So I was watching My 600 lb life-Where are they now episodes.  In this follow up for Pauline, Dr. Nosaradan [Sic] is correcting Pauline as she didnt lose the expected amount of weight.  He tells her the surgery only has an "effect" for 5 years.

I find this to in direct contrast to my experience (i.e. about 1-1.5 years. I can now gain if I try or eat simple carbs (then I dont have to try at all)).

I have heard others talk about the year 3 weight gain.

I wonder if this 5 year effect is his experience or a study.

Your thoughts?

never heard anything about a time limit-

My real "honeymoon" was 2+ years.  After that I started gaining. Not a lot at first...But eventually I found myself app 25 lbs above my goal. But year 5 was when I turned things around. Realized that my tool still works- I just need to start using it again.  And go back on a diet.  

Yes - a diet... Hated word.  I lost close to 20 lbs... And maintained that within 5-7 lbs for a couple of years. In last 6 months I decided I want to get back to my real goal. Lost app 10 lbs. 2 more to go..  The last 2 is hard. Really hard.. 

I don't know that it's a loss of effectiveness regarding surgery, but rather a resurgence of habits.  I'm just 11 months out, and I already notice how easy it is to slip into habits when I'm not vigilant or diligent.  It could also be that it's more comfortable to eat in general the further out you are from any stomach resectioning procedures, even normal gastrectomies done for non-weight loss.  It could also be the body's adaption to off-setting the malabsorption and restriction, too.  It could be many reasons, all of which might just be correlations.  The body and mind are tenacious in going back to the way they were before an event, though.

One of the reasons the DS works so well for us SMO people that many physicians and counselors have told me, is that we who are SMO have the hardest time changing our eating habits, and the powerful malabsorption offsets poor choices, somewhat.  Of course, that's a complex issue too, and is like attributable to several factors, as well.

Behavior is a powerful factor, though.  Being a counselor myself I'm biased. ;)  However, I do think that you can even have the DS and regain with poor choices - as people do, who just eat too many complex carbs.

English is not Dr. Now's first language and sometimes it is confusing when he expresses an opinion.

I think he meant if you haven't gotten with the program in five years, you are never going to do it.

I think you may be right. By 3 years many of my friends had regains. By year 5, some of them had gotten back on track, but others gained much more at that point.

Back in 2007 I read a statement that 50% of RNY'ers had regained 50% of their lost weight by year 5.  So if they lost 100 pounds, they had gained 50 back.

By year seven even more weight was regained and by year 10 it was not uncommon to see a 75 pound regain in the people who had large regains.  People 10 years out at that time would have had surgery in 1997 or before.

There was no follow-up nutrition care or psychological care then.  I have a friend who had surgery in the late 1990's.  He was in the Cleveland Clinic for 30 days following his open RNY.  Afterwards he lost weight rapidly, but also muscle mass and stamina.  He went from 350 pounds down to 180.  He looked terrible and was always sick. 

Most people who knew him were terrified of RNY.  When they saw how easy it was for me and how much better I looked and felt, some of the people who knew both of us ended up having RNY and being quite successful.

As you already know, regain is a constant threat and must be dealt with.

I agree!

Dr. Younan Nowzaradan, from Iran living in America since the 1970's.  I googled him curious and thankful his calling turned out to do what most surgeons wouldn't do for anything.  His statements probably come from years of observation.  In the little town of Park Rapids, Minnesota, Dr. Dan Smith was willing to operate on my SSMO body. One of the best things said to me was, "you are at high risk for regain."  I owe many people to control that risk.  (Edited to add for those curious to know:  at 3 1/2 years out, I  have regained 15 of a 200+ pound loss.) 

I just saw my surgeon and expressed my concerns about regain.  He told me that sugar is the real enemy and that I need to focus on not having simple carbohydrates (complex carbs are OK) and watch the sugar content of items.  I plan to continue to focus on protein and really watch the sugar. I am very afraid of regain, but plan to do all that I can to prevent it.