At What Point is Revision Medically Appropriate?

I had RNY surgery in 2006, and my weight plumeted from about 350 to 150 in a year.

I was thrilled.  Weight and health have been pretty stable overall, except for a slow, gradual creep towards 170 (and  beyond, I fear).  My malabsorption seems to be great, but I have hit two snags.

First, I now seem to be able to eat about as much as I'd like, volume-wise (a change).  Second, I had to switch from high-protein and low-carb (which was pretty high fat) to high-protein, moderate carb, because any fat I eat winds right up in the toilet, and I don't even want to talk about how terribly that impacted my life.  The least amount of carbs cause me to gain, but it's hard to ingest that much lower-fat protein nto accommodate the reduced fat, so I wind up consuming the difference in carbs.  Let's just say, I'm not interested in adding any more malabsorption to my situation.  Right now, I'm into reducing my dietary fat because the consequences of fat malabsorption are pretty hideous.

At my most recent surgeon's visit five months ago, the doctor noted that it might be appropriate to start thinking about some kind of revision, but he wasn't specific about what.  I'm wondering about some kind of band-over-bypass, because I'm not willing to go with greater malabsorption, and my bigger problem seems to be volume, right now.

Any thoughts or suggestions?  

Mostly I'd like to know at what point, BMI-wise, it's legitimate to start thinking about revision.

Whether or not your insurance will cover a revision depends on your policy. Mine was considered medically necessary but my insurance does not cover WLS.

I'm not concerned about insurance approval, at this point.  I'm asking myself, at what point is revision surgery realistic, at any cost?

If my BMI is not (yet) 30 -- is it a mistake to pursue revision?

Wondering.

I think your post may not get many responses, since to me it is confusing.....  You want to eat low fat, which is NOT difficult on a low carb diet, you just have to pick your protein and low carb vegetables.  Picking lower fat proteins, like primarily fish with no added fats or chicken breast with not added fats, you would have no issue with low fat, higher % protein, and low carb veges.  Everyone gains with carbs, it isthe amount that is different for everyone.  If the dr noted that it may be appropriate for a revision there must be something esle going on with a bmi of 30.  BMI plays into when to get a revision, but it is not the most important reason....as there are people (of which I know personally and are on OH) that revise with a BMI of 19 or lower.   good luck with your journey.....

People revise with a BMI of 19 or lower?  

Is t his true?  It's not for weight loss, I would imagine -- is it?  Is it for some other reason?

 DId your doc give you a reason for the need for revision? Can you just control your eating habits or is there something else going on? What is medically appropriate is completely up to you, your doctor, and in the end the insurance company. You had the surgery 5 years ago so it is completely normal for the volume of food you eat be the same or more before you had surgery. My insurance company would not look at a revision with a BMI so low if there was no medical reason like obstructed bowels or a medical need such as that. Like Airbender said your post is somewhat confusing. Are you interested in a revision bc of the weight gain or do you have some sort of medical problem going on? 

I recently had a revision and my weight was 154 at the time of my revision.  I had gained approximately 6 to 7 pounds and I was freaking out big time.  Also, I was having stomach pains and when my surgeon went in to explore he found out my bowels were obstructed.  So he fixed my bowels and did the revision at the same time.  My weight loss stalled quickly, but I reached my goal within a couple of weeks.  My current weight is 132 and I am very satisfied.

Good luck.
Sherline