Why You’re Regaining Weight After Gastric Sleeve Surgery


Maintaining a weight loss, whether it’s through vertical sleeve gastrectomy or not, is often harder than losing those pounds in the first place. Sure, our patients want every pound lost to be gone for good, but sometimes the scale starts creeping back up again in the months and years after you’ve hit goal weight. But it doesn’t have to be that way. Let’s take a look at some of the most common reasons VSG patients experience regain; knowledge is power!

Reason #1: You’re not eating for your new body.
If you dig into a bag of chips or a carton of ice cream every night, you likely know why your pants are getting tight again. But it’s not just the obvious missteps that cause regain. In general, the less you weigh, the fewer calories you need to maintain that weight. In other words, a 300-pound person will stay at 300 pounds eating the same number of calories that often will cause a 150-pound person to gain weight. So what does that mean for you? It means that you might need fewer calories than you think in maintenance mode, especially if you don’t do much vigorous exercise. Just 100 calories over what your smaller body needs adds up to about a pound a month. If you’re gaining weight and don’t know why, the first step should always be to record every bite (preferably in an app that tracks calories) so you have an honest account of your eating habits.

Reason #2: You don’t have enough muscle.
Exercising is a good way to lose weight. But if their weight loss is going well, many people put exercise on the back burner, not realizing that it’s actually a way to prepare your body to fight regain when you’re done losing. The more muscle you have, the more calories you can eat without gaining weight. The opposite is true, too, of course: the less muscle you have, the fewer calories you can take in without gaining weight. Muscle is pretty much a golden ticket to maintaining a weight loss because it burns more calories when you’re moving and when you’re not. Another exercise secret is that, for reasons scientists don’t fully understand, a consistent exercise regimen reduces your body’s natural desire to regain weight. Your body doesn’t like weight loss. It doesn’t know that you’re trying to reverse disease; it just assumes there’s a famine happening and tries to revert to a state of extra padding. But when you exercise, a lightbulb goes on deep in your body’s cells, signaling your brain that this lower weight is actually a good thing!

Reason #3: You made changes that aren’t sustainable.
Losing weight is fun. Seeing the scale move down to numbers you might not have seen since high school, swimming in clothes that previously were too tight, getting compliments left and right…all of that positive reinforcement drives some patients to drastically restrict their gastric sleeve diet or exercise to extremes in order to sprint across the “finish” line. Once you see your goal weight in the scale, though, the motivation to keep at your hard-core routine lessens. Yes, you feel great without the excess weight, but you’re not getting the gratification of losing pounds and clothes sizes anymore. If you spent three hours in the gym every day to get into those size 4 pants, then guess what? You’ll probably need to spend nearly that amount of time in the gym to maintain it, too. For most of us, that’s not a commitment we can keep forever. Similarly, if you rushed the weight loss process with a gastric sleeve diet too low in calories, eating the number of calories in a typical maintenance diet will likely be far too many to maintain your loss. So as you’re losing weight, be sure you’re making smart changes to your lifestyle that you can maintain indefinitely.

Regaining weight you’ve lost with VSG isn’t inevitable. A few simple strategies can keep you at a healthy weight and off the yo-yo diet rollercoaster.

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“Changing lives…one sleeve at a time”.