Revision...when is it needed?

 I have a friend who had rny 7 yrs ago and had gained some weight back.  She seems to be eating pretty healthy and does not understand whats going on.  Her surgeon is about 10 hrs away so has not seen him in years.  I was just wondering if she would need a revision.  But Im not even sure why/when revision is done.  Just curious!  Thanks everyone...

She would have to begin by keeping track of her intake of food and liquid.  A good look at her regular habits may show what is rally going on.  The RNY is only a tool.  first she would have to do her part.

I'm 5 years out and have had some regain. A simple check of my calories told the story. I can't hold much at a time but I can eat 30 minutes apart, so I was doing it ... and I gained weight. Now that I'm tracking my calories again, it's coming off. It's as simple as that.

A revision only works if there is some kind of mechanical problem such as the pouch or stoma stretching out.  It may be necessary if there are complications such as too much malabsorption.  It would be pretty impossible to get a revision if your BMI is below 40 or there are no problems with the surgery.  The best thing to do is to track every bite that goes in and find out if it is a problem with intake.  If a person is following things to a letter and still MO they may need a more malabsorptive procedure like a DS.  It wouldn't make a difference to make a pouch smaller if the person isn't overeating in the first place.  If the problem is metabolic then the DS could address that.