3 years post op... Need help getting back

Hey everyone!

I am 3 years post op. I initially lost about 90lbs and then had some health problems due to rny and have since gained about 30 lbs back. I want to get back to where I was or actually better than I was before. I want to lose that 30 and more if I can. Any tips or suggestions on resetting my pouch so its working properly again. I'm scared I have stretched it.

Thanks! Leah

Hi Leah and welcome. Also congrats on making the decision to take control of your body.

As I'm sure you know, the months right after RNY are the easiest to lose weight, but it is certainly possible after that. It just won't fall off like it did then.

I am about 2 years out but there are folks on here that have lost regain and hopefully they will jump in with more personal experience.

A couple of key things:

First, the RNY forum has a daily menu thread where folks post their menu for the day and talk about life. It is a GREAT place for accountability, seeing what other people are eating and getting input on what works.

Second, I will add an aside here that on FB and other places people talk about doing a pouch reset, a cleanse or a week of protein shakes. Don't waste your time. You can do searches on this site and see that these "plans" only lead to more hunger which usually leads to snacking and binging. What real people here have found that works is AMAW or CAMAW (do a search for LOTS of info). Basically, eat all meat (or dense protein) for a week or longer. After the first few months post-RNY, the pouch will often be able to handle LOTS of carbs, it is amazing how little dense protein can make and keep you full. Focus on eating moderate portions of dense protein throughout the day. You can add in some non-starchy veg after a while if you like but get the carbs out of your life, including fruit. This menu actually works, not always fast, but it is effective for weight loss. Again, do a search on AMAW and CAMAW on the OH site and you will see lots of info.

Third, make a commitment to measure and log everything that goes into your mouth...NO EXCEPTIONS! It may be a pain, but it is the only way that you can be honest and see where the extra calories and carbs are coming from. It will give you a structure for making real change. You can use any number of programs or apps for logging. It isn't really important what you use, just do it.

Fourth, many of us have found that drinking only the "recommended" 64 oz of fluid a day isn't nearly enough to keep your body healthy and losing weight. I suggest working your way up to 120 oz or more a day. It doesn't "wash" the calories away, but it keeps your body hydrated so that you can lose weight. Lots of plain water is great, but most of us also count non-calorie, non-carb fluids like ice tea, Crystal Lite, PowerAde Zero, etc. It is really hard at first but challenge yourself to keep sipping all day and it works. Just be sure not to drink for 30 minutes after you eat so that you don't wash your meal out of your pouch and get hungry again right away.

Fifth, I will add in my personal favorite "advice". Move your body! It is true for some people that "exercise" doesn't cause weight loss or burn off extra calories. That said, regularly moving your body will improve your health, make you feel better in your body and for me, it helps me to de-stress when I'd be tempted to stress eat. You don't have to run or join a gym, just challenge yourself to walk every day as much as you can. Take a water aerobics class (includes great resistance training). Do something every day to move and raise your heart rate. Many of us have lived with body issues and for me, learning to listen to my body and get more comfortable in it, has done a world of good!

Okay, there are other things that folks here have found to be useful to healthy weight loss, maintenance and life after RNY. Seriously read old posts, do searches, join in the discussions daily and you will see the struggles and successes of REAL people. Also you might want to seek the help of a therapist who has experience with food, weight, WLS issues. We all got MO not just because we ate too much of the wrong things, but because we had a lifetime of thoughts, feelings and habits that didn't keep us healthy. WLS gave us the tool but it didn't fix our heads and that is a large part of the problem.

You can do it, but it really helps to not do it alone! Again, welcome!

I can't thank you enough for your message. It really hit me hard reading all that. I have the tool but I need to use that tool again. I will definitely try all the things you suggested. Again, thank you, thank you, thank you!

Leah, if you aren't, please be sure that you are also taking your vitamins and getting regular labwork too!

Wow, what timing. I came here this morning because I too am struggling. I'm nearly six years post op in January and had lost 140 pounds but never quite made it to goal with 20 pounds or so left.

Over the past couple years I put back 15 pound plus or minus three and I was ok with that. I rationalized it away. I was still in onederland which I hadn't seen since I was 14. I'm menopausal, it's normal. Then Friday I got on the scale and I was 199.4. That's up 22.4. Yeah, this is real.

So here I am and thank you Leah for coming here too. It's hard. But it's harder to be back where we were. Thank you Librarian? for your generous response. I was sad and panicked, but it's going to be ok.

I just checked my vitamin stock and that's set. I need to get back to journaling food. I used to use myfitnesspal but deleted it. I will search around here for what the new APPs are.

Thank you both and best of health to you!

Bonnie

We are definitely not alone in our struggles. Hopefully OH can help us turn this around. I added you as a friend. Maybe we can try and hold each other accountable. Here's to hoping for the best! ?

I'll be 13 years post op in February. I had a regain of over 50 pounds at almost 10 years post op. 2015 was a horrible year. My sister died, I had heart surgery, my father-in-law died, my daughter had a serious medical condition, my cat got cancer, and we bought a new house. This was all in a six month period.

i did not handle the stress well. I went back to soothing my angst with sugar. I did not exercise. I was in such a bad place. It wasn't pretty. I'm surprised I only gained 50 pounds.

