Will the weight come back?

The honest answer is that weight regain can happen with both treatments. The difference lies in why it happens, how common it is, and how it is managed.

Understanding that difference matters before choosing your next step.

Why Weight Regain Happens After Injections

Medications such as Mounjaro and Ozempic work by regulating appetite hormones and slowing stomach emptying. While you are taking them, appetite is reduced and calorie intake falls.

The challenge is what happens when the medication stops.

These injections do not permanently change the anatomy of the digestive system. Once the medication is withdrawn:

• Appetite hormones gradually return to baseline
• Hunger increases
• Calorie intake rises
• Weight regain can occur

Clinical studies have shown that a significant proportion of weight lost on GLP-1 medications may be regained after stopping treatment if no structured long-term plan is in place.

This means injections need to be continued long term to maintain results. Medication is a lifelong treatment for a chronic disease. That carries a commitment to continuing the medications with clear cost implications and requires ongoing medical supervision.

Why Weight Regain Happens After Bariatric Surgery

Weight regain after surgery is different.

Procedures such as Gastric Sleeve and SADI-S permanently alter stomach size and, in some cases, nutrient absorption. They also create long-lasting hormonal changes that reduce hunger and improve insulin sensitivity.

However, surgery is not immune to weight regain.

Reasons may include:

• Gradual adaptation of the stomach over time
• High-calorie liquid intake
• Grazing behaviour
• Emotional eating
• Reduced follow-up engagement
• Lack of dietary structure

The key difference is that the anatomical and hormonal changes from surgery remain in place. This makes weight regain generally slower and often less dramatic than after stopping injections.

In most cases, surgery provides more durable long-term weight loss, particularly in patients with BMI over 45.

How Much Weight Regain Is Normal

After bariatric surgery, small amounts of weight regain several years later can be normal. The body stabilises after the initial weight loss phase. The goal is not zero regain. The goal is maintaining significant net weight loss and improvement in health.

After stopping injections, weight regain can be more rapid because the hormonal effect is removed entirely.

The pattern is different. The underlying biology explains why.

Which Offers More Durable Results

For patients with severe obesity, especially BMI above 40, bariatric surgery consistently shows stronger and more durable long-term outcomes compared to injections alone.

Injections can be effective for moderate obesity. They are valuable tools. But they do not currently match the long-term metabolic impact of surgery in higher BMI groups. That does not mean injections have no role. In some patients, they are appropriate as:

• A primary treatment
• A bridge before surgery
• Support in cases of mild post-surgical regain

For many patients the treatment of their obesity may involve both – often surgery now and medication later if ever required.

The decision depends on the individual.

What Happens if Weight Regain Occurs

At Blackrock WeightCare, weight regain is managed proactively.

This may include:

• Nutritional review
• Behavioural support
• Medical optimisation
• Use of medication where appropriate
• Consideration of revisional surgery in selected cases

Mr William Robb assesses each situation carefully. As an Upper GI and Robotic Bariatric Surgeon, he evaluates anatomical, metabolic and behavioural factors before recommending next steps.

The focus is always on long-term health, not short-term numbers.

The Bigger Question

The real question is not whether weight regain is possible. It is which treatment offers the most sustainable control of a chronic disease.

Obesity is a long term chronic disease. It requires a long-term plan and an ever evolving algorithm of care.

Injections require ongoing use to maintain effect. Surgery creates permanent anatomical and hormonal changes that support durability, particularly in higher BMI patients.

Neither is a quick fix. Both require commitment and follow-up.

Choosing the Right Path

If you are concerned about weight regain, whether after injections or surgery, the right step is expert assessment before making changes.

At Blackrock WeightCare, complex and high BMI patients are routinely assessed to determine the safest and most effective long-term strategy.

To know more, click here and fill the enquiry form or speak directly with our team on 01 255 2479.

Your Health. We Care.

The post Weight Regain After Injections vs Bariatric Surgery: What is the Difference appeared first on Blackrock WeightCare.

But for some, once the weight has stabilised, a new concern emerges. Excess skin following significant weight loss can affect comfort, mobility and confidence. It can cause practical issues such as skin irritation, hygiene difficulties and challenges with clothing.

At Blackrock WeightCare, we believe care does not end when the weight comes down. That is why Body Contouring Surgery is now available for our patients following bariatric procedures, delivered within a structured, medically supervised pathway.

Why excess skin happens after bariatric surgery

Patients who undergo procedures such as Gastric Sleeve, Gastric Bypass or SADI-S often lose a substantial amount of weight, particularly those who begin their journey with a higher BMI. Skin that has been stretched for many years does not always retract fully after major weight loss.

This is especially true in patients who have undergone metabolic surgery for severe obesity. The abdomen is most commonly affected, though the upper arms, thighs and chest can also be areas of concern.

For some individuals, excess skin is primarily a cosmetic issue. For others, it becomes a functional problem. Recurrent rashes under skin folds, fungal infections, difficulty exercising, discomfort during movement and lower back strain are not uncommon. These concerns can affect quality of life and, in some cases, confidence in maintaining an active lifestyle.

When is the right time to consider body contouring

Body contouring is not rushed. In most cases, we advise that weight has been stable for some months. This allows the body to adjust fully and ensures the best possible surgical outcome.

