A minority of patients may experience suboptimal weight loss or postoperative problems. We provide a structured assessment and targeted solutions to restore progress and comfort.
Suboptimal Pesponse to Metabolic / Bariatric Surgery
We might see these problems in two phases:
First, in the first two years after surgery, we could see that the body didn’t respond well to the metabolic or bariatric surgery. This might mean not losing enough weight or seeing a surprisingly small improvement in a major obesity issue.
Later on, we might notice a decline in the patient’s health after surgery. This could happen if the patient starts gaining weight again or if a significant obesity issue gets worse, even though they had a good start in the first few months after surgery.
Common Contributors
• Dietary grazing, liquid calories or high-energy snacking
• Low physical activity levels
• Anatomical factors (e.g., sleeve dilation, enlarged pouch, wide anastomosis)
• Psychological or behavioural barriers
• Hormonal/metabolic adaptation
Issues We Manage
- Inadequate improvement/worsening in an obesity complication
• Initial suboptimal weight loss (less than 20% of preoperative weight in 2 years)
• Recurrent weight gain (more than 30% of initial surgical weight loss)
• Nutritional issues (protein, vitamin or micronutrient deficiencies)
Our Management Pathway
• Multidisciplinary review (surgeon, dietitian, psychologist +/- endocrinologist)
• Diagnostics: labs, imaging and endoscopy to assess anatomy and function
• Optimisation: nutrition, pharmacotherapy and behaviour strategies
• Revisional/Conversion surgery when indicated, with shared decision-making
Why Mr. Spyros Panagiotopoulos?
As a fellowship‑trained bariatric surgeon and clinical supervisor, Mr. Panagiotopoulos offers nuanced evaluation and safe, evidence‑based solutions—from conservative care to revisional procedures.