My wake up call happened in December of that year. My A1C was 12. I knew I had to do something. I went back to eating like I did the first few years post op. I focused on protein first. This worked for the first 20 pounds and it took almost 2 years. This sucked.

i joined weigh****chers this year I've lost the other 30 and 20 more I'm smaller than I have been my entire adult life. I needed the login hog my food and the accountability of the meetings to keep me on track.

Now, don't get too excited about WW. The last 20 lbs was due to my inability to keep food down At almost 13 years post op, I had a Petersen's Hernia that had to be repaired These are becoming more common and now almost always happen to RNY patients.

You can do this. Try keeping a food journal Go back to focusing on lean meats, fruits, and veggies. WW makes that easy and the new point system rocks. I've got so good at this that I can easily feel full and stay within my points.

Good luck. Holler if you need help.

The one thing I want to add to the excellent advice already posted is this.

Regain is a normal phase of RNY. At least 99% of RNY people regain 20 pounds by the end of year three. It is called bounceback.

The intestines are lined with fingerlike appendages call villi. As food passes through the digestive system, these villi grab it and hold it against the walls of the intestines so that the calories can be absorbed by the body.

Right after RNY surgery, many of those villi are gone and food passes through without being absorbed. One theory that I personally believe is that the intestines realize that the body is essentially being starved and grow more plentiful and more efficient villi.

Once that process kicks in, the weight starts to accumulate rapidly. Unless you do something to slow the gain down, twenty pounds is accumulated in a few months. Without intervention it is not uncommon to regain half of the lost weight by year five.

For most people stopping the regain means counting calories. This is the moment when a structured program like Weigh****chers might be what you need. I accept that I will need to diet for the rest of my life. I weigh daily, track food intake, drink lots of water, and exercise.

If I stop doing that, I will regain the weight.

I've been working on a 90 lb regain. I found doing protein drinks for breakfast and lunch and a small dinner for the first week was a big help to reducing the pouch size. Now let me add it was very hard to follow and it take a huge amount of desire and encouragement. However after the 1st week things got easier. Since doing the "reset" I've continued to lose 53 lbs in the last 8 months. Lately I've started Contrave and that has help a lot. I'm in graduate school and the stress has been crazy high. I started binge eating and gained 4 lbs in 6 weeks. Once the stress died down I was able to lose weight again. The doctor thought it might help and it has. It doesn't encourage you to lose weight, but it does give your brain a chance to think about if you really want that cookie or is it just cravings in your head.

Also move, exercise, and move some more. I got a set exercise program set up and I went 5 times a week. There were days I went, complained the whole time, and didn't push myself very hard, but I still went. Now I don't have a problem going and even miss it when I'm out of town.

It can be a challenge but you can do it. Find a reason you can hold onto that will help keep you motivated.

Hi Leah,

You have already taken the hardest step by saying enough is enough and now I want to get back on track. I maintained 118-125 for over 10 years after losing 200 pounds. Due to a personal tragedy I gained and hit the 190 mark a year ago. After several starts it finally clicked and I am back to goal losing 70 pounds of regain. Here are some steps that helped me and I hope they will help you too! You may have several starts and stops but don't give up, don't beat yourself up. IT WILL CLICK!!! Our tool works if we work the tool and get back to the basics.

Planning/Preparing

Remember when we were preparing for surgery? How many meetings, classes and such did we attend? We were told the more prepared we were the better our chances were for success. And they were right. Go through the house, car and work place and get rid of trigger foods. Stock up on foods that will keep you on track. I removed every bad carb/sugar temptation and replaced it with lots of protein, veggies, grains and fruits.

Journaling

Get back to journaling. This will help you identify when you feel like eating, stress factors and any triggers in your life. Once you identify these factors, this will help you put tools in place to keep you from eating. It became clear I was not taking time for me anymore. I worked my day job and then spent the rest of my time caring for my husband. It was easy to reach for fast, prepackaged food. Since I purged my home I have to eat clean as there are no other options LOL

Use a tool to track you're eating and exercise like Getting Started with Health Tracker. Once I started to track ever bite and drink it became clear why I had gained.

Goals/Rewards

Make a list of goals for yourself. Make them realistic and small. Some of mine were move more, purge all junk from my home, eat more protein. If you didn't make a Weight Loss Surgery bucket list when you first had surgery do it now. GREAT reminder of all the things you can enjoy in life after losing weight.

Food

In general, a long term post-weight loss surgery eating plan includes foods that are high in protein, and low in fat?, calories, and sugar. Important, vitamins and minerals are provided as supplements. (if you had a different surgery adjust this to your food plan).

Water

Water is our Best Friend. I have to say I never went back to pop or any bad drinks, however I was drinking tea like crazy. What is wrong with drinking tea? I was either using sugar or 3 equals and 3 sweet n lows per 32 ounce glass. I found once I started carrying one of the metal bottles of water to keep it cold I drank water all day.

MOVE!

I can't say enough about how key this was for me. The reason I kept my weight off for almost 10 years was no matter what, I kept moving. If I could not go to the gym I would walk. Grab a cart and walk all the isles at your local box store. I loved Zumba, bootcamp workouts, lifting weights. When I stopped, the weight started coming back. So for me I am starting slow to avoid injury by walking and using some of the workouts on my Demand TV. Find something you love to do and it won't feel like a pain in the *** to do daily.

Support

If it's an option "run" don't walk to a support group. Come here on OH daily for support and participate in one of the food threads. It helps you be accountable and also great ideas for food prep.

Keep me posted on how you are doing.