group
  • Exercise: Be more active and start a new exercise routine.
  • Medications: Have you started gaining weight since you started a new medication? Speak with your doctor to discuss other alternatives.
  • Bariatric Revision Surgery: Undergoing a correctional procedure is one of the best methods to get back on track when all else fails.

Have a gastric sleeve revision

Gastric Sleeve Revision

Fortunately, there are many options available for you to take advantage of if you fail to get to goal weight with sleeve procedure. Popular revision procedures include:

  • Sleeve to Gastric Bypass
  • Sleeve to Mini Bypass
  • Sleeve to Duodenal Switch

Find a top bariatric surgeon in Mexico that specializes in revising failed surgeries.

Stomach Stretching

Rather than your sleeve stomach “stretching”, patients can see an increase in capacity for food. By overeating, you are causing loss of restriction, which can result in weight gain or increased capacity for food.

After gastric sleeve surgery, the stomach size holds roughly 2 to 3 ounces of food as opposed to the average stomach holding 40 ounces of food. It is a common misconception that the smaller stomach is capable of stretching back to its original size. This is false, but patients may encounter slight dilation with bad eating habits for long periods of time. The stomach is an elastic organ, making stomach stretching after gastric sleeve possible, but insignificant.

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