Houston we have a problem

Thank you SkinnyScientist! This makes so much sense to me. I was PCOS too... ended up with a hysterectomy when they had to remove an 8 pound fibroid tumor about 12 years ago. Prior to that, every month was agony. But even with all the plumbing out, I gained with the slightest intake of carbs and I craved them constantly. The RNY has helped a lot with my food decision making. I eat protein first (something solid like steak, fish, cheese, eggs, or chicken (about 2 ounces) and then a few bites of vegetable like green beans, lettuce, spinach, kale, broccoli, cauliflower or for a real splurge, beets. No potatoes, pasta, rice, bread, grain or anything made with flour or sugar. I do drink a protein shake for an afternoon snack and have recently added nuts to my diet. I'm averaging about 800 calories a day and am losing about 1.5 pounds a week right now. I suspect that will slow down as I get closer to goal, but this is very doable.

I am only 18 months post-surgery, but here are my ideas - time for a real data-based discussion with your surgeon.

It is my understanding that the surgeons use a mandril of a set size to form your pouch around that and remove the form before the last staples are put in.  I am not 100% your surgeon did this, but it is standard for many.  When he said it was already small, he might have meant that it was not big enough to cut off your old staples and still have enough stomach left to make the new line of staples and  leave you a pouch.  I don;t know, but I would be having a conversation where we are talking about stomach capacity in cubic cc's.  How big is your stoma, etc.  I am not sure you really know what he did (before and after dimensions) and why. 

At over a year out, my doctor says not to drink your protein or calories - you need the chewing etc to feel satisfied.  So that is reasonable advice from your doctor.

Also,  I read that most people lose on 600-800 and then maintain on 1000-1200 cal/day.  When I told this to my NUIT, she blurt out - "If that much!!!!"  She said that most people would gain on 1200cal/day. 

The other reseach that I have done shows that post-RNY, people absorb all the calories they eat in the form of carbs and protein, but only 70% of the fat calories(That is from a Baylor Univ MC study).  You need the protein, so you can't really cut that down, so that is why a low carb (and somewhat lo fat) diet is recommended.   

I can;t speak to anything about your surgery being done properly, but the rest of the advice seems spot on, if disappointing. I am sweating getting out of the honeymoon phase, but I will do what you are doing - doing everything to prevent regain and more if it happens.

Thanks for your input. I am waiting for the surgical notes and from there I will see what needs to be done.  I want to make sure my insurance isn't billed for a revision that didn't happen just in case in the future one is truly needed.

Correct me if I'm wrong but isn't it true that eventually we're able to eat more and more again after RNY? So it would make sense that you could eat a lot again.

I'm sorry about the hernias, those sound painful.

But if the doctor went in and said it was still small then I would believe him. Getting a second opinion would definitely be in your right to do as well as getting the notes and then contacting the insurance company to make sure what they paid for.

But if you want to lose weight you know what you need to do if you're on this site and you've lost weight before. I'm not trying to be callous, but it does sound like you just want it to happen again. I'm eating 700-800 calories currently to lose weight. It's not great but it is what it is. I don't eat carbs either. I put myself into this situation by eating too much and getting to my previous weight unfortunately.

I'm post menopausal as I had to have my ovaries removed at 26 too and have not great genes going against me. I'm only 13 months out so I'm not saying I won't be having issues with regain either but it sounds like you just want it be fixed without doing the work.

I am doing the work and not eating either.  I want to wait and see what the surgical note say and go from there.  I want to make sure my insurance was only charged for the hernia repair (it was large in my chest) and not for an RNY revision.   I am 10 years out and it's a battle.  I think sugar free popsicles and I will be friends for a very long time.

I can eat half a pizza. I can eat an 8 ounce steak. I don't depend on having a super tiny sized stomach to keep me from gaining weight though. That happens in my head. 

Weigh your portions, and log everything you eat. Every bite. Dont drink your calories, even protein drinks. Make your protein dense. Cut carbs. No matter how big or small your stomach or stoma is, it's the calories that count.

There is no revision that will control eating behaviors. You really need to look elsewhere for the success you want. I wish you well.

Ugh. Why do you always say what I don't want to hear?!?!? 

I think that if you didn't get a revision, maybe after you're healed up another surgeon can go in & take a look? It could be what another op posted & that once he went in there, there wasn't much left for him to work with, so you can't get a pouch as small as you'd like.

It's time to stop depending so much on the size of your pouch & depend more on your eating choices, just because you feel that you can eat more doesn't mean you should. I think you know this already. Our tool is just that, a tool, it can only do but so much. 

It sounds like your pouch matured to whatever size you ended up with, but you're trying to recapture the honeymoon period that came with your original surgery. Frankly that's like the addict that's chasing that first high, you never get it again.

Get your notes & get another surgeon to take a look at you. You might have to stick with what you have & you'll have to find a way to make it work for you.

I didn't see anyone mention this, but you only have malabsorption from an RNY for a limited period of time, usually two years.  After that, your body starts to absorb all the calories that it receives.  If you don't reduce your caloric intake, weight will come back.

I didn't have the RNY so I'm no expert, but this could be a factor in your weight gain.  Do you track all the food you eat using an app like My Fitness Pal?  How many calories are you eating each day?

I am 11 years out and maintain at 135lbs on between 1000-1200 calories, so to lose I would have to cut back to at most 800 calories probably less.  As we age we need fewer calories to maintain, you really are gonna have to jus****ch those calories and eat as few as possible to lose weight. I can physically eat every two hours but I only eat 1 meal a day and two snacks.  What you can eat and what you should eat are totally different.  No revision is gonna make you easily lose weight and as far as leak tests that happened during my surgery not after in my case so you can't go by that as a way to tell what your doctor tweaked.