Question:
Why are people gaining weight at the 2-5 year mark???

Wondering if it is because of returning to the comfort zone of eating the wrong foods or not exercizing??? I am about to have my RNY Feb 11th 2010. I was wondering how to stop myself from having this possible weight gain happen to me. I certainly don't want risk anesthetic and the surgery itself and to loose the weight to only regain it back in the end.. Any ideas????    — OntarioSilk (posted on January 4, 2010)


January 4, 2010
I think we do have control of this, we can make the right decision or the wrong decision for a food choice and many people do get in the comfy zone. I was 4 yrs post op yesterday and I have maintained my 90 lbs weight loss with the RNY. I really don't see how people can gain weight, honestly, I feel sick to my stomach if I overeat or eat a bad food. So I don't overeat. I eat until I am content, then I do that throughout the day. Perhaps that is why I haven't gained weight. I know a lot of people say don't snack in between meals, but I can't get 1200 calories in 3 meals, so snacking is a good choice for me. I think it also depends on how much weight your doctor wants a person to lose. I wasn't so much on morbid obese side, I had a lot of comorbidities, so my weight loss surgery was based on the fact the PCOS and comord's prevented me from losing weight. But people that are morbidly obese should consider whether or not they can or should snack. (consider the two factors) I think it depends on what you snack on; not the fact that you snack.
   — Kristy

January 4, 2010
Thanks Kristi, I was thinking along those lines as well. I can't understand how people fall into the trap of I'll have this quick fix surgery and I know that I will gain weight back in 5 years time. I certainly don't want that to happen to me. Thanks for your input. I appreciated it very much. Pam
   — OntarioSilk

January 4, 2010
Hi, I'm a doctor who had lap RNY 10 months ago and had patients with problems post op back in the 80's and 90's so I reviewed the medical literature carefully before proceeding to surgery. The literature emphasized how much better people did with long term monitering and supplements to prevent deficiencies. Also in a 20 year follow up study it was noted that 75% of patients kept at least 75% of the weight off that they had lost. I don't want to gain back 25% of the 164 pounds lost but even if I do that's still a lot better than where I was. My surgeon said it best. "weight loss surgery is a powerful tool to lose weight but weight maintainence still comes down to diet and exercise." I am so glad that I can exercise now and I know that will help in the forever struggle to keep the weight off. Hang in there. Kevin
   — hapkidodoc

January 4, 2010
Oh I forgot to mention, the best non-surgical long term result was 2% of patients keeping 50% of their weight off at 5 years. This was traditional weight watchers. All drug regimens, fad diets etc have near total failure over 1 year out. This modest success of traditional weight watchers emphasizes to me that we need support groups!! It also tells me that bariatric surgery works in the long run it just isn't easy and does require long term work on our parts to change lifestyle. (can you tell I teach resident physicians and tend to get long-winded?). :) Kevin
   — hapkidodoc

January 4, 2010
What great answers. I am only 6 months out from Lap RNY. Before the surgery I promised myself that there is no way I am going to regain the weight as I have done all of my life. For me, working with a therapist is key to finding out the reasons why I have "insisted" upon fattening myself back up every time I have lost. I think the key is what is in our minds, and how well we manage the changes that occur because of the weight loss. Gaining weight also puts you back into your "comfort zone", if we dare call it that.
   — browngathers

