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Review
. 2023 Mar;23(3):31-42.
doi: 10.1007/s11892-023-01498-z. Epub 2023 Feb 8.

Weight Regain After Bariatric Surgery: Scope of the Problem, Causes, Prevention, and Treatment

Sabrena F Noria  1 , Rita D Shelby  2 , Katelyn D Atkins  3 , Ninh T Nguyen  4 , Kishore M Gadde  4
Affiliations
Review

Weight Regain After Bariatric Surgery: Scope of the Problem, Causes, Prevention, and Treatment

Sabrena F Noria et al. Curr Diab Rep. 2023 Mar.

Abstract

Purpose of review: Although bariatric surgery is the most effective treatment of severe obesity, a proportion of patients experience clinically significant weight regain (WR) with further out from surgery. The purpose of this review is to summarize the prevalence, predictors, and causes of weight regain.

Recent findings: Estimating the prevalence of WR is limited by a lack of consensus on its definition. While anatomic failures such as dilated gastric fundus after sleeve gastrectomy and gastro-gastric fistula after Roux-en-Y gastric bypass can lead to WR, the most common causes appear to be dysregulated/maladaptive eating behaviors, lifestyle factors, and physiological compensatory mechanisms. To date, dietary, supportive, behavioral, and exercise interventions have not demonstrated a clinically meaningful impact on WR, and there is limited evidence for pharmacotherapy. Future studies should be aimed at better defining WR to begin to understand the etiologies. Additionally, there is a need for non-surgical interventions with demonstrated efficacy in rigorous randomized controlled trials for the prevention and reversal of WR after bariatric surgery.

Keywords: Antiobesity drugs; Bariatric surgery; Behavior therapy; Obesity; Weight regain.

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Conflict of interest statement

Kishore M. Gadde reports grants to his institution from AstraZeneca, BioKier, Indiana University Foundation, and National Institutes of Health, outside the submitted work. Ninh T Nguyen receives honorarium as a speaker from Olympus and Endogastric Solutions.

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