Nutritional status must be optimised before any reconstructive procedure. Following bariatric surgery, careful monitoring of protein intake, iron levels, vitamin B12, folate and vitamin D is essential. For patients with a history of type 2 diabetes, blood glucose control must be stable.

Because our patients are already in structured follow-up, we are well placed to assess readiness safely and responsibly.

Surgical expertise you can trust

Body contouring after significant weight loss requires specialist experience. These procedures are different from standard cosmetic surgery. Patients who have undergone bariatric surgery have unique considerations, including nutritional status, weight stability, previous surgical history and areas of functional concern.

At Blackrock WeightCare, post-bariatric body contouring is performed by experienced Consultant Plastic, Reconstructive and Aesthetic Surgeons who specialise in surgery after major weight loss.

Ms Silvia Marino is a Consultant Plastic, Reconstructive and Aesthetic Surgeon with broad experience across Ireland and the UK. She has a particular interest in body contouring following bariatric surgery, with careful attention to patient safety, realistic expectations and balanced outcomes.

Mr Sergio Mitic brings extensive international training and experience in reconstructive and post-weight loss body contouring procedures. His approach focuses on restoring proportion, improving comfort and addressing functional concerns such as recurrent skin irritation or mobility limitation.

Both surgeons work closely with the multidisciplinary bariatric team. This collaboration ensures that each patient’s surgical history, weight loss progress and nutritional optimisation are fully understood before planning any contouring procedure.

It means decisions are not made in isolation. They are made with a full picture of the patient’s journey.

That continuity of care is important to us. Our goal is that no patient feels they are navigating the next stage of transformation alone.

A dedicated support pathway after body contouring surgery

At Blackrock WeightCare, we understand that body contouring after major weight loss is not just about the operation itself. Recovery matters just as much. Patients need reassurance, access to their surgical team and clear guidance as healing progresses. Wound problems can occur and patients need to be confident that they have access to wound care during their recovery.

Just as we provide structured follow-up after bariatric procedures, we have established a dedicated aftercare pathway for patients undergoing body contouring and skin removal surgery. This ensures that patients know exactly what to expect after their procedure and that support is readily available throughout recovery.

After surgery, follow-up is carefully organised to ensure each patient is reviewed appropriately. Two post-operative consultations with your plastic surgeon are scheduled as standard, allowing healing to be assessed and any concerns addressed. If you need more appointments – no problem and no further expense. Recovery is monitored individually, depending on the procedure performed and how you are progressing.

If additional reviews are required, including wound checks or dressing clinic support, these are arranged without additional professional fees. Patients also have access to specialist wound care services so that concerns such as swelling, fluid collections or infection concerns can be managed promptly and safely.

Care continues until your surgeon is satisfied that healing is complete and you are ready to be discharged from follow-up.

We believe patients feel more confident when they know support does not end once they leave the hospital after their operation. Clear communication, accessible clinical advice and planned follow-up remain central to how we care for those undergoing body contouring surgery at Blackrock WeightCare.

Common questions patients ask

Patients often ask whether body contouring is “necessary.” The answer depends on the individual. Some choose not to proceed and are comfortable as they are. Others find that excess skin limits exercise, affects clothing choices or causes ongoing irritation that impacts daily life.

Another common concern is scarring. Body contouring does involve surgical scars, and this is discussed openly during consultation. The focus is always on balancing improved function and contour with realistic expectations.

Patients also ask about recovery time. This varies depending on the procedure performed and individual health factors. Detailed guidance is provided during assessment so that patients can plan appropriately.

What matters most is that the conversation happens in a supportive and informed environment.

Supporting long-term success after weight loss surgery

Maintaining weight loss requires continued physical activity, nutritional discipline and follow-up. When excess skin causes discomfort or limits movement, it can become a barrier to staying active.

By offering body contouring as part of our extended care pathway, we aim to support patients in sustaining the health improvements achieved through bariatric surgery. This includes improvements in diabetes, hypertension, sleep apnoea and overall cardiovascular risk. It also helps enabling exercise routine and removes barriers to a more active lifestyle.

Obesity treatment is not a single event. It is an ongoing process of restoring health, mobility and confidence.

For patients and GPs

If you have achieved significant weight loss after bariatric surgery but are now struggling with excess skin that feels uncomfortable, restrictive or difficult to manage, it is reasonable to seek advice. Many patients hesitate to raise the issue, unsure whether it is appropriate to ask. If it is affecting your comfort, mobility or confidence, it is worth discussing. Coming for an initial consultation allows you to be informed of your choices. Then you can make a decision you are comfortable with.

For GPs, patients who have done well metabolically may still present with ongoing functional concerns related to excess skin. Recurrent irritation, hygiene difficulties or limitation in activity can all impact long-term wellbeing. Assessment for body contouring may be appropriate in selected cases.

GPs can now refer directly to Blackrock WeightCare for body contouring assessment via Healthlink, in the same way as bariatric referrals. This allows continuity within a trusted service where the patient’s surgical history and weight loss journey are already understood.

At Blackrock WeightCare, our focus remains on providing complete and considered care. From bariatric surgery through to reconstructive options where appropriate, we aim to ensure that no patient feels their journey has been left unfinished.

If you would like to explore whether body contouring is right for you, you can submit an enquiry here or speak directly with our team on 01 255 2479.

