Reasons for revision?

I guess I am just a little nervous and scared about surgery. I have been reading alot about revisions, and don't want to have to go through surgery twice. What is some of the reasons that people end up needing a revision? What gets to that point? Why couldn't they lose enough weight on their first one.. just didn't work with their body?

WLS is not one-size-fits-all, so you owe it to yourself to learn all you can about the RNY, VSG and DS - the three mainstream procedures, then the one-off's from there.  Understand how each one works and what makes it unique from the others.  Compare what you learn with your own body and history of diets and results.  Some of the reasons for revisions

• Lack of results (likely choosing the wrong procedure or non-compliance)
• Surgery caused complications
• Lapband very popular for this result - emergency surgeries
• RNY pouch or stoma stretch
• Malnutrition caused by uncontrollable malabsorption (not as common)
• Regain 
• Surgical complication
• Lack of compliance

I asked my surgeon about this last week at my initial appointment.  He said most folks who have surgery come out and can/do eat/absorb a certain amount of calories...say 1200-1500/day after the honeymoon period.  However, some folks don't have the metabolic rate to burn that many calories.  So, they lose weight initially but over time begin to gain it back even though they have restriction and maybe even malabsorption working for them.  The revision surgeries in that case would add more restriction or more malabsorption to get the patient to the point where they burn all the calories they consume/absorb or more.  He did say that adding exercise and counting calories with the help of activity/food trackers helps, but sometimes is not enough.  He stressed that the most compliant patients experience the best results long term.

Otherwise, revisions are for the reasons mentioned above...band problems, pouch stretching, complications, too much malabsorption, etc.  

I know several folks who have re-gained a significant amount of weight after WLS.  I can say that all of them that I know are fairly sedentary and eat the same foods they did before surgery (even in smaller quantities).  All of them have gone back to a regular soda habit (mostly diet sodas).  

I too am concerned that I will fall back into old habits and not be successful with surgery.  So, I am doing my research to determine which surgery will work best for me and also starting to make changes even now during the pre-op phase.  That's not to say that I won't fall back into bad habits, but I have committed to myself that I will never let myself get back to the place I'm at now health-wise.  The good news is that even if you do fall off the bandwagon with WLS, your tool is still there.  You can make changes to your eating/exercise habits and likely get back on track much faster than if you had never had WLS.  The further I get into this, the more I realize that surgery is not a magic bullet. 

Worth noting, the first paragraph above about malabsorption was probably only referring to bypass. Bands and the sleeve do not cause any malabsorption at all and the DS causes a higher level, albeit of fats not sugars.