January 4, 2010
Greetings Pam & Kristi: Kristi, you should be having from 5 to 6 small meals daily and not 3. What you are doing could be considered "grazing." It sounds as though you truly do have control of what you are doing and your thinking is right; but, things can happen. I think you will find you are able to more easily control your snacking (grazing) if you plan to have 5 to 6 meals. Whoever gave you the advise to continue to have 3 meals did not have a handle on understanding the needs of bariatric surgery survivors. Our pouches (folks who have had an RNY) are the size of an egg and not humungous watermelons. Pam, people are so afraid of opening up to the psychiatrist about their innermost feelings because they think if the psychiatrist really gets to know them, they will not be allowed to have this life-changing surgery. Well, perhaps that is true; but, how sad if they truly do not get to know themselves inside. We go through 16 or 18 different life-changing belief systems following this surgery. Not having a firm foundation -- ignoring the needs to reign in our emotions, understand what makes us tick and what we need to do to feel good inside ourselves -- makes the journey most difficult. Weight regain can be most common. Folks fool themselves by not truly addressing life-changing issues. I am the leader of a support group and I see these issues all the time. One person I met had the RNY confident that because the RNY makes those of us who have had this surgery a minimum of 50% malabsorptive (meaning we don't have the small intestines which masticates all the foods passing the nutrients readily into our blood streams and therefore must rely on supplements), that she could eat any and all things because she figured she could pig out and not regain any weight. Well, she never did eat appropriately, and now, 4 years later she weighs 100 lbs. more than she did (400 and going up). Now, she wants a revision but, she still loves to eat junk food in great quantities. She's looking forward to a revision which will enhance her malabsorption. Back to other examples. Another lady I know carries so much anger inside herself, that she boils over all the time about how rotten "x" is. She is on anti-depressants; but, she is doing nothing about the underlying issues. She doesn't attend any support group meetings and is always blaming other folks for perceived injustices. If something doesn't work out, which is all the time, she rages at folks on the freeway, says "oh well," and blames everyone else for bad things, and if something isn't bad, she'll find a way to let us all know how bad it is. In her mind, it is bad. I believe the underlying anger she has about everything keeps her body so wrapped up in tension that nothing inside her works right, and so, she is now almost 100 lbs. heavier than she was. Her first surgery was 16 years ago. Her revision surgery was about 8 years ago. Now, she is well on her way regaining an enormous amount of weight. Another woman I know was focused on being sure she got a surgeon who had his practice close to her home. It was more convenient for her, you see. That surgeon is a near-do-well, and after seeing a person twice following surgery, tells them to "have a good life." He has no desire to help folks for the long term and knows absolutely nothing about nutrition. He thinks that folks who have had RNY's should be able to eat whatever they want and that having a minimum of 100 grams of protein is not important. This lady's lost no weight at all. It's now been 1 1/2 years since her surgery. Her hospital cost was in excess of $25,000, and her husband was most unhappy with this cost even if it was paid for by their insurance company. She concentrates on eating anything sweet. She takes care of her grandchildren and feeds them cakes, cookies and candy, all the time. Her house was wall-to-wall filled with sweets at Christmas. Yet, each of these 3 examples are beautiful women who weighed too much and so have many medical problems. They wanted the surgery, but were not prepared for it emotionally. Am I an angel? I do love fudge. I have a picture I truly need to get posted on my website. I always thought I was so beautiful. How my eyes deceived me! That picture shows that if you put me up in front of a barn, you wouldn't see the barn. Yet, I remember that I couldn't get up off the floor if I was down on the floor. I couldn't walk more than 10 feet without dripping in perspiration. I couldn't walk up a hill. I had to sit in a chair because I couldn't get myself squeezed into a normal-sized booth. I couldn't sleep on my side (either one) because all my organs were squashed. I didn't dare turn over in bed or I'd fall out of bed. Etc. I remember those issues, along with sleep apnea, high blood pressure, and high cholesterol. I was determined I would be successful. I have struggled and struggled to learn the proper foods to eat, the proper amounts, to eliminate any and all forms of milk from my diet, to eliminate any and all forms of white foods, and initially, to concentrate solely on getting protein. Like one of the ladies I mention here, my surgeon had great bedside manners but dropped me right after the surgery to "have a good life." I found it an incredible challenge to find out any information to help me eat the right foods, drink the right protein drinks, get the right amounts of exercise, etc. Even professional trainers (and I paid a humungous price to retain one) do not necessarily have a clue about what makes us bariatric surgery survivors tick. My professional trainer thought we can eat 2,000 to 3,000 calories daily: we can simply burn it off through exercise. Bunk! I became a support group leader several years ago connected with obesityhelp.com. Thanks to the incredible support, teaching, and materials available to us leaders, I have learned tons of information I pass on to my support group members. However, I have since learned the absolute importance of juicing greens (you know, the tops you throw away) in my Vita Mix, and adding in fruits (yeah, that type of sugar is good for the body), making green smoothies. I get my protein in first and then have a minimum of 1 quart of green smoothies daily. Initially I lost 135 lbs. Kept that off for 4 3/4 years in spite of several years of medical challenges (from a failed liver to vertigo, restless leg syndrom, and 2 vegas responses). The end of November 2009 I started up the green smoothies, and now I've dropped another 15 lbs., my apron is shrinking, my panties are 2 sizes smaller, my frame is 2 sizes smaler, my skin is looking ever so healthy, my hair is thick and shiny, and my teeth are whiter. Do I have emotional issues? No. I spend a minimum of 1 hour daily in prayers of Scripture. I'm now 5 years post-op RNY, have kept the weight off through dieting, exercise, and eating only foods good for me, knowing I must at all times balance what I eat to eat a complete pallette of foods from greens, vegetables, fruits, especially protein (100 + grams minimum daily), and absolutely no white foods. I have to watch what I eat and be very religious about it because of the malabsorption issue which makes it so much tougher to get the proper nutrients into my body. This requires 3 to 4 times a year having a multiplicity of blood tests, with adjustments in my supplements as I better learn proper nutrition. I'm 5 years out and I'm still learning what works and what doesn't. This is a very, very long posting and may perhaps be one heck-of-a-run-on-paragraph! Hope this helps. Blessings to both you, and may 2010 bring you loads of great blessings. Christine Gibson, MS, MA, Bariatric University Support Group Coach, Obesity Help Support Group Coach, Obesity Help Support Group Leader, www.ObesityHelp.com/group/BellevueWA. See my positive affiramtions at my personal site for further help.
   — Christine Gibson

