Many individuals who have undergone gastric bypass surgery find themselves regaining weight within two to five years after their initial operation. In fact, most patients gain between 5% and 15% of their lost weight back within 10 years, regardless of whether they are living a healthy lifestyle.

Unfortunately, over half of the gastric bypass patients gain around 40% of their weight back, and around 10% regain all their lost weight. Many wonder if they can have bariatric surgery two times or what their options are for getting back on track again.

Today, we are going to talk about whether you can have gastric bypass twice and options to restart weight loss for those who have gained weight since undergoing bariatric surgery.

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The Basics Of Bariatric Surgery

To better understand the elevated risks related to a second weight loss surgery after gastric bypass or gastric sleeve, you need to understand the changes that are made during each procedure and how they are completed.

Gastric Sleeve

Gastric sleeve surgery involves removing a large portion of the stomach, leaving a small, sleeve-shaped section that limits food intake and reduces hunger. It is most often performed laparoscopically, requiring four or five abdominal incisions to gain access to the stomach. The surgeon cuts and removes about 80% of the existing stomach tissue and then staples the remaining edges together, leaving a new stomach with significantly reduced capacity.

Bypass gástrico

Gastric bypass surgery starts with the surgeon making four to five small incisions in the patient's abdomen. Then, using a laparoscope and other special surgical tools, the stomach is divided into two unequal sections. Surgical staples are placed in strategic locations to create a small pouch-like section that becomes the new stomach. Then, the surgeon reroutes a portion of the small intestine (about 30%) and attaches it to this new pouch. This limits the individual’s food intake and shortens the amount of time the food is in their digestive system, reducing the volume of calories their body can absorb.

Interruptor duodenal

Duodenal switch surgery is the most complicated and is a combination of both gastric sleeve surgery and gastric bypass. It involves removing a large portion of the stomach using the same procedure as gastric sleeve surgery and then rerouting a significantly larger section (about 70%) of the small intestine to limit both food intake and the absorption of nutrients.

Is Gaining Weight After Gastric Bypass Common?

Bariatric surgery is known to be an effective tool to help individuals who suffer from obesity lose weight, but many patients experience less-than-ideal outcomes. They either don’t lose as much weight as they expected (11%-22%) or they begin regaining the weight they initially lost after their surgery.

On average, the percentage of patients who gain at least 10% of their lost weight back increases year over year, as demonstrated in the following chart.

<table class="iksweb"><caption>Chart: YOY Weight Regain 1 -5 Years After Bariatric Surgery</caption><tbody><tr><th>Year</th><th>Percentage Of Patients Who Regain Weight*</th></tr><tr><td>1 Year After Surgery</td><td>23%</td></tr><tr><td>2 Years After Surgery</td><td>51%</td></tr><tr><td>3 Years After Surgery</td><td>64%</td></tr><tr><td>4 Years After Surgery</td><td>69%</td></tr><tr><td>5 Years After Surgery</td><td>72%</td></tr></tbody></table>

* 10% or more of their previously lost weight.

Why Would Someone Start Gaining Weight After a Gastric Bypass?

Lifestyle Choices

A recently published study shows that common reasons for weight regain after surgery include unhealthy eating habits like loss-of-control eating or grazing, not following dietary recommendations, returning to old eating patterns, and a lack of physical activity.

Physiological Changes

Additionally, after a few years, individuals can experience changes in the balance of hormones that control hunger, which can increase their appetite and food cravings. Psychiatric conditions such as depression can also contribute to the failure of weight loss surgeries.

In 10% to 15% of the cases, regaining weight after gastric bypass or gastric sleeve surgery is not something that is within the individual's control. The changes that are made during their initial surgery become less effective over time, put an end to their weight loss, and lead to gradual but significant weight gain. If these issues are not corrected, their situation will become worse and their health will decline further.

Widening Of The Stoma

After gastric bypass surgery, one potential issue that can develop over time is the widening of the stoma. The stoma is the opening and connection point between the newly formed small stomach pouch and the small intestine. This opening controls the rate at which food passes from the stomach into the intestines. As the stoma widens, it allows food to pass more quickly than intended, reducing the feeling of fullness and leading to an increase in calorie intake.

