Obese patients banking on weight-loss surgery for a quick fix in a healthier lifestyle will not be pleased to see the results of a recent Israeli study pointing to weight regain and a decrease in remission rates of diabetes five years after surgical treatment.

The Israeli long-term follow up, reported in a study published online by JAMA Surgery, is one of the first in-depth studies on laparoscopic sleeve gastrectomies (LSG).

Dr. Andrei Keidar of Beilinson Hospital in Petah Tikva and colleagues collected data from 443 LSG patients who underwent surgery between April 2006 and February 2013. The data showed that five years after surgery the average patient gained back nearly half the weight taken off during the operation.

“The longer follow-up data revealed weight regain and a decrease in remission rates for type 2 diabetes mellitus and other obesity-related comorbidities. These data should be taken into consideration in the decision-making process for the most appropriate operation for a given obese patient,” the authors write.

The study found that after five years, complete remission of diabetes was maintained in 20 percent of patients after five years and remission of hypertension was maintained in 46 percent of patients after the same period.

“The first year after surgery is usually a honeymoon period that should be used for coining new habits, and the ones that don’t do that regain weight,” Keidar, a researcher at Tel Aviv University, tells Reuters. “Don’t take surgery as a panacea – beware of bad eating habits.”

According to the World Health Organization, 1.9 billion adults are overweight or obese.

Keidar says it’s important for doctors to learn more about which patients can most benefit from LSG operations and what approaches can help make post-operation results continue long-term.