January 4, 2010
i had my surgery a year ago and i had it because i couldnt lose the weigth my self, just like all of you who have had the surgery or we wouldnt have had it if we could have done it our self. i am able to eat any and all foods i could eat before and i can eat a good amount at a time. i have already started to gain some of my weight back. and it scares the hell out of me. just because we have had the surgery doesnt mean we have lost our old bad habits. i dont want to gain it back but it is an addition just like drugs and booze. i am getting phyc help for this, but dont be so quick to condem those of us who still struggle. its not what we want but sometimes is happens. food is always a part of our life and you cant just walk away from it. to learn to control it would be the ultimate but if i could have done that i wouldnt have needed the surgery to start with. no one wants to fail but some times it happens. so dont judge and hate, try to understand and help. its really not what we want but sometimes it happens. and we need love and support more than ever.
   — pinky_711

January 4, 2010
Have you ever heard of the Doudenal Switch surgery it has the best results for not gaining weight back and if you are diabetic it has the best cure rate for that as well I am scheduled for this surgery Jan 20 in Omaha Nebraska with Dr Anthone. If you want more information check out the Doudenal Switch Forum.
   — Nikki W.

January 4, 2010
during the 1st two years after your surgery, you are suppose to develop new eating habits and exercise habits. I am 5 years post op. Last year I quit exercising and got back in to those old eating habits and put on 27 lbs. This scared me. So I saw my surgeon to get a stern talk and motivation from him, went back to my basic diet, and joined an exercise program. After one week I have lost 8 lbs. For me......as long as I do what the surgeon and his staff trained me to do, I am fine. It is when I venture out on my own and think I can have those chips, french fries, and sweets is where I get myself in trouble.
   — Janet H.

January 5, 2010
What is a green smoothie?
   — MzScarlet

January 5, 2010
One more thing: The surgery is a tool for wls. Not a quick fix, and we also have to have the mental change in our behavior. We have to look at food in a whole new light. I really had to do a lot of deep soul searching in my heart, to cut the ties and the love of food. I still love the taste of food, I just don't see it in the same way as in the past. I had to jump in with both feet and be honest with myself as to why I was overweight. Once this food demon is gone, it will be much easier to keep the food to a minimum. I don't live to eat, I eat to live.
   — Kristy

January 5, 2010
Christine, I was not given the instructions to eat 3 meals a day, but as you know, that is what most doctors will recommend. I was going off of posts from previous patients, that I have read. For myself, my doctor did recommend the 5-6. So I just wanted to clear the air about that. I suppose you could call my "grazing" a small meal, as it is not candy or junk, just a healthy snack, but it might take a while to consume it. So this works for me. Not everyone can do this.
   — Kristy

January 5, 2010
Hi Pam. I've also heard that people start gaining again after a few years. I also know people who have taken up other addictions when they were unable to eat after surgery. I just had surgery on Dec. 10, 2009 and am presently in therapy with a food addiction specialist to figure out why I was eating out of control. Hopefully I will understand what is going on inside my head so that I will not have the pitfalls many do. The surgery is just a tool to weight loss but it is letting me lose weight while I work on my mental demons. Best of luck in your journey.
   — Cynthia T.

