Weight Regain After Gastric Sleeve: What Successful Patients Do

Success after weight loss surgery begins in the kitchen

Success after weight loss surgery begins in the kitchen

The five year study looking at the gastric sleeve showed that about half of the patients regained their weight after five years. Specifically A total of 443 LSGs were performed. Complete data were available for 54% of patients at the 1-year follow-up, for 49% of patients at the 3-year follow-up, and for 70% of patients at the 5-year follow-up. The percentage of excess weight loss was 77%, 70%, and 56% at years 1, 3, and 5, respectively; complete remission of diabetes was maintained in 51%, 38%, and 20%, respectively, and remission of hypertension was maintained in 46%, 48%, and 46%, respectively.


The gastric sleeve surgery, currently the most popular weight loss operation in the United States, is based on removing a great portion of the stomach.


What the report doesn’t answer is what happened to those who had regained weight – and what was the difference between those who were successful?

In my practice we monitor a group of successful patients, and those who don’t succeed – and there are a few striking differences:

  1. Of the successful patients over 85% of them cook. The patient cooks, not the spouse, not the parent, the patient. Less than 10% of them cooked before they had weight loss surgery.
  2. Of the successful patients about 75% of them exercise at least three times a week
  3. When you look at the successful patients the food they eat today does not look anything like the food they ate before surgery.

Contrast that with patients who, after five years, are not successful with weight loss surgery:

  1. Less than 10% of the unsuccessful patients cook, and most of them go out for their meals
  2. Less than 20% of them engage in some form of exercise
  3. When examining food journals from before surgery and after surgery about 80% of the meals are similar – no change in what they ate.
Success after weight loss surgery doesn't end with an operation. It just gets started

Success after weight loss surgery doesn’t end with an operation. It just gets started

It isn’t the operation that means a patient is successful or not – it is what they do with it.

Weight loss surgery is a tool, and often the tool is given without an instruction manual. Our plan for our patients is simple, and based on biochemistry. If you wish to have weight loss surgery the answer is to learn to cook, base meals upon a ketogenic diet (or Paleolithic) and begin to move. That works.


Original article appeared in JAMA Surgery

Dr. Terry Simpson About Dr. Terry Simpson
Dr. Terry Simpson received his undergraduate and graduate degrees from the University of Chicago where he spent several years in the Kovler Viral Oncology laboratories doing genetic engineering. He found he liked people more than petri dishes, and went to medical school. Dr. Simpson, a weight loss surgeon is an advocate of culinary medicine. The first surgeon to become certified in Culinary Medicine, he believes teaching people to improve their health through their food and in their kitchen. On the other side of the world, he has been a leading advocate of changing health care to make it more "relationship based," and his efforts awarded his team the Malcolm Baldrige award for healthcare in 2011 for the NUKA system of care in Alaska and in 2013 Dr Simpson won the National Indian Health Board Area Impact Award. A frequent contributor to media outlets discussing health related topics and advances in medicine, he is also a proud dad, husband, author, cook, and surgeon “in that order.” For media inquiries, please visit www.terrysimpson.com.

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