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Maybe you've gained muscle mass which could show as weight gain, but is totally different from gains due to fat. It sounds like you are on the right path to getting things figured out by contacting your nutritionist. But I wouldn't be surprised if your BMI has changes due to mucles mass increase, which makes weight loss seem slower than normal. Sent from my SM-N910P using the BariatricPal App

Hi everyone.. Hoping for some advice. I had my sleeve done in March 2013..and lost approx 66 pounds....I had done really well up until about 6 months ago where I have just been on an eating road to destruction. I can now eat so much more...which is my downfall.I am snacking between meals now because I "think" I'm hungry...and now I get occasional hunger pangs which of course I never had initially after surgery.Up until 6 months ago I would get warning signs that I was full but now when I do get them it's way too late and I feel ill.I've been reading the tiny amounts people are still only able to et at 3 years post surgery,but I can still eat good sized meals. I don't eat meat..and after surgery I had a lot of Protein shakes to keep my protein up,but thats also stopped too.I do eat fish and chicken but not that often. I had started exercising before Christmas..after no exercise after surgery..just keeping busy with incidental exercise but fell off the wagon,so currently do not do any form of exercise except for a job that keeps me moving a fair bit. I've also stopped taking Vitamins,not intentionally..but wonder if they make a difference? I've tried rebooking into my surgeon but they have no appointments until April. I've been under a lot of stress lately and have reverted back to my comfort eating which is what got me to the point of surgery in the first place. Do anyone think i should go back on the Optifast VLCD as a kick start? I was thinking if I did that for a few weeks for Breakfast and lunch and just have a regular meal for dinner? Any input would be really appreciated.

Hi Smallbird...I feel your pain.I have come to the forum today because I too have gained 13 pounds in the last 6 or so months and don't know what to do with myself. I'm hoping for some advice too. I'm glad you have made the first step of going back to your surgeon.I can't get an appointment for mine till April which I'm not impressed about. Sounds like there could be more to your weight gain as you are following all the rules and exercising without any luck. I hope you get some more replies...hopefully someone can help you overcome this stumble.. Good luck :-)

What are you eating? Do you track your foods? Medication can be a tough one. I'm on a med for my anxiety that is known for weight gain. I do plan to get off it after my surgery (scheduled for 4/4)...but my health anxiety was getting the best of me so I had to get back on it. Sent from my iPhone using the BariatricPal App

yes that can slow things down a bit. you could be holding Water, with the little weight gain. if you can manage to get more fluids in I think that number will change. The scale has started moving again and I have lost an additional 3 lbs! Down 37 since surgery. Sent from my SAMSUNG-SM-N910A using the BariatricPal App

yes that can slow things down a bit. you could be holding Water, with the little weight gain. if you can manage to get more fluids in I think that number will change.

Lenny Vartanian, PhD., from the Psychology Department of the University of New South Wales in Australia and her colleagues recently analyzed the effect of stress on overeating by placing Cookies in a cluttered/clean kitchen and watching the results. According to a study involving 101 women at Cornell’s food and Brand Lab, researchers showed that when those with heightened stress levels were placed in a noisy, messy kitchen — think scattered newspapers, a stacked sink of dirty dishes, relentless telephone ringing — and they were asked to wait patiently for another person, they ate more. In fact, these women ate twice as many of the cookies left out for them as did their equally-stressed counterparts, who waited in the same kitchen, but one which was organized and quiet. Environmental chaos can induce stress. Stress then leads to a coping mechanism. In this instance, the coping mechanism was to overeat. And overeating? It’s your one-way ticket to weight gain. But what’s also worth considering are the cascade of events that led to the overeating — a cascade not relegated to just this one experiment, but one that’s applicable to the broader population. A better understanding of this could help with the diet-and-food-related issues many of us face. Stress is a condition characterized by symptoms of physical or emotional tension and anxiety. In a normal, stress-free state, we have hormones that circulate our body, catecholamines, called epinephrine and norepinephrine. These hormones give us the energy to perform daily tasks in a calm, consistent manner. But if we’re triggered by an unpleasant feeling or event, these catecholamine levels rise. And our bodies’ natural response is to find a way to lessen them. One coping mechanism in dealing with stress is to overeat. Eating increases another of the body’s “feel good” hormone, called serotonin, which helps to improve mood. Serotonin tempers the catecholamines, thus reducing feelings of stress. More of this article is available here. http://acsh.org/news/2016/02/12/81099/

I'm pre op but I have pcos and have been on all types of BC? Started with pills but had to stop when I went on blood pressure meds, did depo for years, loved it but the weight gain was over 60 pounds. I have a mirena IUD put in last year, have had maybe 10 days of cycle in the 10 months I've had it. Love that I don't have to think about it, but it really doesn't do much for my hormone level fluctuations. I can't get pregnant so I don't worry about that, it's more to control bad bleeds for me. Sent from my iPad using the BariatricPal App

I'm really glad you're back too! I missed your posts! I hope you use a computer and not a phone to post. People are having trouble with the app. It's so much easier on a PC or laptop to see all the forums. There are several threads about all of us working on regain. One is weight gained since sleeved. I'm working on taking 10 lbs off again but it is really hard. I hope to see you posting every day!

