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Hi! I’m having revision from VSG to RNY in June. I’m 52, and had the sleeve almost 10 years ago. I did well with the sleeve as far as no complications, but I regained almost all of what I lost, so here I am now. I’m older, hopefully wiser, and my reasons are different this time around. Best wishes to you!

A protein shake is really a meal replacement so you are having more than a meal or two. And no, don’t load up on junky snacks or empty calories. Look too foods that will add additional nutrients: fruit, complex carbs i.e. whole/multi grains, good fats like avocado & nuts, boiled egg, cheese stick, etc. Keep the deli/luncheon/charcuterie meats intake low too - highly processed, high salt & high fat, lower protein. Better to buy a bbq/rotisserie chicken& package it up in single serves & eat that. Give your body time to settle. It takes time for your body to work out what it needs to function effectively & for you to physically be able to eat appropriate sized portions & meals. My hunger didn’t really come back until about a year so after I reached goal at 6 months & it played a part in my continued weight loss. And it took a while to work out the calories I needed. When my weight first stabilised at around 18 months I was eating 1300 odd calories - it took me all that time to eat that much. At 4 years I was eating 1500/1600 & still maintaining much the same weight so it took that long for my body to work out what it really needed. Your lowest weight may not be your final weight either. There’s the quite common 5-10lb bounce back regain around the 2 or 3 year mark. Or lifestyle choices may mean you settle a little higher. And finally, your goal weight might not be your body’s goal weight (your new set point). My new set point was 11kg/24lbs less than my goal.

OK I am not a vet so feel free to ignore. Someone with much more experience will be along shortly and I too will be reading with interest. If you could track what you're eating now, in an app of your choosing, then that might help A LOT. Know thine enemy and all that. If I was in your shoes (and I may well be in a few years' time) then I think I would go back to protein first at most meals. Loads of veggies first at at least one meal a day too - raw or cooked. Track all of your macros. Ditch ultra processed foods and refined carbs *completely* - they are nobody's friends. For my own info please may I ask how long you maintained for following your sleeve and how quickly you regained when things got stressful?

Hi vets- It's been TEN years this year since I had my surgery. I hate that I'm writing this, realizing that I became the stereotypical regain person that I NEVER pictured I would be. I had so many life events- parent death, spouse job change, personal job change, night time job, kiddo diagnosed with severe anxiety/depression, etc etc and have had some regain. Has anyone got a good 'recipe' for regain/reset? I've read multiple posts here from someone recommending 2 shakes plus 1 meal a day. Ideas? Can anyone offer some wisdom to a failed sleever?

Catwoman is right. It depends what's on your plate. By and large, at least according to two prominent surgeons (Dr. John Pilcher and Dr. Matthew Weiner), pouch stretching isn't really a thing. Your pouch is meant to regain elasticity as it heals, allowing you to eat the amount of food you'll need for maintenance. It's what you choose to fill it with that makes the difference. Bearing in mind I'm still in the early stages so this is just based on research instead of personal experience, this is what I have read and heard. You want to keep your protein serving to 3-4oz and your starch/carb serving to 1/4 to 1/2 cup (or 1 slice bread), and the rest non-starchy veg. That would be 1/2 your plate is veg and 1/2 your plate split between protein and carb. And a smaller lunch/salad plate, not a dinner plate bigger than your head! The meal you posted looks pretty healthy to me. I found this video really informative:

@brandycsiz - I think its pretty common. I've deifinitely gone off track, mostly due to other health issues and stress outside of the surgery itself. I was able to walk several miles without stopping in December, then after getting Covid (and I'm assuming long-Covid now), if I go more than 3 miles in a day or try lifting weights in the gym, I get physically ill for 2-3 days afterwards. I keep walking 1-2 miles in the evenings after work, but the lack of progress and regain of weight is very discouraging. I tended to stress eat before, and to be honest, the surgery was a success because at least it limits the amount I tend to binge on when having a bad time. I still have those cravings, but at least now I can drink 8-12oz of water and delay eating. I'm probably on track with my diet 3-4 days per week, but have been overdoing it or eating too many calorie/carb-dense foods when I have an off day or when I see family, who aren't the most supportive. My mom likes to drop off Little Debbie cakes and other snacks on my porch twice a week as she's driving by, and it's straining our relationship because I throw them away immediately, and she sees that as me being ungrateful and disrespectful. I am 6lbs heavier than I was around 8 weeks post-op, so its really getting me down. After covid, I developed some issues with my heart rate. It drops down in the upper 20's to low 30s in my sleep and my blood pressure drops too low, but if it get it past 100bpm, my blood pressure spikes, and I get dizzy and almost faint. I'm trying to get in to see specialists, but I can't get in with a specialist for 5+ months just for initial consult. I have to drive 3+ hours to another area to try to get in sooner, but I burned all my leave time for the year with Covid in January, so I can't take the days off to travel.