January 5, 2010
Hi Pam!! Congrats on your upcoming surgery. My surgiversary is 2/15/10 --- I will be 3 years out. I was one of the FREAKS that lost a bit more than expected. I went from 268lbs at 5'8" in a size 26/28 to 132lbs at 5'8" into a size 2 and was still losing. I got very sick. Not deficient in anyway --- all of my labs were good. I ate 5-6 times a day because like a lot of people I cannot eat a lot of food in one sitting. My body just kept on keepin' on. I am not at a comfortable 155-160lbs --- -depending on my monthly visitor and water gain. I still lost over 100lbs and wouldn't change a thing. Those size 2's and 4's were fun, but not at the expensive of being dizzy, passing out, adding enough salt into my diet be considered a salt lick, couldn't drive, extreme fatigue, etc. I ended up gaining a bit of weight back and was diganosed with Fibromyalgia ---- because of the rapid weight loss and the intestinial issues I had? Who knows? No one knows why you get fibro. Anyway... to answer your question, a lot of people do slip back into bad habits. eat things they shouldn't. as your pouch matures you will be able to eat more, eat differnet and yummier things. just don't get caught up in it. be good. eat right. exercise and all should be well. Good luck!!
   — jammerz

January 5, 2010
Greetings Kristy: My oh my, what a shocking, horrifying, and simply awful "rest of the story!" My heart goes out to you. So many deaths and then, so many medical issues, and all you write about is 3 meals a day and snacking? Right now, I am feeling overwhelmed with reading "the rest of the story." I will respond again. For now, my eyes are filled and brimming over with tears of compassion for you. My head is spinning as well. Yet, in 30 minutes, I must be "up, front, and center" for a support group training class. Kristy, I was prepared to send you a short e-mail letting you know that I did the very same thing of snacking. My thoughts were the same as yours are. Then, my health plummeted with the 2 Vegas Responses. This is where your heart stops and so you stop breathing, fall down, split open parts of your body (my face), bleed a lot, deficate everything and end up hospitalized, tons of pain, tons of issues, tons of ..... nightmare issues. Fortunately, my calcium and other supplement levels are extraordinarily decent so I didn't break any bones. Now, I know about green smoothies and I'm out of pain,out of issues, have my life back, have lost 15 additional pounds, etc since the 3rd week of November when I started the green smoothies. In fact, last February when I had my 2nd Vegas Response, my then-doctor (who I fired and retained a new one) told me I needed to sell my home and move into Assisted Living! Assisted Living? At my age? I am a very active 72 year old and have much too much life to live to go to assisted living! I will be posting information on the green smoothies as well as my recommended list of books helpful to us at my North West WLS" Support Group website www.ObesityHelp.com/group/BellevueWA. It will be available for any and all to help anyone. Blessings, Christine Gibson, MS, MA, Bariatric University Support Group Coach, Obesity Help Support Group Coach, Obesity Help Support Group Leader. Also, if anyone is interested, go to my personal site www.ObesityHelp.com/members/ChristineGibson where I have posted my positive affirmations. All these methods help me keep my weight down, my mood up, my energy level thriving, my mind alert, and continuing to believe that life is worth living!
   — Christine Gibson

January 5, 2010
Hello Pam! Congrats on your upcoming surgery and I wish u well! I wanted to thank Shelly for her post to this question and the fact that she recongnized that everyone is different and we all have our own demons. Some people get WLS and lose what they wanted and keep it off and thats great! and some dont take off all the weight and still struggle keeping it off and have a life long struggle even though they have had wls. The point is that we support, love and give assistance to everyone no matter what the circumstances are. The fact that they are brave enough to get on here and say they have gained weight after WLS and need help from all of us is admirable in itself. Best of luck to everyone with their path of weight loss!
   — jann91

January 6, 2010
I'm 6 years out from a Lap RNY 1oz pouch with 100cm bypassed. I've gained about 25lbs since my lowest of 180 3 years ago. My surgeon said that a 20-30 lb regain at the 5-7 yr mark was normal. It's just your body readjusting. Was he wrong? Most everyone I know has gained that much back at a few years out.
   — Jennifer T.

January 7, 2010
I have gained back about 6lbs since my bypass in dec 2004. If you drink diet carbonated drinks or any other carbonated drinks, you are stretching your pouch back out and making it possible to hold more food. DON'T DO THAT !!! Don't drink ANY carbonated drinks of any kind. This includes beer, champaigne, sparkling wine, etc... Of course your comfort zone may have something to do with it too, but you have to remember to watch your portions. remember that this surgery is just a tool, not a cure. it is a tool to help you to control how much you eat or drink. you still have to exercise and watch your sugars, breads, and portions. I lost a total of 160lbs and it has been 5 years. so if i have only gained 6lbs, that is pretty good. email me if you have any questions. [email protected]
   — cynthia vanheiden




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