I was weighed at my dr's office. I'm a 5'5" female. Now 326 lbs. (a few years after the...

Congratulations.  I am just over 5'3" and started at 332, so were were about the same size.  I am six years out and maintaining right around 145 pounds (with the occasional couple pound swing either direction).

Lora

I'm "just a newbie", so take whatever I say with as many grains of salt as you like, but I can't really agree with the people saying the sleeve didn't work for you, and dieting didn't work for you. Yes, you have some challenges, but losing weight with any of the surgeries requires effort and commitment. Just because you have a lot to lose doesn't mean you can't do it! You have to make up your mind that you're going to change your life, and understand that it will take time. Before you start looking at another surgery as your answer, I'd really suggest you make a commitment to yourself to really, really try to work with the tool you have. Start by weighing and measuring and tracking ALL the food you eat, you may be surprised at how much you're actually taking in. Eat lean protein first, then non-starchy vegetables if you have any room, avoiding "white" carbs and keeping your carbs low overall. Make sure you're getting about 100 ounces of water a day (I'm a big believer in H2O!) In time, if you stick with it, you'll see your weight go down. Add light exercise as you can, and then increase the level of exercise as much as possible. Therapy is a great idea, and can help with any issues you may have that contribute to your weight.

You can do this!

I have to agree here.  You (the OP) need to get your mind in the game before involving your body in any more surgeries. No matter what (or if!) surgery you end up doing, it is only a tool!  Your brain and determination is what will bring you success, whatever you choose.

Hang in there and think positive.  Plan and research and do your soul searching - are you willing to do (and stick to) what is needed! Best wishes.

I wonder with your extensive background of problems that your doctor didn't push for the DS instead of the VSG?  I love my sleeve, but being that you have Lupus and Fibromyalgia and have days and weeks where your life is sedentary, I don't think your doctor personally did his/her best to get the best results for you.  I am not coming down on you at all, i actually feel for you because we all know how you feel.  I hope you discuss in full this time around your concerns with your doctor and he/she is on the same page as you.  You need to do this for you.  Standing up for yourself will show your 8 year old that you are a strong person who can overcome and conquer.  Good luck to you.

Ok, I'll be the bad guy.  The sleeve didn't fail you.  Diets didn't fail you. Like you said yourself, you didn't follow the plan.  I remember after regaining 100 lbs thinking my surgery failed.  Then I decided to make changes to my eating and I lost weight?  It did work, when I did what I was supposed to.  The surgery didn't fail, I did.

You sound like a very smart person and you are being honest with yourself, which will serve you well.  You said it yourself.  Before you subject yourself to any more surgery you need to find out why you weren't compliant with this one.  That is the key to success.  I have honestly seen people with 2, 3 and more revisions who couldn't get the weight off because they weren't able to make the necessary changes.  They seem to me to be in denial and say they don't eat much but I kind of find it hard to believe that a person can weigh 300 lbs only eating salads.  Call me a cynic but I've been there. I ate a truckload to regain 100 lbs.  And I had malabsorption.  Malabsorption only does so much.  Simple carbs are absorbed 100% no matter what surgery so if that is your problem, like it is mine, then that needs to be worked on.

Another thing, and this is just my opinion again.  I kind of get worried when someone admits they  haven't been compliant with their WLS and it is suggested they have a revision to add malabsorption. If they aren't compliant now what will change to make them compliant to the even more stringent requirements of malabsorption and the extra expense of labs and supplements?  The reason it seems to me that surgeons don't want to do the DS has more to do with liability and non compliant patients then anything else.  It is a fact that most people with WLS do not follow up over the long term.  To not be compliant with the sleeve can mean only inadequate weight loss or regain but not following up with the DS can mean death.  That is why I think surgeons are pushing the sleeve so much these days and why they pushed the lap band.  They have seen first hand how few of t heir patients are able to keep up with the requirements and they are playing it safe.

I agree 100%! 

Our surgeries do not fail us. Unfortunately for whatever reasons, we can fail our surgeries. The personal responsibility factor for compliance and follow through with diet and exercise and vitamins is simply crucial and essential. This is not blame, it is just reality.

Adding a high risk surgery to a failed surgery... Not a simple solution.

Both of my Bariatric surgeons have said to me what you are saying about the complication and mortality factors and difficulty managing patients who have undergone the DS, Ladytazz. They also say the compliance rate for post-surgical DS patients is substantially lower than for the other surgeries. They say these are the reasons they will not perform the DS.

Quote from AMSBS clinical guidelines, 2013 update: "Physicians should exercise caution when recommending BPD, BPD-DS, or related procedures because of the greater associated nutritional risks related to the increased length of bypassed small intestine."   

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JAMA Surgery Releases for September 17, 2012  Study Compares Duodenal Switch vs. Gastric Bypass for Morbid Obesity   "Although researchers note a relative increase in the use of the DS, this procedure is still used much less in the United States compared with gastric bypass. The researchers suggest that is likely due to several factors, including the technical difficulty of the procedure, the higher reported rates of short-term complications and concerns about the longer-term nutritional consequences of a primarily malabsorptive procedure (where absorption of calories and nutrients is reduced)."  

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Duodenal Switch vs. Gastric Bypass "There are higher complications with the duodenal switch as opposed to a gastric bypass or a laparoscopic sleeve gastrectomy or a lap band.  There is a higher risk of leak and a higher mortality with the duodenal switch versus the gastric bypass. Also, there are many more nutritional and vitamin deficiencies with the duodenal switch. Duodenal switch patients have a higher incidence of diarrhea after the procedure, as well."    David Buchin, MD Long Island Bariatric Surgeon    

That's not entirely true...wls can and does fail people.  The general mindset that if a person regains, it MUST be because they are doing something wrong, INFURIATES ME.  This mindset of my original surgeon left me miserable for MONTHS before they finally caved and humored me by allowing me to get an endoscopy.  Shaming people is why so many go into hiding and don't seek help when the truly need it.

I hear what you are saying, clpeltz, about the shame factor and how awful that is. I also agree with you that there are complication and metabolic issues that contribute to weight gain. However, there are relatively few people effected, and you got to be one of the unlucky ones.

For the great majority of us, though, the willingness to take personal responsibility for managing ourselves is simply the way it has to be. We do fail our surgeries when we are unwilling to do that and continue old behavior patterns with our eating and unwillingness to exercise.

Useful article about WLS success and personal responsibility:

http://www.localbariatricsurgeon.com/weight-loss-behavior/pe rsonal-responsibility-improves-weight-loss-results

Not meaning to be offensive, only I have to ask. If those so now proud about how they successfully manage personal responsibility for their eating, why did you have WLS in the 1st place? There is certainly a variance on what "acceptance of personal responsibility" actually requires for each individual. I'm happy for everyone able to maintain an acceptable weight, but I hear a bit too much pride and too little recognition of the variance in cir****tances.