Long rant ahead sorry ... So, I'm slightly angry (understatement). I saw my french primary care doctor yesterday. She's never been great to be honest. I've been seeing her for 6ish years. 5 years ago I gained over 80lbs pounds in a year and a half going from 118lbs (that had been my standard adult weight since my teenage years with a BMI of 19) to 200lbs ( BMI 32.3) after taking antidepressants. I stopped the antidepressants after a year because the weight gain was making me more miserable than I was being slightly depressed and thin. I have been struggling to loose the weight since... loosing and regaining the same 15-20 lbs again and again. As I've mentioned before, I have slight cérébral palsy - nothing too bad but enough to make walking pretty painful on my legs when I hit over about 130lbs and to make me generally clumbsy - I also lack gross motor coordination and don't have the best fine motor skills either... I can't really do any sports that require coordination and can only really ride a bicycle in a flat straight line and it takes a lot of mental effort for me to keep my balance, crowds freak me out because I'm scared of tripping and falling and don't even mention jumpy little dogs, my nemisis as my balance is so precarious. However I've always made do and It's never stopped me having an enjoyable fufilling life and a pretty decent career. My weight gain really really made me suffer, emotionally of course, my self esteem, my self worth etc ( I live in Paris which is the thinnist city in a thin country ... and it's not a place where people are kind to overweight people at all - I checked and the mean BMI of a Parisienne woman is 22.3 - so when you hit a BMI of 30 here you're really a fat outlier and are basically scorned in all public spaces ). It also made me physically miserable and I lost the little flexibilty I had - constant pain when walking - loss of gross motor skills, trouble showering standing up at 30 years old, not being able to put my socks on etc etc. For the last 4 years I have been to my Primary care doctor about 5 times asking for a referal to a nutritionist - she's always refused as told me "but it's simple, you just need to eat less and move more, it's not magic, No need to waste money on a nutritionist if you have no willpower "No **** sherlock! She has no idea the willpower it takes to get out of bed at 200lbs with cerebral palsy when you feel like your legs are litterally going to snap, when your feet are burning with weight stress induced neuropathic pain. In January I finally cracked after a lot of introspection and thought and booked my VSG for February in Turkey. I've now lost 35lbs since my preop diet so in just under 2 months. I already feel a lot better, the pain when I'm walking is lessening, I'm fitting back into the "second round" of fat clothes I got myself. So I walked into her office yesterday ( I had the intention of "fessing up" to having had a VSG and asking her for iron supplement ideas as I'm still being sick when I try and take iron ) She took one look at me and said "ah, you've finally found your willpower, loose another 20kg (40 pounds) and you'll be an attractive young woman again" I had a surge of red rage inside me, I kept my calm, but didn't tell her about the surgery, I just smiled and told her I needed a refferal to a dermatologist for a mole on my face and left. I'm never going back to see her again. I spoke to my physical therapist on the phone this morning and he sort of helped he said "can I be unprofessional ? Honestly, qu'elle aille se faire foutre, (she can go f*ck herself)" Lets find you another doctor." My physical therapist knew about the surgery, as did my orthopedic surgeon and booth agreed that with my CP anything is better than being even slighty overweight and that the surgury was worth the risk as they've both seen me loose my mobilité over the last few years and has seen how its affected me. They said that if I could afford to go private abroad I should because If not I'd have to jump through hoops for years in france because my BMI (32) wouldn't have been considered high enough as a stand alone. So yeah... this weekend I find myself another doctor who's not a fatphobic arsehole and has a minimum of human compassion. And for the iron I'm just going to go and ask directly at the pharmacy what the have to propose. Sorry that was long but I just had to get it out, I'm slowly realising all the **** I've put up with because of my weight these last years and I am ANNNNGRYYYY!!!! Hope everyone is having an okay hump day!

