Lapband...Than Gastric Bypass?

I had the lapband put it, and in one year lost 100 pounds...and in another 2 years gained the entire 100 pounds back...I Have absolutely no restriction...i feel as if I dont even have  a band...I am done with all the Clearences and waiting for insurance to approve the removal of my lapband and to have the gastric bypass procedure...has this happened to anyone else??

Im super excited about getting gastric by-pass, and in a way starting over...the doctor who placed the lapband, wont even give me the time to talk to me, last time he did he yelled at me...my current doctor(Dr Cussati) has been amazing...and his support team couldnt have been better, he actually said the post-op consist of meeting with his staff once a month after surgery...my last doctor only wanted to see me every 6 months!!!! which was insane!! so I feel this second time around is going to be so much better...

Hind sight is 20/20 so I offer you some advice.  I failed every diet.  I failed RNY.  I failed the Restore procedure.  The past 4 years have been the most shameful and humiliating experience of my life.  I wouldn't wish my experience on anyone.  20% of RNYs fail and in the end the patent's character and weakness is blamed. However, RNYs are not all equal and you need to have the most appropriate RNY for yourself to make sure this time you are successful.  Some RNY pouches are 1/2 to 3 oz.  a huge difference!  Some bypasses are 40cm to 250 cm long...again a huge difference!  The stoma can be made with different techniques.  They can be made with different size "punches".  They can be put in different locations.  I keep requesting OH to do some research and find out how surgeons decide what to do.  I hear bits and pieces from other people over the years  I know I had a 2 oz pouch, 25mm stoma hole punch and a 70 cm bypass.  I never had limitations, restrictions, never dumped or vomited from eating too fast or too much.  I never have felt fullness since 2 weeks before surgery when I started a liquid diet.  I know that my RNY was not appropriate for me.  My guess is that some of the other failures have inappropriate RNYs as well.  The Restore trial was stopped early because of poor results and the Rose procedure took it's place.  PLEASE ask your surgeon what he is going to do and why he is choosing to do what he is going to do. You need to have a positive experience this time.  I know you want to be on the losers bench and you need the best chance to get there.  You deserve to be on the loser's bench.  Sincerely, Daisy

Hi Daisy,
I just wanted to comment and say that I agree with you that any WLS patient needs to be very well informed about the procedure that they are having, as well as all the specifics, but everyone is a different individual and no two people will have the same result. You mention your specific surgery as well as the size of your pouch and stoma and your revisions, BUT how is it possible for you to not lose weight if you are eating the right foods, in the right portions, as well as exersicing, I can clearly hear your frustration from your posting, but you never mention the role that you play in your unsuccessful weight loss, I find it very hard to believe that you are doing all the right eating and exercising and still not losing weight.  Are you doing any counseling to help you deal with your issues with food? Surgery is only one of the many tools a person needs to lose weight, it should never be viewed as a fix for whats broken and that is issues with food. All of us here are in the same boat, we wouldn't be were we are if we didn't have a problem with food. I feel very sad for you that you have had to go through so much surgery and still be as frustrated as you are and not losing the weight that you so badly want to lose. Sometimes its hard for us to be honest with ourselves!!!! I wish you luck in the future as you attempt to reach your weight lose goals!!!

Hi Karen

If I could ALWAYS eat the right food and the right amount I would lose weight.  That is why people have bariatric surgery.  We are looking for a tool to decrease our appetite.  We count on dumping syndrome to not allow us to make the wrong food choices.  That is why people have bariatric surgery. 

I suspect that "feel full" hormones are released sooner after a longer bypass because some of them are released as food reaches certain locations in the gut.  So a 250 cm bypass will feel satiety sooner than a 40 cm bypass.  The longer the bypass the more malabsorption of calories and nutrients.  I have still had normal labs and some high without supplements.  A GI doctor told me my bypass is not less than 70 cm.  I didn't receive that part of the "tool". 

The 1/2 cm pouch will be stretched and feel full with less food than a 3 cm pouch.  People vomit when they eat too fast or eat too much.  I never vomited or dumped.  I didn't receive that "tool". 

