This is a tricky one, as the bypass is difficult to revise. The most common things that are done are basically minor tweaks to your existing bypass - either putting a lapband over the pouch, or tightening up the stoma to try to restore some restriction. Neither seems to have a very good record of success. The most successful thing that I have seen is to revise it to a duodenal switch, but that is a very complex procedure, and there are only a handful of surgeons (maybe half a dozen) around the country who can do it. The other thing that is sometimes done, as the DS is too complex for most, is to convert to a distal RNY, which basically moves the pouch much further down the intestinal tract increasing the malabsorption, but that seems to be more trouble prone than the other alternatives.