Why Does Recurrent Weight Gain Happen After Bariatric Surgery?
Why Does Recurrent Weight Gain Happen After Bariatric Surgery?
by Nicole Freebairn, Registered Nutritionist
For many people, the early months after surgery bring significant weight loss, improved health markers, and a life-changing fresh start. The impact that surgery has on hunger and satiety hormones often means that hunger is drastically reduced, providing a welcomed reprieve from the intense hunger and food noise that may have been there before surgery. This period is often referred to as the “honeymoon phase.”
Whilst this stage of the post-op journey can be very exciting, it’s not a long term reality. Eventually weight will stabilise, hunger and satiety signals will come back online and you’ll move into the “maintenance phase.” This can look a little different for everyone, and this phase is much more impacted by your eating habits, mindset and lifestyle.
One thing that is almost certain after bariatric surgery, is that there will be some degree of weight gained from the lowest weight that you reach. This is normal and expected. If weight gain continues beyond 30% of the initial weight lost, or there is substantial worsening of an obesity-related condition (such as diabetes or hypertension), this is referred to as Recurrent Weight Gain. Navigating weight challenges such as this after bariatric surgery can feel really frustrating, but it’s important to understand that it’s not a personal failure.
There are many factors that impact weight regulation. If you have experienced Recurrent Weight Gain, or you’d like to prevent this from happening, understanding why it happens is the first step towards navigating this in a healthier, more sustainable way.
The Honeymoon Phase Does Not Last Forever
In the first 6 - 12 months after surgery, weight loss is supported by powerful physiological changes:
Reduced stomach capacity
Altered hunger and satiety hormones
Strong appetite suppression
Clear structure around eating
Over time, these effects naturally fade. Appetite increases, tolerance to food improves, and life starts to look more “normal” again. This is expected physiology, not something going wrong.
This is one of the reasons that multi-disciplinary (nutrition, psychology, exercise) support is so important alongside surgery - to build a lifestyle that supports weight maintenance long term.
Eating Patterns Gradually Drift
As portions increase and food tolerance improves, it becomes easier for eating habits to shift without noticing:
Protein intake may drop
Grazing or snacking can increase
Highly palatable foods become easier to eat
Meals may become less structured
Without regular check-ins, these changes can slowly contribute to a calorie surplus over time.
This is not about a lack of willpower. It is about biology, environment, and habits evolving together.
Emotional and Psychological Factors Play a Big Role
Surgery changes the body, but it does not automatically change your emotional relationship with food.
Stress, emotional eating, social pressure, and long-standing coping mechanisms can resurface over time, or may still be present through the honeymoon phase. Some people may also experience a sense of grief or loss around food, which can be difficult to navigate without support.
Making changes to your eating habits is not simply about having a good understanding of nutrition. Addressing the underlying emotional and psychological patterns that contribute to your relationship with food is hugely important.
Muscle Loss and Reduced Metabolism
Significant loss of muscle mass can occur after bariatric surgery, particularly if:
Protein intake is inadequate
Resistance training is not prioritised
Weight loss occurs rapidly without exercise support
Muscle is metabolically active tissue. When muscle mass declines, resting energy expenditure drops, meaning the body requires fewer calories to maintain weight. This is another factor that can make weight regain more likely.
Life Changes and Long-Term Sustainability
As time passes, life gets busy again. Work, social support, injuries, illness, menopause, some medications, and ageing can all influence weight regulation.
Bariatric surgery does not make you immune to these factors. Long-term success requires ongoing adjustment, reflection, and support as circumstances change.
Why Support Matters Beyond the First Year
Recurrent weight gain is not a sign that surgery has failed. It is a sign that the next phase of care is needed.
With the right guidance, it’s possible to:
Regain clarity around eating patterns
Improve protein and nutrient intake
Build sustainable habits
Address emotional eating
Protect muscle mass
Lose weight in a healthy, sustainable way
The key is approaching this phase with curiosity and support rather than shame.
Join Our Webinar: Navigating Recurrent Weight Gain
If this resonates with you, or you’d like to learn more about navigating the maintenance phase, we have created a dedicated webinar, Navigating Recurrent Weight Gain, to support people who are beyond the honeymoon phase and want practical, evidence-based guidance on what to do next.
In this webinar, we will cover:
What recurrent weight regain is and what it isn’t
The factors that contribute to recurrent weight gain
How to navigate weight fluctuations with more ease and confidence
Mindset strategies to support you
How to change your eating habits to support your goals
How to lose body fat in a healthy and sustainable way
Tips for navigating the maintenance phase of bariatric surgery
Practical and actionable tips to navigate weight challenges without the panic
& more
This is a live webinar, with time dedicated for you to ask questions. All registrants will be provided a recording to watch in your own time, if you cannot attend the live session.
You can learn more and register here
Recurrent weight gain is not the end of your journey. With the right tools and support, it can be a turning point.
Disclaimer: this blog post is intended for educational purposes only and does not replace individual medical advice. For more support please always seek the guidance of your relevant health practitioners.