Revision Guidance

Hi, I had RNY in 2014. Highest weight was about 240. Got down to 150. I am now able to eat much more and I have been gaining over the past 2 years. I'm up to 195 and freaking out. I have seen my original surgeon about this twice. Both times he had me get imaging done and said it was normal. He wants me to come to the office and eat in front of him. That would be fine, but I know that will make me anxious and zap my appetite. I went to another doctor who doesn't accept insurance and he recommended overstitch. It's ~$6,000 though, and I don't think I can come up with that amount in the near future. Does anyone have any recommendations about how I can get some sort of revision approved by a doctor who accepts insurance?? My insurance is Cigna BTW.

First off the overstitch or ROSE procedure or what every they are calling it is a waste. You get maybe 20-30lbs weight loss, but then gain that back. Cigna (as I have them) does not cover procedures like that as they are still considered experimental. Plus they can be a ***** to get an approval for a revision.

Weight gain really comes down to what and how much you are eating. What does your daily menu look like? Are you measuring/weighing what you eat? Are you eating carbs or dense protein? How much water/liquids are you drinking? Are you drinking with your meals or right after?

There are some on here who have gained and were able to lose it again just by eating the correct foods and amounts.

Almost everyone gains back 20 pounds during year three. About 50% regain 50 pounds by year five.

The body becomes much more efficient at absorbing calories. So the only way to lose the weight is by eating less and moving more. Revisions only work if you eat less and move more.

I accept the fact that I will be on a diet for the rest of my life. There is no maintenance phase. If I slack off, I gain weight.

Get yourself a smart scale. It will tell you your weight, body fat, BMI, muscle weight, and water weight. Be aware of all of those measurements. Weigh****chers is an excellent place to start your weight loss process. Their points system will show you how to lose weight without having to eliminate any foods.

Look up "pouch rules for dummies". I have used this list of rules for 15 years. I have gained then lost about 15 lbs through the years. If you are eating toomuch, what happens is you stretch the stoma, the surgical opening connecting your pouch to your small intestines. Then you have your small intestines available to pack full, since food slides through the pouch easily.

I'm not trying to be mean, just explaining the situation if we overeat. So eating any kind of meat, and then veggies only is the first part of the plan. Don't drink with meals or immediately after. No excuses. No carbs, no fruit, no sugar, no sodas, no milk, no shakes, no dry peas or beans. No carbs, cereal, bread, rolls, rice, crackers, noodles, ice cream.

If you must have fruit, eat only apples and pears with the peels on, they take longer to digest. Eat them in small quantities after eating meat.

Eat very small meals. Eat out of a saucer. Eat snacks like an ounce of cheese and 2 tablespoons of almonds. Deli turkey rolled around firm cheese. Check out some Lean Cuisine, some are 160 calories or 180 with about 10-16 carbs. These are for maybe 4 times a week to break things up. Eat eggs with tuna and light mayo. Grilled chicken ground beef, or steak with low carb veggies. Just eat the meat first. Only use about 4-5 ounces of meat or chicken. Fish is excellent because of no carbs.

Plan your meals and snacks by the week. Check specials at the grocery store so you can afford to eat the way you need to eat. If you have family living with you, prepare them the same meals, just larger portions if they don't have any weight problems, and add just enough carbs for their serving. do not over cook meals unless you can resist and refrigerate for your lunch tomorrow. I am thankful my husband was very considerate when I stopped buying and cooking sweets. I also kept chips and snack crackers out of the house.

I hope this is helpful. If I can help you in any way, please ask. Maybe I missed something but can't think of it right now.

Best wishes.

Excellent advice and a much needed reminder!!!