Unsure if my weight loss is considered failure for RNY?

I had RNY WLS in June 2008 at 297 lbs. Shortly after surgery, I had stenosis, and my surgeon performed an endoscopic dilation as treatment. After, I went on to lose 112 lbs over 1.5 years at a somewhat slow weight loss pace.

I got really into nutrition and fitness, exercising at least 1-2 hrs a day 6-7 times a week but never got down lower than 185 lbs. I then injured my femur and couldn't keep up with the intense exercise, and my weight went back up to 215 by 4 years post op. I then had some problems with drinking too much alcohol and went up to 240lbs. I got that under control and lost 20lbs from cutting it out of my life.

I have since been sitting at 220lbs for a while and have not been able to get under 200lbs since my initial post op weight loss. I eat a whole foods plant based diet, but I do feel like I have trouble controlling my appetite. It has become such a problem that I have turned to phentermine to help suppress it, and I am worried that I will gain weight if I go off of it.

I am starting to consider seeing a surgeon for revision. So, I guess what I'm wondering is if my maintained weight loss of 77 lbs after 10 years is considered a rny failure considering that I started at 297 lbs? My current BMI is 34.5 and my starting BMI was 46.5.

Weight loss happens in the kitchen not the gym.

If you are not losing the weight you want then you may need to look at what you're consuming. Your surgery hasn't been a failure and you should be able to lose more but it will require some changes.

Are you using a digital scale to weigh what you eat and are you tracking everything that goes into your mouth (with an app like MyFitnessPal)? If you're not doing these things then it could help, assuming your goal is to figure out how to lose more weight.

Can you share what you typically eat each day? This will allow veterans to provide some suggestions on troubleshooting your diet. Take advantage of their experience with regain and getting back on track.

Many of us are most successful with keeping hunger at bay by eating dense protein first followed by non-starchy vegetables and then some fruit, if there is still room. And even more by limiting: snacking, consumption of simple carbs, processed food, desserts, sugar, juice, soda, alcohol.

As I'm sure you know, you can eat around any bariatric surgery and having a revision procedure will not resolve any over-eating or food addiction issues. Have you tried working with a therapist on any of this? Just something to consider as it has helped many folks on OH.

YMMV

I really do not appreciate your snarky and patronizing response. I am fully aware that you cannot outrun a bad diet, and I obviously could not maintain even a 77lb weight loss for years if I was eating crap. As mentioned, I eat a whole foods plant based diet, meaning my meals consist of veggies, fruits, whole grains, legumes, nuts and NO animal products, processed foods, or oils.

I do eat way too much to feel satisfied and it's as if I never had WLS. I can eat a salad of 2 cups of kidney beans, 4 cups of fresh spinach, 1 cup of broccoli, 1 cup of mushrooms, 1 cup of carrots, and 2 oz of tofu and be hungry for more 30 min later. I now power lift heavy weights 4-5x a week, so that likely contributes to my insatiable appetite that I have a hard time controlling. Obviously, I should not be able to eat so much even 10 years post op.

Regardless, I was not asking for nutritional advice, and I really do not care to hear your opinion on my diet. I was simply asking if my weight loss numbers were considered an RNY failure.

There are many posts around regain and revision, so IDK why you are coming for me? Seems like you like to think of yourself as some kind of authority on WLS- maybe YOU should see a therapist? I would think that someone *****sulted to WLS in MX at such a low BMI would have more empathy. I, too, had a swollen head and thought I knew everything about WLS and nutrition as I was riding my weight loss high in the early stages of my post op (it's annoying when someone assumes everything about your WLS journey, isn't it?). I suggest you humble yourself, and I hope that strangers on the internet will be less assuming and more empathetic to you than you were to me if you ever regain and seek help in the future.

in defense of this commenter, I don't feel like her response was snarky at all. She was just trying to help, like we all are. I occasionally see snarky comments around here, but this was not one of them. Maybe she didn't fully understand your situation or what you were asking for, but she wasn't being snarky.

I do not think I'm an unreasonable person, but I personally found the user's original response quite patronizing, snarky, and a little mean spirited with insinuations about my approach to weight loss and lifestyle like saying "You can't expect surgery to be a magic fix for your bad eating" and bolding certain parts of their message.