Any advice helps I’ve regained 40 pounds and I want to get to my goal weight which is 66 pounds away I’ve went back to basics but struggle mindset wise and can’t afford the therapy part 😭 any advice?

Oh and I forgot! Regarding your original sleeve: I know you'll be aware that after my sleeve I had reported being able to eat bigger volumes than I had expected. This was a constant throughout all my food stages. Given my eventual regain do you think there might be a merit to reducing the volume of my sleeve when you do the SADI?

Okay now that I’ve told my regain story and done as much research as I can (there is not a ton of info out there about the SADI) I have questions. Some that are white awkward tk Ask the doctor. First and foremost is how many of these procedures he had done. He is a very well knows surgeon, head of the bariatric department at the hospital even but I don’t think he has done a lot of this particular procedure. In fact the poster schematic is not yet on the wall and his office did not have any information packets to share about the procedure yet. If he says I am first I want to ask what makes him comfident he is capable? I’m pretty sure he just does sleeve and bypass primarily. So how differnt is if than a bypass?? I sorta understand the gist of it but I admit I don’t understand normal anatomy nevermind the exact differences between the procedures. also, I read some medical research on the procedure and they were talking about less complications after the learning curve a couple years later. Did that mean the individual surgeons learning curve or did they mean the field has learned from each others mistakes. I have to admit maybe being in the first few adds a little bit more anxiety to all this. Next I need to ask him, if he made my sleeve to big if he will correct that as well I have always felt like my sleeve was a little larger than everyone else’s based on how much I could eat so if he gets in there and that’s the case does he fix that as part of the procedure if so, is that now a differnt procedure and does that matter? I am not expecting anyone to know answers to these questions just help me with the way to word them so that I can feel comfortable asking I don’t want him to think I am questioning his surgical skills because I know he is really good but I still need some reassurances here

Thank you for sharing your story. All of us who have had WLS have a fear of regain but it happens. It's helpful to hear where you went off the rails. I hope your second surgery gives you another chance to get to where you want to be. Please let us all know how you're doing.