I opted for the Depo Provera shots. No daily pills, no Nuvaring (my daughter saw the commercial about the bad side effects of it and I stopped using it). Just once every three months, and that's it. I don't even have periods anymore. I'm loving that!!! And I haven't gained weight with it. It even says that average weight gain is five pounds. The weight I have gained is due to PCOS and not being able to exercise like I'd like to. Just thought I'd share an alternative to pills. Sent from my iPhone using the BariatricPal App

Most places in Mexico require payment in full before surgery. It's not a problem. Just save up. It took me less than a year to save up for mine. If you want to go that route then the best bet is to do self pay in the States. You can find doctors who will bill you out like that but you will pay far more than had you gone to Mexico. Congrats on quitting smoking. However, don't let that be an excuse for a huge weight gain.

My husband & I went to Mexico last week on vacation and I just wanted to share with everyone that it IS possible to have a fun vacation and not worry about food, even though we are on specific eating programs. I am 4.5 months post-op and pretty much adhered to my proper diet with a few exceptions. I took my vitamins, ate a lot of lean/grilled protein and tried to get my water in. If we were off-site on an excursion, I made sure to have a protein bar and extra water on hand. Breakfast was usually an omelet with veggies or a yogurt & fruit and lunch/dinner was grilled or poached fish, shrimp, chicken or lean beef and veggies. We stayed at our favorite inclusive resort and I pretty much ate dessert every night, only had pasta once (two spinach raviolis) and only ate rice once (a couple bites of sofrito & rice). I did have crusty bread at dinner most nights (usually with olive oil & balsamic) and I did drank alcohol most nights at dinner and at the swim-up bars at the pools. Before everyone gasps, I only gained two pounds. We walked a lot and went on several off-site excursions, along with swimming almost every day. I got back home Saturday night and went back on program Sunday. I weighed myself this morning and not only did I lose the two pounds I gained on vacation, but I also lost an additional pound. We took this same trip at the same resort two years ago and we both ate and drank like no tomorrow and I gained 14 pounds. I did have to say “no” to a lot of things that looked delicious and I couldn’t finish a lot of the yummy food on my plate, but it is possible to go on vacation and enjoy your meals with minimal weight gain.

Hi sleeved 2/3/14, dealing with reflux and regain of 20lbs (never got under 200 lbs with the sleeve) Surgeon predicted my goal weight as 222 SW: 297. I've never felt my sleeve was done correctly. Looking to revise due to reflux and regain. Being directed toward roux en y, but I do not have a gallbladder, so wouldn't it make more sense (since I'm already sleeved) to go with the DS? HELP, I need some input.

okay so youre using weight gain shakes? if so why use almond milk? it seems kind of weird to limit your calories when your trying to gain weight.

I am 34 months RNY gastric bypass. I chose this type of surgery because I have severe acid reflux (GERD) prior to surgery and this is the recommended approach for that condition. I was in the weight loss phase for 6 or 7 months and then transitioned into the maintenance phase. What you are requesting, I believe is how to minimize your weight gain prior to surgery. This is somewhat similar to the maintenance approach, perhaps the following article might provide you some clues. http://www.breadandbutterscience.com/Surgery2.pdf

You mean in the maintenence phase? I feel in moderation and factored into your daily caloric consumption there is no issue having a drink once a week or even once a day if it's not causing you any adverse effects like weight gain or dependence. The losing phase is a bit more challenging because like stated above, drinking can hinder weight loss and rob you of the precious honeymoon period window of time where hunger is low and weight loss is easier. The honeymoon period is also a time where you should be setting up healthier habits in preparation for the maintenence phase, and in my opinion, drinking other than ocassionally doesn't really fit into that equation.

Studies show weight gain or loss is mostly about diet and very little about exercise. Excercise will improve your cardio and build muscle which will help increase your metabolism, but in the end it's all about what you put in your mouth. I lost 22 pounds on my preop diet and 100 pounds overall, without engaging in any exercise whatsoever. Sure, I have a physical job and an active lifestyle, but it's the same job and lifestyle I've always had. Nothing changed except my food choices and portions. Just concentrate on eating healthy, stay away from carbs, drink LOTS of Water and focus on the things you can control in order to reach your goal.