I also have basically no stoma.  My stoma was made with the largest stoma hole punch.  I followed the diet I was given.  I have kept food journals for years before and after surgery.  I didn't deviate from the plan for months.  One day I ate a whole NY strip stead I had cooked for my husband and expected to get nauseous or vomit but nothing happened I felt fine.  That is when I asked and found out I had a 2 oz pouch to start with.  I had my stoma made with the largest size stoma hole punch.  Food just slides right from my mouth into my intestines.  Think of a normal stoma as the small end of a tube of toothpaste and mine as the other end of a small tube of toothpaste cut off.  Food just slides on through.  They say that constant overeating will stretch the stoma.  I think the stoma is too big and then we overeat because nothing stops us.  I have 5 close friends that had RNYs.  When they eat too much they vomit...over and over again since they had their surgeries.  Their pouches have not stretched.  Their stomas have not stretched.  People have to have their stomas surgically stretched larger when they have too small a stoma. They can't just eat more.  

I am very honest with myself and the calories I ate before surgery and now.  I do not have eating "disorders".  I have attended Weigh****chers meetings most of my life.  I am a lifetime member.  I lost 110 lbs. over 15 years before surgery.  I practice the behavioral tools they teach.  I met with a psychologist before my RNY and as part of the Restore Trial.  I am grateful I don't vomit and dump.  I don't eat much junk food.  I enjoy a large variety of food.  I would really find it helpful to feel satiety though.  I would like to not feel hungry most of the time.  My short bypass has helped my blood sugars I think.  I am very grateful for that.  I do exercise at a wonderful health club almost every day.  I even have completed triathlons and can run a 5K.  They are for good causes and a lot of fun.  It would be so much easier to exercise if I could weigh less.  I am grateful I am 185 lbs. rather than 276 lbs. like I was 20 years ago.  I guess I just counted too much on the RNY to help me.  If I had known I was getting a 2 oz pouch, large stoma and short bypass I would have asked for a more invasive surgery.  With my highest weight, family history, PCOS, and diabetes I was depending on my surgeon to do the most he could do to help me.  I thought all RNYs are the same...1 oz pouch, 150 cm bypass and all the same size stoma.  They are not and that is why, I think, we have different results.  I hope I get to my "overweight" goal too.  I am pretty sure I can.  I could maintain 165 lbs before surgery for years.  I just have to get used to not feeling like I have eaten anything.  I had hoped that the RNY would have given me the extra help I needed to get to a normal BMI but I am adjusting to the fact that will probably never happen.  Not what I planned on 4 years ago but I have adjusted. 

I hope your lap band is serving you well.  Are you having it removed now that you have worked through your issues with food?  It sounds like you don't need the physical limitations of the tool anymore. 

Glad everything has worked so well for you.

Sincerely, Daisy

Weight loss surgery is just a tool. Only 30% of WLS patients have dumping, no matter their pouch size, stoma size, limb length or type of surgery.

Honestly, unless you make the changes you need to make, there is no weight loss surgery that will work for you. Not band, not RNY, not VSG, not DS.

Medical studies and statistics do not bear out that a difference in limb length or pouch size has truly anything to do with success. Not distal or proximal. The ONLY thing that guarantees auccess with any weight loss surgery is to change your eating habits totally, for the rest of your life.

Unless you can stop making so many excuses why you are not in control of your eating and your future, it won't matter what surgery you pick. People can be successful even with larger pouches, and it is normal for increase in pouch size and stoma size over time. It happens to everyone. That's why the total life change is necessary.

I have not felt "full" since my surgery. I think we need to rethink what "full" is. Thin people do not eat till full. They eat what they need and then stop. There are ways of dealing with the hunger too. Don't eat carbs, eat dense protein.

I know I'm being a little rough, but I see an entire post that basically is not taking any responsibility whatsoever for why you haven't been successful. The best thing you might be able to do is get some counseling. And be really honest with yourself. If you were doing everything right, you would be losing. With or without WLS.

There has to come a time when you really look deep within, realize this is just a tool, and take the bull by the horns and decide to change, for your health and for your future. Until you can stop the victim mentality, it's going to be impossible to be successful at this. The most telling comment in your post was your first sentence, that if you could diet, you wouldn't have needed WLS. It's not magic. It's really really hard work. For the rest of your life.

For the people who are keeping the weight off, it's tremendously difficult. It involves constant vigilance, constant hard work, denying the things you used to eat, and the realization that you have to change. It's really hard. But unless you make a conscious decision to do it, and not blame a surgeon, or obscure things like pouch or stoma size, it's just not going to work.

Sounds like you've already given up, and want to blame the surgery. This can work for you, but you have to decide you really want it to. You say you overeat because nothing stops you? You have to stop you.

I know that's hard to hear.