Okay this is long and boring at parts but here it goes. I am 3 years post sleeve and I have gained all my weight back . First of all I was on the smaller side to have the sleeve but I do still have all the same struggles and if I had waited until I was older it was just a matter of time until I was a higher bmi having the surgery. The fact that I have lost and then gained it all plus some within less than years is probably proof of that. Anyways, with the sleeve I did lose a big chunk of weight. I went from 235 to 168 which I could not have done with regular diet. But, i was always able to eat a little more than I should at every given stage and everything was easy for me. From day one I had no gas pain and water was easy to get down, then fluids and protein which were easy to keep down, I had no food intolerances and advancing through each stage. I was living my best life watching the pounds fall off but I was alway able to eat just a little more than everyone else at the same stage. Well, while the hunger hormone was gone and I was focused I was able to eat exactly what I SHOULD be eating and I measured my portions to the Amount I should be eating and I was satisfied. So lost most of the weight the dr suggested I would. i held that weight for a few months but then the hunger started creeping back and between the hunger and the extra room in the pouch I started gaining in spite of still making healthy food choices (my food was fine but my portions were too large and too frequent). Well, even though I knew I was losing control my friends and family continued to look at me as doing great..I was still on the road to getting to where I needed ti be in their eyes. I was ashamed. I was failing yet They kept complimenting me and offering me food. They were saying things like your doing so good, you can have one slice or pizza or one brownie. It won’t kill you. It’s okay that you’ve gained a couple pounds I’ve gained a couple it’s Christmas. You can lose that. Well I have since learned that no I cannot just have one of anything to do with carbs or I crave them for a week but I didn’t know that back then Anyways, was still going to my surgeon asking for help but I have bipolar disorder and the meds I take for it limit what other meds I can take so I cannot take many of the weight loss meds they had to offer. And the one I can take worked wonderfully during the day but when it wore off I ate all night Fast forward a few months and I stepped on the scale and I was back over 200. That sucked but I wasn’t giving up. went back to my surgeon asking about revision to bypass. I have heartburn gerd whatever you call it and clearly the sleeve wasn’t working so I wanted to know my options. Well let’s go back. I knew I didn’t want to have surgery if I was going to just repeat the yo-yo that had just happened so I decided I wanted two opinions this time. Well the second opinion dr had a cancellation so I seen him first. He was on board. He was going to bypass a shorter amount of bowel so i had less absorption issues and my meds Would work fine he said which seemed to be his concern even though it wasn’t really my question. I just needed my dr to say that it shouldn't be a repeat of last time and I was going forward. Well even though the bypass was an option he presented to me to start he said he wouldn’t do a bypass for me. He thought it would be a bad call with my mental health issues. This was confusing to say the least because I have one dr saying it’s fine and another dr I really respect saying it’s not and I started this thinking bypass was always an okay option in terms of mental health but worried the surgery just wouldn’t work for me. I am of course concerned about my mental health so took some time to think about it. I tried for a while to find a bariatric therapiest but none near me are taking any new patients. I even asked the surgeon and he said he would look into it but be never did. Anyways I called around for the better part of two days. They all just do the evaluations now for surgery. I have had every hormone test and lab they have that could possibly be the problem. I changed all my meds in case they were the issue. I tried everything myself and my doctors could think of but I kept gaining. When I revisited the idea of surgery I was scared. Anything that was going to upset my mental health again just isn’t an option I decided. I already know what life without my medication is like and I do not want to go back there. I continued to gain. I got back up to 245 and I am miserable. I am so depressed when I look at what I have let happen to myself. I had a chance and I blew it. I am disgusted when I look in the mirror. I decided that the weight is causing me to be more depressed so I needed to get some real answers. I went back to my surgeon. Not to ask him to do the surgery but exactly why he thought it was a bad idea. The plan was to take that info and talk to the other surgeon to make sure he had considered that and see why he wasn’t worried about it. Well, surprise…my surgeon is on board now with doing a revision for me. When I asked why he said no before he said something about a nite in my chart that said I wasn’t complaint with my meds back them and he didn’t know I have a psychiatrist and psychologist and take my meds but now he is comfortable doing surgery. So, frustrated I had to wait until I gained almost 50 more pounds to get here but excited he is willing to do it I am researching the other surgery he thinks will be a better fit for me called the SADI. At the same time I am still not buying the note in my chart thing. Cause that was never true. I guess the important takeaway for those of you here that are just starting out is even if you do regain don’t lose touch with your team and don’t give up. I feel like my dr wavering in whether he would do the surgery didn’t help but I could have asked more questions sooner and I wouldn’t have so much to lose this time. Plus, hopefully you guys can take the weight loss meds and won’t be facing a second surgery.

My friend are you speaking to a therapist with relevant expertise? I know you are currently choosing your revision surgery and that's a huge decision. Please in the midst of that don't lose sight of your relationship with food and how you lost and regained weight in the past. We've all been there MANY times. Feel free to ignore me if you have all of this under control. You have done so well before and I know you can do again xxx xxx

I have also learned lots from people here who haven't done as well as they wanted to. Everyone has something to share. There's no shame in regain, it happens to loads of people for so many reasons. I say post away wherever you like. I suspect all you will get is well wishes. I really really hope you get a better sustainable result with your revision. You're doing a good thing for your health. 🤗

you can always increase calories to gain weight (or to stop a loss), but keep In mind that a vast majority of us experience a 10-20 lb bounce back regain around year 3. You might want to factor that in. I purposely went below my goal just in case I had a rebound (and I did...actually closer to 30 lbs for me...).

I kept losing for almost another year after I reached my goal. It began at a similar rate of loss as I was experiencing but gradually got less & less until it stopped. Over that time I increased my calorie intake (added more & more snacks) & my portions got a little larger. I was eating about 1300 calories when I initially stopped losing but eat about 1500/1600 to maintain at about the same weight now. Like @Spinoza, I’m a believer in our changed set point. This is the weight my body is happy at & this is the weight it wants me to be thanks to the surgery. Could I eat my set point up? Yes, if I wanted. I mean that’s what we did before - ate our set point higher. Our original set point wasn’t an obese weight. Don’t forget you may initially stop at a lower weight than you expected but it may give you wriggle room if you experience the bounce back regain around years 2 or 3. Give your body time to resettle. Lots of things change when your weight starts to stabilise. Just give it time. Slowly increase those calories. Get in touch with your dietician for ideas of what you can add or how you could adjust your current eating plan. Good luck.

