NYU Langone and its surgeons recently reviewed over 200 files of patients who had gastric bypass surgery at least ten years ago and discovered that 30 percent of them hadn’t lost 50 percent of their excess weight. This common occurrence can bring with it feelings of personal failure — especially because it is common that this weight is regained rather than simply never lost. Dr. Christine Ren-Fielding and her colleagues like Dr. George Fielding have advice for how to work through this possibility.

Understanding the Stomach

The stomach is elastic. If it were not, ruptures could occur in the event of overeating. The stomach stretches, which begins the process of sending the “full” message to the brain. This is why weight loss experts often advise people looking to lose a little weight to eat a little and then wait — the message is not immediately sent and requires this stretching.

Bariatric surgeries, like those performed by Dr. Christine Ren-Fielding, reduce the size of the stomach that holds food either through removing a portion of the stomach or use of a band: the smaller the chamber, the sooner the message is sent resulting in eating less. The stomach, however, does not lose its elasticity which means that it can, with time, stretch to a larger size. In these cases, the patient is able to eat more before feeling sated. Making poor food choices or turning to comfort food to fight those feelings of hunger can bring on weight regain.

Calories are not Old News

Weight gain and loss are always going to come down to calories over volume. Before or after bariatric surgery eating a serving of salad is better than eating a serving of french fries if the goal is to lose or maintain a healthy weight. Salads contain fiber and vegetables are low calorie. No or light dressing, low fat or a small amount of cheese, and other decisions can be made to enjoy a protein rich, low fat and low calorie salad that can enhance health. French fries, however, are full of fat, carbs, and calories. A patient with reduced capacity in their stomach should make healthy choices. The reduced amount and caloric value help with loss and maintenance. This age old wisdom is important to remember according to Dr. Christine Ren-Fielding.

Tools vs. Magic Pills

Bariatric surgeries are an excellent tool to help jumpstart weight loss and improve health and wellness. But they are not the only tool needed. Reducing the stomach size and hunger, and bringing satiety about earlier is an excellent boost. From there, patient and doctor must work together to see the quickest and best results. The eating of healthy foods is the quickest, easiest way to develop lifelong habits to lose weight. These choices should be consistent and the surgeon is there to guide the patient after surgery. Patients should work on eating the right thing and also paying attention to their body and how it feels. This enables the surgeon to understand whether or not the stomach is starting to stretch again.

Revision Surgery Can Be An Option

Dr. Christine Ren-Fielding works with patients who make good choices but eventually may notice hunger, a lack of satiety, and cravings for comfort foods. This is not failure but simply a result of the elasticity of the stomach. As it stretches and can hold more food, it takes longer to feel full. There is revision surgery available when needed to decrease the capacity of the stomach. The stomach in some patients can eventually stretch to half the size of the original stomach, resulting in the potential for weight gain.

Not all stomachs will stretch this much however understanding that this is a possibility over time and having open dialogue with the surgeon about hunger, satiety, food choices, and cravings help the patient have the best experience with their bariatric surgery.

Learn more about the surgeries and services offered by Dr. Christine Ren-Fielding here.