I need Ya'll to comment?? :) Questions inside...(Revision)

Most often revisions will only be authorized by insurance for flaws in the sleeve or pouch. It usually can't be billed for just weight gain. If the RNY is intact, likely any weight gain is due to habit, unfortunately. I work with many post-operative bariatric patients with all surgeries (DS, RNY, VSG, etc) to improve outcomes. Several have lost 300-400 pounds, and several have regained 50-100. Even DS patients will regain with poor habits, though it is the least likely with the DS operation.

Typically, with the RNY if weight loss is unsatisfactory, often people will consider the DS, particularly with a higher BMI. With an RNY, most revisions are much more technically difficult. You will want to seek out a surgeon who is experienced in converting an RNY to a DS. Changing the RNY into the gastric sleeve is a very difficult operation, and it needs someone who is skilled.

As for how insurance works, you need to call your insurance company and confirm that they allow revisions. Many policies that include bariatric surgery will only allow one revision, and/or will require documentation that the original surgery is flawed. It really depends on the insurance company.

Whatever you decide to do, hopefully it will work out. As a bariatric counselor and patient, I'd also encourage you to seek out a counselor. It can help the revision process to show you are determined to resolve any issues on your part, and if nothing else surgery is stressful and it will help to have extra support. Of course, I am biased ;)

After RNY, people lose on average 100 pounds.

During the third year after RNY most regain 20 pounds.

By five years after RNY, 50% of people have regained 50 pounds.

The only way to change that is by eating fewer calories than you burn.

Revisions typically result in 20 pounds of weight loss. Most of that is from the pre-op and post-op diet.

Any surgeon that tells you something different is not being completely honest.

revisions typically result in 20lbs? first time I've heard that. is that true of all revision types?

RNY to RNY and band over bypass are good for about 20 pounds, due to the pre-op and post-op diets.

A VSG or band to bypass or DS would result in a bit more loss due to the malabsorption that is added.

With RNY that malabsorption is temporary.

With DS, there is fat malabsorption for life, but you still absorb carbs.

Any more weight loss is from also changing your eating habits. You can change your eating habits without additional surgery.

Carnie Wilson had RNY and then band over bypass. She lost 20 pounds and claimed to have dropped another 10 pounds by changing her family's eating habits drastically. I don't think that lasted very long.

If you follow the revision forum, you will notice that people stop posting soon after their revision.

The only exceptions are when there is truly a problem with the original surgery, such as when a fistula forms between the pouch and old stomach. The surgeries for tightening the stoma, reducing the pouch, or reshaping the sleeve do not seem to have any long term weight loss success.

They are a great way for surgeons to make more money.

So you didn't mention band to bypass. I suspect it is the exception. Because nobody mentioned a 20lb loss to me. And I'm down over 90 so there is that :)

I think it is crazy that they even do band over bypass given the issues with the band!

Ignore all these meanies. They certainly sound like they want you to fail.

I have no doubt that you track and weigh your food, and log everything you eat. I'm sure you always get at least 64 ounces of fluids daily. Your surgery obviously failed you.

So what if your pouch is small? There HAS to be something mechanically wrong for you to gain weight after your RNY.

Here's the bad news. It's highly unlikely that your insurance will pay for your revision. You haven't had any complications and the endoscopy confirmed that it's still functioning. Your surgeon told you that you qualified for a revision, but he probably didn't mean that your insurance would agree to pay for it.

So start socking away those nickles and dimes because it's going to be very expensive out of pocket. And if there are any complications that result from your revision, your insurance probably won't cover that either.

Good luck!

What's with the header? It says "Revision 3/23/17"??????