3 Solutions for Regain after Gastric Sleeve 

Is regain an issue for you after gastric sleeve surgery?

Approximately 90% of bariatric patients lose 50% or more of their excess body weight after surgery and maintain weight loss over time. Furthermore, many bariatric surgery patients report improved sleep apnea and hypercholesterolemia symptoms after surgery.

However, researchers found that even patients who achieve initial success in bariatric surgery can struggle to maintain weight loss over time. On average, patients regain about 30% of their lost weight. Approximately one-quarter of patients regain their lost weight within ten years. 

Each person’s reasons for gaining weight after bariatric surgery are different.

Some gastric sleeve patients don’t follow a meal plan or program yet flourish and maintain their weight loss. In contrast, others follow every rule but stop losing weight after six months of getting a gastric sleeve. 

In this article, we will discuss reasons why some people regain and while others do not after bariatric surgery and gastric sleeve and solutions to prevent the regain.

We’re all different!

The reason why some people regain and while others do not after bariatric surgery and the gastric sleeve is that we are all different from each other. 

None of us are alike, and we are all different in the following:

• genetic
• cellular
• hormonal
• bacterial level

All these impacts your success after gastric sleeve surgery and influence how easily you regain. 

So here’s the good news, though. There are solutions! There are things you can do that can optimize your hormones, your cellular function, your gut bacteria, and your genes. Let us discuss solutions for regaining after bariatric surgery and gastric sleeve surgery.

If you are interested in discussing these items in depth, please schedule your Free Consultation Here

3 Solutions for Regain 

It is not necessary to stay where you are. You can improve your odds by using certain strategies. Even so, there is no one formula that works for everyone after gastric sleeve surgery. But there are some, let’s call them, just general things. 

It is possible to optimize your genes, cellular function, hormones, and gut bacteria if you are experiencing weight regain after gastric sleeve surgery. This can improve your chances of losing weight and maintaining it for a long time.

The right foods, exercise, water, and supplements are, of course, all important. But here we discuss the leading 3 solutions of regain that are:

1. Restore gut imbalances
2. Improve blood sugar stabilization
3. Decrease inflammation

Genetics, hormones, gut bacteria, and cellular health are all interwoven into all of these. When you focus on that, your body will function as it should, and you’ll maximize your results.

#1 Restore gut imbalances

Researchers discovered that the gut microbiome affects your ability to lose weight by helping you digest food and absorb nutrients. So restoring gut imbalance can help you regain after bariatric surgery and gastric sleeve.

To restore gut imbalance following things you need to do:

1. Correct dysbiosis
2. Improve gut bacteria diversity
3. Add polyphenols
4. Regulate Hormones

How to Correct dysbiosis?

Dysbiosis is just an imbalance in your gut bacteria. You have either too little good bacteria, too much bad bacteria. Or Too much bacteria in the wrong location or a combination of all of those. So that’s dysbiosis, just an imbalance and gut bacteria.

Are you thinking about how to correct dysbiosis? To correct dysbiosis, you simply need to:

1. Increase the good bacteria 
2. Decrease the bad bacteria
3. Evaluate if you have too much bacteria in the wrong location
4. Improve firmicutes/bacteroidetes ratio
   1. Extract more calories from food
   2. Increase fat storage

Increase the good bacteria 

The presence of good bacteria maintains a healthy balance of gut bacteria and has been linked with a variety of health benefits. Among them are weight loss benefits, digestive benefits, immune benefits, and more. So, the first step toward correcting dysbiosis is to increase the good bacteria.

Decrease the bad bacteria

Several chronic diseases are caused by dysbiosis of gut bacteria communities, such as obesity, cancer, and autism. Therefore, correcting dysbiosis is essential. As a second step, we can reduce bad bacteria to maintain a balance between good and bad bacteria.

Evaluate if you have too much bacteria in the same location

To correct dysbiosis, it’s also essential to evaluate the number and location of bacteria. 

Most of the bacteria are testable. So you can do a stool test, for example, to determine if your Firmicutes to Bacteroidetes ratio is off. It will sometimes give you enough information to know where to go, Which direction, what’s driving your weight loss resistance, and what is driving weight gain. So if that is elevated, then you will know that we just really need to work on that to correct dysbiosis.

