I'm tired of having a weight issue.

Wouldn't that be a question for your insurance company?

re: having a surgery where you lose only half of your excess weight:  that's the percentage of loss that a surgeon considers "successful".

 The average weight loss for RNY patients is something like 70% of excess weight.  However, this is just an average.  Lots of people lose  more - or less - than that.  There are many people on OH who have lost 100% (or more) of their excess weight.  But it does take a lot of work and determination to do that.  I don't think any of us can eat (or drink) whatever we want to.  Maybe there's some lucky person out there who can - but for the vast majority of us - no.

Having more than two decades of exp in the insurance industry, I can tell you that you will not qualify for the reasons you are seeking.  

Not all insurance carriers cover revision and some have a 1 per lifetime clause, regardless if they were your original carrier or not when you had your first proc.  However, those that do cover them, follow the same guidelines for a person seeking surgery the first time around.   The only diff is that if your BMI is not at 35 with one co-morbid or 40 without, you must have diagnostic tests to confirm if your failure to lose weight or if the cause of regain is due to mechanical breakdown and not non compliance.  

The tests must be submitted for review to your case manager, showing that there is a breakdown, so it is not just based on the determination of the surgeon who will do the surgery, if approved.  There has to be qualified medical evidence that demonstrates it.  

To "never" have excess weight again you need to "always" eat the amount of calories you need, or fewer calories.  This DOES require constant vigilance.  

I'm actually shocked that you see a therapist "multiple times a week" and haven't gotten to this realization. Diet and exercise would work for you - but you've stated you have no intention of doing either AND that you're an alcoholic.  More surgery won't fix that, you'll just learn how to eat around the new surgery and be right back where you are now.  Probably with greater regain.  

Get your brain sorted out.  

Thanks Nik. 

At the end of the day, a DS revision isn't going to work for you.  The DS, like your RNY, malabsorbs some fat and protein, but not carbs. (This is why your ex could eat a high fat diet with his DS.)  The process of carb digestion (and caloric absorption) begins in your mouth.  You eat a carb heavy diet and have repeatedly stressed that high fat/high protein is not pleasurable to you.  So how exactly would the DS benefit you?  Even if you could find a surgeon willing to do this surgery for you (unlikely) AND an insurance company to pay for it (more unlikely), the end result would be pointless.  You are going to eat (and drink) around the point of the surgery.

Side note: have you thought that your inability to get modeling work may be the result of your advancing age and not your pant size?  

Further side note: Excessive alcohol consumption takes a heavy toll on one's appearance.  You may not recognize it, but I'm sure it is noticeable on film. 

You are absolutely correct that regular alcohol consumption is facially noticeable and it's the one factor that might eventually get me to stop or at least reign it in a bit. 

But the flip side is - I work very hard in a crazy high stress field . I wasn't born to this like ( most ) of the people I work with and I'm totally self-made and still striving for breakthrough success. 

It's not a crime to need a little help and daily stress relief. Binging and purging provided that for me for years... and that too shows on your face. 

It's not a crime, but it IS an addiction, and it's still a shame.

I've been going to 12 step rooms Forever originally as a teen to deal with the bulimia and excess food addiction. Overeaters Anonymous, HOW, etc. 

i think I know by now how to define an addict. And I'm an artist which makes me an unusually sensitive soul even among the population that self- medicates whether destructively or not. 

My point is this - some of us use whatever to get through what feels like profoundly uncomfortable threatening constant pressure to push ourselves to the next level of success. For me using whatever less is about normalizing my life and utilizing /seeing /allowing myself to enjoy the beauty and non-caloric non-destructive relaxation alternatives already in front of me. 

On that note I took a skin-scrubbing Jacuzzi bubble bath at 2 Am  rather than having another wine spritzer. 

I expect today to be a tough day emotionally because I'm starting a long-overdue project. There will be brutal negotiations, tricky contract signing, hard physical work probably a very long pressure filled day where I will be beating myself up for not having completed this and benefited from it financially and personally many years ago. I do plan to drink at the end of the day but less ... and to eat more mindfully. 

You're unwilling to give up alcohol AND it's damaging your quality of life.  Sounds like addiction to me.  

You say you're an artist - you're probably also aware that many artists die early due to their vices.  It's your choice to make, but the choices you're making now are keeping you on the path to self-destruction.