Integrative Strategies in Primary Care: Addressing Recurrent Weight Gain Post-Metabolic and Bariatric Surgery

Metabolic and bariatric surgery (MBS) is the most effective and durable approach to treating obesity, yet recurrent weight gain occurs in a subset of patients. Primary care often serves as a routine point of contact for patients following MBS and is a potential gateway for addressing and/or preventing recurrent weight gain.

Although guidelines for the management of recurrent weight gain after MBS exist, this narrative review was undertaken to clarify the role of the primary care providers in enhancing long-term outcomes and preventing weight gain after MBS.

Regular follow-up in primary care provides an opportunity to identify challenges related to weight management and overall health outcomes, which may include concerns related to nutrition, mental or physical well-being, body image, motivation, and behavior change, for example. The availability of multidisciplinary providers within primary care settings, including behavioral health specialists, dietitians, and physical therapists, is an important strength of this setting in addressing potential post-MBS concerns such as recurrent weight gain.

This review outlines clinical considerations for managing recurrent weight gain post-MBS in primary care and includes recommendations for both primary care providers and specialty clinicians working in primary care to deliver care effectively and mitigate weight stigma post-MBS.