Improve firmicutes/bacteroidetes ratio

Bacteroidetes & Firmicutes are two phyla, when they are elevated, and their ratio gets off. You are going to have issues with your health and with your weight. Bariatric surgery generally flips or shifts the Firmicutes to Bacteroidetes ratio. And we know that it lowers that Firmicutes to a more normal number. Which is good. So the Firmicutes is the

One, whenever it’s elevated this..whenever you have a high Firmicutes. Then that means your body is:

• Extracting more calories from the foods you are eating. So it really makes it hard to lose weight because you are absorbing more from the foods you’re eating. 
• Increasing fat storage. So that alone really does not help you get the results that you’re hoping for when it comes to weight loss or maintenance. 

There are a couple of evidence-based strategies that are definitely known to improve the Firmicutes to Bacteroidetes ratio. So it’s just changing and shifting things that you’re doing. 

So to restore gut imbalance, correct dysbiosis, and then improve Firmicutes to Bacteroidetes ratio. We must also improve our gut bacteria diversity to restore the gut imbalance.

Improve gut bacteria diversity

Diversity just means that you have lots of different bacteria represented. There are trillions, and there are multiple different species that you can have in your gut. The more, the better! 

Our gut actually has good and bad bacteria that live together harmoniously. So it’s not like you’re going to have zero bad bacteria. That’s not necessary. That’s part of the balance of having good and bad. So that’s where kind of understanding these basics. 

So How do you improve gut bacteria diversity? There are a number of things to consider to improve gut bacteria diversity:

1. Add Fiber!
2. Increase resistant starch
3. Increases short-chain fatty acids that lower Inflammation & improves gut integrity. This protects from increased intestinal permeability(aka leaky gut)
4. Add polyphenols
   1. This boosts akkermansia muciniphilia
      1. Associated with healthier metabolism & blood sugar balance

Add Fiber!

Gut bacteria diversity really improves by adding fiber to your diet. That means plants, plants, and more plants!

So you need lots of fiber to accomplish diversity. There are lots of varieties of different plants that will improve gut microbiota diversity.

Foods restore gut imbalances at the cellular level

Your nutrient levels can also impact gut bacteria diversity. So make sure you don’t have deficiencies in your nutrition. So that’s a kind of cellular health and ensuring that your cells get the vitamins and minerals. 

For example, patients undergoing weight loss surgery should have a serum B12 test yearly to ensure they get enough B12 in their supplements and diet. Serum levels indicate what’s circulating in your blood. MMA is a better indicator of what is getting inside the cell. It will inform you of what is available in your diet. Is it adequate enough? Do you have the ability to get it into your cells? At a cellular level, that’s the part that matters, and it also occurs in your gut.

Increase resistant starch

You also need resistant starch. However, potatoes get a bad rap. But, if you choose the right type of potatoes, they help you. They actually grow the diversity in your gut, and you have more variety of bacteria. The starch molecule in potato gets tangled up when you chill it, making it difficult to digest. As a result, it acts as a prebiotic and encourages the growth of short-chain fatty acids that benefit our health. 

So increase the resistant starch. Potato salad is superior to chips, fries, mashed potatoes, baked potatoes, etc. 

Increase short-chain fatty acids

The next one is increasing short-chain fatty acids. They are kind of the byproduct of what happens when we eat undigestible fibers. So those are the FODMAPs, the fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. 

All of those are different types of fibers that will actually increase the short-chain fatty acids that our gut bacteria produce, lowering Inflammation in your gut and improving your gut wall integrity. 

Moreover, it helps tight gut wall junctions by making it so that you can protect yourself from viruses, autoimmune diseases, food allergies, sensitivities, histamine reactions, and all kinds of things that cause our gut wall to break down and cause disease.

Basically, it’s increased intestinal permeability, but most people would describe it as a leaky gut. Thus, increasing short-chain fatty acids is crucial to increasing diversity. 