The user edited out these parts and rewrote their response after I replied to their message.

You're eating a "salad" with about 8 cups of food in it, in one sitting?

I get you are really upset and frustrated because you have a problem losing weight.

But, there is no reason to respond like that to the person that is trying to be helpful. I don't see and snarkiness in her response.

And she explained why she was asking about what are you eating and how much.

Unfortunately, plan based diet would have a lot of carbohydrates. Carbohydrates turn into sugar, and from that point the body does care if you gave it candies or starches.

Eating carbs makes me hungry. Like really hungry. Before I had my WLS I tried many diets. In late 90's plant based diet was supposed to be "the way to good health and weight". It did not worked for me that way. Under a naturopathic doc, I attempted really healthy plant based diet. That included vegetarians for 3-4 months, then vegan for snoanot 3-4 months. They diet -- while was great for my skin, made me gain a lot of weight, instead of losing. In 7-8 months I gained app 50 lbs total. My body made too much insulin and I was gaining, even though I felt hungry most off the time. And I was not cheating, or eating things like French fries, or other "unhealthy" vegan foods.

If what you doing, eating, it not doing what you hope it would do - it may be a time to rethink your approach to the diet. Revising to more malabsorbing type WLS - like DS, or ERNY, while you eat carbs may not help you lose more weight permanetly.

Hi there, thank you for your input and sharing your experience on PB diet and providing your insight on why it might be hindering my weight loss. While I will not be going back to eating meat for personal reasons, this does give me a lot to think about on how I may need to adjust my diet and specifically my carb intake.

In terms of my response to the other commenter, I will share what I said to another user:

I do not think I'm an unreasonable person, but I personally found the user's original response quite patronizing, snarky, and a little mean spirited with insinuations about my approach to weight loss and lifestyle like saying "You can't expect surgery to be a magic fix for your bad eating" and bolding certain parts of their message.

The user edited out these parts and rewrote their response after I replied to that message.

we are good. The problem with internet is we really can't see the non verbal ques that could tell us if the person is genuine or snarky. Sometimes -it may be nice to step back and ... try to be as positive as you can.

And "reading" that person response in a best possible way. I know that when things are not going good for me - I am see others laughs or smiles as an insult. As if they are laughing at me. Making fun of me.

You don't know if she edited the post because your response to her made her realized that took it the wrong way. I don't know that either. but -she changed it - so the message can be viewed as advice an not view as anything but that. Means - she cares.....

Some of us that are still posting and respond to people, most of us - we do that because we genuinely want to help. Either because we understand the struggle, or because we don't want others to struggle.

Some of us may think "I know it, and my way is the best way" Only to wake one day and realize, "Crap, I don't know it anymore". the longer post op I ma the more I get the "O crap.. not again..." things going.
Like now... If you knew my current diet as I am losing weight... you would think I am crazy. I am crazy.

But that just it. We all have our own path. we all have to walk it while we are being watched... and sometimes judged..

Be well.. be yourself. But if the path yo are not does not give yo results you like - consider changing your path.. You never know what can you find on a new way to your own personal goal...

I hope you have a wonderful Christmas... really do... HUGS.

I don't know if we could give you that answer. Each doctor and insurance company has it's own guidelines. Typically any bariatric surgeons first consult or group meeting is free. It never hurts to try. While you feel anxious about the success of what you maintained the person feels anxious about the failure to maintain. Doctors and insurance companies are all different. My surgeon didn't just nip and tuck my revision but completely remade it so I would have a greater success. However at the every same hospital when I had to have a procedure ordered by my surgeon the radiologist was just nasty that any surgeon would even consider a revision. How I want to walk in and say something to that woman. But again it's each persons concept.

I will add that I know NOTHING about nutrition and only what works for me. I do work out and exercise a lot. I wish I could eat like you do! Other than protein. I need a LOT of protein and even moreso when I work out. I would really up my protein while seeking advise on your revision. I think it will help to sustain your appetite and honestly make you feel so good. So not harping on you at all just sharing that when I am low protein I want to eat and I am not as strong in the gym. I have learned to love protein bars and drinks not because I am that kind of person they are just convenient.

Good luck on your road I hope you have much success with it.