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Suboptimal Pesponse to Metabolic / Bariatric Surgery

A minority of patients may experience suboptimal weight loss or other postoperative issues. We provide a structured assessment and targeted solutions to restore progress and comfort.

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?

Mr Panagiotopoulos provides a thoughtful assessment and safe, evidence-based solutions, whether you need conservative care or want to revisit your procedures.

Talk with us