Ep 64: Weight Regain with Dr Simon Monkhouse
This post is a companion to Episode 64 of the Bariatric Nutrition Coach Podcast. Listen to the full episode on Spotify or Apple Podcasts.
In this episode I was joined by Dr Simon Monkhouse — consultant weight loss surgeon based in London and one of the most respected voices in bariatric education on social media. We talked about one of the most feared topics in the bariatric world: weight regain.
About Dr Monkhouse
Dr Monkhouse has been a consultant for over 10 years, specialising in helping patients living with obesity. He set up his Instagram account to give patients a voice, reduce the stigma of obesity, and provide accessible, evidence-based education. His passion comes from seeing not just physical transformation but the profound psychological and life changes that happen when someone gets the right treatment. You can find him on Instagram for wonderful educational content.
What Is Weight Regain?
Dr Monkhouse defines weight regain as gaining weight above your lowest stable weight after surgery — which typically occurs around 12-18 months post-operatively. Some degree of weight regain over time is very common and should not be seen as failure. The goal is to minimise it through strong habits, ongoing support, and early intervention when it begins.
Why Does It Happen?
The metabolic effects of surgery ease over time. Restriction reduces. The hunger hormone suppression that was so powerful early on gradually fades. Meanwhile, old eating habits — grazing, liquid calories, irregular meals, emotional eating — can quietly creep back in. This combination, without the awareness and tools to manage it, leads to gradual weight regain for many people.
The Surgeon's View on Support
Dr Monkhouse was emphatic: surgery is one part of the equation. The dietitian, psychologist, and ongoing support team are equally important. People who access ongoing follow-up do significantly better long-term. Weight regain is not a surgical failure — it is most often a signal that the behaviour change work needs more attention. And that work is absolutely possible, at any stage.
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