RNY 01/05/09 looking for revision

I had RNY done January 5th 2009. It could not have went better. I had ZERO complications. I lost around 190 lbs. I was 374 and got as low as 185. I wound up having some major issues with alcohol use after the weight loss. I actually wound up going to two rehabs and six detoxes during a 3 year period. I have not had a drink in 5 years...but since I stopped drinking I haven't stopped eating. I am now around 300lbs which is still 74 less then my highest weight. I have tried many things, nutritionist, dietician, Weigh****chers, many calorie counting apps, intermittent fasting and therapy. The surgery did not fail me, I failed the surgery. I have been trying to lose weight for the past 5 years. I have omitted wheat, flour and sugar at times. I always go back to eating. I have tried meditation and prayer. I don't really know much about revision surgery but what I have read has not seemed promising. StomaphyX and Transoral (sic?) I am not really sure where to turn. I have tried OA as well as Grey Sheet Anonymous. I have not given up but I have to admit my hope is fading. My feeling is that my stoma has stretched, the reason I feel this way is because I still get some feeling of restriction but it does not last long. I'm sure it has stretched somewhat naturally but mostly because of my overeating. I can't look back and what could have been. I am asking for advice. I am a 58 year old male. Thanks for taking the time to read this. I look forward to any and all responses.

Kevin

First of all...congrats on your sobriety. We "old timers" on this site spend a lot of time trying to warn people about transfer addictions and to stay away from alcohol.

Have you had an endoscopy to see if your original surgery is intact? That would be my next move if I were you. If your original surgery is working, then there is no need for a revision and you CAN lose weight on your own. I have a friend on this site that recently lost over 50 pounds and she is more than 15 years out from surgery.

Unfortunately there are not any good revisions to RNY. Most of the surgeries that tighten the stoma fail and the average weight loss is about 20 pounds. If you have a stretched stoma, I would go ahead with the surgery to fix it, but know that if you don't carefully measure every bite of food, it will fail almost immediately. You will have to learn to be a strict rule follower.

As for food: Eat dense protein first, then non starchy veggies. Dense protein fills you up. Stay away from carbs, don't drink your calories (only zero calorie drinks), don't drink with your meals or for 30 minutes after, get a good food scale and measure your food. You should not be eating more that 1 to 1/12 cups of food per meal...that is the TOTAL volume. We obese people have a really skewed view of what a portion size should look like. If you are eyeballing your portions, I can guarantee that you are over eating.

Eat by the clock. Don't eat between meal times. If you are hungry...ignore it. Nothing bad will happen to you if you force yourself to wait until your next scheduled meal. Stop chasing the full feeling. You will never feel that sense of fullness that you had before surgery. Your anatomy has changed. Stop depending on restriction to keep you from eating. Your stomach has been lying to you for decades, telling you that it's hungry when it's not. You need to get your head back in charge and take your stomach out of the equation. Eat what you measure out and then stop eating.

Sometimes stomach acid mimics hunger, a PPI might help. Don't make the mistake of thinking that a gurgling stomach is a sign of hunger. It's not. We all have noisy stomachs after WLS. That never goes away for some of us.

I would suggest finding a good therapist and stop trying to find a weight loss program to lose the weight. There is a reason you choose to overeat. There is a reason you turned to alcohol. Until you figure out why you are self sabotaging you won't lose weight. Find someone who specialized in eating disorders. Many of us add a therapist to out WLS team. I believe that you don't get to be 200 pounds overweight without having disordered eating. You are worth the emotional work and the expense to figure things out.

YOU CAN DO THIS!!!!

I have a friend whose daughter just went through rehab. Her drinking problem started after RNY. Congratulations on being sober.

As Rocky pointed out, revisions do not seem to work for more than 20 pounds. Weight loss after surgery is like magic for a few years, but it is a once in a lifetime opportunity. The body will always try to get back to where it was. There might be medical intervention program that would help you.

The first step is to get to a surgeon and have your surgery evaluated. See what type of help they can suggest. Whatever happens you will have to find a way to eat less. It is not easy, but you have shown remarkable perseverance and courage in staying sober.

That shows you have strength and the ability to make healthy changes for yourself.