LOL Goodness, you're giving me too much credit I have zero self control, which is why I needed the lap band in the first place... My blessing is that I've always been a good eater in that I love ALL foods. Fruits, veggies, Proteins, good carbs... I love all the foods I'm "supposed" to eat, but I also love the foods I'm NOT "supposed" to eat. My problem before WLS was that I'd load up my plate, big time. Heaping piles of potatoes, 8-10 ounces of meat, heaping piles of veggies covered in olive oil and/or tossed with feta cheese and lemon juice (YUM!!!) and then I'd eat dessert like a 2 pack snack cakes or a bowl of ice cream. And I'd eat my partner's leftovers. Every meal I ate would be balanced, but would also be enough to feed 2-3 normal sized people. The lap band enables me to eat an appropriate portion for one person. I think you need to focus on what your problem is. For me, it's always been portion sizes. I have a hard time dishing up a normal serving size for myself and I use salad plates now so I won't over-do it. I fill the plate mostly with Protein and veggies, and then one scoop of rice/potatoes/pasta because I just can't do without a few bites of it. I eat the protein first, then the veggies, and that leaves very little room for starches so I eat a couple bites and then I throw the rest away. Usually that's good enough for me. I eat until my stomach says "stop" and then I'm done. If I eat beyond that "stop" I get a stomach ache. There are times where I'll stare at my food and feel totally baffled because I WANT to keep eating but I CAN'T keep eating. It's a very, very strange feeling for a volume eater. My PA told me everyone's weight problem stems from different issues. Some of the folks she saw ate only carbs and had to get used to including proteins and veggies. Others loved dessert too much. Others struggled with emotional issues and needed counseling. My problem is I'm an enthusiastic eater with a very powerful appetite. The lap band itself easily resolved that for me - my issue appears to be purely physical. I've thought about it a lot because I thought I was an emotional eater and I went through counseling only to learn that I'm really not... I don't know why I have an abnormal appetite, I just do. So I think you need to really think about why you're struggling. What are you eating? How much? How often do you get hungry? When do you get hungry? Do you have situations that trigger your hunger? Are you drinking enough Water? Do you have a medical condition that caused/causes weight gain? Hope that helps a little... I'm sorry you're struggling I'm not quite an expert yet because I only just had my surgery a couple months ago but I'm happy to answer any questions!

my doctor explained to me that in the first six months there is still swelling and things are not back to normal, which is why your stomach can seem to stretch after the "honeymoon" period. the doctor told me they leave the least stretchy part of the stomach. I have no doubt that xray of stomach after surgery and after a year show a difference, but I do not think it is anything that someone has done "wrong" but rather a normal part of the process. I am pretty sure that weight gain would be due to eating around the sleeve, or drinking calories.

