Skip to main content
Top
Published in: Current Nutrition Reports 4/2018

01-12-2018 | Gastroenterology, Critical Care, and Lifestyle Medicine (SA McClave, Section Editor)

Weight Regain After Bariatric Surgery: Prevalence, Etiology, and Treatment

Authors: Saketh R. Velapati, Meera Shah, Aravind R. Kuchkuntla, Barham Abu-dayyeh, Karen Grothe, Ryan T. Hurt, Manpreet S. Mundi

Published in: Current Nutrition Reports | Issue 4/2018

Login to get access

Abstract

Purpose of Review

Obesity is a life-limiting disease that is associated with a number of co-morbidities. Bariatric surgery remains the most efficacious and durable weight loss method available to patients. However, a significant percentage of patients can regain weight resulting in frustration, depression, and return of obesity-related co-morbidities. The present review provides an overview of the most common therapeutic modalities available to combat weigh regain after weight loss surgery.

Recent Findings

Given the high percentage of patients with weight regain after surgery, significant effort has been placed on developing treatment options in the last few years. Tremendous work has taken place in the realm of cognitive behavior therapy, appetite suppressants, and endoscopic procedures with the hope of reducing the need for revision surgery which can be associated with significant complications.

Summary

Weight regain is unfortunately a common phenomenon associated with all weight loss modalities including bariatric surgery. We now have a number of treatment options that can reverse the weight loss trend.
Literature
2.
go back to reference Kraschnewski JL, Boan J, Esposito J, Sherwood NE, Lehman EB, Kephart DK, et al. Long-term weight loss maintenance in the United States. Int J Obes. 2010;34(11):1644–54.CrossRef Kraschnewski JL, Boan J, Esposito J, Sherwood NE, Lehman EB, Kephart DK, et al. Long-term weight loss maintenance in the United States. Int J Obes. 2010;34(11):1644–54.CrossRef
3.
go back to reference Anderson JW, Konz EC, Frederich RC, Wood CL. Long-term weight-loss maintenance: a meta-analysis of US studies. Am J Clin Nutr. 2001;74(5):579–84.CrossRef Anderson JW, Konz EC, Frederich RC, Wood CL. Long-term weight-loss maintenance: a meta-analysis of US studies. Am J Clin Nutr. 2001;74(5):579–84.CrossRef
4.
go back to reference Weiss EC, Galuska DA, Kettel Khan L, Gillespie C, Serdula MK. Weight regain in U.S. adults who experienced substantial weight loss, 1999-2002. Am J Prev Med. 2007;33(1):34–40.CrossRef Weiss EC, Galuska DA, Kettel Khan L, Gillespie C, Serdula MK. Weight regain in U.S. adults who experienced substantial weight loss, 1999-2002. Am J Prev Med. 2007;33(1):34–40.CrossRef
6.
go back to reference •• Sjöström L, Lindroos A-K, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26):2683–93. https://doi.org/10.1056/NEJMoa035622. A key landmark study that evaluated the impact of bariatric surgery on various obesity-related co-morbidities showing significant benefits compared to patients who did not undergo surgery. CrossRefPubMed •• Sjöström L, Lindroos A-K, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26):2683–93. https://​doi.​org/​10.​1056/​NEJMoa035622. A key landmark study that evaluated the impact of bariatric surgery on various obesity-related co-morbidities showing significant benefits compared to patients who did not undergo surgery. CrossRefPubMed
7.
go back to reference • Ikramuddin S, et al. Roux-en-Y gastric bypass vs intensive medical Management for the control of type 2 diabetes, hypertension, and hyperlipidemia: the diabetes surgery study randomized clinical trial. JAMA. 2013;309(21):2240–9. An important study showing impact of bariatric surgery on type 2 diabetes. CrossRef • Ikramuddin S, et al. Roux-en-Y gastric bypass vs intensive medical Management for the control of type 2 diabetes, hypertension, and hyperlipidemia: the diabetes surgery study randomized clinical trial. JAMA. 2013;309(21):2240–9. An important study showing impact of bariatric surgery on type 2 diabetes. CrossRef
8.