Your Health. We Care.

The post Body contouring now available for patients following bariatric surgery at Blackrock WeightCare appeared first on Blackrock WeightCare.

A common concern we hear is this – Do I need to lose weight with injections first before I can be considered for bariatric surgery?

In many cases, the answer is ‘No’.

You Do Not Always Need Injections Before Surgery

Patients with BMI above 45, and particularly those above 50, are sometimes told they must reduce weight before surgery is even discussed. This can lead to months or even years spent trying medications first.

At Blackrock WeightCare, we regularly assess and treat high BMI and complex cases. Surgery is not automatically ruled out because your BMI is high. In fact, procedures such as SADI-S are specifically designed for patients who require a stronger metabolic effect.

If surgery is clinically appropriate, it can be planned safely without asking you to invest time and money into injections first.

Each case is assessed on its own merits.

When Injections May Be Helpful

That said, weight loss injections can sometimes be useful.

They may help:

• Improve blood sugar control before surgery
• Reduce liver size
• Optimise medical conditions
• Support short-term weight reduction in selected cases

But this is strategic and individual. It is not a requirement for everyone.

Injections should never be viewed as a mandatory first step before surgical assessment.

High BMI Is Not an Automatic Barrier

Severe obesity often comes with additional conditions such as Type 2 diabetes, sleep apnoea, joint disease or cardiovascular risk. These patients need specialist input, not delay.

At Blackrock WeightCare, complex and high BMI patients are routinely assessed by Mr William Robb, an experienced Upper GI and Robotic Bariatric Surgeon. Careful evaluation determines:

• Whether surgery is safe now
• Whether optimisation is required first
• Which procedure offers the best long-term outcome

In many cases, metabolic surgery such as Gastric Sleeve or SADI-S provides more durable weight loss and stronger metabolic improvement than injections alone.

Why Expert Assessment Matters First

Starting injections without specialist advice can lead to:

• Modest short-term weight loss but no long-term plan
• Weight regain after stopping medication
• Delayed definitive treatment
• Additional financial cost

Obesity is a chronic disease. The treatment pathway should be planned properly from the outset.

An expert consultation allows you to understand:

• Whether injections are appropriate
• Whether surgery is the more effective option
• Whether a combined approach makes sense
• What is safest given your BMI and medical history

The right decision depends on your health, not on trends.

The Bottom Line

Weight loss injections can play a really positive role in obesity treatment. They are very useful tools in well selected and educated patients.

But you do not need to “prove yourself” with injections before being considered for surgery.

If you have a high BMI or complex medical history, the first step should always be specialist assessment. That way, you avoid unnecessary delay and move forward with a clear plan. Surgery and medication are very often complementary in the treatment of obesity – rather than it being the case of one or the other. 

If you would like to discuss your options, you can enquire here or speak directly with our team on 01 255 2479.

Your Health. We Care.

The post Can Weight Loss Injections Help You Qualify for Surgery appeared first on Blackrock WeightCare.

SADI-S is one of the more powerful bariatric procedures available and is designed for people with severe obesity who need more than a standard sleeve alone.

What SADI-S Means in Practical Terms

SADI-S combines a sleeve gastrectomy with a bypass of part of the small intestine. The stomach is reduced in size, and food passes further down the intestine, which creates a strong metabolic effect.

This tends to result in:

• Greater overall weight loss in higher BMI patients
• Strong improvement in blood sugar control
• Reduction in cardiovascular risk factors
• Better long-term outcomes in patients with BMI above 45

The procedure is carried out by Mr William Robb using advanced robotic and minimally invasive surgical techniques, with a focus on precision and patient safety.

Who is it Suitable For

SADI-S is generally considered for:

• Patients with BMI over 45
• Severe obesity with significant metabolic disease
• Poorly controlled Type 2 diabetes
• Patients who require substantial and sustained weight loss

This is not a routine operation for lower BMI ranges. It is chosen carefully, based on clinical need and long-term goals.

What to Expect Before Surgery

The preparation is thorough. You can expect:

• A detailed surgical consultation
• Full medical assessment and blood tests
• Review of medications and current health conditions
• A structured pre-operative diet plan
• Clear explanation of risks and long-term responsibilities

An important part of the process is psychological evaluation. This is not a test to pass or fail. It is there to ensure you are emotionally prepared for the changes ahead. Surgery alters eating patterns, routines and coping mechanisms. Understanding your relationship with food, stress and lifestyle habits helps build a safer and more sustainable outcome.

This step is about support, not judgement.

What to Expect Around the Time of Surgery

SADI-S is carried out under general anaesthesia. Most patients stay in the hospital for 1-2 days.

After surgery, you can expect:

• Early mobilisation
• A gradual transition from liquids to soft foods
• Smaller portion sizes
• Rapid early weight loss
• Regular contact with the clinical team

The first few weeks require adjustment. Energy levels can fluctuate as your body adapts.

What to Expect in the Months After

Weight loss usually progresses steadily over 12 to 24 months. Many patients experience:

• Significant total body weight loss
• Improved diabetes control, sometimes with reduced medication
• Lower blood pressure
• Less joint pain
• Improved sleep quality
• Greater mobility

Results vary, but meaningful health improvement is the goal.

