Obesity and Diabetes

Weight regain occurs in 10–20 % of patients after approximately 36 months post-
bariatric surgery (Sheppard et al. 2013). Different philosophies exist, as to whether

weight recidivism is due to a lack of behavioral lifestyle change or simply a
mechanical failure of the procedure (de Gara and Karmali 2014). Several methods
exist for managing such patients. These include revisional surgery, endoscopic
interventions, and medical management. The frequency of undergoing revisional
surgery ranges from 2.5 to 18.4 % (Sheppard et al. 2013). Inevitably, these surgeries
have higher complication rates than primary surgery (Worni et al. 2013). As such,
revisional surgery due to weight regain comprises a long-term direct cost to the
healthcare system that has yet to be quantified.