Regain

I have heard a lot about regain and that it happens to a large percent of people after WLS. So, when does this normally start? Anyway to get in front of it? What should I keep an eye out for?

Thank you,

Liz

Regain is a big problem for people who have restrictive only procedures like the crap band and the sleeve. Next is the RNY because in a standard procedure, not much is bypassed and around the 2 year mark the body has adapted and many start to put on weight.

I worked in an office full of fat women and 15 years ago, 10 of us had WLS. 1 band, 1DS(me), and 8 RNY. Fast forward 15 years and 1 RNY, and 1 DS still look pretty normal. The band person never lost anything and the other 7 RNY people all weigh more now that they did when they had surgery.

Be glad you had the DS. There is nothing out there that works better. Some people are really lucky and they can eat protein plus whatever for life. Don't count on that being you! The best maintenance plan I ever saw was written up by woman on this site. Her name was Carolyn. I haven't seen her here for years.

She weighed every day and if she was over her magic number for 3 days in a row, NO carbs till the gain was gone. The whole idea was to never let the regain get out of hand. Catch it right away. Deal with it right away. Once you declare yourself at goal, pick your magic number and go from there.

Some people get a longer free ride than others. Right now you are about 2 years post so you may have time left in your window. Can't say for sure.

Thanks Patty,

My Aunt had the sleeve 11 years ago and does the same thing. She weighs herself every week, same day and same time, if she's over her magic number she gets back on track. I'm about 15 pounds down from my WLD goal but 3 lbs over my GP goal (he keeps changing it...) and I feel great where I'm at right now. I still log everything I eat and will up through year three, I think that will help give me an idea of what my body needs and can handle. I think if I can get that last 3 pounds off and then work on maintence with my "magic number".

Thanks again,

Liz

Liz - as Patty said, alot depends on the type of surgery. Agreed I've known a number of VSG'ers who have regained. Some RNY'ers as well. I don't really know any DS'ers who have had massive regain (a few pounds but nothing extraordinary).

I know that for me personally the DS keeps me from regain. I'm still within my goal weight and I'm 15+ years post-op. Of course the main culprit is always carbs. I do weigh myself (at least once a week) but I can definitely tell by my clothes. Carbs are what I use to gain or lose weight. If I notice I've put on a few pounds (I'm talking about 5 or so and that can happen within days depending on what I'm eating) I simply eliminate some of the extra carbs that have crept into my diet and the extra pounds seem to disappear.

Try not to stress about retain. Just stay true to yourself and how you've learned to eat to accommodate your DS (high protein, moderate carbs, lots of water, all your vitamins). If you notice a few extra pounds (whatever is comfortable for you), adjust your carb intake and see what happens.

Really, you can eat around any WLS surgery. The DS has the lowest level of regain but nothing is perfect. While I'm not sure I believe it there seems to be a honeymoon period for the DS going from 1 to 2 years. Personally, I think people get close to their goals (weight, exercise, travel, whatever) and slack off a bit as opposed to something happening physically. While there is some information that your absorption might get more efficient over time it seems to be such a small percent that it shouldn't make much of a difference.

At 5.5 years out I can definitely see that regain is a possibility. I have a roughly 10lb spread (used to be centered around 230 but lately around 220 -yay) that I use as an indicator.For me it's old habits and less exercise that can put me on the regain train. Fortunately, if I go back to eating to the strengths of my DS I eventually lose the extra but I'm very careful not to let it get out of that range. Weekly weigh ins for me.

Tracking for me is key. I use MFP, not for the calorie count, but as a protein /hydration tracker and just the diary function. I have a great capacity to understate what I eat and logging keeps me aware. I fins the calorie count interesting but it is never a real focus.

Pete

The average range of regain is 15-25%, and it starts around years 3-4. To get ahead of it, lose as much as possible the first year or so, leaving some wiggle room, so to speak. I regained 14% and maintain that pretty effortlessly. I could probably fight it back down, but I really am done with the extreme dieting life and I can be content where I am.

Your question about regain refers to all WLS's not just duodenal switch, is that right? The long term efficacy is best for DS, then RNY, then sleeve and finally the band. [A new procedure is claiming to be a DS, but it is different and may be less effective over time. Be sure and ask the surgeon about whether you are getting a traditional (Hess) duodenal switch or not.]

I had the tried and true DS 13.5 years ago and went from nearly 300 pounds to a low of 135. My surgeon wanted me closer to 150, and 147 is where I am now. A bump to 161 happened at year 10, during a stressful time, but easily went down to 150 again when I decided to. In my family, there are two other WLS veterans, sleeve and RNY. Both are near their original weight at 5 and 9 years out. Some people have success with each procedure, but based on these experiences, I know I didn't work as hard as they did at weight loss or attempts to maintain.

Research. In my experience, the most knowledgeable patients get the DS.

I'm currently 20 months out of a true DS and I've gone from 398 to 157 (just hanging here for the last month...) trying to get down to 150, my Surgeon goal was 175, I hit that a few months ago but have kinda stalled since them. I'm still eating on program, weighting everything I ea****ching carbs, drinking my water, walking 5 miles a day, plu****ting the gym 3 times or more a week. Hopefully the scale will move soon...

I was mostly asking for when I'm past the two year mark. I was told that's when you really have to be careful with what you eat and it's actually harder to lose once you pass 3 years. So just doing more research for the next chapter.

Liz

Congrats on doing so well! It's the carbs and sugar that will get you. I am never hungry because I can eat whenever I want. It's just eating what I crave that is the problem. I can eat freely and frequently, as long as I keep sugar and white carbs in small portions and not with every meal.

15-25% of regain is specific to DS long-term. For the other procedures, they consider them successful if you manage to keep 50% of your weight off.