Amelie2016 - I have been researching this myself and today I found these questions and answers. Unfortunately, according to this, bariatric patients do not qualify for this procedure.I am only 3 weeks out and having the worse GERD of my entire life and it is not being controlled with medication. This is from Massachusetts General Hospital Frequently asked questions: LINX® system Q: What is the LINX® Reflux Management System? A: The LINX® Reflux Management System is an FDA-approved device implanted laparoscopically. The system relies upon a flexible bracelet of magnetic titanium beads that, when placed around the esophagus, supports a weak lower esophageal sphincter (LES), the muscle that opens and closes to allow food to enter and stay in the stomach by restoring the body’s natural barrier to reflux. Q: What are the risks associated with the LINX® procedure? A: All surgical procedures have risks, such as the risks associated with anesthesia, risk of bleeding and risk of infection. These risks are small. The most common side effects of the LINX® system are difficulty swallowing, post-operative pain and temporary bloating of the stomach. In the long run, many surgeons have concern that the device might erode into the esophagus and need to be removed. This has not been observed in the clinical trials to date. : How soon after the procedure can I eat? A: You should be able to eat soft foods with 48 hours of surgery. Q: How soon after the procedure can I resume normal physical activities? A: Routine daily activities can begin within a few days of surgery when pain medicine is no longer required. Activities such as sit-ups or weight lifting, which require use of the abdominal muscles, should be deferred for three to six weeks. Q: Will I have to take acid suppression medication after the procedure? A: Based on the clinical trials performed prior to FDA approval of the device, only 10% of LINX® patients required daily medication at one- and two-year follow-up. Q: Is there any risk the device will be too tight and cause food to get stuck? A: Yes; about 3% of patients that have had the device implanted had this problem and required removal of the device. Q: After the device is placed, is there any risk of infection? A: There is always a small risk of infection whenever a foreign object is placed in the body, whether it is LINX®, a pacemaker or an artificial joint. There is not enough data at this time to calculate the percent risk of infection, but the early data suggests it is quite small. Q: Will the device ever have to be removed? A: The intent is for this device to be permanent. But, since there is no 10-year follow-up data available yet, we cannot be sure. : Is there any chance the LINX® system won’t work as well if I gain a lot of weight after the procedure? A: The LINX® system works by creating a pressure of approximately 25 mm at the gastroesophageal junction (the place where the esophagus and stomach meet). Weight gain increases the pressure inside the abdomen, so it is possible that significant weight gain can create more pressure than the LINX® valve can counteract, leading to the return of reflux symptoms. Q: Will my insurance company pay for LINX®? A: Nearly all insurance companies pay for antireflux surgery. Since the LINX® procedure is a new form of antireflux surgery, insurers are learning about the procedure. We are working closely with them to obtain pre-authorization for these procedures on a case-by-case basis. Q: If my insurance won't pay for it, how much would the procedure cost? A: Please contact the Mass General Billing Office at 617-726-4098 or at cs.mgh@partners.org for more information. Q: I have heard that because I had bariatric surgery, I am not a candidate for LINX®. Is it possible this will change and I could be eligible for the system in the future? A: The LINX® system is not approved for use in patients who have had prior bariatric or esophageal surgery. Q: If the LINX® device needs to be removed or isn't effective, can I have a standard Nissen fundoplication (NF)? A: Patients often mention that an NF was suggested to them in the past, or they were considering it when they found out about LINX®. As the screening tests are the same for both procedures, NF may still be considered, providing testing doesn't exclude you. If you cannot or choose not to have LINX®, NF may still be an option. Thank you for this. This is not good news, is it. =( I guess now I need to find out why, good to know because I will take this info to my next appt. too. Yes, that;s what I hear as well but preop and with the surgery I've lost 45 lbs and my GERD has not improved at all. Of course I still have a lot of weight to lose. I don't think I have ever been so miserable with pain. If I didn't know it was acid, I would swear I was having a heart attack. No its not good news so if you find out anything different let me know.