I hope talking to them about it will help! It's funny because everyone knows right now I can barely eat anything, but they all catch themselves offering me food because it's "polite." I'm eating dessert, want some? I made this big meal full of stuff you can't even look at right now, can I get you a plate? And then I see it on their faces, it's like oh, wait... But since you're dealing with regain, it's good that you are figuring out your triggers and asking others to help you avoid them now so you can have the best chance for success the second time around.

That’s very true. Even as we spoke today she was researching it a bit. Perhaps it peaked her interest and she will search it a bit more. My surgeon is not at a weight loss center but he does have a NP and I am expected to do follow up appointments with her. Post sleeve I stopped going as soon as they said I could get my labs at my pcp but that’s just because I was so ashamed about my regain. I know that the malnourishment is a lot bigger of a deal with this procedure though so I will be more diligent this time around if I choose to go with the SADI.

Has anyone looked into the lower calorie options in the factor75 meals. They are not cheap but they are prepared but they are fresh and they have vegan and keto options as well. I assume this would be an option to consider for those in maintenance for busy nights but I’m not the greatest at reading labels. I am currently looking into converting to SADi and just want to get started with something while I do my research and the insurance process (I was sleeved 3/9/21 and gained the weight back). I never did learn to understand all the macros and stuff the first time around which I’m sure contributed to my regain. I’m am just curious if anyone who understands all that has researched them and has any feedback about them.

For me the decision was fairly easy, I didn't want to risk GERD chances (I have the worst luck and if there was a chance - even a small one I'd get it) and I didn't want to risk yet another surgery AND the possibility of my insurance declining another bariatric surgery. The second reason was usually you lose more weight with a bypass and I've had a few surgeries with organs removed...I just wanted at least one after a surgery (my stomach) to not being one of them, stupid I know but ...its what helped me decide. Lastly, I'm a researcher and all the numbers in the medical studies journals / research papers looked better to me they pointed to better overall outcomes with bypass, more weight lost, less weight regain, better chances of reducing my pre-diabetes etc. I'm fairly anal retentive so I knew I'd be the same way on making sure I took my vitamins so I didn't worry about that aspect of it. I listened to my surgeon who didn't really help..he said both were good choices for me, so that left me having to research on my own. Good luck on your journey!

I am almost two and a half years post sleeve. At your stage I was eating around 800 calories I think, but if I've learned anything it's that we're all totally different! Well into maintenance, my typical day is: Breakfast: full cream milk latte. I have never eaten breakfast at breakfast time and never will. Mid morning: one or two fried or scrambled eggs, depending on how hungry I am. Generally one. Lunch: a salad with some protein (last night's dinner meat, tinned tuna or deli meat - sometimes cheese). Or more often soup - usually homemade and usually with either chicken or pulses for protein. Or occasionally, if I'm feeling really lazy and can take the sugar hit, 100g tinned baked beans with cheese and hot sauce. Snacks, probably three a day at this point: cheese (and usually a couple of crackers with that); 150mls [approx] full cream milk kefir or a kefir yoghurt; nuts (30g approx); seeds (20g probably); deli meat; fruit (I eat at least one portion of berries or an apple every day). I tend to keep lots of meat snacks in the fridge as they're filling and help me reach my protein goal. Dinner: whatever I've cooked for everyone else but without the carb element, or just a tiny bit. Basically protein and veg - in that order. But that includes fried chicken, bolognese, casseroles, sausages, roast dinners, fish pie (no potato topping) - everything I used to eat before my sleeve. Supper: I do most of my carb intake here. Toast and butter, porridge (oatmeal to you lot) with stewed fruit, crackers with butter (or cheese if I haven't cheesed out by then). Exercise: I do a 1 hour aerobic exercise class 3 days a week. I walk between 2 and 4 miles every day and I jog about a mile once or twice a week instead of walking. I am still amazed by what my new body can do. I probably should do more. This is my diet 90% of the time. I have lots of days when I stray badly off the path and eat chips (crisps) and occasionally chocolate. I also drink wine every weekend, which I accept is totally empty calories with no nutritional value. I just track everything and try to adjust if I can. I've had a couple of regains of a few pounds now (4ish), but so far I've been able to jump on those, ditch the rubbish (carbs mainly), up my exercise and get back to 140 or thereabouts. It's no problem at all - a couple of weeks of being more vigilant about what goes into my mouth and a few runs instead of walks. I really hope I can keep doing that. I may have to accept that my set weight is higher than 140 but I am loving it here!

