Revision and weight loss progress

Can someone give precise medical reasons they say weight comes off slower with a revision than with your original surgery? I forgot to ask my surgeon but keep seeing people say that so much. Is it because the starting weight tends to be lower than originally? Just curious. Thanks!

 

I have always heard that, too, but my experience was that I lost weight faster, and more weight lost, with a revision then the original WLS.  I also ate better after my revision, which is why I think I lost the weight.  After my first WLS I didn't make any changes in what I ate and with the revision I cut out refined carbs, sugar and gluten.  For me, that has more to do with the rate of loss then being a revision.

When they say you are going to lose slower, they don't mean slower than your first surgery.  They are saying you will lose slower than a virgin surgery of the same type.

I'm band to sleeve and in six months lost the regain and 30 pounds more than I did in 3.5 years with the band.  When I check in on FB with all the other virgin sleevers from our Jan group, they have lost 10 to 80 pounds more than me.  The average virgin has lost 30 pounds more than me in the same time period.  That said I have lost more/faster with the sleeve than the band.

I don't know if there is a medical reason, like you have already gone thru a major weight loss and maybe a weight regain.  I would say yes, you are starting at a lower weight than before could be a factor.  Another reason that others have given is, now that your have "failed once again" and at a WLS that you were sure was going to be the help you need to make it forever, it is hard to keep you head in the game.  I know mentally it has been way different this time around.

Good luck to you with your revision.

 

Hi,

I can not give you and medical reasons. I think it is individual. How much you have to lose, the original surgery and what you are revising to...tons of other factors. I revised from RNY to DS and my weight loss has not been slow. I lost 50 pounds in the first 12 weeks then another 35 over the next 4. It has slowed down quite a bit but I am ok with that I only have another 8 to reach my personal goal. If I reach it fine but if not that's ok too. 

Best,

Whitney

 

Thank you all for your replies. I get how many factors can affect it. I appreciate all the info!

I think LadyTazz hit on something about being aware of the mistakes we made the first time around.  I'm 3 weeks post-op with a RNY revision and I'm feeling great.  I've lost about 13 lbs. since my surgery and have been exercising regularly and sticking to the liquid diet while keeping track of calories, carbs, sodium and protein. 

I asked my surgeon about this trend during my last visit and he explained that our bodies experienced more of a shock with the first WLS whereas our bodies already adapted to lower food intake by the time of the revision. 

I think a part of the slower losers is they really screw up our metabolism with the band. We live on a diet literally for years. Now you eat more normal (after you heal of course). I lost pretty close to normal.
teri

I think it is because our bodies are used to the lower calorie diet. For instance when I had my first band placed I lost all the weight I would lose with the band 80 pounds within the first 6 months then I did not lose again until I revised to the sleeve. My body was used to a 600 - 800 calorie diet(it thought it was starving). Now I take in around 700-1000 calorie diet and I am losing weight. Go figure.

My surgeon thinks it's partly behavioral and partly related to hormonal changes that occur. He is at a research center, and this is one of their areas of interest. He proposes that because of the initial changes in ghrelin and other hormones with the first surgery, there is not as pronounced of a change with the next surgery (the "not virgin territory" thing.) I don't presume to understand all the hormonal mechanisms, but the gestalt makes sense to me. He also feels that being obese to begin with (although no one will argue there's a strong behavioral issue) might also be related to abnormal levels of the hormones that drive hunger and satiety.

That being said, I had a VBG almost 30 years before my RnY. Although I have not lost as fast as I want to, I've lost significantly more than I ever did with my VBG, and at a much older age, and I am confident I can get to the surgeon's goal, and hopefully to my goal, which is 20# lower. So, in my case, I attribute greater weight loss to the malabsorptive component to the RnY, and to being more careful with my diet as well. The VBG was much like a band with a pouch, but no malabsorption. I'm SO happy with the RnY, my only regret is not doing it sooner!

Dolores, thanks for your input. Your surgeon sounds like he may be on the right track. I have been getting a lot of slack about even thinking about revising to RNY from VSG. I, too, feel like the malabsorption would be beneficial to me. It gives you a longer time to really get a hold of your eating habits before that part wears off. And having already a small stomach, I wouldn't have a pouch that can stretch as much as would've been possible had I not had the vsg. It's nice to hear someone else happy with the RNY and not judging me because of it. I just feel like I need a little more help than what I had with vsg. Thanks again and good luck to you!!