6 Ways to Prevent Weight Regain and Diabetes Recurrence After Metabolic Surgery

Metabolic surgery is the most effective treatment for morbid obesity and type 2 diabetes. But it is a tool that cannot provide a cure, as obesity is a relapsing and chronic disease. Weight gain is a possibility in some patients after they have undergone a successful metabolic surgery too. In India, approximately 36.7% of patients can experience weight regain by 5 years after a metabolic surgery. Diabetes can also recur though it is not common. However, both of these events can be avoided with the following 6 evidence based tips:

1. Commit to Lifelong Follow-Up

Maintaining regular contact with your bariatric team is the most important thing that you can do to ensure that you succeed in the long term. Those who keep in touch with their surgery team will be able to spot signs of weight regains at an early stage. You will also be able to see your doctor regularly so that they can check on your nutrition, prescribe any changes to your medication and hold you accountable. Surgery should not be seen as a one off.

2. Return to Structured Eating Habits

Most people are very compliant during their first year post-surgery. Unfortunately, old habits can develop again over time. People often snack, eat when not hungry and consume lots of fatty or high calorie foods. Getting back into structure is key. Concentrate on eating lean protein, vegetables, fruits and wholegrains. Try not to eat between meals. Keep on top of portion sizes. If you have got off track, you could speak to a registered dietitian to get you back on track.

3. Prioritize Protein and Muscle Mass

Weight can quickly be lost after a metabolic surgery. It is important to maintain muscle as it will burn more calories. If your diet lacks protein then muscle will be lost quickly which will cause a reduction in metabolism and make you more likely to gain back weight. Try to have enough protein in every meal. Resistance exercise like weight training and body weight training can help you maintain muscle.

4. Exercise Beyond Walking

Exercise is very important. However, some types are more important than others. Resistance exercise should be included in your routine as it helps to build and maintain muscle. This will help to counteract the loss of metabolic rate that happens when losing weight. Aim for at least 150 minutes of moderate intensity aerobic activity per week and include strength exercises twice a week. Do what you enjoy.

5. Recognize Diabetes Recurrence Risk

There are multiple factors that affect whether a patient gets re-diagnosed with diabetes after metabolic surgery. If you were on insulin prior, had a high HbA1c value or have had diabetes for a long time then you are more likely to get re-diagnosed. However, it is very important to stay vigilant. Continue to check your blood sugars as recommended, attend your HbA1c appointments. If we can catch an increase in your glucose early then we can intervene quickly to prevent a full relapse.

6. Seek Help Early, Not Late

Many patients are reluctant to admit to regaining weight as it can be seen as a personal failure. However, evidence shows that it is better to address this with either diet advice, behaviour modification or medication as soon as possible rather than waiting for significant weight gain. If you notice any weight coming back or increasing blood sugars, please speak to your doctor as soon as possible. Obesity is a long-term disease so having an ongoing management plan shows you are wise!

If you have had or are considering having metabolic surgery, it is vital to have structured post-surgery care. Springfield Wellness Centre has all your bariatric and metabolic surgery needs covered by providing comprehensive post-surgery support. Located in Chennai, we will provide you with an individualised approach to managing your metabolic disorders. If you are concerned about weight gain or diabetes returning please speak with Dr. Maran, an experienced Bariatric Surgeon who can help you with evidence-based strategies to help ensure long term success.