Because part of the intestine is bypassed, lifelong vitamin and mineral supplementation is required. Regular blood monitoring forms part of follow-up care. The structured aftercare programme at Blackrock WeightCare supports patients for the long term, not just the immediate post-operative period.

Accessing SADI-S Surgery in Ireland for High BMI Patients from Northern Ireland

Patients in Northern Ireland with very high BMI can face limited access to advanced bariatric procedures or long waiting times. Choosing treatment in Dublin at Blackrock WeightCare allows surgery and follow-up to take place within Ireland, with regular communication with your GP and ongoing monitoring close to home.

Many patients prefer this to travelling abroad, where long-term follow-up and nutritional supervision can be difficult to maintain.

SADI-S is a serious decision. It requires commitment and follow-through. It is also one of the most effective tools available for treating severe obesity and its related conditions.

If you would like to explore whether SADI-S is suitable for you, you can enquire through our website or speak directly with our team on 01 255 2479.

Your Health. We Care.

The post What to Expect if You Are Considering SADI-S Surgery appeared first on Blackrock WeightCare.

Many people are simple told they should lose weight before having a hernia repaired. That advice is not given lightly. There are sound medical reasons behind it – but simply telling patients living with obesity to lose weight through diet and exercise so they can have a hernia repaired is not enough. They need a real treatment for the disease of obesity and that is where surgery is so effective.

Understanding why hernias are more common in severe obesity helps explain why treatment planning needs specialist input.

Why Severe Obesity Increases Hernia Risk

A hernia develops when tissue pushes through a weakened area of the abdominal wall. In patients with high BMI, several factors increase the likelihood of this happening.

Constant internal pressure
Excess intra-abdominal fat raises pressure inside the abdomen. Over time, this strains natural weak points such as the umbilicus or previous surgical scars.

Previous abdominal surgery
Patients with obesity are more likely to have had procedures such as gallbladder surgery or caesarean sections. Incisions can weaken the abdominal wall, leading to incisional hernias.

Reduced tissue strength
Obesity affects collagen and tissue quality. The abdominal wall may not hold sutures or mesh as effectively, increasing recurrence risk after repair.

This is why umbilical, ventral and incisional hernias are more common in patients with a high BMI.

Why Hernia Repair Alone Can Be Problematic

Repairing a hernia without addressing severe obesity often leads to:

• Higher recurrence rates
• Increased wound complications
• Greater infection risk
• Technical difficulty due to abdominal wall thickness

In some patients, repairing the hernia first may only provide temporary relief if abdominal pressure remains high.

That is where bariatric surgery can change the long-term outcome.

Can Hernia Repair Be Done During Bariatric Surgery

In selected cases, yes. The decision depends on:

• The size and type of hernia
• Whether it is symptomatic
• Risk of bowel obstruction
• Overall BMI and medical condition

Small hernias can sometimes be repaired at the same time as a bariatric procedure such as Gastric Sleeve, Gastric Bypass or SADI-S. Very often however they are repaired at a later date when there has been significant weight loss and the repair is then likely to be more robust and enduring.

Larger or complex abdominal wall defects may be better treated in stages. In these cases, weight loss surgery is performed first. Once weight has reduced and surgical risk is lower, hernia repair can follow under safer conditions.

There is no standard rule. 

The Importance of Specialist Assessment

This is where experience matters.

Mr William Robb is an Upper GI Surgeon and Robotic Bariatric Surgeon with extensive experience in complex abdominal surgery. His background in upper gastrointestinal surgery means he regularly manages conditions involving the stomach, oesophagus and abdominal wall, alongside bariatric procedures.

At Blackrock WeightCare, assessment involves:

• Careful physical examination
• Imaging where needed
• Review of previous surgical history
• Evaluation of metabolic health and BMI
• Discussion of the safest sequencing of procedures

Robotic surgical techniques are used where appropriate, particularly in higher BMI patients. Robotic assistance allows greater precision and improved visualisation inside the abdomen, which can be especially helpful when managing both bariatric surgery and hernia repair in the same setting.

The key decision is not simply whether surgery can be combined. It is whether it should be combined in your specific case.

What Patients Can Expect

If you are being assessed for both severe obesity and a hernia, you can expect:

• A detailed consultation
• Honest discussion about risks and benefits
• Clear explanation of whether a combined or staged approach is safer
• Structured preparation before surgery
• Long-term follow-up after bariatric treatment

If a combined procedure is appropriate, both issues are addressed in one surgical setting. If staging is safer, you will understand why and what the timeline looks like.

Why Treating Obesity Improves Hernia Outcomes

Sustained weight loss reduces abdominal pressure. This improves healing, lowers recurrence risk and makes future abdominal surgery safer.

In many patients, addressing obesity first creates better long-term results for hernia repair.

Managing hernias in the setting of severe obesity requires careful judgment. A specialist assessment at Blackrock WeightCare ensures the decision is based on safety, surgical expertise and long-term outcome.

If you would like to discuss your case, you can click to enquire here or speak directly with our team on 01 255 2479.

Your Health. We Care.

The post Why Hernias Are More Common in Severe Obesity and Can They Be Repaired During Bariatric Surgery appeared first on Blackrock WeightCare.

