After weight loss surgery called sleeve gastrectomy, some patients gain back at least 10% of the weight they lost. Researchers studied 100 people who experienced this weight regain to understand why it happens. They found that most people weren’t following eating guidelines, weren’t getting enough vitamins, and were struggling with unhealthy eating habits like grazing (constant snacking) and binge eating. The study also discovered that men and women had different patterns in how well they stuck to recommendations and what nutritional problems they developed. These findings could help doctors create better support programs to help people keep weight off long-term after surgery.

The Quick Take

  • What they studied: Why do some people gain back weight after sleeve gastrectomy surgery, and what eating and lifestyle habits do they have in common?
  • Who participated: 100 people (76% women) who had sleeve gastrectomy surgery about 8 years earlier. Average age was about 50 years old. They all gained back at least 10% of the weight they had lost.
  • Key finding: Most people who regained weight weren’t following the eating plan (only 65% stuck with it), weren’t exercising enough (only 15% did the recommended 150 minutes per week), and had vitamin deficiencies. Two-thirds reported constant snacking habits, and nearly one-third struggled with binge eating.
  • What it means for you: If you’ve had or are considering weight loss surgery, this suggests that following the eating plan, taking vitamins, exercising regularly, and getting help with eating habits are crucial for keeping weight off. Talk to your doctor about support programs that address these specific challenges.

The Research Details

Researchers looked at information from 100 people who had sleeve gastrectomy surgery (a procedure that makes the stomach smaller) and gained back at least 10% of their weight loss. This is called a cross-sectional study, which means researchers collected all the information at one point in time, like taking a snapshot. They gathered data about people’s current weight, eating habits, exercise routines, sleep, vitamin levels, and whether they were struggling with unhealthy eating patterns like constant snacking or binge eating. The study took place at a medical center and included detailed information about how well people were following their doctor’s recommendations.

This type of study is useful for understanding what’s happening right now with people who regained weight. By looking at many people at the same time, researchers can spot common patterns and differences between men and women. This helps doctors understand what factors might be most important to focus on when helping people maintain their weight loss after surgery.

This study has some strengths: it looked at a decent number of people (100) and collected detailed information about multiple areas including eating, exercise, sleep, and blood work. However, because it’s a snapshot in time rather than following people over years, we can’t be completely sure which factors caused the weight regain. The study was done at one medical center, so results might be different in other locations or populations. The researchers did note some differences between men and women, which is helpful for understanding that people may need different types of support.

What the Results Show

The study found that people who regained weight after surgery were struggling in several key areas. Only about two-thirds (65%) were consistently following the eating recommendations their doctors gave them. When it came to getting enough protein (which is important after this surgery), 74% met the basic goal of 60 grams per day, but only 11% got the highest recommended amount. Most concerning was vitamin deficiency: 83% didn’t have enough vitamin D, 57% had low iron levels, and 26% had anemia (low red blood cells). Exercise was a major problem—only 15% were doing the recommended 150 minutes of moderate activity per week. Sleep was also an issue, with only 35% getting the recommended 7-9 hours per night. Perhaps most telling, 67% reported grazing (constant snacking throughout the day) and 32% reported binge eating episodes.

The study also revealed important differences between men and women. Women and men had different patterns in how well they followed recommendations, what eating problems they experienced, and what nutritional deficiencies they developed. Only one-third of people were taking their daily vitamins as recommended, which is particularly concerning given the high rates of vitamin deficiencies found in blood tests. The fact that so many people were struggling with grazing and binge eating suggests that the psychological and behavioral aspects of eating after surgery are major challenges that aren’t being adequately addressed.

Previous research has shown that weight regain after weight loss surgery is common and often linked to not following eating guidelines and not getting enough exercise. This study confirms those findings and adds important details about specific vitamin deficiencies and eating behaviors. The high rates of grazing and binge eating align with other research showing that behavioral issues are key to weight regain. The gender differences found here are new insights that suggest men and women may need different types of support programs.

This study took a snapshot at one point in time, so we can’t say for certain which factors caused the weight regain—they might all be connected in complex ways. The study was done at one medical center, so results might be different elsewhere. We don’t know if these patterns were the same before people regained weight or if they developed afterward. The study didn’t include information about people’s mental health, stress levels, or access to support programs, which could all be important. Finally, we don’t know how these findings apply to people from different backgrounds or in different parts of the country.

The Bottom Line

If you’ve had sleeve gastrectomy surgery or are considering it, focus on these evidence-based strategies: (1) Stick to your eating plan—this is supported by strong evidence from this study. (2) Take your vitamins daily, especially vitamin D and iron, since deficiencies are very common. (3) Aim for at least 150 minutes of moderate exercise per week. (4) Get 7-9 hours of sleep nightly. (5) Get professional help if you’re struggling with constant snacking or binge eating—these behaviors are very common and treatable. (6) Work with your surgical team regularly to monitor progress and adjust your plan. Confidence level: Moderate—these recommendations are based on patterns observed in this study and supported by previous research, but individual results vary.

This research is most relevant for people who have had or are planning to have sleeve gastrectomy surgery. It’s also important for family members and friends supporting someone after surgery. Healthcare providers who work with bariatric surgery patients should pay attention to these findings when designing follow-up care. If you’re considering weight loss surgery, this information can help you understand what commitment and support you’ll need after the procedure. People who have regained weight after surgery should know they’re not alone—this study shows these challenges are very common.

Weight regain typically happens gradually over months to years after surgery (this study looked at people 8 years post-surgery). If you make changes to follow the eating plan, exercise regularly, and address eating behaviors, you might see improvements in how you feel within weeks and in weight stability within a few months. However, maintaining weight loss is a long-term commitment that requires ongoing effort and support.

Want to Apply This Research?

  • Track daily protein intake (goal: at least 60 grams), vitamin supplement use (daily multivitamin, vitamin D, iron), exercise minutes (goal: 150 minutes per week of moderate activity), sleep hours (goal: 7-9 hours), and eating patterns (note times of grazing or binge episodes). Use the app to set reminders for vitamins and meals.
  • Start with one change: either committing to taking vitamins daily or adding 30 minutes of walking three times per week. Once that becomes a habit (usually 2-4 weeks), add another change. Use the app to log meals and identify patterns in grazing or binge eating, then work with your healthcare provider on strategies to address these patterns.
  • Weekly check-ins on the app to review protein intake, vitamin adherence, and exercise. Monthly reviews to look at weight trends and eating behavior patterns. Share monthly summaries with your healthcare provider. Set quarterly goals to gradually improve adherence to all recommendations. Use the app’s reminder features to support consistent vitamin taking and exercise scheduling.

This research describes patterns observed in people who experienced weight regain after sleeve gastrectomy surgery. It is not medical advice. If you have had or are considering weight loss surgery, speak with your bariatric surgeon and healthcare team about your individual situation, nutritional needs, and appropriate follow-up care. The findings about vitamin deficiencies, exercise, and eating behaviors are important to discuss with your doctor. Anyone struggling with binge eating or other eating disorders should seek professional mental health support. Results may vary significantly between individuals based on many factors not covered in this study.