The Role of Revision Surgery in Gastric Bypass and Sleeve Gastrectomy After Weight Regain

Weight regain is a concern that patients often face after bariatric surgery [1]. While primary bariatric surgery, such as a gastric bypass or sleeve gastrectomy, offers effective and substantial weight loss, some patients may require a revision surgery. Revision surgery is a secondary bariatric procedure that's performed when the initial weight loss surgery doesn't yield the desired results or leads to complications. This can occur due to several reasons such as inadequate weight loss, weight regain, or medical complications like gastric ulcers or gastroesophageal reflux disease (GERD) [2].

In the context of gastric bypass or sleeve gastrectomy, revision surgery may involve adjusting the size of the stomach pouch, changing the length of the bypassed small intestine, or converting to a different type of bariatric surgery altogether, such as a duodenal switch. Revision surgery, such as a re-sleeve gastrectomy, gastric bypass, or duodenal switch, is performed to help patients achieve their weight loss goals and to improve obesity-related health conditions [3].

Dietary Counseling and Behavioral Modifications and Psychological Support After Revision Surgery

Following revision surgery, patients absolutely need to see a dietician. Revision surgeries have unique nutritional implications, and dietary counseling is crucial for successful weight management post-procedure [4]. Dietitians offer personalized nutrition plans to accommodate the new structure of the digestive system and the individual's nutritional needs [5]. Counseling sessions can help ensure that patients meet their nutrient requirements, maintain weight loss, and prevent nutritional deficiencies.

Simultaneously, patients must also consider attending behavior modification sessions with psychologists after a revision. Psychological factors significantly influence the outcomes of bariatric surgery and weight regain, and postoperative psychological care is integral to the success of the procedure [6]. Professionals in the field help patients address emotional eating, develop healthier coping mechanisms, and foster an improved relationship with food and body image [7].

Support Groups and Weight Loss Success

Support groups offer a unique avenue for individuals to share experiences, learn from others, and receive emotional support. Recent research suggests that participation in such groups improves long-term outcomes following bariatric surgery [8]. These outcomes include greater weight loss, better adherence to diet and exercise plans, and improved psychological wellbeing [9].

Revision surgery for weight regain following a gastric bypass or sleeve gastrectomy is a crucial tool for achieving weight loss goals. However, it is evident that success after surgery isn't only about the procedure itself. At Bariatric Associates, we believe in a comprehensive and patient-centered approach. We provide our patients with access to experienced dietitians who guide them in creating personalized nutritional plans, ensuring a healthy and balanced diet tailored to their new digestive structure.

Understanding that psychological factors have a significant influence on weight management outcomes, we have a team of psychologists on board to support behavior modifications. They are equipped to help our patients develop healthier eating habits, improve body image, and build robust coping mechanisms. Additionally, we recognize the importance of community and shared experiences in this journey. That's why we also offer support groups, where you can share your experiences, draw strength from others who are on the same journey, and never feel that you're alone in this process.

We strive to provide not just the surgical solutions but also comprehensive post-surgical care. Our multidisciplinary team is dedicated to your long-term success in weight management and to improving your overall health and wellbeing. Your journey is our journey, and at Bariatric Associates, we walk alongside you every step of the way. Reach out to our team for your weight management concerns and let's explore the best route for you together.


1. Magro, D.O., Geloneze, B., Delfini, R., Pareja, B.C., Callejas, F., Pareja, J.C. (2008). Long-term weight regain after gastric bypass: A 5-year prospective study. Obesity Surgery, 18, 648-651.

2. Brethauer, S.A., Kothari, S., Sudan, R., et al. (2014). Systematic review on reoperative bariatric surgery: American Society for Metabolic and Bariatric Surgery Revision Task Force. Surgery for Obesity and Related Diseases, 10, 952-972.

3. Stefanidis, D., Kuwada, T.S., Gersin, K.S. (2013). The importance of the length of the limbs for gastric bypass patients—an evidence-based review. Obesity Surgery, 23, 59-68.

4. Mechanick, J.I., Youdim, A., Jones, D.B., et al. (2013). Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient—2013 update. Obesity, 21, S1-27.

5. Ziegler, O., Sirveaux, M.A., Brunaud, L., et al. (2009). Medical follow-up after bariatric surgery: nutritional and drug issues. General recommendations for the prevention and treatment of nutritional deficiencies. Diabetes & Metabolism, 35, 544-557.

6. Livhits, M., Mercado, C., Yermilov, I., et al. (2012). Preoperative predictors of weight loss following bariatric surgery: systematic review. Surgery for Obesity and Related Diseases, 8, 575-582.

7. Sarwer, D.B., Wadden, T.A., Fabricatore, A.N. (2005). Psychosocial and behavioral aspects of bariatric surgery. Obesity Research, 13, 639-648.