Obesity affects nearly every area of medicine. We work closely with GPs, Endocrinologists, Women’s Health practitioners, Orthopaedic surgeons and other specialists who are supporting patients with weight related illness. 

Many are caring for individuals with Type 2 diabetes, PCOS, infertility, fatty liver disease, joint degeneration, sleep apnoea and cardiovascular risk. In many cases, simply treating obesity appropriately is central to improving long term outcomes.

Bariatric surgery can support that goal.

Who is Eligible

In general, patients may be considered for bariatric surgery if they have:

• A BMI of 40 or above
• A BMI of 35 or above with obesity related medical conditions such as Type 2 diabetes, hypertension or sleep apnoea

Patients with higher BMI and more complex medical needs can also be assessed, including those who may have been declined surgery elsewhere. We have particular experience managing very high BMI cases safely.

Supporting Specialists Across Disciplines

Referrals are welcome from:

• GPs managing chronic disease in the community
• Endocrinologists seeking better metabolic control for patients with poorly controlled diabetes
• Women’s Health clinicians supporting patients with PCOS, fertility challenges and cancer risk
• Orthopaedic surgeons whose patients require weight reduction before joint replacement
• Physicians managing obesity related cardiovascular, respiratory disease and renal disease amongst others

Our aim is to work alongside the referring clinician. Patients return to their own doctor for ongoing care with a clear aftercare plan in place.

Care in Ireland with Insurance Cover

Many patients in Ireland are insured for bariatric surgery through their private health insurance, subject to policy approval. Having surgery with Blackrock WeightCare allows patients to receive treatment at home in Ireland, close to family and their usual medical team.

Travelling abroad for surgery can seem attractive at first, but continuity of care, structured follow up and access to your own GP and specialists are critical for long term success.

All procedures are performed by Mr William Robb. We provide:

• Gastric Sleeve
• Gastric Bypass
• Gastric Band Removal and conversion to Bypass or Sleeve
• SADI-S for patients with higher BMI and complex metabolic disease

Healthlink referral ensures a secure and straightforward pathway for assessment.

If you would like to refer a patient, please look for Blackrock WeightCare via Healthlink.

For further information about Blackrock WeightCare, please click here or contact our team on 01 255 2479.

Your Health. We Care.

The post Making Referrals from General Practice for Bariatric Surgery Easier – Direct Referral to Blackrock WeightCare Now Available via Healthlink appeared first on Blackrock WeightCare.

Bariatric surgery helps patients lose weight by changing the digestive system, but it also changes something deeper: the relationship with food.

At Blackrock WeightCare, we often tell patients that surgery is a powerful tool, but learning how to live with that tool is an important part of the journey. Understanding how eating habits and feelings around food evolve after surgery can help patients approach this change with confidence.

Food Becomes about Nourishment, Not Just Quantity

Before surgery, many patients feel that food is constantly on their mind. Large portions, frequent snacking, or emotional eating may have developed over time.

After bariatric surgery, the stomach becomes much smaller. Because of this, patients naturally eat smaller portions.

Meals become less about quantity and more about quality and nourishment.

Patients often begin to think differently about what they eat. Instead of asking, “How much can I eat?” the question becomes, “What will help my body feel satisfied and energised?”

This shift does not happen overnight, but over time, many patients feel they develop a more balanced and mindful approach to food.

Eating Slower Becomes Important

After surgery, eating too quickly can cause discomfort. This is because the stomach pouch fills more quickly than before.

Patients learn to eat slowly, chew carefully, and pay attention to the signals their body sends.

For many people, this slower approach to eating becomes a positive change. Meals become more intentional and less rushed. It also allows patients to recognise the feeling of fullness more easily.

Hunger Feels Different

Another change many patients notice is that hunger feels different after surgery.

Hormonal changes that occur after procedures such as gastric sleeve or gastric bypass often reduce the intensity of hunger signals.

This does not mean that patients never feel hungry again. Rather, hunger often becomes more predictable and manageable. Patients may find they feel satisfied with smaller meals and do not experience the same strong cravings they once did.

Emotional Eating May Still Need Attention

While surgery changes the digestive system, it does not remove emotions.

Some patients realise that certain eating habits were linked to stress, boredom, or emotional comfort. Recognising these patterns is an important step in building a healthier relationship with food.

This is why bariatric care includes more than surgery. It involves education, support, and follow-up care to help patients develop long-term habits that support their health.

At Blackrock WeightCare, we encourage patients to stay connected with the team of experienced dietitians if they notice challenges around food choices or emotional eating.

Food Preferences May Change

It is quite common for patients to notice changes in taste or food preferences after surgery.

Foods that once felt appealing may feel too heavy or uncomfortable, while other foods become easier to enjoy. Many patients find themselves naturally leaning toward foods that are higher in protein and easier to digest.

This shift can help reinforce healthier eating habits over time.

Social Situations Around Food Can Feel Different

Food is often part of social life. Family gatherings, celebrations and eating out with friends are important parts of everyday living.

After bariatric surgery, patients may initially feel uncertain about these situations. Smaller portions or slower eating can feel different from what others expect.

With time, most patients find their own comfortable way of navigating these moments. Many discover that social events are still enjoyable, even if food plays a smaller role than before.

The Importance of Support and Aftercare

Changing your relationship with food is not something that happens in a few weeks. It develops gradually over months and years.

