Unique Situation

 I recently, I had a friend who had her VSG surgery approx 3 years ago.  She managed to lose all of her excess weight plus a little extra and had her weight exactly where she wanted it.  In the next year she began to gain a few pounds here and there and eventually gained a total of about 20 pounds. She was disappointed and against my judgement decided to have the VSG turned into the DS.  She had Dr. Gagner do the surgery partially based upson the fact that she had always wanted the DS surgery from the beginning it was just her original surgeon who had chose to do the procedure in two parts.  She has had the DS surgery over 5 weeks ago and so far has not lost any additional weight at all.  She eats protein first and is following all the guidelines but still has not lost.  She says she is keeping her caloric intake under 1800.  Has anyone heard of this? I know that most people who have the 2nd stage of the DS still have weight to lose so she is not the norm but we are both confused as to why she is not losing.  Does anyone have any experience or advice for her.  She does not belong to the OH so I said I would post her experience and see if anyone here could help her out or offer any advice.  Thank you for your help.

1)  No weight loss surgery promises 100% EWL.  DS is best, and maintenance is best, on average, but the average is 75% after 15 years.

2) The DS surgery works best when both parts are done together - the two parts seem to act synergistically.

3) Diabetics who are not obese who get just the switch to cure their diabetes tend to lose about 25 lbs, and then gain most of it back.

4) Since she is already fairly low BMI, AND she already has restriction, it is not terribly surprising that she isn't losing much.  Her body is happy where it is.

5) She still may lose some - but she is recovering from surgery and fluid loading.

6) She will likely at least stop gaining, if she keeps the carbs under control, so she should stop worry about getting to some elusive "goal" other than healthy.