Gained Weight...can I do the surgery again?

Hi - I know this is probably not a healthy question to ask on here, but has anyone heard about a surgery for RNYer's that have gained back their weight.  I heard something about 'stoma' but cannot remember who told me or what it was about.

thanks, I am having a terrible time.

If you are talking about a surgery to tighten a stretched stoma, yes, there ARE such things but both one of the ones I am aware of (the Rose procedure and Stomaphyx) have terrible statistics and most insurance companies won't pay for them because they simply don't work.

Chances are, though, that there isn't anythign wrong with your pouch or stoma.  The problem with the weight gain likely is a combination of too much food (getting lax about portion control or eating until the pouch is very full), too many carbs creeping back into your diet (VERY easy for all of us to do!), and simply eating more calories than you burn (whether because of too many calies consumed or not enough physcial activity).

I realize that this is purely anecdotal, but my surgeon indicated that less than 20% of the people that she ordered EGD's for who had gained weight and swore up-and-down that they were eating properly (both in food choices and portions) actually had a stretched out pouch or stoma. That means that over 80% of the people just weren't adequately controlling what they were eating.

The good news about that, of course, is that THAT is something you can do something about (as opposed to a stretched stoma which may or may not be able to be remedied)!  Go back to basics: protein forward food choices, limited carbs, limited portions (measured, if necessary), and no liquids with or right after meals.  

Most people find that if they honestly track everything they eat (and measure portions to be sure they are adequately tracking intake) for 2-3 weeks, the reasons for the weight gain is often evident.  In many cases, it just means making small changes (e.g., eliminating the extra carbs that have crept in).

Lora

That was a thoughtful response.  More than what I was going to type. 

Thank you Lora, that was a very thoughtful response.  I keep trying to get back to basics but am just too hungry.

Thanks

Are you focusing on dense proteins (e.g., meats, poultry, hard cheeses, dense fish, beans) rather than slider foods (e.g., yogurt, soft cheeses) or foods that chew down into almost nothing (both healthy things like green beans and unhealthy things like CheezIts) that don't keep you full for very long?

(I assume you are still not drinking with meals or right after. If you are, that can contribute to significant overeating by washing food from the pouch.)

Food choices really are key in maintenance, but I know how hard it can be sometimes to feel like you're eating the same dense proteins all the time (especially for people like me *****ally cook very little).

Lora

Thanks, I do try to eat protein, but also am eating lots of Greek Yogurt and Mozz. cheese.  Maybe I should watch those a bit more. I did try no white flour, no sugar, for one month and didn't lose anything so I got more discourage and depressed, but I guess I should go on that bandwagon again.

You are so kind.

Judy

Don't be shy let me hear it :)

First, for your own peace of mind, go to your surgeon and get an scope done to make sure that there's nothing mechanically wrong with your workings.  My doctor made the same statement as Lora's - that there's almost NEVER anything wrong with the pouch or sleeve.

If you're having trouble with hunger, try taking an antacid like pepcid or prilosec.  It may be acid that's causing the trouble.  And make sure you're drinking enough.  Otherwise, I'm going to second what Lora said.  Best of luck to you!

Thank you, but can you expand on the Pepsid observation.  Why would acid be making me hungry?

Both excess acid and dehydration can feel like or mimic hunger.  It you're eating, then feeling hunger shortly after (and it's not head hunger!), one of those two culprits could be the problem.  That's one reason many surgeons put their patients on an antacid right after surgery.  The stomach will continue to produce its normal amount of acid for awhile, which is bad for the stomach lining and makes you want to eat to give the acid something to work on.  Same thing now.  If your stomach is overproducing acid, the signal your brain gets is to put something in your stomach to soak up the acid and give it something to do - my very simplistic explanation to something that's much more complicated.

Anyway, try an antacid and see if it helps.  It's an easy and relatively cheap fix if that ends up being the issue.