Amelie2016 - I have been researching this myself and today I found these questions and answers. Unfortunately, according to this, bariatric patients do not qualify for this procedure.I am only 3 weeks out and having the worse GERD of my entire life and it is not being controlled with medication. This is from Massachusetts General Hospital Frequently asked questions: LINX® system Q: What is the LINX® Reflux Management System? A: The LINX® Reflux Management System is an FDA-approved device implanted laparoscopically. The system relies upon a flexible bracelet of magnetic titanium beads that, when placed around the esophagus, supports a weak lower esophageal sphincter (LES), the muscle that opens and closes to allow food to enter and stay in the stomach by restoring the body’s natural barrier to reflux. Q: What are the risks associated with the LINX® procedure? A: All surgical procedures have risks, such as the risks associated with anesthesia, risk of bleeding and risk of infection. These risks are small. The most common side effects of the LINX® system are difficulty swallowing, post-operative pain and temporary bloating of the stomach. In the long run, many surgeons have concern that the device might erode into the esophagus and need to be removed. This has not been observed in the clinical trials to date. : How soon after the procedure can I eat? A: You should be able to eat soft foods with 48 hours of surgery. Q: How soon after the procedure can I resume normal physical activities? A: Routine daily activities can begin within a few days of surgery when pain medicine is no longer required. Activities such as sit-ups or weight lifting, which require use of the abdominal muscles, should be deferred for three to six weeks. Q: Will I have to take acid suppression medication after the procedure? A: Based on the clinical trials performed prior to FDA approval of the device, only 10% of LINX® patients required daily medication at one- and two-year follow-up. Q: Is there any risk the device will be too tight and cause food to get stuck? A: Yes; about 3% of patients that have had the device implanted had this problem and required removal of the device. Q: After the device is placed, is there any risk of infection? A: There is always a small risk of infection whenever a foreign object is placed in the body, whether it is LINX®, a pacemaker or an artificial joint. There is not enough data at this time to calculate the percent risk of infection, but the early data suggests it is quite small. Q: Will the device ever have to be removed? A: The intent is for this device to be permanent. But, since there is no 10-year follow-up data available yet, we cannot be sure. : Is there any chance the LINX® system won’t work as well if I gain a lot of weight after the procedure? A: The LINX® system works by creating a pressure of approximately 25 mm at the gastroesophageal junction (the place where the esophagus and stomach meet). Weight gain increases the pressure inside the abdomen, so it is possible that significant weight gain can create more pressure than the LINX® valve can counteract, leading to the return of reflux symptoms. Q: Will my insurance company pay for LINX®? A: Nearly all insurance companies pay for antireflux surgery. Since the LINX® procedure is a new form of antireflux surgery, insurers are learning about the procedure. We are working closely with them to obtain pre-authorization for these procedures on a case-by-case basis. Q: If my insurance won't pay for it, how much would the procedure cost? A: Please contact the Mass General Billing Office at 617-726-4098 or at cs.mgh@partners.org for more information. Q: I have heard that because I had bariatric surgery, I am not a candidate for LINX®. Is it possible this will change and I could be eligible for the system in the future? A: The LINX® system is not approved for use in patients who have had prior bariatric or esophageal surgery. Q: If the LINX® device needs to be removed or isn't effective, can I have a standard Nissen fundoplication (NF)? A: Patients often mention that an NF was suggested to them in the past, or they were considering it when they found out about LINX®. As the screening tests are the same for both procedures, NF may still be considered, providing testing doesn't exclude you. If you cannot or choose not to have LINX®, NF may still be an option. Thank you for this. This is not good news, is it. =( I guess now I need to find out why, good to know because I will take this info to my next appt. too. So sorry you're having GERD right now! I do hope it resolves itself. I keep reading that as we lose weight, the loss of pressure helps. I do hope it goes away for you! =( Yes, that;s what I hear as well but preop and with the surgery I've lost 45 lbs and my GERD has not improved at all. Of course I still have a lot of weight to lose. I don't think I have ever been so miserable with pain. If I didn't know it was acid, I would swear I was having a heart attack. No its not good news so if you find out anything different let me know Amelie2016 - I have been researching this myself and today I found these questions and answers. Unfortunately, according to this, bariatric patients do not qualify for this procedure.I am only 3 weeks out and having the worse GERD of my entire life and it is not being controlled with medication. This is from Massachusetts General Hospital Frequently asked questions: LINX® system Q: What is the LINX® Reflux Management System? A: The LINX® Reflux Management System is an FDA-approved device implanted laparoscopically. The system relies upon a flexible bracelet of magnetic titanium beads that, when placed around the esophagus, supports a weak lower esophageal sphincter (LES), the muscle that opens and closes to allow food to enter and stay in the stomach by restoring the body’s natural barrier to reflux. Q: What are the risks associated with the LINX® procedure? A: All surgical procedures have risks, such as the risks associated with anesthesia, risk of bleeding and risk of infection. These risks are small. The most common side effects of the LINX® system are difficulty swallowing, post-operative pain and temporary bloating of the stomach. In the long run, many surgeons have concern that the device might erode into the esophagus and need to be removed. This has not been observed in the clinical trials to date. : How soon after the procedure can I eat? A: You should be able to eat soft foods with 48 hours of surgery. Q: How soon after the procedure can I resume normal physical activities? A: Routine daily activities can begin within a few days of surgery when pain medicine is no longer required. Activities such as sit-ups or weight lifting, which require use of the abdominal muscles, should be deferred for three to six weeks. Q: Will I have to take acid suppression medication after the procedure? A: Based on the clinical trials performed prior to FDA approval of the device, only 10% of LINX® patients required daily medication at one- and two-year follow-up. Q: Is there any risk the device will be too tight and cause food to get stuck? A: Yes; about 3% of patients that have had the device implanted had this problem and required removal of the device. Q: After the device is placed, is there any risk of infection? A: There is always a small risk of infection whenever a foreign object is placed in the body, whether it is LINX®, a pacemaker or an artificial joint. There is not enough data at this time to calculate the percent risk of infection, but the early data suggests it is quite small. Q: Will the