Weight Gain After Bariatric Surgery: Everything You Wanted to Know

Average weight regain after 5 years from Bariatric Surgery ranges from 0 to 10%, depending on on two key factors: 1) The procedure chosen and 2) Patient behavior.

However, several non-surgical measures exist to prevent or reverse weight regain.

First lets see which procedures cause how much long-term weight loss and average weight regain from our Center’s experience and various studies published in medical journals:

Highest long-term weight loss with little to no weight regain:

Duodenal switch: 70%+ excess weight loss (EWL) after 3 years with little or no weight-gain

Duodenal switch is a procedure where the first part of our small intestine called Duodenum is partially removed and replaced with a graft of the last part of our small intestine called Ileum.

We are the most experienced Center in India in Duodenal Switch Surgery which can also be used in non-obese type 2 diabetes patients for permanently resolving Diabetes. In fact we were the first in India to offer Duodenal Switch Surgery since 2010.

High long-term weight loss, with 8 to 10% weight regain:

Gastric sleeve: 60% EWL after 3 years

Gastric bypass:  60% EWL after 3 years

Lap-Band: 55% EWL after 3 years, but highly variable from patient to patient

Moderate short-term weight loss, with 100% weight regain possibility if a secondary procedure is not done:

Gastric balloon: 30% EWL in 6 months, then must be removed. If the patient does not receive another gastric balloon after their first one is removed or does not undergo one of the more interventional procedures listed above, 100% weight regain is likely.

The key to preventing weight regain after Bariatric surgery depends on these 4 actions:

  1. Lose as much weight as possible before Surgery:

Studies show that your BMI before surgery directly correlates to how much weight you will lose and keep off after surgery. Hence we put patients on a liquid diet two weeks before surgery so that much weight is gone as you get operated, and the procedure would accelerate loss of remaining excess weight.

  1. Follow Bariatric Diet:

The right bariatric diet addresses “What” to eat. It includes:

  • High-protein, low-carb diet, and no cheating before surgery
  • Slow transition from clear liquids to solid foods after surgery
  • Healthy foods, proteins first
  • Lots of sugar-free liquids, but never around meals
  • Minimal snacking
  • Small portion sizes, chew thoroughly
  • Adhering to prescribed vitamin regimen
  • Avoiding “trigger” foods and alcohol


Our Center has well experienced Dietician to help you with this part.

  1. Bariatric Eating:

The right bariatric eating is about “How” to eat what you have chosen to eat.

These techniques help prevent complications, weight regain, and malnutrition. They include:

  • Preparing your food properly
  • Controlling portion sizes
  • Eating slowly and chewing thoroughly
  • No drinking before, during, or after meals
  • Being mindful of warning signs


We guide all our patients through this process in detail.

  1. Moderate Exercise

 A reputed study by UCLA (University of California, Los Angeles) in the US reveals that those who moderately exercised after Bariatric Surgery had 4.2% lower BMI than those who didn’t exercise.

Another study from University of Virginia found that patients who maintained 2 ½ hours per week exercise routine showed significantly greater long-term weight loss vs patients who didn’t exercise.

2 ½  hours as you realise is just 30 minutes exercise for 5 days a week.

I am sure you can find this much time and motivation however busy or uncharacteristic of physical activities you are.

Why does moderate exercise matter so much for long term weight-loss success?

The reason is counter-intuitive.

Moderate exercise by itself may burn as little as 200 calories per session. These many calories can be gained back in 5 minutes by eating two gulab jamuns or a small piece of black forest cake.

The more important reason a 30 minute moderate exercise works is by boosting your metabolism, which is especially important considering your body’s natural tendency to slow down your metabolism as you lose weight.

A higher basal metabolic rate means that your body will automatically burn calories at a faster rate even while you are resting, thus leading to additional weight loss.

Key is to start slowly and build endurance at your pace.

The best exercise for bariatric surgery patients achieves a balance of Flexibility, Strength and Endurance.

For more details on exercise plans, please do connect with us for a detailed discussions. If you have any chronic pain, our highly experienced physiotherapists will be able to help.

If you wish to learn more about any of the points shared above, please feel free to call us at +91 22 2888 6666 for an appointment with Dr Abhay Agrawal or his Dietician or Physiotherapist.

Dr Abhay Agrawal is also available at Apollo Spectra Hospital Tardeo, Seven Hills Hospital Andheri East and Thunga Hospital Malad West on prior appointment so that you can meet him at a convenient location to you.