8. Elakkary, E., Elhorr, A., Aziz, F., et al. (2006). Do support groups play a role in weight loss after laparoscopic adjustable gastric banding? Obesity Surgery, 16, 331-334.

9. Klem, M.L., Wing, R.R., McGuire, M.T., Seagle, H.M., Hill, J.O. (1997). A descriptive study of individuals successful at long-term maintenance of substantial weight loss. The American Journal of Clinical Nutrition, 66, 239-246.

Maximizing Weight Loss Outcomes:
Combining Surgery and Medication

Understanding Sleeve Gastrectomy

Sleeve gastrectomy is a potent tool in our armory against obesity. It is a surgical procedure that entails the reduction of the stomach's size to about 15% of its original volume1. The result is a smaller, banana-shaped stomach that restricts the amount of food a person can consume and hence the number of calories they can take in. The surgery also reduces the production of hunger-inducing hormones, which helps to suppress appetite, making it easier for patients to adopt healthier eating habits.

The primary goal is to promote weight loss by creating a physical limitation on intake, encouraging satiety earlier in a meal. Numerous studies have shown that sleeve gastrectomy effectively aids significant weight loss in obese patients, often leading to an improved quality of life and reduction in obesity-related conditions like type 2 diabetes and hypertension2.

The Role of Weight Loss Medications: Saxenda and Wegovy

While sleeve gastrectomy plays a transformative role, it alone does not offer a remedy for weight loss. For various reasons, including the body's adaptive responses to weight loss, some patients may encounter weight loss plateaus or even regain weight after surgery3. This is where the pivotal role of weight loss medications like Saxenda and Wegovy comes in.

These FDA-approved drugs work by mimicking a hormone that targets areas of the brain to regulate appetite. As a result, you feel less hungry and more satisfied after eating4. Saxenda and Wegovy have shown promising results in enhancing weight loss outcomes when incorporated into a comprehensive weight loss plan. This plan includes dietary changes, regular physical activity, and behavioral changes5.

The Combined Approach: Harnessing the Benefits of Surgery and Medication

Bariatric Associates believes in the power of a combined approach to tackling obesity. Sleeve gastrectomy, coupled with post-operative weight loss medication, has yielded superior results in our practice.

For those patients who have plateaued after weight loss surgery or regained weight, the addition of Saxenda or Wegovy often proves to be a game-changer, empowering patients to overcome weight plateaus and regain control over their progress. The tandem use of surgery with medications allows for more predictable, controlled, and sustainable weight loss6.

Moreover, combining these treatments provides a two-pronged attack against obesity. The sleeve gastrectomy limits physical intake while the medications help manage appetite and metabolic responses. This dual strategy optimizes the weight loss journey and helps patients achieve sustainable and long-lasting results.

Patient-Centered Care at Bariatric Associates

Weight loss is a complex, individual journey. At Bariatric Associates, we understand this intricacy and tailor our approach to fit each patient's unique needs and circumstances. Our team is committed to helping you find the right combination of treatments to reach your health goals.

The combined approach of sleeve gastrectomy and weight loss medications offers comprehensive, personalized care. It goes beyond merely treating obesity – we aim to help our patients embrace a healthier lifestyle, improve their quality of life, and sustain their weight loss over the long term. If you are ready to start your weight loss journey, we are here to guide you every step of the way. Contact us today to explore the possibilities towards a healthier future.


  1. Mayo Clinic. (2020). Gastric sleeve surgery: Who is it for?
  2. Gagner, M., & Hutchinson, C. (2016). Sleeve Gastrectomy and Type 2 Diabetes. Canadian Journal of Diabetes, 40(5), 398–402.
  3. MacLean, P. S., Bergouignan, A., Cornier, M. A., & Jackman, M. R. (2011). Biology's response to dieting: the impetus for weight regain. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 301(3), R581-R600.
  4. U.S. Food and Drug Administration, “FDA Approves New Drug Treatment for Chronic Weight Management, First since 2014.” FDA Approves New Drug Treatment for Chronic Weight Management - First in 2014
  5. Astrup, A., Carraro, R., Finer, N., Harper, A., Kunesova, M., Lean, M. E., & Van Gaal, L. (2012). Safety, tolerability and sustained weight loss over 2 years with the once-daily human GLP-1 analog, liraglutide. International journal of obesity, 36(6), 843–854.
  6. Rubino, F., Nathan, D. M., Eckel, R. H., Schauer, P. R., Alberti, K. G., Zimmet, P. Z., ... & Dixon, J. B. (2016). Metabolic surgery in the treatment algorithm for type 2 diabetes: a joint statement by international diabetes organizations. Diabetes care, 39(6), 861-877.