There may be periods where patients feel confident and in control, and other moments where they need reassurance or guidance.

This is why ongoing aftercare is such an important part of bariatric treatment.

At Blackrock WeightCare, our Aftercare Programme helps patients:

• Understand how their eating habits are evolving
• Maintain balanced nutrition after surgery
• Navigate plateaus or challenges
• Stay motivated in the long term 

Having professional guidance available makes the journey easier and helps patients build habits that support lasting success.

A New Relationship With Food

Bariatric surgery does not take food away from your life. Instead, it often helps patients rebuild a healthier and more balanced relationship with it.

Food becomes less about overeating or constant hunger and more about nourishment, energy, and wellbeing. For many patients, this shift is one of the most meaningful parts of the journey.

If you are considering bariatric surgery or would like to learn more about the support available before and after surgery, the team at Blackrock WeightCare is here to help.

You can make an enquiry here or call 01 255 2479 to arrange a consultation.

Your Health. We Care.

The post How Bariatric Surgery Changes Your Relationship with Food appeared first on Blackrock WeightCare.

But for some people, things can change again years later.

They may notice that the weight starts creeping back. They don’t feel as full as they once did. Meals that used to satisfy them suddenly seem too small. Some patients also begin experiencing unpleasant symptoms of dumping syndrome.

It can be confusing and upsetting. Many people wonder if they have somehow caused the problem themselves.

Often, that isn’t the case at all.

In many situations, the reason is anatomical. The body changes over time, even after successful surgery.

To help explain what happens and what options may exist, we spoke with Mr Achille Mastrosimone, Consultant General and Upper GI Surgeon, who specialises in advanced endoscopic treatments for bariatric patients.

Interview with Mr Achille Mastrosimone

What is TORe?

Mr Mastrosimone: TORe stands for Transoral Outlet Reduction. It is an incisionless endoscopic procedure designed for patients who previously had a Roux-en-Y gastric bypass and later develop problems such as dumping syndrome or weight regain.

The procedure is performed using a flexible endoscope that is passed through the mouth, so there are no external cuts or abdominal incisions.

After gastric bypass surgery, the stomach pouch connects to the small intestine through a small opening called the gastrojejunal anastomosis, often referred to as the outlet.

Over time this outlet can stretch. When that happens, food moves through the stomach more quickly and the feeling of fullness becomes weaker.

During TORe, we place sutures around this outlet using a specialised endoscopic suturing device. This reduces its size again, which helps slow gastric emptying and restore restriction.

In some cases, if the gastric pouch has also stretched, we can reduce its size endoscopically at the same time.

Why does gastric bypass sometimes stop working as well over time?

Mr Mastrosimone: Weight regain after gastric bypass is usually multifactorial. There are often several contributing factors, including physiological adaptations, behavioural changes, and, in some patients, significant anatomical changes.

In some patients, over time, the outlet between the stomach pouch and the small intestine can widen, and the pouch itself may stretch slightly. When that happens, the restrictive effect of the operation becomes less effective.

As a result, food can pass through the pouch more quickly, patients may feel hungry again sooner after eating, and portion sizes may gradually increase. This can contribute to weight regain.

It is important to stress that these changes can be mechanical and are not simply a question of behaviour. They may occur even when a patient is doing everything right.

Is dumping syndrome one of the main reasons people consider TORe?

Mr Mastrosimone: Yes, very often. In fact, in my experience the strongest indication for TORe is dumping syndrome.

Dumping syndrome occurs when food moves too quickly from the stomach pouch into the small intestine. Patients may experience symptoms such as sweating, dizziness, nausea, palpitations, diarrhoea or low blood sugar after eating.

By reducing the diameter of the outlet, TORe slows gastric emptying. This can significantly improve these symptoms and help patients feel more comfortable after meals.

How do you decide if someone is suitable for the procedure?

Mr Mastrosimone:  The first step is a careful assessment of the anatomy. Before recommending TORe, I perform an OGD, also known as a gastroscopy. This is a procedure that uses a small camera to look inside the stomach. It allows me to measure the opening and assess the size and length of the stomach pouch.

This evaluation is essential because TORe works best when the outlet is enlarged. Patients with an outlet diameter of 2.5 cm or more tend to benefit the most, and results are often even better when the outlet is greater than 3 cm.

If the pouch is also significantly enlarged, we may perform an endoscopic pouch revision at the same time as the outlet reduction.

This ensures that the procedure is tailored to each patient’s anatomy.

What happens during the procedure itself?

Mr Mastrosimone: The procedure takes place in theatre under general anaesthetic, which means the patient will be asleep throughout. The anaesthetist will give the anaesthetic and monitor the patient carefully.

We start by performing an OGD (gastroscopy) to reassess the size and length of the stomach pouch. If appropriate to proceed, we then treat the inner lining of the join between the stomach and bowel (the anastomosis) using a special heat probe called APC.

 After this, a specialised stitching device attached to the endoscope is used to place stitches around the outlet. These stitches make the opening smaller, which helps food stay in the stomach pouch for longer and move through more slowly.

The procedure usually takes about 60 to 90 minutes.

As there are no cuts on the outside of the body, recovery is usually quicker than with revisional surgery.

How does TORe compare with revisional bariatric surgery?

