Nutritional management of weight regain after bariatric surgery

The aim of this study was to propose dietetic guidelines for the nutritional management of weight regain in Roux-en-Y gastric bypass (RYGB) patients.

Thirty patients more than 2 years after RYGB surgery were followed up once every 15 days for at least 3 months. We collected from the medical records weight before surgery, excess weight, minimum weight reached 2 years after surgery, and percent of body fat before the operation. Current weight and bioelectrical impedance analysis were assessed at every appointment. The prescribed diet had a low glycemic load with 45% of carbohydrates, 35% of protein (80 g for women and 100 g for men) and 20% of fat, three servings of dairy products, and a supplement of soluble fibers (15 g/day).

The patients had a previous average weight regain of 8 kg (+/-19). Forty percent of the sample had an excess weight loss (EWL) of less than 50%. After the intervention, 86% of the patients lost weight. The mean weight lost was 1.8 kg in the first month, 1.2 kg in the second month, and 1.3 kg in the third. Half of the sample with unsuccessful weight loss achieved an EWL of at least 50%. The failure rate of the group dropped from 40% to 20%. The percentage of body fat declined from 36.2% to 34% (p < 0.001).

Despite the short period of time, we observed that the nutritional counseling reduced the weight of patients with previous weight regain. There was also a reduction in body fat, which improves the perspective of weight maintenance in the future.