This is such a bummer

I had gastric bypass in 2008.  I lost over a hundred pounds, felt great.  Arthritis pain almost gone from knees and hips, barely shortness of breath, able to leap tall buildings in a single bound, etc.  Over the past two years though, I have not been able to satisfy my hunger.  My stomach obviously holds much more now and therefore, I have gained back 50-60 pounds.  It is such a tremendous failure feeling.  I feel like crap.  I have no idea anything about what revision there is, or if I could even qualify - medically or financially.  Reading these forums have been helpful, I guess, but I'm even more confused.  I don't want to go back to my surgeon and have to go through all the nutrition appointments and therapy again.  I have no time for that with my current employment.  However, I will do whatever it takes to feel better, I suppose.  As long as I know what is a possibility before I go in.  In all of this reading up, I still can't figure out if something can be done 5 years after bypass.  Is it that switch thing, or what?  Please help me.  I am really depressed about this and now have taken to giving up and eating like I used to.......for comfort.  I turn 56 tomorrow and would like to live to read to my grandchildren.  Thanks so much.

You may want to go see your surgeon to make sure your parts are still in working order, but the bottom line is that you need to eat less to lose weight. No surgery will do it all for you long-term. You have to learn new habits and stick to them. Measure your portions. Track your food. Find something else to do besides eat. I know I eat out of boredom so I have to keep busy.

You can do this but you have to choose to do this.

One quick word about shame/feeling like a failure. If this were easy, everyone would have a glistening lean body. This **** is hard. But you know this. You didn't lose 100 lbs without picking up that lil tidbit. 

Now you've regained. Not good, but also doesn't make you a failure. It's good you've reached out for help. There are lots of good people on here in the same boat as you and lots of who have great tips and proven strategies. But don't be shy about reaching out to the experts--your surgeon, primary care provider, nutritionist, therapist, priest...whatever.

The course you're on now is not working. You need to get back to the one that provided results. Do what you did to lose the 100 lbs. You know the answer. Make sure nothing's changed with your body and health (and only your doctors can tell you that), then buckle down and DO YOUR WORK!

Chin up, kiddo. You've got this. Throw on your cape. You'll be leaping tall buildings again in no time.

Make an appointment to make sure everything is still working properly and get your lab work done.  If your pouch is still working, the good news is, you can still use it to lose the regain.  You know that the reason you have gained weight because you have stopped following the WLS rules, are eating the wrong foods, and your portions are too large.  There is nothing confusing about it.  You have to start being brutally honest with yourself. You have to get back to living the WLS lifestyle.

Eat dense protein first and then non-starchy veggies.  Dense protein keeps you feeling full longer.

Cut all simple carbs ( Bread, crackers, chips, rice, pasta, potatoes, etc.) out of your life.  It will be white knuckle for a week or two, but after a while, you will stop craving them.  We can eat A LOT of simple carbs and eating them makes us feel hungry all the time.  I suspect that is why you can not satisfy your hunger.

Limit fruit to one serving per day ( be mindful that a serving of fruit is 1/2 apple or 1/2 banana, 3-4 strawberries).  The body sees fruit as sugar and eating too much of it will slow or stop your weight loss.

Eat 6 very small (200 -300 calorie) meals daily, spaced about 3-4 hours apart.  If you feel hungry IGNORE IT.  Anyone can wait 3-4 hours until they eat again.  Hunger is not an emergency.  Nothing bad will happen to you if you wait until your next meal time.  

Measure and weigh everything you eat.  Portion sizes tend to creep up on us.  We obese people have a skewed idea of what a proper portion looks like.  The most successful WLS patients track their food forever.  I am 5 year out and still measure everything.  I know that if I guessed at portion sizes, I would over-eat.  At 5 years out, I eat between 1 cup and 1 1/2 cups per meal.  Never over that amount.  It usually adds up to about 1200 calories daily.  I am within 5 pounds of my lowest weight and maintaining.  Don't eat until you feel full.  Most of us have used that full feeling as an emotional crutch.   Measure out your portion size and then STOP EATING.  We have to re-learn how to feed our bodies and learn to be satisfied instead of full.   We actually need very little food to thrive.  If you are gaining weight, you are eating too much.  It really is that simple. 

Drink at least 64 ounce of fluid daily.  That is the MINIMUM amount needed.  I drink closer to 120 ounces in order to feel good.  Everyone is different.  You will need to find your own optimum amount.

