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    Weight Gain after Gastric Bypass
    RobtJ12 posted:
    Hello, like the majority of you I too am concerned about weight gain after a 2007 bypass. My weight was 312 at surgery melting down to 195. Now I an seeing a gradual weight gain, now @ 222.
    After getting angry/frustrated I have faced the reality that I became complacent, well in all honestly, lazy about exercise. Thus far my re-newed attention food intake and exercise seems to be the key.
    Hopefully others reading these posts have friends, family, and/or know of others dealing w/ the same issues might get together acting as mentors to each other. What's life w/o a little struggle.

    brunosbud responded:
    I have a few questions...

    You are under no obligation to respond, of course, but your answers may be helpful to others that are experiencing weight gain after successful gastric bypass surgery. Regardless, thanks for sharing!

    1. After the surgery, could you describe, in terms of percentage (100% for total change in diet and 0% for no change; just ate much less of what you've always eaten), how your diet changed during the period you reduced from 312 to 195?

    2. During the recent weight gain from 195 to 222, do you feel you are eating much more than previously or do you think the amount you're eating now has not significantly changed since the initial stages after surgery?

    3. Now that you've renewed your fight to prevent weight gain, are you changing your diet or are you attempting to eat less of what you've always eaten?

    4. When the scale transitioned from downwards to upwards, you did not feel the need to take action, immediately. Did you believe the gain was only temporary and would eventually reverse? What advice could you give to others about this transition period and what would you differently, now, in hindsight?

    5. Were you diabetic before your surgery and have you taken blood glucose readings to determine relative control, since? Any comments regarding this particular area would be most appreciated.

    Good luck, RobtJ12!
    RobtJ12 responded:
    Brunosbud, I am happy to answer your questions.
    1. The procedure itself limits the food intake, at least during the initial post-op period. Unfortunately after that one begins to test what and how much you can eat. The slow increase is due to that error.
    2. After the 3rd year I believe it was my being too comfortable about the diet, and loss of attention to the diabetes that was no longer requiring medications. As weight and the way clothes fit I had nothing to be concerned about. Coupled with the renewed "anything I wanted to eat" phase the pounds increased.
    3. Mainly the fear of diabetes meds, as well possible insulin injections. I pay particular attention to carbo and sugar intake both for control but also the diabetes issue.
    4. Quarterly blood test for not only glucose but also iron and associated indicators.
    Hopes that answers your questions.
    brunosbud replied to RobtJ12's response:
    Much appreciated. I hope others who've read what you've shared can learn from your experience. Please post again and tell us how you are doing from time to time. Good luck and thanks for sharing!
    Haylen_WebMD_Staff responded:
    Here's a post from our expert Pam Peeke from an earlier discussion about post-surgery weight gain:

    Pamela Peeke, MD, MPH, FACP replied:

    Hi everyone. I'm popping back in again to reiterate what I've said in the past. Bariatric surgery of any kind presents challenges. There's no guarantee at all that the weight will al come off, and that anything you shed will stay off. More often than not, weight regain occurs. Why? Some reasons are associated with they type of surgery you had. But, the most important reason for regain is that there was never a supportive program in place to keep you on track mentally, nutritionally and with physical activity. Whether you've dropped 100 pounds or 50, you need to live a different lifestyle for the rest of your life to keep the weight off.

    Go to and read what it takes to keep weight off for years. Substantial changes have to be made--- daily physical activity, monitoring the quality and quantity of your food, and psychological support as well.
    I would highly recommend that anyone who has had bariatric surgery work closely with a registered dietitian who is expert with bariatrics. They are invaluable at educating you and keeping you on track.

    As well, seek counseling to learn how to deal with stress without resorting to compulsive eating. This is key to longterm success.

    Dr. Peeke
    njt424 responded:

