Weight gain after RNY

I'm not sure where to begin (again!). I had RNY in Feb 2004 without any postop complications. My weight loss all along has been slow/suboptimal, but I did lose about 95 lbs by about 9 months-down from about 300. I did have my GB out at about 6 mos post-op and have had trouble with a hiatal hernia since the procedure. The good news is that my HbA1c (indicates blood sugar control) is great. Blood pressure and lipids creeping up. 

The bad news is that I just had a yearly with my surgeon yesterday and I'm back up to 255. I've been gaining for some time despite nutritional counseling and gym 3x weekly (and regular f/u with the surgeon).  I've also been having some reflux and substernal pressure (not cardiac) radiating to my back, particularly in the evening after dinner, so am going for EGD on 2/25 to check pouch, stoma, etc. 

I started on WW again about 2 wks ago just because I felt I needed to do something. However, the WW is hard to follow when you've been taught to eat protein first, etc. The surgeon mentioned possibly banding my RNY depending on the outcome of the EGD. I'm really torn between wanting to have a procedure that might help me to lose the again and having another procedure. I'm also a little angry at myself (and the surgeon) for letting the weight gain progress this far. But I need to move on.

Has anyone else been in a similar position? What did you do? Should I be more aggressive with this reflux/chest pressure issue? Thanks (and sorry for the rambling).

For me, I am not in a similiar position but, have gained & I do understand how you feel. Is it too easy to say go with your gut ?  Research again. Start by doing what your doing. Reassure yourself. Consider what your surgeon has recommended. He's the specialist & knows your history. If you are able to go thru it health wise....for your health, I'd go for it ! All the best to you !   

I am several years out from BPD/DS and have gained back over 70 pounds. I haven't started eating more and I've always exercised several times a week. The gain started 2 years ago, slowly at first, but just relentlessly.  My original surgeon is retired. I really don't know where to go from here. Have you ever heard that opur bodies recover from the surgery, and begin to absorb more of the food we eat?  I really don't know what to do.

First of all, you need to find another bariatric surgeon to follow you. One of the first things they will most likely do is assess your pouch and stoma size and go from there. I am going for another EGD in about 2 weeks. I've had one done before and it's no big deal. Our bodies are also amazing at adapting our metabolism to reflect the food we eat. It is really important to drink at least 8 cups of water and eat enough protein daily (my surgeon/nutritionist recommend 60-70 g daily). Another thing to do is to go see a nutritionist familiar with WLS. They can be very helpful and supportive. Lastly, you have to be very honest with yourself. Despite exercise (although not so much lately), I gained weight. However, I am guilty of poor food choices at times. Particularly because I never really had any post-op complications (other than anemia) and can now eat just about anything. I can eat more than I used to, but I find that because the amounts are relatively small, I eat more frequently (and we have to be mindful of "grazing" behaviors). We have to be careful about hidden calories too. For example, I know that in order to increase my protein post-op, I started drinking decaf non-fat lattes (lots of non-fat milk). But even non-fat milk has calories (90 per cup). So when I drink 3 lattes with 1.5 cups each, that adds up to 4.5 cups and 405 calories--just in coffee!! Then you have to add the food. So I went back to WW mostly for monitoring my weight and food intake. (I also make sure to get 60-70 g of protein daily.) So, keep the faith and find another WLS doctor!

Have you posted in the Accountability thread?  What have you been eating/drinking since you started the gain? Please post on the DS board, as this kind of gain is atypical, and I'm sure you'd get lots of help and support, either in finding another surgeon in your area, or in tweaking your diet.  Also, please consider posting this at www.duodenalswitch.com .  There are several postops that post there who are 5+ years out and can really advise you.

I am 14 months post op RNY and have not lost in a while.  I exercise regularly.  I can eat more than I wish I could and can eat foods that I wish I could not!  I also joined WW and find the flex plan ok, but I probably should do the core.  Did you tell anyone there you had WLS?  I did not... felt weird about it.  I never made it to goal.  I am at a healthy weight according to my regular DR, but I fear gaining.  I have gained about 8 lbs from my all time low.  I am trying to stay on top of things before it gets out of control.  Good luck to you on WW.  I also like the website www.5daypouchtest.com  It works to break the carb cravings if you can get through it! Robin

Robin, thanks for your note! Talk to your surgeon/WLS doctor/nutritionist about the weight gain. I also started gaining before 18 months post op but have not been successful thus far with managing the weight gain. However, keep in mind that it is not uncommon to gain some weight. As long as we keep it under control and work to lose any excess weight before it gets "unmanageable." (Maybe I should have considered WW sooner because it "forces" you to get weighed weekly.) Anyway, I did let my WW leader know that I am diabetic (although now controlled without meds since the surgery) and post-RNY. Privately, she was supportive. However, at my meeting on Sat, she actually made a comment along the lines of "its better to lose weight behaviorally than surgically." If nothing else, my surgery has thus far corrected my diabetes, hypertension, and cholesterol levels. Those are 3 big cardiovascular risks! It helps if you follow the Flex Plan, but try to choose foods from the Core Food list. Good Luck!! PS. Thanks for the www.5daypouchtest.com  suggestion. It sound like it might be a good idea to try.

WW is good for keeping us on track. I hate I joined after I regained too much weight but I am on the right track now.

I had open RNY with GB removal at the same time in 11-03.  I lost 106 lbs and have now gained it all back.  I went back to my surgeon who told me only 10% gain all the weight back and referred me to another surgeon to talk about lap band.  He said he knew the pouch had to be stretched out so no need to test.  I also wonder if another procedure is what I need.  I just don't see how I can lose that much weight again by dieting with success.   Besides not knowing where to start, I am looking for people to visit with that have had this happen.  I am mostly seeing posts from people that are upset because they have gained a small amount of weight back.  It is very difficult to find information about the "10 %" of us.         

My surgeon suggested the possibility of band placement also, but had me go for an EGD to check the esophagus, pouch, and valve (I also have been having trouble with epigastric pain/pressure and wicked heart burn). I went yesterday and everything was normal (except for some esophageal irritation.) So, once I get the results of the biopsy next week, it's back to the surgeon. In the meantime, I started weigh****chers (lost about 10 lbs in 2.5 weeks) and went to the nutritionist (having occasional episodes of hypoglycemia). I had to do something, and at least I have to be accountable for weigh-ins. And the nutritionist and I worked out 6 small meals with protein to try to minimize the episodes of low blood sugar, which may be an explanation for why I am almost always hungry.

My point to all this... set a small WL goal to start (maybe 10 lb increments) and attempt some kind of eating program on your own. (I am now diabetic controlled with diet, which is why I don't have a problem getting the nutritionist covered by insurance.) The other thing is to MOVE! Even if it is just walking to the corner and back to start. I know for me, it's hard in the winter. But I figure no one can criticize that I don't try. Right? Beside all that, I you don't agree with your surgeon, get a 2nd opinion! And you can check to see if there are support goups in your area. I am relatively new to this board, but I believe there is an area to check for support groups. Feel free to post again or e-mail me if you want to talk more. (I believe you can send a personal message via OH.)  Most of all, keep the faith!!