Add polyphenols

The next one to help improve diversity is adding polyphenols. Polyphenols are those foods that are dark in color, dark purple, blue, and red. Therefore, cherries, blueberries, and raspberries are excellent sources of polyphenols. 

Polyphenols boost Akkermansia muciniphilia. And Akkermansia is associated with a healthier metabolism and better blood sugar balance. It is a newer bacteria that have been discovered as a potential game changer for weight loss. So add polyphenols.

Role of Akkermansia 

Akkermansia plays a role in your metabolism. Scientists are discovering some interesting evidence about this bacteria that benefits weight loss and blood sugar balance, but we don’t know how it works. 

In recent years, researchers have discovered that Akkermansia has an affinity for polyphenol-rich foods. The things that are really rich in polyphenols make them grow, which will help improve your diversity. As a result, more Akkermansia will benefit your metabolism. 

Studies have shown that after a roux-en-y gastric bypass, the Akkermansia actually increases. But it does not change after a gastric sleeve. So again, we don’t understand all of this yet.

So we’re improving the gut bacteria with fiber, resistant starch increasing the short chain, fatty acids, and adding polyphenols. It will improve metabolism, gut health, weight loss, and overall gut diversity in your gut. The other thing that we need to consider is hormones!

Hormones & regain

The next thing that is influenced in your gut or another area that needs to be evaluated or potentially restored is hormones. Because this isn’t a common thing that can happen with females. For this, we consider Beta Glucaronidase.

Beta-glucuronidase is a stool marker of estrogen metabolism, and this is associated with:

1. Dysbiosis & SIBO, when elevated
2. Indicates interference with phase 2 detoxification

So when you have elevated levels of Beta Glucaronidase in your stool test. This will tell you that you have dysbiosis and maybe SIBO.

So you would probably need to do a breath test when they are elevated. And then it’s also an indicator that you are having issues with phase two detoxification in your liver. So there’s some liver connection with this indicator. So again, that all play a role in Inflammation and your gut.

As your hormones are rooted in your gut, if you feel like your hormones are off. So think of estrogen, testosterone, and progesterone. Even you have to weave in the stress hormones like cortisol and DHEA. All of those are important to understand, and they’re all going to be influenced by what’s happening in the gut. Dysbiosis in the gut may result in hormone regulation issues. So cleaning up your gut and fixing that. So if you feel like, Hey yeah, I’m having some hormone issues.

#2 Blood sugar stabilization & regain

Blood sugar stabilization is the second solution to regain after gastric sleeve or bariatric surgery.

Why does blood sugar stabilization matter? It’s really kind of at the root of you being stable. Blood sugar stabilization help reduce your cravings, and it will impact how your body manages insulin. When insulin shows up to rescue all this excess sugar in your bloodstream, it makes it easier for you to store fat.

Blood sugar stabilization and the role of genes

Blood sugar stabilization is important, but it also has a genetic component. Thus, your genes can affect how well you regulate your blood sugar. 

Genetics can tell you how your body can manage blood sugar stabilization. Examples include:

1. SLC2A2- associated with impaired insulin metabolism and type 2 diabetes with increased insulin response to sugar & refined carbohydrates
2. PPAR- major regulator of glucose stabilization, lipid metabolism & vascular Inflammation.

SLC2A2

The SLC2A2 gene has been associated with impaired insulin metabolism and type two diabetes, along with increased insulin response to sugar and refined carbohydrates. Therefore, if you have this genetic SNP, you will have a greater response from sugar and refined carbohydrates.  

Hence, we should consume complex carbohydrates. Those are the fibers and the plants that help grow our gut bacteria diversity and help us with blood sugar regulation. So you want those but not the refined carbs.

PPAR

PPAR is a major regulator of glucose stabilization, lipid metabolism, and vascular Inflammation. This genetic SNP does play a role in your body’s natural ability to stabilize blood sugar. If you have this particular genetic SNP, a specific allele, you are at a higher risk of developing type two diabetes. 

In any case, you can make a difference to these genetic SNPs through diet, lifestyle, supplements, or isolated nutrients.

