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Weight Loss Surgery Failure

Weight Loss Surgery Failure

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      If you are considering weight loss surgery, you likely have scoured the internet for personal stories on weight loss surgery failure and success. Perhaps you have even investigated the weight loss surgery failure rate. What you need to know is weight loss surgery failure depends on how you define failure.

      Indeed, the weight loss failure rate you found online may have been failure based on the number of patients who experience weight regain as opposed to the rate of patients who had a failure of the surgical procedure itself. To fully understand weight loss surgery failure, let’s take a look at what causes failure and explore ways to prevent failure so that you meet your weight loss goals.

      What are the causes of bariatric surgery failure?

      Two of the predominant causes of failure after weight loss surgery include:

      • Adverse outcomes from the surgical procedure
      • Failure to lose weight or maintain weight loss

      While these are the most common sources of weight loss surgery failure, many people also find failure from surgery because of long term complications and negative psychosocial experiences.

      Picture of the words "failure" and "success" written on small pieces of paper.
      Identifying what constitutes success and failure is important when establishing your weight loss goals.

      Adverse outcomes from the surgical procedure - Like any surgery, there is a risk for complications and adverse outcomes in patients who have bariatric surgery. The risk of adverse outcomes depends on the type of bariatric surgery that is performed. A large study conducted by the American Society for Metabolic and Bariatric Surgery found that the risk of death from bariatric surgery is much lower compared to most other surgeries. The study identified that one bariatric surgery patient out of 1,000 would die within 30 days of surgery. Surprisingly, it is more common to die from staying obese as opposed to undergoing weight loss surgery.

      Of course, there are other adverse outcomes from bariatric surgery. Failure rates include failure from different sources and causes including:

      • Severe nutritional deficiencies
      • Complications from nutrient deficiencies
      • Failure to lose weight
      • Weight regain

      Interestingly, the rate of reoperation for gastric bypass surgery is the lowest among all bariatric surgeries at 4.9%. In comparison, 9.8% of gastric sleeve patients and 26% of laparoscopic adjustable gastric band patients will undergo reoperation.

      Doctors together performing a surgery.
      There are greater risks to your health by staying obese compared to undergoing weight loss surgery.

      Failure to lose weight and maintain weight loss - Weight loss surgery is not the easy way out when people decide to lose significant weight. Choosing to have surgery requires that you commit to changing your lifestyle to succeed. Many patients who undergo weight loss surgery experience weight plateaus and weight regain. In some situations, the surgery may not have been aggressive enough to meet the patient’s weight loss goals, and reoperation is necessary. However, one of the most common causes of weight regain after surgery is because behavioral patterns and habits have not changed. Indeed, succeeding after weight loss surgery requires that you adhere to a strict diet, avoid destructive eating habits, and adopt a healthy, active lifestyle.

      There is a common misconception that most people who have weight loss surgery regain the weight. And while it is true that nearly 50% of patients will regain a small amount of weight two or more years following surgery, the long term outcomes are incredibly favorable.

      Ways to prevent bariatric surgery failure

      If you want to avoid weight loss surgery failure, there are specific strategies you can employ to have the best chance at success.

      1. Set realistic goals that are true to you - If you are thinking about weight loss surgery to help you reach your weight loss goals, think ahead to what will define success for you. Perhaps your goal is not to reach “onederland” but rather to be able to play with your kids or dogs in your backyard. Maybe your goal is to feel confident in your skin as opposed to reaching a specific number on your scale. Maybe success for you is reaching “onederland.” Before you sign up for weight loss surgery, identify what outcome you would like to see and create a map for yourself on how you are going to get there. It can also be beneficial to create checkpoints so that you meet smaller goals along the way to reaching your most significant weight loss goals.

      Educate yourself - Once you have established your goals, learn about all of your options for weight loss surgery, and explore what recovery and long term maintenance involve. Knowledge is power, and if you enter the operating room, fully informed, you are more likely to succeed, starting from the moment you wake up in recovery.