device ever have to be removed? A: The intent is for this device to be permanent. But, since there is no 10-year follow-up data available yet, we cannot be sure. : Is there any chance the LINX® system won’t work as well if I gain a lot of weight after the procedure? A: The LINX® system works by creating a pressure of approximately 25 mm at the gastroesophageal junction (the place where the esophagus and stomach meet). Weight gain increases the pressure inside the abdomen, so it is possible that significant weight gain can create more pressure than the LINX® valve can counteract, leading to the return of reflux symptoms. Q: Will my insurance company pay for LINX®? A: Nearly all insurance companies pay for antireflux surgery. Since the LINX® procedure is a new form of antireflux surgery, insurers are learning about the procedure. We are working closely with them to obtain pre-authorization for these procedures on a case-by-case basis. Q: If my insurance won't pay for it, how much would the procedure cost? A: Please contact the Mass General Billing Office at 617-726-4098 or at cs.mgh@partners.org for more information. Q: I have heard that because I had bariatric surgery, I am not a candidate for LINX®. Is it possible this will change and I could be eligible for the system in the future? A: The LINX® system is not approved for use in patients who have had prior bariatric or esophageal surgery. Q: If the LINX® device needs to be removed or isn't effective, can I have a standard Nissen fundoplication (NF)? A: Patients often mention that an NF was suggested to them in the past, or they were considering it when they found out about LINX®. As the screening tests are the same for both procedures, NF may still be considered, providing testing doesn't exclude you. If you cannot or choose not to have LINX®, NF may still be an option. Thank you for this. This is not good news, is it. =( I guess now I need to find out why, good to know because I will take this info to my next appt. too. So sorry you're having GERD right now! I do hope it resolves itself. I keep reading that as we lose weight, the loss of pressure helps. I do hope it goes away for you! =( Yes, that;s what I hear as well but preop and with the surgery I've lost 45 lbs and my GERD has not improved at all. Of course I still have a lot of weight to lose. I don't think I have ever been so miserable with pain. If I didn't know it was acid, I would swear I was having a heart attack. No its not good news so if you find out anything different let me know Amelie2016 - I have been researching this myself and today I found these questions and answers. Unfortunately, according to this, bariatric patients do not qualify for this procedure.I am only 3 weeks out and having the worse GERD of my entire life and it is not being controlled with medication. This is from Massachusetts General Hospital Frequently asked questions: LINX® system Q: What is the LINX® Reflux Management System? A: The LINX® Reflux Management System is an FDA-approved device implanted laparoscopically. The system relies upon a flexible bracelet of magnetic titanium beads that, when placed around the esophagus, supports a weak lower esophageal sphincter (LES), the muscle that opens and closes to allow food to enter and stay in the stomach by restoring the body’s natural barrier to reflux. Q: What are the risks associated with the LINX® procedure? A: All surgical procedures have risks, such as the risks associated with anesthesia, risk of bleeding and risk of infection. These risks are small. The most common side effects of the LINX® system are difficulty swallowing, post-operative pain and temporary bloating of the stomach. In the long run, many surgeons have concern that the device might erode into the esophagus and need to be removed. This has not been observed in the clinical trials to date. : How soon after the procedure can I eat? A: You should be able to eat soft foods with 48 hours of surgery. Q: How soon after the procedure can I resume normal physical activities? A: Routine daily activities can begin within a few days of surgery when pain medicine is no longer required. Activities such as sit-ups or weight lifting, which require use of the abdominal muscles, should be deferred for three to six weeks. Q: Will I have to take acid suppression medication after the procedure? A: Based on the clinical trials performed prior to FDA approval of the device, only 10% of LINX® patients required daily medication at one- and two-year follow-up. Q: Is there any risk the device will be too tight and cause food to get stuck? A: Yes; about 3% of patients that have had the device implanted had this problem and required removal of the device. Q: After the device is placed, is there any risk of infection? A: There is always a small risk of infection whenever a foreign object is placed in the body, whether it is LINX®, a pacemaker or an artificial joint. There is not enough data at this time to calculate the percent risk of infection, but the early data suggests it is quite small. Q: Will the device ever have to be removed? A: The intent is for this device to be permanent. But, since there is no 10-year follow-up data available yet, we cannot be sure. : Is there any chance the LINX® system won’t work as well if I gain a lot of weight after the procedure? A: The LINX® system works by creating a pressure of approximately 25 mm at the gastroesophageal junction (the place where the esophagus and stomach meet). Weight gain increases the pressure inside the abdomen, so it is possible that significant weight gain can create more pressure than the LINX® valve can counteract, leading to the return of reflux symptoms. Q: Will my insurance company pay for LINX®? A: Nearly all insurance companies pay for antireflux surgery. Since the LINX® procedure is a new form of antireflux surgery, insurers are learning about the procedure. We are working closely with them to obtain pre-authorization for these procedures on a case-by-case basis. Q: If my insurance won't pay for it, how much would the procedure cost? A: Please contact the Mass General Billing Office at 617-726-4098 or at cs.mgh@partners.org for more information. Q: I have heard that because I had bariatric surgery, I am not a candidate for LINX®. Is it possible this will change and I could be eligible for the system in the future? A: The LINX® system is not approved for use in patients who have had prior bariatric or esophageal surgery. Q: If the LINX® device needs to be removed or isn't effective, can I have a standard Nissen fundoplication (NF)? A: Patients often mention that an NF was suggested to them in the past, or they were considering it when they found out about LINX®. As the screening tests are the same for both procedures, NF may still be considered, providing testing doesn't exclude you. If you cannot or choose not to have LINX®, NF may still be an option. Thank you for this. This is not good news, is it. =( I guess now I need to find out why, good to know because I will take this info to my next appt. too. So sorry you're having GERD right now! I do hope it resolves itself. I keep reading that as we lose weight, the loss of pressure helps. I do hope it goes away for you! =( Yes, that;s what I hear as well but preop and with the surgery I've lost 45 lbs and my GERD has not improved at all. Of course I still have a lot of weight to lose. I don't think I have ever been so miserable with pain. If I didn't know it was acid, I would swear I was having a heart attack. No its not good news so if you find out anything different let me know