#3 Decrease inflammation to improve regain

Decreasing inflammation is the third solution to regain after gastric sleeve and bariatric surgery. This gets woven back into blood sugar stabilization and your gut bacteria. So all, again, these are all interwoven with each other. So fixing one helps the other in a way.

To decrease Inflammation. Are you wondering, how to decrease Inflammation? Read on to get the answer!

How to decrease Inflammation? 

There are many things to consider to decrease Inflammation:

1. Restoring gut imbalances can prevent low-grade Inflammation
2. Plants are considered anti-inflammatory
3. Lower histamine levels- high levels impacts inflammatory responses
   1.  address SIBO
4. Blood sugar stabilization can lower Inflammation
5. Check levels
   1. CRP- acute & chronic inflammatory blood marker
   2. Stool test can identify microbial Inflammation
   3. Genetics can tell you how your body manages inflammatory responses
      1. DAO- deficiency linked to histamine intolerance
      2. HNMT-plays a role in histamine degradation
      3. TNFA- plays a powerful role in regulating inflammatory pathways

Restoring gut imbalances & Inflammation

You can decrease Inflammation by restoring your gut balance. It will help prevent that low grade inflammation. 

Obesity is essentially a chronic low grade inflammation. Therefore, improving your gut dysbiosis will improve your inflammatory markers. 

Plants are considered anti-inflammatory

Plants are considered anti-inflammatory. So again, that goes back to your gut diversity. So the more plants you eat in a week the better. Several people feel and find that hitting 30 to 40 different types of plants per week will give you the diversity you need.

The anti-inflammatory properties of plants should also be considered when it comes to lowering Inflammation.

Lower histamine levels & inflammatory responses

Every person has a histamine response, and some of us are genetically more able to manage it than others. But high levels of histamine impact your inflammatory responses. 

One thing that can really increase histamine, especially in bariatric patients, gastric sleeve included, is SIBO, the small intestinal bacterial overgrowth. However, some of you who have SIBO may experience high levels of histamine due to genetics, but not everyone who has SIBO does. 

If you reduce the burden of bacteria in your small intestine and you don’t have the overgrowth, you’re in a better position. It’s not an infection, it’s just an overgrowth then that allows you to lower that histamine level and that histamine response. 

Blood sugar stabilization & Inflammation

The next one is blood sugar stabilization can lower Inflammation. Inflammation occurs whenever your blood sugar is chronically elevated.

Blood sugar stabilization is important since our bodies are not designed to have high levels of blood glucose. 

Check levels

To decrease Inflammation, it’s probably helpful to check a few levels.

You can check your CRP, which is just a blood test, and this is kind of an, an acute in a chronic inflammatory marker. This can tell us that you have had some inflammation for some time. And that’s just a great way to discover if I have inflammation issues. 

There’s also a Stool test that can identify microbial Inflammation. So if we know that your calprotectin is elevated, we know that there is some inflammation in your gut and you will likely have a lot of digestive problems. The other thing to consider is genetics.

Regain, genetics and inflammation 

There are certain SNPs that can tell you how your body manages the inflammatory responses. 

One is DAO (diamine oxidase). This one is just when you have a deficiency it’s linked to histamine intolerance. So this is what kind of captures that excess histamine and keeps it in, in check. Keeps you where it’s not causing you havoc. 

Another one is HMNT plays a role in histamine degradation. If you have this genetic SNP, you will have difficulty breaking down histamine. 

So if you have both of those histamine issues are going to be a, a big problem. Those are the people that get hives and have allergic reactions to things and flushing. They have exercise intolerance will be red

In addition, TNF alpha is a tumor necrosis factor-alpha that regulates inflammatory pathways. So if you have that, then this SNAP will tell you whether you manage your Inflammation well or poorly. As you know, we are all genetically unique. So it’s hard to say unless, you know, those genetics.

Conclusion

Restoration of gut and balances, improvement of blood sugar stabilization, and decrease in Inflammation, those three things will provide you with a strong foundation to manage your regain and lose weight once again. The key is to understand these three things and put them into practice.

If you’d like to learn more let’s connect by scheduling your free consultation here!