3+ years out. Please respond

This is pretty dangerous misinformation in terms of the nutrient deficiencies being 'overblown'. If you can't manage to take your vitamin supplements then you should not get RNY done. Period. Getting labs done and tracking your personal trends is extremely important and I haven't been told this only by the 'online RNY community' but also by my bariatric surgeon, my Neurologist, my PCP, my therapist (who specializes in bariatric patients) and my Oncologist.

Do you have your MD?

Thank You Brian, I appreciate you responding. Its been almost 8 years and 2 surgeries and its hard to believe I am still almost the same weight as when i started. I did the best with my lapband losing 75lbs total but I never made it to goal weight. Then, after regaining almost all of the weight in about 15 months I barely lost 40 with the VSG and again never made it to goal. If not for my current health issues I wouldnt be considering a revision because just like you said, every time I regain I go through awful body image issues/ sadness. Even more defeating is when the regain comes at the cost of major diet and exercise that just isnt working (luckily it delays the gain but nothing is more defeating that eating small portions, watching calories, vigorously exercising and still gaining) 

Thanks again

I'll address the online technical squabbles further down.  But the most important thing, by far, Sarah, is that you forgive yourself.  You've done the very best you could in each instance, with what in reality is an incredibly difficult physical disease process, and against a culture of ignorance and toxic judgmentalism that exists in both the public and medical spheres.  Give yourself credit for all your immense efforts.  Don't give up.  Keep forging ahead.  Move on to the next challenge.  I promise you will get there!

Now, for those of you clutching your pearls and crying out for a safe space to group soothe...  Yes, it is a 100% myth that caloric malabsorption plays a real role in the weight loss mechanism of proximal RNY surgery.  Below is just a small sample of peer-reviewed, quality research establishing this fact (for some time now).  And if that's not enough to scare you, here is another "well-known fact" also disproven by research (that your family doctor has wrong).  It is a actually myth that clinical depression is caused by a chemical imbalance of serotonin (or norepinephrine or dopamine).

(1)  ''The traditional view that gastric bypass and bariatric surgery in general works primarily through restriction & malabsorption of nutrients has become obsolete.''  What is the Mechanism Behind Weight Loss Maintenance with Gastric Bypass? [2015 study]

(2)  "It has been widely perceived that [weight loss surgery] works by mechanical means, i.e., food restriction and/or malabsorption...A growing body of evidence suggests that profound changes in body weight and metabolism resulting from [weight loss surgery], and particularly [RNY], cannot be explained by simple mechanical restriction or malabsorption (7-27)." [note reference to 21 additional scientific studies supporting this fact.]  "Overall caloric malabsorption % (incl fat, protein, carbs) after RNY was only 4%."  "Although we observed a small decrease in nutrient absorption after [RNY] in this model, there was no evidence of clinically significant malabsorption." Roux-en-Y Gastric Bypass Enhances Energy Expenditure [2009 Harvard study]

(3)  "It was initially thought that bariatric surgery results in weight loss only due to restriction of caloric intake and malabsorption...later studies argue that malabsorption and inflammation are not the primary mechanisms explaining weight loss after bariatric surgery." Mechanisms Responsible for Excess Weight Loss after Bariatric Surgery [2011 Cedars-Sinai study]

(4)  Increased Postprandial Energy Expenditure Explains Superior Long Term Weight Loss after Roux-en-Y Gastric Bypass [2013 study]

(5)  Resting energy expenditure and energetic cost of feeding are augmented after Roux-en-Y gastric bypass [2012 Harvard study]

(6)  Roux-en-Y Gastric Bypass Surgery Increases Respiratory Quotient and Energy Expenditure during Food Intake [2015 study]

(7)  "The common-wisdom explanation is that [gastric bypass surgery] is the intestinal equivalent of wiring your jaw shut...patients simply can't absorb as many calories, so they lose weight and the weight-loss cures their diabetes...It's bologna." -Randy Seeley, neuroscientist at University of Cincinnati and Director of the Cincinnati Diabetes and Obesity Center [commenting on 2014 study published in Nature]  The Humble Heroes of Weight-Loss Surgery

As I said, you should take a potent multivitamin/mineral combo set after RNY.  Also as I said, taking B12 is esp important given the anatomical change of the surgery re intrinsic factor and potential neurological ramifications.  And, also as I said, supplemental iron is a good idea for premenopausal women, as is supplemental calcium.  Get your lab values checked, by all means.  I would add to make sure your multi does not contain cupric oxide as the form of copper, because this form has almost zero absorption, and there is a risk of long term copper deficiency with RNY.  But I stand behind the assertion that this issue is overblown.  Consider that simply taking, just as one commercially available example, a Celebrate Multi-Complete chewable (with or without iron) and a couple of chewable calcium supplements a day is all you need for life.  People seem to enjoy the drama that they are constantly staving off death, and the research states the opposite is the case with proximal RNY if you take basic care.  In fact, a number of vitamins will likely increase after your RNY (e.g., folic acid).  DS, on the other hand, is much more serious with respect to deficiencies.

Big picture, I could go on and on citing studies (there are only 28 studies listed above including the noted subreferences) -- but it takes more time than I have to fight back an angry mob with their hateful pitchforks and fear of "dangerous" information, when all I have on my side is scientific evidence...

Again, Best of Luck to you, Sarah!