Weight recidivism after bariatric surgery: Evaluation and implications

Abstract

Bariatric surgery is the most effective treatment for morbid obesity. A minority of patients will suffer from inadequate weight loss or weight regain. The reasons for this are multifactorial, including anatomic, physiologic, behavioral, and psychosocial factors. A thorough assessment begins with a history and physical examination in order to identify any contributors to poor weight loss outcomes. Common reasons for weight recidivism include maladaptive eating habits, psychosocial stressors, and decreased energy expenditure and physical activity. Anatomic and surgical factors, such as infrequent band adjustments or large pouch size, play a role as well. Management includes in-depth counseling regarding nutrition and behavior modification and, depending on the patient, may include revision or conversion surgery.