      Find an experienced bariatric surgeon that makes you have confidence in your procedure - Like any profession, some surgeons are competent and highly skilled at performing bariatric surgery, and then some surgeons are not as experienced. To reduce your risk for surgical errors and adverse outcomes, allow yourself time to find the right bariatric surgeon for you. Your relationship will last a long time after you leave the operating room, so finding a bariatric surgeon you jive with can make a huge difference in your weight loss surgery experience. Feeling confident in your bariatric surgery team is crucial to finding success in weight loss surgery.

      An open book with inspirational words written on the pages.
      Set goals, both large and small, for yourself before you undergo weight loss surgery.

      Follow the diet - After you have surgery, you will have to follow a strict diet to allow your digestive tract to heal. Furthermore, depending on the type of surgery you have, you will need to limit food intake and avoid certain foods. Start modifying your diet and portions before surgery so that you are prepared and confident in following a healthy diet after surgery. Indeed, following a healthy diet is not only crucial for protecting the surgical modifications made to your digestive tract, but it also increases weight loss and improves obesity-related conditions such as diabetes. Finally, avoid alcohol and carbonated beverages. Drinking your calories is a quick way to put weight back on. In regards to drinking alcohol, a small percentage of bariatric surgery patients struggle with alcoholism. This is in part due to physical changes in the stomach that make you have a higher sensitivity to alcohol. However, it can also become an easy habit to pick up if you are struggling with life after bariatric surgery.

      Picture of a healthy breakfast of eggs, tomatoes, and grits.
      Following a healthy diet is a necessity after surgery. 

      Put in the physical effort - It is common for weight loss surgery patients to rely heavily on the physical changes from surgery and their diet to achieve weight loss goals. However, you must get the right amount of physical exercise to meet your goals. While the number on the scale and the image reflected in the mirror are usually the driving forces that send us to the gym, the importance of exercise goes beyond our outward appearance. Regular exercise combats health conditions associated with obesity, including diabetes, obstructive sleep apnea, osteoporosis, high blood pressure, and depression. Interestingly, it also improves mood by flooding your body with endorphins when you increase your heart rate for a sustained period. Your surgeon will make recommendations for how much exercise you should be getting in the days, weeks, and months following surgery.

      Keep follow up appointments -  Meeting with your bariatric surgery team keeps you motivated and ensures you are on the right track in meeting your goals. Firstly, make sure to attend your post-op appointments with your surgeon to verify that you are recovering from surgery with no complications. Secondly, you will likely be referred to other weight loss professionals to help you after surgery. Indeed, your bariatric surgery team may consist of a nutritionist, therapist, and personal trainer.

      Find your community - There is no doubt about it - weight loss surgery and recovery can feel like a lonely process, and many emotions accompany it. Some days you will feel great because you are proud of your accomplishments. However, there will undoubtedly be days where you will feel low and may struggle to carry on with your weight loss goals. Finding community and support in others who have had weight loss surgery is important to healing the emotional scars from being severely overweight and going through weight loss. Interestingly, but not surprisingly, many people experience confusion in their identity following significant weight loss. For example, some people who have always been called the “fat girl/boy” or who have struggled to participate in certain activities have difficulty adjusting. Therefore, a supportive network can help you find confidence and develop a positive self-perception.

      Picture of women together and laughing.
      Finding community and individuals to lean on who share your experience with weight loss surgery can have profound effects on your success.

      Yes - weight loss surgery can fail. And failure can be caused by many different factors. If you are interested in weight loss surgery failure stories, you will find an abundance of personal accounts online and perhaps even in person. However, you will not be among those that failed. With proper preparation, diligence, determination, and a sound bariatric surgery team and reliable support network, you will succeed.

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        Julia Rae Walker, RN, BSN, BA


        Julia is an experienced critical care nurse with a background in pediatric and adult patient populations. Her passion is helping patients maximize their quality of life.

        Gintas Antanavicius, MD, FACS, FASMBS

        Medical Reviewer

        Dr. G is a co-founder of BariBuilder. A US-based expert surgeon with over 10 years of bariatric experience, he regularly publishes research in medical journals like SOARD, Obesity Surgery, etc.