Thank you !! Amelie2016 - I have been researching this myself and today I found these questions and answers. Unfortunately, according to this, bariatric patients do not qualify for this procedure.I am only 3 weeks out and having the worse GERD of my entire life and it is not being controlled with medication. This is from Massachusetts General Hospital Frequently asked questions: LINX® system Q: What is the LINX® Reflux Management System? A: The LINX® Reflux Management System is an FDA-approved device implanted laparoscopically. The system relies upon a flexible bracelet of magnetic titanium beads that, when placed around the esophagus, supports a weak lower esophageal sphincter (LES), the muscle that opens and closes to allow food to enter and stay in the stomach by restoring the body’s natural barrier to reflux. Q: What are the risks associated with the LINX® procedure? A: All surgical procedures have risks, such as the risks associated with anesthesia, risk of bleeding and risk of infection. These risks are small. The most common side effects of the LINX® system are difficulty swallowing, post-operative pain and temporary bloating of the stomach. In the long run, many surgeons have concern that the device might erode into the esophagus and need to be removed. This has not been observed in the clinical trials to date. : How soon after the procedure can I eat? A: You should be able to eat soft foods with 48 hours of surgery. Q: How soon after the procedure can I resume normal physical activities? A: Routine daily activities can begin within a few days of surgery when pain medicine is no longer required. Activities such as sit-ups or weight lifting, which require use of the abdominal muscles, should be deferred for three to six weeks. Q: Will I have to take acid suppression medication after the procedure? A: Based on the clinical trials performed prior to FDA approval of the device, only 10% of LINX® patients required daily medication at one- and two-year follow-up. Q: Is there any risk the device will be too tight and cause food to get stuck? A: Yes; about 3% of patients that have had the device implanted had this problem and required removal of the device. Q: After the device is placed, is there any risk of infection? A: There is always a small risk of infection whenever a foreign object is placed in the body, whether it is LINX®, a pacemaker or an artificial joint. There is not enough data at this time to calculate the percent risk of infection, but the early data suggests it is quite small. Q: Will the device ever have to be removed? A: The intent is for this device to be permanent. But, since there is no 10-year follow-up data available yet, we cannot be sure. : Is there any chance the LINX® system won’t work as well if I gain a lot of weight after the procedure? A: The LINX® system works by creating a pressure of approximately 25 mm at the gastroesophageal junction (the place where the esophagus and stomach meet). Weight gain increases the pressure inside the abdomen, so it is possible that significant weight gain can create more pressure than the LINX® valve can counteract, leading to the return of reflux symptoms. Q: Will my insurance company pay for LINX®? A: Nearly all insurance companies pay for antireflux surgery. Since the LINX® procedure is a new form of antireflux surgery, insurers are learning about the procedure. We are working closely with them to obtain pre-authorization for these procedures on a case-by-case basis. Q: If my insurance won't pay for it, how much would the procedure cost? A: Please contact the Mass General Billing Office at 617-726-4098 or at cs.mgh@partners.org for more information. Q: I have heard that because I had bariatric surgery, I am not a candidate for LINX®. Is it possible this will change and I could be eligible for the system in the future? A: The LINX® system is not approved for use in patients who have had prior bariatric or esophageal surgery. Q: If the LINX® device needs to be removed or isn't effective, can I have a standard Nissen fundoplication (NF)? A: Patients often mention that an NF was suggested to them in the past, or they were considering it when they found out about LINX®. As the screening tests are the same for both procedures, NF may still be considered, providing testing doesn't exclude you. If you cannot or choose not to have LINX®, NF may still be an option. Thank you for this. This is not good news, is it. =( I guess now I need to find out why, good to know because I will take this info to my next appt. too. So sorry you're having GERD right now! I do hope it resolves itself. I keep reading that as we lose weight, the loss of pressure helps. I do hope it goes away for you! =(

