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Q&A with Australian Health Practitioners
Additional gastric sleeve surgery
I had a gastric sleeve surgery circa 4 years ago, it was a great success and I lost approximately 35 kg. I have since put on 18 kg with no sign of stopping. Dieting isn't helping.
Is it possible to have another gastric sleeve surgery or complete by-pass surgery? -
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Mr Ramez Bassari
Bariatric (Obesity) Surgeon, General Surgeon, Laparoscopic Surgeon, Upper GI Surgeon (Abdominal)
Mr Ramez Bassari is a specialist surgeon in the fields of Bariatric (Obesity/Weight Loss), Upper Gastrointestinal (reflux, stomach, oesophagus), Laparoscopic and General Surgery - including … View Profile
Hi,
Weight gain after bariatric surgery can be due to multiple factors. It is important to see your surgeon to explore the factors involved. Most likely you will need further investigation to ascertain the reason for weight gain.
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Dr Jason Wong
Bariatric (Obesity) Surgeon, General Surgeon, Laparoscopic Surgeon, Upper GI Surgeon (Abdominal)
Jason Wong is a skilled Laparoscopic and Bariatric Surgeon with expertise in sleeve and gastric bypass surgery, gallbladder, hernia, endoscopic pilonidal, antireflux and emergency general … View Profile
Dieting should not be required after gastric sleeve surgery as regulated, planned dietary intake in accordance with the caloric intake and meal composition the dietician would have provided education about after your initial surgery should achieve good weight maintenance. Eating well is not dieting.
It is not uncommon as time progresses that old habits can return including snacking behaviours, excessive alcohol intake, emotional eating as examples.
Further surgery is certainly possible, but any maladaptive behaviours need to be addressed first, and if fixing these do not assist with weight-loss, then revision bariatric surgery can certainly be considered.
Exact revision procedure will depend on a number of factors which should be reviewed by your surgeon, but re-sleeve, gastric bypass and SADI certainly are options.
I wish you all the very best.
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1
Thanks
Dr Jason Wong
Bariatric (Obesity) Surgeon, General Surgeon, Laparoscopic Surgeon, Upper GI Surgeon (Abdominal)
Jason Wong is a skilled Laparoscopic and Bariatric Surgeon with expertise in sleeve and gastric bypass surgery, gallbladder, hernia, endoscopic pilonidal, antireflux and emergency general … View Profile
Dieting should not be required after gastric sleeve surgery as regulated, planned dietary intake in accordance with the caloric intake and meal composition the dietician would have provided education about after your initial surgery should achieve good weight maintenance. Eating well is not dieting.
It is not uncommon as time progresses that old habits can return including snacking behaviours, excessive alcohol intake, emotional eating as examples.
Further surgery is certainly possible, but any maladaptive behaviours need to be addressed first, and if fixing these do not assist with weight-loss, then revision bariatric surgery can certainly be considered.
Exact revision procedure will depend on a number of factors which should be reviewed by your surgeon, but re-sleeve, gastric bypass and SADI certainly are options.
I wish you all the very best.
Report this post
You must be a HealthShare member to report this post. to your account or now (it's free).
-
1
Thanks
Dr Jason Wong
Bariatric (Obesity) Surgeon, General Surgeon, Laparoscopic Surgeon, Upper GI Surgeon (Abdominal)
Jason Wong is a skilled Laparoscopic and Bariatric Surgeon with expertise in sleeve and gastric bypass surgery, gallbladder, hernia, endoscopic pilonidal, antireflux and emergency general … View Profile
Dieting should not be required after gastric sleeve surgery as regulated, planned dietary intake in accordance with the caloric intake and meal composition the dietician would have provided education about after your initial surgery should achieve good weight maintenance. Eating well is not dieting.
It is not uncommon as time progresses that old habits can return including snacking behaviours, excessive alcohol intake, emotional eating as examples.
Further surgery is certainly possible, but any maladaptive behaviours need to be addressed first, and if fixing these do not assist with weight-loss, then revision bariatric surgery can certainly be considered.
Exact revision procedure will depend on a number of factors which should be reviewed by your surgeon, but re-sleeve, gastric bypass and SADI certainly are options.
I wish you all the very best.
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4
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Kirsty Woods
Exercise Physiologist
Hi I’m Kirsty Woods,I would like to use my experience, expertise and passion to help you reach your weight, energy and health goalsI have been … View Profile
Great question, thought you may find this video and article of interest:
1) https://www.facebook.com/metabolichealthsolutionsclinics/videos/2346247688733906/
2) https://mercybariatrics.com.au/obesity-surgery-2/weight-regain/
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Dr Ashok Gunawardene
Bariatric (Obesity) Surgeon, General Surgeon, Laparoscopic Surgeon, Upper GI Surgeon (Abdominal)
Dr Ashok Gunawardene is a Specialist General and Upper GI Surgeon dedicated to helping patients achieve better health through weight loss surgery and metabolic support. … View Profile
It happens. The first thing to do is make sure you don't blame yourself. We now understand obesity is a chronic relapsing condition and sometimes despite our best efforts weight regain occurs. The important thing is you have recognised it and are doing something about it. My approach is to first make sure we have fine-tuned everything we can before considering re-operative surgery. Re-operative surgery carries more risk than primary procedures and shouldn't be rushed in to. I would ensure you re-engage with a specialised bariatric dietician to really analyse your dietary intake and eating behaviours on a granular level to make sure any improvements can be made. Next, you may wish to consider a trial of medication-based weight loss. This may be enough to get your weight down to a level where regular physical activity and exercise become more achievable. Eventually those medications could be reduced to a low maintenance or fortnightly dose. In terms of re-operative surgery, it is important to get a good roadmap of your anatomy. This involves doing a gastroscopy to assess whether the sleeve has become dilated or stretched, or whether part of the stomach was not fully removed in the initial surgery. Generally I do not offer a "re-sleeve" procedure as my philosophy is not to do the same thing and expect different results. I would tend to offer a conversion procedure to a bypass procedure (either roux en-Y if you suffer with reflux, or one anastomosis gastric bypass) which works in a slightly different way.
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Dr Ashok Gunawardene
Bariatric (Obesity) Surgeon / General Surgeon / Laparoscopic Surgeon / Upper GI Surgeon (Abdominal)1 Answer