go back to reference • Schauer PR, et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med. 2012;366(17):1567–76. A large randomized control trial that revealed improvement in diabetes control with bariatric surgery including the need for less medication. CrossRef • Schauer PR, et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med. 2012;366(17):1567–76. A large randomized control trial that revealed improvement in diabetes control with bariatric surgery including the need for less medication. CrossRef
9.
go back to reference Mingrone G, Panunzi S, de Gaetano A, Guidone C, Iaconelli A, Leccesi L, et al. Bariatric surgery versus conventional medical therapy for type 2 diabetes. N Engl J Med. 2012;366(17):1577–85.CrossRef Mingrone G, Panunzi S, de Gaetano A, Guidone C, Iaconelli A, Leccesi L, et al. Bariatric surgery versus conventional medical therapy for type 2 diabetes. N Engl J Med. 2012;366(17):1577–85.CrossRef
10.
go back to reference Bond DS, Phelan S, Leahey TM, Hill JO, Wing RR. Weight-loss maintenance in successful weight losers: surgical vs non-surgical methods. Int J Obes. 2008;33(1):173–80.CrossRef Bond DS, Phelan S, Leahey TM, Hill JO, Wing RR. Weight-loss maintenance in successful weight losers: surgical vs non-surgical methods. Int J Obes. 2008;33(1):173–80.CrossRef
17.
go back to reference Himes SM, Grothe KB, Clark MM, Swain JM, Collazo-Clavell ML, Sarr MG. Stop regain: a pilot psychological intervention for bariatric patients experiencing weight regain. Obes Surg. 2015;25(5):922–7.CrossRef Himes SM, Grothe KB, Clark MM, Swain JM, Collazo-Clavell ML, Sarr MG. Stop regain: a pilot psychological intervention for bariatric patients experiencing weight regain. Obes Surg. 2015;25(5):922–7.CrossRef
22.
go back to reference Burke LE, Wang J, Sevick MA. Self-monitoring in weight loss: a systematic review of the literature. J Am Diet Assoc. 2011;111:92–102.CrossRef Burke LE, Wang J, Sevick MA. Self-monitoring in weight loss: a systematic review of the literature. J Am Diet Assoc. 2011;111:92–102.CrossRef
23.
go back to reference Guerciolini R. Mode of action of orlistat. Int J Obes Relat Metab Disord. 1997;21(Suppl 3):S12–23.PubMed Guerciolini R. Mode of action of orlistat. Int J Obes Relat Metab Disord. 1997;21(Suppl 3):S12–23.PubMed
24.
go back to reference Garvey WT, Ryan DH, Look M, Gadde KM, Allison DB, Peterson CA, et al. Two-year sustained weight loss and metabolic benefits with controlled-release phentermine/topiramate in obese and overweight adults (SEQUEL): a randomized, placebo-controlled, phase 3 extension study. Am J Clin Nutr. 2012;95(2):297–308.CrossRef Garvey WT, Ryan DH, Look M, Gadde KM, Allison DB, Peterson CA, et al. Two-year sustained weight loss and metabolic benefits with controlled-release phentermine/topiramate in obese and overweight adults (SEQUEL): a randomized, placebo-controlled, phase 3 extension study. Am J Clin Nutr. 2012;95(2):297–308.CrossRef
25.
go back to reference Greenway FL, Fujioka K, Plodkowski RA, Mudaliar S, Guttadauria M, Erickson J, et al. Effect of naltrexone plus bupropion on weight loss in overweight and obese adults (COR-I): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2010;376(9741):595–605.CrossRef Greenway FL, Fujioka K, Plodkowski RA, Mudaliar S, Guttadauria M, Erickson J, et al. Effect of naltrexone plus bupropion on weight loss in overweight and obese adults (COR-I): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2010;376(9741):595–605.CrossRef
26.
go back to reference Astrup A, Carraro R, Finer N, Harper A, Kunesova M, Lean ME, et al. Safety, tolerability and sustained weight loss over 2 years with the once-daily human GLP-1 analog, liraglutide. Int J Obes. 2012;36(6):843–54.CrossRef Astrup A, Carraro R, Finer N, Harper A, Kunesova M, Lean ME, et al. Safety, tolerability and sustained weight loss over 2 years with the once-daily human GLP-1 analog, liraglutide. Int J Obes. 2012;36(6):843–54.CrossRef
27.
