3+ years out. Please respond

No offense to pre op or newly post op but I am really hoping to hear from the long timers here. I never considered RNY in the past as it seemed there was way too much research that showed the pouch would eventually stretch, malabsorption eventually stops working very well and hunger returns. However I have now had two surgeries (Lapband) and Sleeve. Its likely I am headed towards a RNY revision do to GERD, a hiatal hernia and non stop severe heartburn since my sleeve surgery. Also my sleeve is dialated and I am wating to learn if my pyloric valve is malfunctioning. I am so worn out from only short term success with my first two procedures that I am pretty scared to try a third one. I also have been away from these forums for quite some time so I am pretty out of date on current RNY procedures and really hoping to hear that there is a fancy new way of doing it that has led to greater success. Any feed back would be appreciated. Mostly Id love to hear if you have continued to find success 3 years or more after your bypass. 

As an aside, I do not think I would be considered for a DS revision even though I know it would make the most sense. My BMI never exceeded 41, ever, and I do not have (nor have I ever had) any of the medical comorbidities. Currently my BMI is 37.

Thank You

I will be 3 years out on October 1st and let me tell you that it is not easy. I've managed to maintain at my current weight of approx. 145 (+/- 5 lbs) for about 2 years now and every single day is a choice to stay on track. 

I excercise a lot (5-6, sometimes 7 days a week) and eat healthy. My pouch has definitely stretched to the point where people who don't know wouldn't suspect I've had surgery. Of course, I can't eat like before but I can eat like a normal or slim 30 year old woman. Some days are bigger pouch days and other days are smaller pouch days. Also, I've had cheat days or cheat meals but that only happened after I knew I could trust myself to get back on track and that it wouldn't affect me - and it hasn't because I much prefer wearing a size 6 pants in the long run! 

My advice to you is if you decide to have another revision, make sure you know that there is no life long solution without effort - you need willpower, you need to make choices and you NEED to put in the effort through exercise, healthy diet and maybe even planning & writing down your food. 

Thank you Nadia. I agree with the hard work. So far I have worked tremendously hard with my first two procedures as neither of them had malabsorption involved so I always had to commit to low calorie and exercise but as soon as my portion sizes snuck back up I always regained. So far I seem to do really well for the first 2-3 years and then I plateau and never reach my goal weight. I was most successful with lapband as it kept my hunger down and helped me to make better choices. My sleeve never stopped the hunger or had much restriction so its been a 4 year battle of non stop effort and gain. I appreciate your feedback!

But the malabsorption wears off after less than a year and then it is all about calorie restriction and exercise. You say that you've had trouble maintaining but the malabsorption doesn't hold you over past those first 9-12 months and you DO feel hunger and cravings. 

That is exactly what I was wondering. If your body just returns to its original state in 1-2 years I am not sure why RNY is a valid surgery for anyone. 

Thank You!

Well it helps you lose the excess weight fast in those first couple months but after that, you're pretty much on the same playing field as with the sleeve! 

I'll give you an example of RNY being valid and one where it's less valid.  

Me:   I had a lapland back in 2008, I never had a BMI over 41-42 either.  Both of my WLS were covered by insurance but both times required a 40 BMI.  The first and second time I needed to gain a little bit in order to push me over and be cleared.  Now the lapland is a terrible demon for most people and over time really doesn't give the best results to many people.  To be clear it does work for some, however it also doesn't work for others, and may even cause harm. So while "shopping" for the best replacement for my band which had to come out due to lack of results over 8 years and erosion I had to decided between the sleeve and RNY.  I choose the sleeve because I did not need to loose a lot of weight quickly, I was not in extreme need of it medically as I also did not have a slew of co-morbids.  So the sleeve seemed like a fine fit.

Sister:   My sister also was "shopping" for WLS at the same time.  This would be her first WLS.  However she had a much higher BMI at 62.  So for her rapid weightless was needed and very important.  RYN's malabsorption is very effective the first 1-2 years.  She has lost 120lbs in the same time I've lost 65lbs, keep in mind though she was about 120lbs more than me and shorter.  

In summary I do think RNY is a very important and valid tool especially for those who are in serious need of dropping a lot of weight quickly.  Now you do have to balance that with, it's a much more extensive surgery and in my sister's case she's lost her weight just as prescribed but is also next week going in to have her gallbladder out which is typical of anyone who has rapid weight loss.  

Personal opinion here but your kinda in the same boat as me, more or less a lightweight in the category of WLS patients.  I think you've done about what I've done as far as WLS as well.  I do think the sleeve can be very effective, however unlike me you have Gerd and that I hear is awful.  My understanding is RNY can help with that, but my advice is not to do a third surgery because you think it might be more effective but because your Gerd is out of control.  I can tell you that my sister eat very similarly to me as far as how much and what types of foods we can eat.  So if you have any ideas about going to RNY because it'll help push towards weight loss maybe rethink that because it may not happen.   

What surgery does is give you a chance to get to a normal BMI and be on the same playing field as those who are not suffering from the disease of obesity.

Only a lifetime of diet and exercise will keep you from finding the lost weight after malabsorption ends.

There is no new RNY.  It still gives malabsorption for a while and then your body gets smart and starts absorbing calories again. 

I never had lapband but understand that it gives a lot of restriction.  The sleeve and RNY do not give restriction for more than about six months.  After that it is up to you to restrict calories, even though you will usually be able to eat pretty much like a normal person.

I count calories, weigh, measure and track my food and weigh myself daily. 

I hope your revision relieves the GERD and heartburn. 

Thank You, every bit of feedback from those of you who have been here already is much appreciated!

On Sept 18th I will be 13 or 14 years out. I forget. I am at goal and to this day I am not hungry. From the very very beginning if I thought I was hungry I told myself my body needs fluids. There are things I can not eat such as ice cream, waffles, greasy food or rich tasting food. I have to remember to eat so for me that never came back. My ' secret' is portion control. I eat what I want but I know I can eat so little I try eat what my body needs .