Gastric bypass surgery is successful for the majority of patients, but gastric bypass revision surgery may be necessary for patients who experience significant weight regain after hitting their low weight.
The most common reason patients consider gastric bypass revision is weight-related, either not enough was lost following surgery or too much was gained back.
Research shows that up to 20% of patients who were morbidly obese prior to their initial surgery and up to 35% of patients who were super obese have gained back more than 50% of their excess weight after 10 years. Sometimes this is the result of internal issues that require surgical revision while other times inappropriate diet or exercise is the culprit.
Gastric bypass revision surgery can carry risks just like your initial surgery, so it is important that you follow your surgeon’s orders exactly to avoid a second surgery if possible. To this end, your surgeon will want to rule out diet or exercise problems before moving forward with another procedure and will likely take the following two steps:
- Rule out diet as the cause of insufficient weight loss or weight
Whether you very carefully track what you eat using a handwritten daily journal or check with a psychologist to determine whether any emotional issues could be causing your diet or exercise goals to go off-track.
- Rule out exercise as the cause Using a special device called an indirect Calorimeter to test basal metabolic rate (BMR), which is the amount of energy your body burns when you are resting. Extremely low BMR could have issues with weight loss even if pouch size and dietary habits are where they should be. Your base metabolic rate can be increased if you add more lean body mass (muscle), so if low BMR is a problem your surgeon will most likely have you work with a personal trainer to properly adjust your exercise after gastric bypass surgery.
After diet and exercise problems are ruled out, your surgeon will want to check your stomach pouch size and the opening between your stomach and your small intestines (also called your “stoma”). If either is too large (or has stretched), it may be the cause of your post-surgery weight loss problems.
If stomach stretching or stoma enlargement is identified, a revision surgery may be your only option to halt or reverse the weight regain.