Surgeon Reveals Why Obesity Can Drive Weight Regain And When Surgery Helps

Have you ever lost a considerable amount of weight, maintained it for months and then watched the kilos gradually return despite continuing the same eating habits? According to robotic surgeon Dr Ashish Gautam, this experience may have less to do with a lack of discipline and more to do with the body's biological response to weight loss. A person may lose 10 or 15 kg, feel healthier and successfully maintain the reduction for some time, only to find that hunger returns and the weighing scale slowly begins to rise again.

Dr Gautam explained that after substantial weight loss, the body can respond in ways that make maintaining the lower weight difficult. Changes in hunger, appetite and the body's energy-regulation mechanisms can encourage a person to eat more or feel hungry more frequently. These biological adaptations can persist even after someone has maintained a lower weight for a period of time. As a result, weight regain can occur despite genuine efforts to follow a healthier lifestyle.

This can be frustrating for people who have invested significant effort in losing weight. Someone may initially achieve results through dietary changes, exercise or a combination of lifestyle measures and then maintain those changes for several months. However, if increased hunger eventually makes the routine harder to sustain, the lost weight may gradually return. Dr Gautam's explanation suggests that this pattern should not automatically be interpreted as a failure of motivation or self-control.

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Obesity is influenced by several interconnected factors, including appetite regulation, metabolism, behaviour and the body's response to changes in energy intake. Weight loss can therefore be more complicated than simply reducing the amount of food consumed. For some people, the biological drive to regain lost weight can make long-term weight management particularly challenging. Recognising these factors can help shift the conversation around obesity away from blaming individuals and towards understanding it as a condition that may require sustained medical management.

Dr Gautam also discussed when bariatric surgery may become an option for people struggling with obesity. Bariatric procedures are not intended simply as a method for losing a small amount of weight. They may be considered for people with significant obesity who meet established medical criteria, particularly when lifestyle-based approaches have not resulted in sufficient or lasting weight reduction. The suitability of surgery depends on an individual's overall health, degree of obesity, related medical conditions and previous attempts at weight management.

For eligible patients, bariatric surgery can be part of a broader long-term approach to treating obesity rather than a substitute for healthy eating, physical activity and ongoing medical care. The decision should be made after an assessment by qualified healthcare professionals who can discuss the potential benefits, risks and long-term implications of the procedure. Dr Gautam's explanation highlights an important aspect of weight management: when lost weight returns, biological factors may be contributing to the process, and treatment decisions should consider the underlying condition rather than treating weight regain solely as a matter of personal discipline.

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