I too had the lap band first-- Feel free to read my blog in the beginning about the Lap Band issue.  I didn't get a chance for mine to work or not work--it flipped, got infected and stayed infected for 9 months--I got it out then gained an extra 60lbs due to giving up, depression, etc.   I got the RNY 4 1/2 months ago and I love it!  I did so much research on the lap band- but in the end it was a mistake to put a divice in my body that can break-move- etc.    I have lost 70 lbs so far- I have restriction on food-and pace that I eat.  I have a 3-4 oz pouch and I am not sure how much intestine they bypassed--but not a whole lot.   I have met several people who had the RNY and "regained" though most haven't gotten back to their original weight.  I think the long term success is based (not totally) on maintaining a balenced diet, portion control, and watching the sneaky calaries--like drinks, booze, etc.  My mom had the intestinal bypass in the 70's (sort of the first DS surgery) and has fluctuated 20 lbs up or down in the last 30 years--when she gets up to 150 she cuts out some of the junk food-etc and she goes back down to 140-135.  

I wish you well! If you did it once you can do it again!

Did your surgeon make a 3 to 4 oz pouch? Or can you eat 3 to 4 oz after he made a 1 oz pouch. I just read your blog and you said you vomit occasionally. From those I have talked to with larger pouches one thing nice or bad about the larger pouch is that we don't vomit. So my guess is that you can eat 3 to 4 oz. but he actually made a smaller pouch. My 2 oz pouch allowed me to easily eat 3 oz. of food 2 days after surgery in the hospital when it was still swollen. Shortly afterward I was upped to 1/2 cup of food and then 1 cup of food. I have never heard of a 3 1/2 oz pouch. The largest I have heard of is a 3 oz pouch. Next time you go to your surgeon could you ask what your pouch size was and bypass was and what size tool he used to make your stoma? I am really interested in a how to make a less invasive RNY surgery work. What is his plan for a long term diet? Is he expecting you to get to a normal BMI? I don't eat much junk and yet I end up with 1800 calories almost daily...just from healthy food. I can struggle down to 1400 calories but not for long. That is why I weigh 185 lbs. rather than 300 lbs. like 20 years ago or 145 lbs which would be my normal BMI. If it were just a matter of not eating or drinking junk food I could do that. I can't even remember the last time I ate a candy bar or a potato chip or a Big Mac or a real full fat ice cream or a piece of real cake with real frosting. I make "diet and healthy" recipes with veggies and whole wheat flower and sugar substitute in my bakery. I buy low fat and low sugar everything. I would really appreciate the general outline of your doctor's general diet. The diet I received 4 years ago is 1200 calories and simply not enough food for me... I am climbing the walls after 1 day. When I add a few more oz. of meat and a couple of fruits or milks or starches there I am at 1800 calories not 3000 but still too much. I plan on reading your blog as soon as I send this. I am really interested how you make a less invasive RNY like I have work. I really want to find a way to get by with 1600 calories. It sounds so simple but I have trouble doing that for a long time. Those 1800 calorie days just slip back in. I am looking forward to hearing from you and getting your advice. I keep searching for someone with my kind of surgery that is making it work. Daisy

One other quick question: If you want to lose weight, why are you eating 1800 calories a day? I don't know any WLS patient who would lose on that. That's your answer right there. I'm on 1200 for maintenance, and most people I knew kept there calories under 1,000 for weight loss - probably around 800. Doesn't matter what kind of food it is. If you eat 1800 calories a day, you're not going to lose weight. You say, 1200 is not enough for you. Do you not think other WLS patients are hungry? Or that's it's hard to keep under 1,000 calories? They don't have some magic surgery that makes it easy for them. I know I'm being a little rough on you, and I'm sorry for that. I just think someone needs to say it. There is no WLS that makes this journey easy.

It's going to have to be a choice you make, a heartfelt from the bottom of your heart and soul decision to deal with the loss of food and what it means to you. A lot of us are hungry, and a lot of the time. It's a fallacy to think that there is any WLS that cures that, except perhaps DS because they truly can eat more. But for any RNY patient far out from surgery, hunger is just a given.

What was your pouch size? How much were you bypassed? What size stoma hole punch did your surgeon use? Have you ever dumped? Have you ever gotten sick from eating too much or too fast? Daisy

I never asked because there was no reason to. There is no difference in results based on length bypassed, hole punched or pouch size. Your success is based on you. If you have a RNY, and you work it, you will be successful. I don't eat too much because I follow the doctors recommendations. Same thing with eating too fast. If you do the wrong thing with any surgery, you will get sick.