Hi Guys,

I am looking to the vets on this.  I am cruising along and doing fine (so far) on my weightloss journey. I had a colleague with a substantial closet with a variety of sizes.  When I was close in size to her, she gave things that didnt fit her (i.e. too big or too small).

Today, I am starting to return her clothes to her and give her some of mine.  I hope I never see the sizes 18-32W again.

She made the comment "I feel bad about taking these because if things dont go as planned, I dont want you to hate me."

Huh?

So now the doubt starts.

Obviously, there are people that need revisions (there a boards full of them). But are there definitive studies out there about weight regain after RNY.  

Vets-what I am asking is "When you followed your surgeons guidelines 2+ years post op, did you have any mysterious weight regain?"

It is probably dumb (and a bit too late) to worry about this now. However, I want to know what I am going into, eyes wide open.  When the honeymoon ends, does hell begin (i.e. the pounds fly back on) or do I just end up in purgatory (i.e. things are good when my food choices are good)?

Thanks in advance

SkinnierScientist

Weight regain is very rarely mysterious.  It usually happens if people start eating more calories than they burn.  Usually they are eating things like potato chips or fast food or cookies or ice cream or drinking soda or... you get the idea.  Or maybe they are snacking frequently between meals.  Or all of the above.  It's very rarely a mystery.

The pounds very rarely fly back on.  They come back gradually, they way most of us gained them in the first place.  You didn't just wake up morbidly obese, right?  Over time, you grew larger and larger.  In fact, for many people, it's easy to kind of ignore because it happens gradually.  First your favorite jeans feel a bit too tight, but you still have some other pants that fit, so you just wear those instead.  Then those get tight so you buy a new pair one size larger.  But it's just one size, so that's not such a big deal.  And so on.

A lot of people seem to think the honeymoon period ends like a light switch going off or something.  It doesn't.  Gradually you begin absorbing more calories and also be begin to be able to eat more.  It happens gradually, almost from the very beginning.  It's not a sudden thing.

What a great explanation,poet Kelly!

I honestly feel that because I have always followed the rules, that I am a Vegetarian, and that I never restricted my calories to an extreme during the “Honeymoon” period, is why I am so successful. Yes, exercise is important for health, but I do not believe the emphasis should be put there for being successful with weight loss or maintenance. You must embrace a lifestyle change with your thoughts and eating habits. Weight loss begins in the mind, not the stomach.

Please see my profile page if interested. I detail my experience with RNY there.

I really was inspired by your blog.  Planned eating is what is helping me. Before I relied on prepackaged and fast foods.  Now I eat a lot of protein instead of breads.

Kelly's response pretty much covered everything that I was going to say.  Occasionally people have SOME regain as a side effect of medication such as steroids, rarely there is a true surgical failure, and sometimes slowing metabolism after menopause can mean having to decrease calories in order to avoid regain, but almost always the regain is because people stop following the rules one way or another.  

It might be grazing/snacking, bad food choices, overeating (even to the point of stretching the stoma), drinking calories, or drinking with meals. If people honestly track what they are eating and drinking for 2 or 3 weeks, the reason for the regain is usually apparent.

Lora

I had a period of regain that started at 30 months out.  I gained three pounds in a month and continued to gain every month until I gained back from 128 to 142.  I was not doing anything different.  I was still eating absolutely no fruit, bread, rice, potatoes, pasta, noodles, cereals, or sugar.  At 142 I joined Weigh****chers, went to meetings and tried to follow their diet.  The weight gain stopped, but it took at least a year to get back down to my goal weight of 136. 

For the first 30 months, weight loss was easy and maintenance was easy.  After 30 months it has never again been easy.  I definitely can pinpoint the time when I no longer malabsorbed foods.  I can maintain my weight now and my surgeon just told me that my weight is perfect.  But I pay attention to everything I eat and I weigh myself every morning. 

My experience is to catch regain as soon as it starts.  Before my regain period I had put the scale out of sight and only weighed at the doctor's office.  He was doing something to treat my sinuses that summer that had me going for an appointment monthly.  If I had not been weighing there it would have been longer before I really faced my weight going back up.  Now I never miss a morning weigh in. 

When I have regain I cut out 500 calories a day to lose a pound a week.  I have added bread back against my surgeon's advice.  I need it to get enough bulk and fiber to be regular.  I also eat fruit now and occasionally other foods that I never touched for years.  It is not hell or even purgatory, because I got to lose all the excess weight.  I have to watch what I eat and weigh daily, but compared to being obese, life almost seven years after surgery is pretty close to heaven.

RNY 11/2/2010; HW 280; LW post-op: 182; Regain to 220; CW: 204.4; GW: 170

My period of regain started at 24 months out. I ignored the scale for close to 18 months, even as the pants got tighter. When I finally faced it, June 25 of this year, I was up 38 lbs. I got back on track and am now losing again at the rate of 1.5-2 lbs. a week. I have now lost 16 lbs. of the regain. Going to continue with the program until I reach goal, and then I'll continue the program through maintenance. For life. 

Key to my regain: not following the program, eating and drinking too much of the wrong stuff (esp. carbs like crackers, bread, pasta, rice, wine, diet soda), very little exercise, not enough water, not keeping track of food or exercise. 

Key to losing again for me: following the program I should have been following all along -- just as the wise vets above have said: high protein, low carb diet; 1200-1400 cal./day; no wine or diet soda; at least 64 oz. water; walking 60-75 minutes 6-7 days/week; weighing myself EVERY DAY; keeping track of food and exercise at MFP; reading and contributing posts here and at MFP. 

Sure, it takes more effort to lose now, but it's not impossible to lose at a reasonable pace if you stick to the program! In fact, I'm now losing more per month now than I was during months 4-12 post-op, when I had the benefit of malabsorption and was able to lose 5-7 lbs. a month without having to work very hard at it.   I regained because I continued in that pattern, malabsorption faded, and I became even less compliant. Now, at almost 4 years out, I'm losing again because I finally started listening to the wise vets and "got with the program."

The next challenge: getting to goal, and then maintaining. Again, I'll follow the advice of the wise veterans above and all around us here. Thanks for all your advice, wise sages, and your example to those of us who have not always been so exemplary or consistent as you. Even with a relapse, we can get back on track! 

The previous posters did a great job listen to them. Just a tip though, some people get jealous when we lose. Seriously. You think, gosh, not my BFF. It happens

If you read the posts about "needing revision" what you'll notice is most people don't need a revision -- what they need is to get back on program.  Face it, to lose the weight and keep it off, you will always need to "follow the program".  Once you reach your goal, you've got to continue working to maintain your loss.  If you start eating the pizza, Chinese food, pastas, crackers etc. you are going to gain weight. That doesn't mean "I need a revision".  It means stick to your calorie/carb/protein and water guidelines.  Yes, at maintenance you can eat more than when you are in "weight loss" mode - but that means a few crackers and cheese, or a slice of pizza, or a few bites of cake -- once in a while, not every day.

Successful weight loss and maintenance is a life-long commitment - not just committing for the "honeymoon stage".