**8. Summary**

Most Morbid obese patients emphasize on importance of having someone, who can give them support in a way that they have felt understood. Most of them also expect bariatric surgery to end their struggle with weight and eating [56]. Unfortunately, Bariatric patients are often unprepared for weight regain and react with emotional distress, i.e., hopelessness, discouragement, shame, and frustration. Regaining weight might be a devastating experience that contribute to a negative spiral in weight management. Negative self-image, maladaptive eating behaviors, substance's use, and overall impaired psychosocial functioning in turn have been associated with internalized weight bias and further weight management difficulties [10, 14, 23, 24, 26, 28, 33]. Postoperative alcohol use has been identified as a predictor for weight regain and even severe episodes of pancreatitis, which unfortunately caused death in two of our cases on 10 years' follow-up after BS. Addiction transfer refers to a shift, where food rewards are replaced


#### **Table 3.**

*Summarized predicting factors for weight regain.*

with other substances post-surgically, which may also contribute to weight regain [24]. Procedures, perioperative protocols, and post operative management for bariatric surgery will evolve over time. Solution of those complex problems and management of WR require a longer follow-up and support of experienced multidisciplinary teams. Most of the contributing factors of WR are summarized on **Table 3**. However, the discussion for a funded and patient-oriented routine review by experts and specialists in Bariatric/Metabolic Surgery up to 5 years after the primary procedure is still open. We need a more serious and honest debate about extended funding of those activities by Governments and Health Insurance Funds.

*Predicting Factors for Weight Regain after Bariatric Surgery DOI: http://dx.doi.org/10.5772/intechopen.108715*