Just checking that that isn't all you're eating! I'd also check with your team that the takeout food that you are eating fits into your overall plan. We have such a small capacity at 2 months that we really need to pack nutrients into every meal. Rice and noodles have nothing to offer at this point. The chicken definitely does. In addition, the months after your surgery, when your appetite is zero and your capacity is small, are your chance to re-train your tastes. In a year's time much bigger volumes of takeout will be much easier to get through and much more apt to cause you not to lose what you should, or even to start to regain. I totally understand that your cooking facilities are limited and that makes things hard. I hope everything goes well for you.

If you have access to therapy, this is something that would be good to address because this mindset of guilt and shame is neither healthy nor productive. I know that not everyone can get therapy, but there are other resources available. Perhaps your clinic has a support group you can join. I highly recommend the podcast, “We Only Look Thin,” which has a lot of great advice relating to mindset. The bottom line is that no single meal is going to make you regain 36 pounds. Beating yourself up over it isn’t going to accomplish anything. You’re new to post-WLS eating and still learning, so learn for next time. Recognize that you weren’t prepared for the event not having food that meets your needs and learn to be prepared next time. Maybe keep a “just in case” protein bar in your car. One of my strategies for an unknown food situation is bringing my own Skinny Girl salad dressing and/or a couple of low-carb tortillas, so I can make a salad or wrap out of what’s available. Also, nowadays people are pretty sensitive about dietary restrictions and won’t be offended if you ask what will be served and even request a special meal if you’re comfortable (though I understand not wanting to call attention to your diet). Having an all-or-nothing mindset where you equate two fries and half an onion ring to failure is really harmful. You made a couple of decisions, in seven whole weeks, that weren’t on track. That’s not going to derail all of your progress. There’s no reason you can’t continue to stay on track aside from those isolated instances. This is a marathon, not a sprint. Don’t quit the race just because your shoe came untied once or twice.

One of the healthiest ways of eating (I don't want to call it a diet) I have come across is in a book called the Pound of Cure by Dr. Matthew Weiner. Last summer, I hit my highest weight ever. That's when I started looking into WLS. I was watching a lot of YouTube videos about it and came across an interview with Dr. Weiner, which led me to his books and videos. He also has a weekly podcast that I love with new episodes every Wednesday. I started implementing a lot of the advice in Pound of Cure (you can get the book on Amazon) and lost close to 15lbs between July and January, which on the one hand is slow, but on the other hand it felt completely natural and not like a diet at all. It's just a sustainable way of living that focuses on healthy foods and good habits that lower your body's set point. He has a lot of resources for dealing with weight regain, too. Congratulations on still being over 100 lbs lighter than where you started! I have every confidence that you can continue to do well and meet your goals over time!

same, same, as the other posters above. i am really, really good at losing weight. I am (was) also really, really good at finding that weight again. i've lost 50-75 lbs three separate times prior to wls, and each time managed to regain it within a year or so, plus a few more pounds for good measure, until i finally hit my highest weight of 235 lbs (i'm 5'2" so thats alot of weight for my height). with WLS (sleeve for me), i lost 120-ish lbs and kept it ALL off (give or take 5lbs) since reaching goal...almost 5 YEARS ago... whats more, maintaining this weight seems relatively effortless compared to before. because i eat so very little in volume (added to the fact that i somehow developed an affection for exercise and activity!), i have quite a bit of leeway in food choices to reach my maintenance calories. i am very grateful for this aspect of my surgery experience, i tell ya. BUT... i will add a disclaimer here that not everyone has the same WLS experience. you won't know what yours will be until you know. though we all of us here already sort of know that low calorie diets alone aren't sustainable long term for us. i mean, that's why we are all here, no?