Don't drink with your meals or for at least 30 minutes after you eat.   The two leading factors in weight re-gain are excessive carb consumption and drinking with meals.  Drinking with your meals pushes the food through your pouch faster and you can eat more volume, causing weight gain.  It also will make you feel hungrier, faster.  

You have to change the way you interact with food permanently.  Food is simply fuel for the body, nothing more.  It's not for entertainment or celebrating.  It's not your source of happiness, comfort, or a stress reliever.  It's fuel.  You wouldn't put kerosene in your car.  Your car would be ruined.   If you put the wrong things in your body, you break down.  

You still have a very powerful tool in your arsenal, but you have to use it the way it was designed to be used.  What is being depressed, giving up, and eating like you used to doing for you?  NOTHING!!!  The only person who has control over what you eat is YOU!  You can do this!  You won't lose as fast as when you first had surgery, but you CAN lose that re-gain if you commit to changing your lifestyle.  No surgery will work for you if you are not willing to stop the behavior that caused you to gain weight.  

You have to see your surgeon to determine if a revision is appropriate.  Did the surgery fail, or did you regain because you stopped following the plan.  You say over the past two years you were not able to satisfy your surgery.  That was the time to see your surgeon, before you regained 50-60 pounds.  Regain itself is not a reason for a revision.  As others have said, go back to your original eating plan and you will lose the weight.  Won't be easy to get back on track -- you have to commit yourself to it.  It's unfortunate you regained.  Everyone's stomach will stretch a bit, but it is still a lot smaller than your original stomach.  It's a bitter pill to swallow -- but if you have a revision, would the same thing happen all over again?  Be honest with yourself - you gained because you ate too much and did not seek the help of your surgeon or his team.  I'm struggling right now -- but I've started therapy and returned to my surgeon's office for help because I know I have the tool, I just have to get back on track, and I'm determined to do so.

It's not easy.  I wish you the best to get back on track!!  Have you checked out the group here called "Back On Track Together"?  I find it to be very helpful.

There are several ways to revise an RNY, but the first thing you need to do is see your surgeon, get a 'scope done, and determine if you have a mechanical failure. A mechanical failure would be something like a stretched-out stoma or a gastro-gastric fistula, for example. A fistula would need to be repaired, which is usually successful. A stretched-out stoma isn't so easy to fix, and in that case your best revision choice would be to either a Sleeve or a Duodenal Switch. As to which would be better, you need to look at your metabolism---the DS has marvelous success at correcting a super-efficient metabolism, one that can hang on to a LOT of calories. But revising an RNY to a Sleeve is fairly complicated, and revising it to a DS is VERY complicated. There aren't many surgeons qualified to revise an RNY to a full DS. A 'virgin' DS is tough enough, but an RNY-to-DS revision takes a specialist.

But you also need to look at your diet. Just because your stomach holds more now doesn't mean that you should be eating enough to fill it up. (And yes, I know it's a lot easier to say this than to practice this. *grin*) How many calories are you eating a day, and where do they come from? How many grams of protein, fat, and carbs? Carbs are wicked, and the more of them you eat, the more of them you WANT to eat. I suggest trying the Atkins induction diet to detox from carbs and re-assessing your eating habits.

http://f1000.com/prime/reports/m/4/19/

2012 report on WLS results from the Mayo clinic.  The research shows  5-30% of people who get WLS do not keep it off on-term.   Your surgeon knows the numbers, so get back to your surgeon and get checked out.  There are some adjustments that can be done, but you need to get a thorough assessment, as suggested above.

It seems as though you have kept off 40-50 pounds, which is much better than non-surgical results.  Keep those pounds off and for goodness sake call your surgeon and get on with it.  If you are confused, you need an assessment. 

Good luck, is there really any reason to wait any longer?

Failure would have been never doing anything about your weight. You took a major step in having the surgery and 100lbs weigh loss is remarkable. Think of this as more of a set back. I have not had the surgery yet so I can not say i understand. But i have fought my weight my whole life and i know the struggle. I do know from my classes with my surgeons facility that there are revisions that can be done. But they will only be effective if you change what caused you to gain the weight back. Do you honestly want to go through the process again though?

I wish there was a magic pill that made everyone skinny and kept them that way. Unfortunately some of us have to work really hard just to be at a healthy weight. You have to exercise and eat just enough to survive. Take your vitamins for the added nutrition that you need but only eat to fuel your body, not satisfy it. You can do this. One day at a time. One lb at a time. I am just starting the process of trying to get insurance approval. I hope I am approved and can get the surgery behind me. I look forward to reading your updates on your progress and joining you on this journey.