    I had Gastric Bypass surgery on August 15,2006. I was 328 before surgery and I lost 174 lbs. My weight goes up and down a bit. Recently I have gained about 10-15lbs. I know how you feel. I am stress eating and that is horrible thing to do. My Gastric surgeon recommended a book called sensless eating. I am going to get it out and starting reading it again. I have going back to what he told me. Only eating what is on the outside aisles of the grocery store and nothing in the middle. Meaning eat fresh fruit, vegetable, dairy, meats and so on. Everything that is in the middles of the store is processing and packaged foods are not good for you. I try to eat as much fruit, nuts, veggies and protein as possible to keep you full. Don't buy the other store items. If you have it you will eat it.And of course exercise, I need to do more as well. You are strong and you can do it. Just stay focused. You will be happier and glad you did it. Your body deserves it. You did not go thru all the trauma to you body to go back to what you use to be. Keep us updated.
    ch1ps responded:
    Hi! This is my first post here, although I've been lurking for a while. I had a ReY bypass in 2009, and I'm struggling a bit, too. On my surgery day, I weighed 258, down from a high of 309. I lost 50 pounds in the first six months, and I would attribute 80% of that weight loss to the surgery. I'm giving myself 20% of the credit for following all of the instructions to letter in terms recommended food and liquid intake. Then the weight loss slowed and I really ramped up my efforts. For the second six month period, I exercised *much* more, both in terms of quantity and intensity, and I focused on eating more nutrient dense foods: lots of fruit and veggies, lean proteins, and only modest amounts of whole grains. On my one year anniversary, I weighed 135, in the "normal" range for my height. I stayed in the 130s for several months, but slowly the weight has been creeping up. This morning I weighed in at 150. I'm still exercising a lot: at least two hours of intensive cardio a day, plus weight training a few times a week (admittedly I'm less disciplined about the weight training than the cardio...). However, I'm eating more, mostly still healthy foods, although those ubiquitous candy dishes at work are not my friends! I know that if I want to get back down, I've got to be much more strict about portion size, measuring everything and journaling what I eat, but it's hard getting back into that groove. Psychologically it was much more rewarding doing all of that when the scale was going down each week than it is now just trying to maintain the loss. Hopefully, this morning's come-uppance on the scale will make me be more consistent with my diet. Oh, how I miss those days when a cup of food would fill me up!...
    ch1ps replied to ch1ps's response:
    This morning I was at 147. Still not good, but seeing that "5" yesterday was a shock and hopefully the wake up call I needed. I think my problem area is definitely portion control, especially for MUFAs, as well as being tempted by sweets. I'm dusting off my food journal as we speak....
    rickone replied to brunosbud's response:
    need to vent, i need help. i became diabetic about five years ago after the perfect storm of lifes events coming together,traumatic back surgery,weight gain, and inactivity for an extended period plus family history. at the time weight loss surgery for diabetics was being discussed and researched. i jumped for any solutions. i subsequently had gastric banding. from 247 lbs to 195 in less than a year. then problems with the band began and it had to be deflated. weight gain followed while decisions were being made as to what to do. weight went up to 230 lbs and band was removed and by pass performed.[ during the time of gastric band the diabetes was non detectable.after deflation glucose began to rise.
    results from by pass were different. my blood pressure went from normal to very high immediately. no explanation why and meds added. glucose was slightly high. weight did not fall off the way the band surgery resulted. i am struggling, back on diabetic meds.
    my weight is hovering at 210-215. metformin i think caused too many side effects and my appetite was increasing. i changed to byetta, an insulin substitute which can cause appetite to decrease. it works, my appetite is less and of course quantity of food is also decreased. however i am not dropping any significant weight.
    i am curbing my food choices and, during the waking hours i am able to exercise good self control. i joined a health club to start the journey back to daily exercise. i am trying to shop smart. i have narrowed my caloric problem down to a specific time frame. that is, after midnight to about seven am. i am eating anythng and waking up every few hours,i sleep poorly waking perhaps four or five times a night eating anything i get my hands on. it is as though i have no control, and don't want any control. i just eat whatever i can get my hands on.i forget i have eaten until i am reminded of what i ate. i don't know what to do. it is this nightime eating that is defeating me. Should i ask for a sleep aid to keep me asleep? the eating is getting worse and i seem to be defient about it. help.
    gjvbbrn replied to rickone's response:
    To ricone,
    If your biggest problem is eating when waking frequently at night, perhaps your real problem is something else. If you have sleep apnea (frequent waking periods and/or snoring that awakens you) you need to see a sleep/pulmonary specialist. restful sleep is the only was our bodies recover for the strains in our life...without an adequate amount daily you are literally killing yourself. You can't make rational choices (abt. food, etc...) and the inflamitory morkers go up cousing your body to get worse. When I started sleeping w/ the CPAP unit it was wonderful! Yes, it can be hard to stick with it at first (people hate the head gear etc..., but it allowed me to sleep through the night solid. Thereby you wake with more energy and are able to connect the dots with things going on in my life. (Don't jump to sleeping pills, they will make it worse...if not kill you.)
    Anon_4858 replied to rickone's response:
    Just as an FYI, Byetta is *not* a substitute for insulin. Byetta is a GLP-1, it causes your liver to secrete more of your own natural insulin, as well as decrease the amount of glucose released into the blood. It also slows digestion, which decreases how fast sugar enters the blood which in turn lowers the severity of sugar spikes.

    If metformin is causing you digestive issues, try using the extended release version. From what people have told me it doesnt have as many side effects.
    thistledown1973 replied to Anon_4858's response:
    The pancreas produces insulin, not the liver. Byetta and Victoza (a similar drug) both work to slow stomach emptying and to activate a cascade of signals that cause the pancreas to produce more insulin on when there is food in the small intestine.

    The downside to the drug is that if you have problems with stomach emptying already (gastroparesis), these medications can aggravate the condition.
    BusyHealthyBee responded:
    RobtJ12 - to state the obvious, maintain a healthy diet - trying to eat a lot of protein, fibrous carbs, dark green veges- and make sure to work out at least 4 times a day (with workouts, interval training will burn more fat, and take much less time than a homeostatic work out on the treadmill or stationary bike). I've also used to answer my questions about my weight, diet, etc. They connect me directly with doctors in real time. Totally just revamped the site as well! Anyway, check out the site if you have questions, and hopefully my "words of wisdom" will help you out.

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