My understanding was that since the stomach is a lot smaller, you can only handle small portion sizes and that’s how you end up losing weight and having it stay off. I do coding for a medical clinic and I see a fair amount of chart notes of people who had the procedure done (and not the temporary one where they can remove the band, either), and they end up gaining a ton of weight back a few years later.
How/why does that happen? Is it the body adjusting somehow?
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Initially after that fast weight loss there’s a level of maintenance required from the patient. Initial weight loss comes from being on a mostly liquid diet of protein with lots of vitamins and supplements.
Once people go on solids, they can eat about as much as you could fit in the palm of your hand, which makes them entirely full.
When I had my surgery, I was told to eat very small meals more often. Over time, we may fall back into bad habits where larger meals are eaten, which ends up stretching the pocket of stomach attached to the bypass. Over more time, this allows you to hold more and more. For a small set of people who don’t develop any side effects from eating high calorie or high fat foods, this can mean that their intake outpaces their output and they will eventually gain weight.
For those of us who didn’t change our activity and just relied on dietary activity, this makes us more sensitive to those caloric imbalances.
I fluctuate 5 or so pounds every few days. My wife had the surgery and was down to 175 at her lowest, but has put on about a hundred pounds of the 200+ that she lost. She exercises regularly, but we’re all susceptible to falling back into bad easting habits. She’s working on it. She’s still healthier than she was and bariatric patients can do a “reset” which requires going back on a liquid diet for 1-3 weeks, essentially repeating our diet from right after the surgery to bring the stomach pouch close to where it was.
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