When the honeymoon is over......

 There have been a number of discussions on the main forum about RNY failures......described as regain when old behaviors are resumed.  They are contrasted with DS advocates who seem to universally claim that old behaviors aren't a problem......that the weight loss outcome is better regardless of adherence to nutritional guidelines.   There are far fewer DS outcomes to measure because few surgeons perform this procedure......and it is often touted because the procedure is more technically difficult to perform hence the outcome.   As someone who trains surgeons for a living I do not find that compelling.  Surgeons love a challenge....and if a procedure offers a better outcome they are quickly on board.   The lag of insurers being willing to fund the procedure still influences my thinking that the DS is still a very big operation with greater complications and is appropriate for a much smaller subset of patients.     There is no doubt that long term success with the RNY requires durable permanent change.    I get frustrated when people talk about surgical failure if they resume old eating patterns.   I feel like I'm like everybody else now....if I want to maintain a healthy weight I have to eat properly and exercise.   The surgery gave me a chance at that.    What are your thoughts.

I am new to your group. 

I agree that our surgeries gave us the opportunity to attain our desired weight goal.  Losing weight is a bit like going to college. I have had to be completely invested in maintaining and reaching my weight loss goal just as I had to stay committed to stay, complete, and graduate from college. 
The real work begins as you get down in weight and begin maintenance. If we stepped up to make an effort because we were uncomfortable in our own obese skins, then why wouldn't anyone want to modulate some self control to keep the weight off showing the same interest as when you were losing? If your weight is down isn't easier to watch and control it here, rather than gain it back only to have to lose excessive amounts again. Moreover, allowing your weight to yo-yo will be more stressful and harmful to your heart than just working  on where you are at.
Namaste',
         penn

My sentiments exactly.  My surgeon, a professor and associated with a medical school, was more than qualified to perform the DS.  However with my lower BMI, he said it was not an option for me.  Not because of his skill level, far from it.  I am thankful I listened to him.

You are right about surgical outcomes.  You quoted him almost verbatim.  The surgery gets us there, but it is up to us to stay there.

It serves no purpose whatsoever to denigrate any surgery.  I have seen remarkable long term success with all surgical types.  It depends upon the patient, in my opinion.