Dr. Starpoli blog on GI disorders

What Causes Weight Gain After Bariatric Surgery?

Written by Anthony A. Starpoli, MD | Mar 25, 2014 2:10:00 PM

Obesity is an epidemic that affects 1.7 million people world wide. An estimated two-thirds of the United States' population is obese. Obesity is a disease that can cause diabetes, heart attacks, strokes and can even be lethal if left untreated. Bariatric surgery is one option overweight and morbidly obese people have for treating their weight problem, however it isn't a total solution. Although bariatric surgery is successful in helping many people lose weight, not only does it require lifestyle changes, it is a drastic surgical procedure with many complications. One such complication includes a failure of the gastric bypass with a resultant weight gain.  One important factor is that the connection between the re-created stomach pouch, and the intestine known as the jejunum becomes quite widened.  This change is know has a dilated GJ anastomosis.  Therefore, as one eats food, materials are dropped quickly into the small intestine, and increase the absorption rate of calorific foods. Most patients will describe that they have lost their sensation of being full after eating. To surgically revise the widening of this connection by formal surgery is often.

 

The first thing any patient undergoing endoscopic suturing needs to understand is that regaining weight after the gastric bypass procedure is not uncommon. It can occur in over 40% of patients having gastric bypass.  During an endoscopic stomal revision, the gastroenterologist specializing in endoscopic suturing also known as the Overstitch Procedure,  will suture the opening from the stomach pouch to the intestine. This connection, called a stoma, can stretch over time, that can lead to weight regain after the procedure because more food can pass through and more calories get absorbed.  This procedure is performed through the mouth with an instrument that goes into the stomach area that allows for a sewing down of the area to take place.  Following the procedure, the patient is placed on a liquid diet for two weeks. Additionally, the patient should see again a registered dietitian, so that behavioral and dietary issues can be addressed.

 

            

 

 

Safe, endoscopic procedures are available for patients who have undergone gastric bypass surgery, in order to reduce the size of the pouch back to it's post-operative size. This allows the patient to become fuller, faster allowing the patient to reduce their overall calorie intake and continue with their weight loss.