go back to reference Smith SR, Weissman NJ, Anderson CM, Sanchez M, Chuang E, Stubbe S, et al. Multicenter, placebo-controlled trial of lorcaserin for weight management. N Engl J Med. 2010;363(3):245–56.CrossRef Smith SR, Weissman NJ, Anderson CM, Sanchez M, Chuang E, Stubbe S, et al. Multicenter, placebo-controlled trial of lorcaserin for weight management. N Engl J Med. 2010;363(3):245–56.CrossRef
28.
go back to reference Jester L, Wittgrove AC, Clark W. Adjunctive use of appetite suppressant medications for improved weight management in bariatric surgical patients. Obes Surg. 1996;6(5):412–5.CrossRef Jester L, Wittgrove AC, Clark W. Adjunctive use of appetite suppressant medications for improved weight management in bariatric surgical patients. Obes Surg. 1996;6(5):412–5.CrossRef
29.
go back to reference Zilberstein B, Pajecki D, Garcia de Brito AC, Gallafrio ST, Eshkenazy R, Andrade CG. Topiramate after adjustable gastric banding in patients with binge eating and difficulty losing weight. Obes Surg. 2004;14(6):802–5.CrossRef Zilberstein B, Pajecki D, Garcia de Brito AC, Gallafrio ST, Eshkenazy R, Andrade CG. Topiramate after adjustable gastric banding in patients with binge eating and difficulty losing weight. Obes Surg. 2004;14(6):802–5.CrossRef
30.
go back to reference Stanford FC, Alfaris N, Gomez G, Ricks ET, Shukla AP, Corey KE, et al. The utility of weight loss medications after bariatric surgery for weight regain or inadequate weight loss: a multi-center study. Surg Obes Relat Dis. 2017;13(3):491–500.CrossRef Stanford FC, Alfaris N, Gomez G, Ricks ET, Shukla AP, Corey KE, et al. The utility of weight loss medications after bariatric surgery for weight regain or inadequate weight loss: a multi-center study. Surg Obes Relat Dis. 2017;13(3):491–500.CrossRef
31.
go back to reference Garvey WT, et al. American Association of Clinical Endocrinologists and American College of Endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity. Endocr Pract. 2016;22(Suppl 3):1–203.CrossRef Garvey WT, et al. American Association of Clinical Endocrinologists and American College of Endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity. Endocr Pract. 2016;22(Suppl 3):1–203.CrossRef
32.
go back to reference Nor Hanipah Z, Nasr EC, Bucak E, Schauer PR, Aminian A, Brethauer SA, et al. Efficacy of adjuvant weight loss medication after bariatric surgery. Surg Obes Relat Dis. 2018;14(1):93–8.CrossRef Nor Hanipah Z, Nasr EC, Bucak E, Schauer PR, Aminian A, Brethauer SA, et al. Efficacy of adjuvant weight loss medication after bariatric surgery. Surg Obes Relat Dis. 2018;14(1):93–8.CrossRef
33.
go back to reference •• Vargas EJ, Bazerbachi F, Rizk M, et al. Transoral outlet reduction with full thickness endoscopic suturing for weight regain after gastric bypass: a large multicenter international experience and meta-analysis. Surg Endosc. 2017:1–8. https://doi.org/10.1007/s00464-017-5671-1. Retrospective evaluation and meta-analysis of the impact of TORe on weight regain after bariatric surgery. CrossRef •• Vargas EJ, Bazerbachi F, Rizk M, et al. Transoral outlet reduction with full thickness endoscopic suturing for weight regain after gastric bypass: a large multicenter international experience and meta-analysis. Surg Endosc. 2017:1–8. https://​doi.​org/​10.​1007/​s00464-017-5671-1. Retrospective evaluation and meta-analysis of the impact of TORe on weight regain after bariatric surgery. CrossRef
Metadata
Title
Weight Regain After Bariatric Surgery: Prevalence, Etiology, and Treatment
Authors
Saketh R. Velapati
Meera Shah
Aravind R. Kuchkuntla
Barham Abu-dayyeh
Karen Grothe
Ryan T. Hurt
Manpreet S. Mundi
Publication date
01-12-2018
Publisher
Springer US
Published in
Current Nutrition Reports / Issue 4/2018
Electronic ISSN: 2161-3311
DOI
https://doi.org/10.1007/s13668-018-0243-0

Other articles of this Issue 4/2018

Current Nutrition Reports 4/2018 Go to the issue

Gastroenterology, Critical Care, and Lifestyle Medicine (SA McClave, Section Editor)

Fad Diets: Hype or Hope?

Diabetes and Obesity (MC de Oliveira Otto, Section Editor)

Dietary Fat and Risk for Type 2 Diabetes: a Review of Recent Research

Maternal and Childhood Nutrition (AC Wood, Section Editor)

An Intergenerational Approach to Break the Cycle of Malnutrition