Just curious

I have just started down the path to this surgery.  I am here because I am wondering how many people after 2-3 yrs started gaining weight and why do you think that was?  Are there any numbers on this?  Is it because people stop following their program?  Just trying to see all sides to what's going on so that I can be as successful as possible.

Thank you
Gwen

You did not indicate which surgery you are looking into... and that does make a difference.

I acn only speak to the RNY. I will be three years out in late August.  According to my surgeon, the studies show that at 5 years post-op, the average weight loss of RNY patients is 65% of their excess weight.  (Keep in mind that a lot of people will not lose 100% of their "excess weight" to begin with... 80% is more common.)  At about 2 years out, I had gained about 5 pounds back from my lowest weight, so I started  really stepping up the exercise (I am NOT an exercise person...) and then gained 6 more pounds in 6 weeks!  When I cut back on the exercise a bit, I lost 5 pounds and my body fat percentage had dropped 2.5%, so the net gain of the 6 pounds was muscle.  I am still at a "normal" BMI.

Most of the time when people who have RNY start to gain weight back, it is because they have started getting lax about what they are eating... especially when it comes to carbs.

Regardless of which surgery you select, I wholeheartedly believe that the key to permanently success is changing your eating habits (and developing good exercise habits, which I did not do very well) during the "honeymoon" period in the months right after surgery.  No surgery is a magic fix... it still all comes down to what you put in your mouth.

Lora

Yeah, I always figured it comes down to doing what you are supposed to do.  I am looking at the RNY or the Sleeve.  They told me that I was ahead of the game since I do work out.  Of couse, not real consistant right now as my weight causes pain in my knees and hips., etc.  Thanks for the response, I truely appreciate it. 

Gwen

She's very right.  I'm 19 months out and my "honeymoon period" is about over.  AND I can tell.  I've started bouncing around a few lbs and am trying to get that under control.  It is SO easy to fall back into old eating habits.  The amounts are still relatively small compared to "pre surgery' - but I'm able to eat more now than I thought I would be able to.

Its all about eating habits and exercising.  Keeping yourself accountable AND support.  Support I find, is the key.  I have been active here on OH since my surgery and I KNOW its what has made me successful.  I've lost almost 100% of my excess, and want to keep it that way.  There is a lot to learn along the way too, such as your body redistributes what you have left along the way.  Its an interesting ride and the outcome and results are phenomenal. 

When you go in for your nutritional counseling - they just talk about the weight loss, vitamin supplementation, etc, NOT about maintenance.  Maintenance is just as hard (applying what we've learned during our weight loss period) and applying it when you CAN eat pretty much whatever you want.  Its all discipline.

Just know - its not an easy road.  Its a tool that helps you get your weight off - its up to you to keep it off.

Jody, thanks for the input.  One of the things I like about the program I am in is there is a lot of folow up.  I have been talking to a therapist for a long time now and will bring up all of this with her. 

the purpose of my chosing surgery was to help me relearn and retrain.  It's one of the reasons the therapist would like me to do the RNY and not the sleeve. 

All good points for me to bring up to the nutritionist, therapist, and dr's. 

I definitely need to seek out more support and am trying to reconnect with friends that have been through it as well and figure out what communities here I may like or fit in with. 

Thank you for responding,
Gwen

I had my surgery in VA and I live in Michigan, so that was an obstacle for me to get through - as I didn't have the support nor resources of my surgeons office.  I knew this beforehand, but didn't realize what it meant.  I've had absolutely NO issues, so I've been fortunate there.

I do go to a support group here that's sponsored by a local bariatric office, - kinda cra****  I learn things from it.  I don't go as much as I should though.

I love the support I get from the OH community.  I am a regular on the Lighweight board, and now have come over to this board pretty recently.  I am at the point of my journey where I need some advice and support from others that are further out from me. I love to see successful people who are a bit further out than I am, and see what they eat/do to maintain.  This definitely helps me mentally.  I pay forward my learnings and the support I received as much as I can. 

I think you're doing a very good thing in looking out and beyond just the weight loss phase. 

Excuse me, but your therapist thinks you don't relearn and retrain with the sleeve? She's DEAD WRONG on that one!

What exactly does she think a sleeve is? It's a restrictively-only surgery so you MUST change your eating habits as you have no malabsorption to help you along like you do with the DS (and the RnY at first).

My surgeon finds that his sleeve patients lose as much as his RnY patients but his sleeve patients have less trouble with regain since they don't have malabsorption that goes away in 2-3 years and they have a pylorus valve and not a stoma. (Over time the stoma gets bigger and so it's harder to stay full leading to less satiety.)

I'm not knocking the RnY. Many people are very successful with it and sometimes it's the only option insurance will cover. But it is the surgery with the biggest regain problem when you look at it statistically.

That was definitely a strike against it in my book since I only had surgery because I wanted to keep my weight off and diet & exercise alone doesn't do that for me.

Even if folks with a RNY do stretch the stoma (and not all do), the pouch is still signfiicantly smaller than the sleeve stomach, so as long as they abide by the rule of not drinking wiuth meals, they will still feel full quickly.  The statistics my surgeon gave us (and the surgeon had nothing to gain by presenting "carefully selected" statistics because she does all the surgeries (although she has sicne stopped doing the DS) indicated that the DS provides the least re-gain, RNY next, the sleeve close behind that, and then the band.

Also, the malabsoprtion never completely goes away with RNYers.  It diminshes markedly but is never completely lost.

Lora

"the pouch is still signfiicantly smaller than the sleeve stomach"

Okay, you are the second RnY to say this that I've seen on OH. I wish I knew where this misinformation is coming from. In fact, the it's the other way around when it comes to capacity.

A typical sleeve can hold a half a cup of food at 1 year out while a typical pouch can hold a cup of food. The sleeve is made from a less stretchy part of the stomach so even if the absolute volume is bigger, less food can go in and that's what counts.

Btw, the stoma stretches for everyone. The pouch gets bigger for everyone. The sleeve gets bigger for everyone too. It's a natural outcome of cutting into our tissues and even has a fancy name (that I can't remember right now). This isn't the same thing as people who have mechanical failure of their surgery where it stretches out way too much. That is pretty rare. But the stoma controls how fast the stomach empties so it getting even a little bit bigger can contribute to regain.

And everything I've read says that the malabsorption of calories in a RnY goes away completely over time. It's only about 20-30% anyway which is not a lot. DSers get much more so, even though theirs lessens over time, it never completely goes away. That's why that surgery has such a high success rate.

Ok, now I'm really confused...unless different surgeons are doing different versions of the sleeve...

The RNY pouch is made of the topmost portion of the stomach (which stretches the least) and is just the TOP portion of what would make up the sleeve.

Lora