Dilation of the Stomach Pouch

The small stomach pouch created during gastric bypass or gastric sleeve surgery may stretch over time, allowing larger amounts of food to be consumed before feeling full. The patient can eat more food at each meal, and over time, this cycle can continue stretching the pouch even further, and lead to increased calorie intake and weight regain.

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How Many Times Can You Have Gastric Bypass Surgery?

For those of you who have asked, “Can you have a gastric bypass twice?” The answer is no; you cannot undergo a gastric bypass more than once because the changes made to your digestive system during the first surgery are permanent. However, you can undergo a different type of surgery to make additional changes or restore the effectiveness of the initial procedure. This is known as revisional surgery, and it can provide correction for certain issues that have led to significant weight regain or alleviate complications from the first surgery.

Conversion Surgery Can Restart Weight Loss

Additionally, to answer another popular question, “Can you have bariatric surgery 2 times?” The answer is yes; it is possible to undergo more than one surgical weight loss procedure. For example, out of the many patients who choose to have gastric sleeve surgery, around 30% begin to experience chronic acid reflux, or GERD. About 10% of these patients choose to convert their gastric sleeve to a gastric bypass because the conversion usually eliminates this unpleasant side effect. These patients have had two different types of bariatric surgery.

An option for weight loss surgery after gastric bypass would be a surgical conversion to a duodenal switch. This would leave the patient’s initial gastric bypass intact and add additional intestinal rerouting to enhance malabsorptive capabilities and promote further weight loss.

Is It Safe To Undergo More Than One Bariatric Surgery?

Undergoing more than one bariatric surgery, often referred to as revisional or conversion surgery, can be safe, but it does come with increased risks compared to the initial procedure. The safety and success of a second surgery depend on the patient’s overall health, the reasons for the revision or conversion, and the skill of the surgeon.

Navigating through an area that has already undergone one surgical procedure takes a high level of expertise and should only be done by the most qualified surgeon. There are increased risks of excessive bleeding, infection, gastrointestinal leaking, hernia, and the same long-term risks as the initial bariatric surgery.

Sometimes, a revision or conversion that was meant to be performed laparoscopically must suddenly be converted to an open procedure due to scar tissue, which substantially increases the risk profile.

What Is The Safest Effective Way To Restart Weight Loss After Gastric Bypass?

If you have had a previous bariatric surgery procedure and you have not experienced adequate weight loss, your weight loss has stalled, or you are regaining weight, you should seek professional help. A board-certified, obesity-trained gastroenterologist like Dr. Steven Batash can help you determine the underlying issues that are contributing to your weight loss dilemma.

Suture ReSculpt And Other Non-surgical Weight Loss Interventions Can Provide A Second Chance At Weight Loss

Batash Endoscopic Weight Loss Center in NYC offers non-surgical alternatives to help patients lose weight without having to undergo surgery, and they can often provide assistance to individuals who have previously undergone weight loss surgery but have not achieved or maintained a healthy weight.

Suture ReSculpt

Dr. Batash can perform a quick endoscopic procedure (Suture Resculpt) to tighten up a widened stoma, reduce the size of your stomach pouch, and restore the restrictive capabilities that were installed during your initial surgery. This 45-minute outpatient procedure can stop your weight gain and promote future weight loss.

Other Non-surgical Weight Loss Interventions

If your weight gain is attributed to unhealthy food or lifestyle choices or battling ongoing hunger, you may be a good candidate for prescription weight loss injections and nutritional and lifestyle guidance. Our team of compassionate professionals is here to help you navigate your way to better health.

Continuing to gradually gain weight will adversely affect your health and increase your risk of exacerbating existing metabolic conditions and developing other medical issues. Let Batash Endoscopic Weight Loss Center help get your weight loss journey back on track.

Avoid another weight loss surgery after gastric bypass or gastric sleeve and set up a consultation today with Dr. Batash and his knowledgeable team. Let us help you get to the bottom of your weight gain and create a customized plan with your circumstances in mind to help you achieve and maintain a healthy weight.

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