Amelie2016 - I have been researching this myself and today I found these questions and answers. Unfortunately, according to this, bariatric patients do not qualify for this procedure.I am only 3 weeks out and having the worse GERD of my entire life and it is not being controlled with medication. This is from Massachusetts General Hospital Frequently asked questions: LINX® system Q: What is the LINX® Reflux Management System? A: The LINX® Reflux Management System is an FDA-approved device implanted laparoscopically. The system relies upon a flexible bracelet of magnetic titanium beads that, when placed around the esophagus, supports a weak lower esophageal sphincter (LES), the muscle that opens and closes to allow food to enter and stay in the stomach by restoring the body’s natural barrier to reflux. Q: What are the risks associated with the LINX® procedure? A: All surgical procedures have risks, such as the risks associated with anesthesia, risk of bleeding and risk of infection. These risks are small. The most common side effects of the LINX® system are difficulty swallowing, post-operative pain and temporary bloating of the stomach. In the long run, many surgeons have concern that the device might erode into the esophagus and need to be removed. This has not been observed in the clinical trials to date. : How soon after the procedure can I eat? A: You should be able to eat soft foods with 48 hours of surgery. Q: How soon after the procedure can I resume normal physical activities? A: Routine daily activities can begin within a few days of surgery when pain medicine is no longer required. Activities such as sit-ups or weight lifting, which require use of the abdominal muscles, should be deferred for three to six weeks. Q: Will I have to take acid suppression medication after the procedure? A: Based on the clinical trials performed prior to FDA approval of the device, only 10% of LINX® patients required daily medication at one- and two-year follow-up. Q: Is there any risk the device will be too tight and cause food to get stuck? A: Yes; about 3% of patients that have had the device implanted had this problem and required removal of the device. Q: After the device is placed, is there any risk of infection? A: There is always a small risk of infection whenever a foreign object is placed in the body, whether it is LINX®, a pacemaker or an artificial joint. There is not enough data at this time to calculate the percent risk of infection, but the early data suggests it is quite small. Q: Will the device ever have to be removed? A: The intent is for this device to be permanent. But, since there is no 10-year follow-up data available yet, we cannot be sure. : Is there any chance the LINX® system won’t work as well if I gain a lot of weight after the procedure? A: The LINX® system works by creating a pressure of approximately 25 mm at the gastroesophageal junction (the place where the esophagus and stomach meet). Weight gain increases the pressure inside the abdomen, so it is possible that significant weight gain can create more pressure than the LINX® valve can counteract, leading to the return of reflux symptoms. Q: Will my insurance company pay for LINX®? A: Nearly all insurance companies pay for antireflux surgery. Since the LINX® procedure is a new form of antireflux surgery, insurers are learning about the procedure. We are working closely with them to obtain pre-authorization for these procedures on a case-by-case basis. Q: If my insurance won't pay for it, how much would the procedure cost? A: Please contact the Mass General Billing Office at 617-726-4098 or at cs.mgh@partners.org for more information. Q: I have heard that because I had bariatric surgery, I am not a candidate for LINX®. Is it possible this will change and I could be eligible for the system in the future? A: The LINX® system is not approved for use in patients who have had prior bariatric or esophageal surgery. Q: If the LINX® device needs to be removed or isn't effective, can I have a standard Nissen fundoplication (NF)? A: Patients often mention that an NF was suggested to them in the past, or they were considering it when they found out about LINX®. As the screening tests are the same for both procedures, NF may still be considered, providing testing doesn't exclude you. If you cannot or choose not to have LINX®, NF may still be an option.

Thank you all so much. I just had a full blown, hyperventilating panic attack. I'm almost certain it's the Wellbutrin which I won't take again. I'm getting back on my regular medication even though it does cause weight gain. I just have to trust that the sleeve will help me battle against that. Logging on here and seeing these encouraging messages was just what I needed. THANK YOU. Really. Sent from my iPhone using the BariatricPal App Oh and my surgeon called me today and told me after 6 mos I can take pills again. Sent from my iPhone using the BariatricPal App

When nuts are available, I have trouble resisting them. Even worse, I keep going back for more until they're done. And THAT'S dangerous! During the first 18 months it didn't seem to matter, but in maintenance, it may cause some weight gain which then needs to be handled. Almonds are more filling, and easier for portion-control than peanuts. Bottom line: nuts are okay if you can keep them in moderation, but that can be difficult.