Mr Mastrosimone: Revisional surgery can be quite complex. Surgeons often have to deal with scar tissue and may need to reconstruct parts of the bypass.

TORe is much less invasive because it’s done endoscopically. There are no abdominal incisions, and the recovery is usually faster. The risk of complications is also generally lower.

For some patients, TORe can delay or even avoid the need for major revisional surgery.

What should patients expect after the procedure?

Mr Mastrosimone: Most people recover well after the procedure and only have mild symptoms. It is quite common to have a sore throat or some temporary bloating. Mild abdominal discomfort can also occur, but this is usually well controlled with common painkillers.

Many patients go home the same day or after a short overnight stay.

Normal activities can usually be resumed within a few days.

As with any bariatric treatment, the best results happen when the procedure is combined with ongoing dietary and multidisciplinary support.

Understanding the Next Step

Weight regain after gastric bypass can feel discouraging, but it is not unusual. Obesity is a chronic condition, and treatment sometimes needs to evolve over time.

For patients who develop dumping syndrome, loss of restriction or anatomical changes after gastric bypass, TORe may offer a minimally invasive way to address the underlying issue.

At Blackrock WeightCare, careful assessment is always the first step. A detailed consultation and endoscopic evaluation help determine whether TORe is the right option for each individual patient.

If you have had gastric bypass surgery and are experiencing weight regain or dumping syndrome, you can make an enquiry here or call 01 255 2479 to arrange an assessment with the team at Blackrock WeightCare.

Your Health. We Care.

The post TORe after Gastric Bypass: A Conversation about Dumping Syndrome and Weight Regain appeared first on Blackrock WeightCare.

Choosing bariatric surgery is not simply about losing weight. It is about improving health, reducing long-term medical risk and selecting the right procedure for your BMI, metabolic condition and overall health profile.

Patients across Ireland, the UK and Northern Ireland often compare three main procedures:

• Gastric Sleeve
• Gastric Bypass
• SADI-S

Each operation works differently. Understanding those differences is essential before making a decision.

Understanding the Three Procedures

Gastric Sleeve (Sleeve Gastrectomy)

Gastric sleeve surgery involves removing approximately 70–80% of the stomach. The remaining stomach becomes a narrow tube.

It works by:

• Restricting food intake
• Reducing hunger hormones
• Promoting early fullness

It does not involve bypassing the intestine.

Sleeve surgery is commonly offered to patients with BMI 35–45 and can deliver strong, sustainable weight loss when appropriately selected.

Gastric Bypass (Roux-en-Y)

Gastric bypass creates a small stomach pouch and reroutes part of the small intestine.

It works through:

• Restriction
• Hormonal changes
• Reduced calorie absorption

It has a strong metabolic effect and is particularly effective in patients with type 2 diabetes.

Gastric bypass is suitable for BMI 35–55 and can also be appropriate in higher BMI patients depending on clinical circumstances.

SADI-S (Single Anastomosis Duodeno-Ileal Bypass with Sleeve)

SADI-S combines a sleeve gastrectomy with a longer intestinal bypass.

It provides:

• Restriction
• Powerful hormonal change
• Greater metabolic impact

It is particularly effective for:

• BMI 45–70+
• Severe type 2 diabetes
• High BMI patients requiring stronger long-term weight loss

SADI-S is technically more advanced and should be performed in experienced centres.

Clear Comparison: Sleeve vs Bypass vs SADI-S

Which Procedure Is Best for Higher BMI?

For patients with a BMI over 50, the strength, durability and metabolic impact of weight loss become especially important.

While gastric sleeve can be effective in selected patients, it may not provide sufficient long-term weight loss for individuals with BMI 60 and above.

Gastric bypass offers significant weight reduction and strong diabetes improvement, and remains an excellent option for many patients with severe obesity.

However, for patients with BMI 50–70+, SADI-S is often considered the most effective bariatric procedure due to its powerful metabolic effect and greater long-term weight loss potential. In experienced hands, it provides stronger hormonal changes and sustained results in patients with high BMI.

That said, the most appropriate procedure always depends on individual factors such as overall health, diabetes severity, previous surgeries and surgical risk profile. A personalised consultation is essential to determine which operation is safest and most effective for you.

Safety and Complexity

All bariatric procedures are safe when performed in experienced centres.

However, high BMI and complex cases require:

• Careful pre-operative optimisation
• Experienced anaesthetic management
• Technical precision
• Structured long-term follow-up

The surgeon’s experience is often more important than the name of the procedure itself.

Long-Term Outcomes

Long-term success is influenced by:

• Procedure selection
• Multidisciplinary support
• Nutritional follow-up
• Patient engagement

For some patients, sleeve is entirely appropriate. For others, especially those with higher BMI or complex metabolic disease, bypass or SADI-S may provide more durable results.

There is no single “best” operation for everyone.

Why Personalised Assessment Matters

Bariatric surgery is not a menu choice. It is a clinical decision.

The safest and most effective approach is to consult an experienced bariatric surgeon who understands:

• BMI-specific risks
• Metabolic disease
• Revision options
• Long-term nutritional management
• Robotic and advanced surgical techniques

An experienced surgeon can evaluate your individual profile and recommend the procedure most suited to your long-term health.

Expertise at Blackrock WeightCare

At Blackrock WeightCare, procedure selection is always personalised. Our team includes experienced surgeons, specialist nurses, dietitians and anaesthetists who guide patients carefully through the decision-making process.

Mr William Robb is one of the highest volume robotic surgeons in Europe and has performed more than 1,500 robotic surgical operations. His experience in complex and high BMI cases allows for careful selection of the most appropriate procedure, particularly where advanced techniques such as robotic SADI-S are considered.

Patients from Ireland, the UK and Northern Ireland seek specialist assessment not simply for surgery, but for clarity, safety and long-term results.

Choosing between sleeve, bypass, and SADI-S is not about selecting the most popular option. It is about choosing the right operation for you, guided by experience and evidence.

If you would like a personalised consultation to understand which procedure may suit you best, fill out an inquiry form here or call 01 255 2479.

Your Health. We Care.

The post Gastric Sleeve vs Gastric Bypass vs SADI-S appeared first on Blackrock WeightCare.

For patients living with obesity and type 2 diabetes, bariatric surgery is not simply weight loss surgery. It is metabolic surgery. In many cases, it can significantly improve diabetes control and, for some patients, lead to remission.

If you are researching bariatric surgery for type 2 diabetes in Ireland, understanding which procedure offers the best results is essential.

Why bariatric surgery works for type 2 diabetes

Bariatric procedures do more than restrict food intake. They change gut hormones, insulin sensitivity and glucose metabolism.

After surgery, many patients experience:

• Rapid improvement in blood sugar levels
• Reduced need for diabetic medication
• Lower insulin requirements
• Improved HbA1c
• Reduced cardiovascular risk 

These improvements often occur within days to weeks, even before significant weight loss happens.

For patients with obesity-related diabetes, surgery addresses the underlying metabolic dysfunction rather than simply treating symptoms.

Gastric sleeve and type 2 diabetes

Gastric sleeve surgery (sleeve gastrectomy) removes a portion of the stomach, reducing hunger hormones such as ghrelin and improving insulin sensitivity.

It is effective for:

• Patients with BMI 35–45
• Early or moderately severe type 2 diabetes
• Patients not requiring high-dose insulin 

Many patients experience significant improvement, and some achieve remission, particularly when diabetes duration is shorter.

However, in patients with long-standing or insulin-dependent diabetes, the metabolic effect may be less powerful than other procedures.

Gastric bypass and diabetes remission

Gastric bypass surgery has been performed for decades and has strong evidence supporting diabetes improvement and remission.

It works by:

• Restricting food intake
• Altering nutrient absorption
• Creating powerful hormonal changes that improve insulin response 

Gastric bypass is often recommended for:

• Patients with poorly controlled type 2 diabetes
• Higher BMI categories
• Those requiring insulin 

Remission rates are significant, particularly when surgery is performed earlier in the disease course.

SADI-S and severe type 2 diabetes

For patients with BMI over 45–50, or those with severe and insulin-dependent diabetes, SADI-S (Single Anastomosis Duodeno-Ileal Bypass with Sleeve) offers particularly strong metabolic benefits.

SADI-S combines:

• Sleeve gastrectomy
• A longer intestinal bypass
• Enhanced hormonal and metabolic impact 

This procedure is especially effective in:

• Long-standing diabetes
• High insulin requirements
• Severe obesity
• Patients declined elsewhere due to complexity 

At Blackrock WeightCare, we are leaders in robotic SADI-S surgery in Ireland. For high BMI patients with complex diabetes, SADI-S often provides greater total weight loss and more powerful metabolic control compared to other procedures.

Does bariatric surgery cure type 2 diabetes

The word “cure” is rarely used in medicine. However, many patients achieve remission, meaning normal blood sugar levels without diabetic medication.

The likelihood of remission depends on:

• Duration of diabetes
• Pancreatic beta cell function
• Pre-operative insulin use
• BMI
• Procedure type 

Earlier intervention generally leads to better outcomes.

Even when full remission is not achieved, most patients see:

• Reduced medication burden
• Lower insulin doses
• Improved cardiovascular risk profile 

For many, this significantly changes long-term health outcomes.

Choosing the best bariatric surgery for diabetes in Ireland

There is no single “best” procedure for everyone. The right operation depends on:

• BMI
• Severity and duration of diabetes
• Insulin dependency
• Reflux symptoms
• Previous abdominal surgery
• Overall medical complexity 

At Blackrock WeightCare, every patient undergoes a comprehensive multidisciplinary assessment. We tailor the procedure to the individual rather than applying a one-size-fits-all approach.

As one of the highest-volume robotic surgical operation centres in Europe, we specialise in complex and high BMI cases, particularly SADI-S for patients with advanced metabolic disease.

Why early referral matters

Type 2 diabetes is progressive. The longer it continues, the greater the risk of irreversible pancreatic damage.

Considering bariatric surgery earlier — rather than after years of escalating medication — can improve the chance of remission and reduce long-term complications.

If you are living with obesity and type 2 diabetes and want to understand your options for bariatric surgery in Ireland, a specialist assessment can provide clarity.

You can contact Blackrock WeightCare by filling the inquiry form here or by calling 01 255 2479.

Your Health. We Care.

The post Which bariatric surgery is best for type 2 diabetes in Ireland appeared first on Blackrock WeightCare.