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I know it’s easier said than done, but don’t be in a rush and don’t compare yourself to others. It’s not a race or competition. Everyone has different circumstances and factors affecting rate of weight loss. For example, the more excess weight you have, the faster it comes off, so you can’t expect to lose as quickly as some who started 50 kg higher than you. i know most of us go down the path of WLS because we are fed up with being obese and we are desperate to lose the weight after a lot other attempts. Of course we want it to happen as fast as possible. But here’s something to consider. WLS makes it virtually impossible to fail at losing a significant amount of weight. That’s the “honeymoon period” for about the first year after surgery and almost everyone has amazing results. What really matters, though, is what comes after the honeymoon period. It is heartbreaking to see people go through all of this to lose 100+ pounds only to regain it. It doesn’t matter how fast you reach your goal weight if you don’t stay there. You have a whole lifetime ahead of you, decades, to enjoy your new chance at life. Trust me, in 20 years, you won’t care how many pounds you lost in the first month or two or six. Don’t worry about how fast of slow you’re losing now. Keep following the program and you will lose a lot of weight. Set your sights on the rest of your life, everything you will get to experience in your new body, and how you will keep it.

Yes, it is okay!! It was kind of embarrassing for me to but I believe it was 26% of sleeves that need to be revised between GERD and inadequate loss or regain. We are not alone. My surgeon said that the sleeve is a really great surgery for many people but obesity is complex and some people just need a greater metabolic change that the SADI should give you. It’s a very exciting journey. I’m excited for you to get started. There is another thread titled “Sadi is so lonely” that I started when I was considering the SADI and couldn’t find many answers to my questions. You can see if you skim over it how lost I was back then but you will likely get the attention of many people who also had the SADI surgery if you post any specific questions you have on there.

Yes, I had sleeve 3.5 years before I started my journey to revision. It’s considered fairly “new” In the medical community but finally got endorsement by the ASMBS so it should become more prominent now but finding info on it as a standalone procedure was tough enough, nevermind as a revision. Like @Arabesque said I had a really difficult time making my decision between the SADI and bypass but i did finally land on the SADI and I am happy with it. This week at six weeks out I was down 40 pounds (including the weight I lost on my two week preop diet which was basically two shakes and a low carb dinner). With the sleeve I felt like I was on a diet. The reduction of the hunger hormone helped me to keep my portions small and get down to 167 (i’m 5’8”) but I was able to eat more than expected from day one. Not a lot more but enough that once the hunger came back and I was eating several times a day I was gaining from even healthy food. The fact that I felt like a failure for not reaching my goal and that I was gaining in spite of my best efforts discouraged me and bad habits started slipping in bit by bit but rather quickly I gained it all back plus some. Things that have been different with the SADI. For one, my level of commitment. I quit going to my follow up appointments at the Dr and stopped posting here when I regained a big chunk of weight post sleeve because I was so embarrassed and I never went to the in person support groups to begin with. After I started my journey to revision I began posting again and committed to doing the in person groups when they meet monthly. I also have made even more than the minimum required appointments with my team to acquire as much information as I can and I asked to do my follow ups more often which helps for now with my anxiety over healing but also will help to keep me accountable In the future. In terms of the surgery itself it seems to have made more metabolic changes for me. For one thing I was actually a salty snacker before my sleeve but post sleeve I craved sweets. I actually woke up from my sleeve surgery craving various desserts but with SADI I was craving Fish Tacos (a meal I never even enjoyed pre surgery) and I have been eating all kinds of stuff I had to force myself to eat pre surgery and I’m actually enjoying them. I mean not like pizza but still pretty good I am back to regular food now and I may have a sugar free popsicle once a week. Other than that I don’t really want sweets and my food cravings are very quiet and good choices are really good. In terms of motivation and energy I have a ton more. Part of that may be due to my exercising this time compared to the sleeve in which I didn’t do any. This time I started out a little shy of a month just walking to the end of my street and back and now I’m up to over 15k steps a day (sometimes 19k) and I’m getting ready to try YOGA at my community center (waiting for my 8 weeks post op just to be safe). I feel fantastic. It’s not just he honeymoon phase either. I actually wake up hours earlier eager to start my day and at night when I hit the bed I feel accomplished and I sleep so much better. Everyone I talked to said fat was okay with the SADI and carbs were the enemy but that has not been my experience. Maybe processed carbs are bad but in things like veggies, fruit and oats or brown rice are okay for me. I actually do lower fat because I had my gallbladder out so think almond milk and 2% cheeses or non fat yogurt (surprisingly not bad tasting though). In terms of carbs if I remember correctly she started me at. 60g and then increased me to 80 because of my activity. They did not resleeve my stomach so my return to food progressed a little slower than yours will if your getting re-sleeved though so that will not be the case this early out. You won’t be able to eat the volume of food that I do at this point. I can actually eat every 3 hours. Most times I’m already up but I have an alarm set for 8 and I wake up and have my proffee which I finish by 9 with my multi vitamin and then every three hours (12,3 and 6) I have a small meal with my three calcium chews. My last meal being a snack at 9pm and I take my magnesium and hair vitamins. I seriously have so much energy. I care so much about what I put into my body. I make everything from scratch and before it was all about convenience (hated to cook) and I won’t lie and say I love exercise but I want to do it. In fact I’m nursing three blisters now and they just weren’t healing with the continued training so I’m having to force myself to slow down today. It’s so weird. I haven’t exercised in over 20 years. I have avoided it at all costs!! I mean I had to make the decision to get started of course but the surgery gave me the energy to do it. Ooh, the recovery was a bit tougher for the SADI, well a lot for me but they took my gallbladder too. I was okay without pain meds once I finally was able to pass gas (like 7 times one morning) but I spent five days in hospital because I couldn’t pass gas and my pain was only managed on meds they wouldn’t send me home with. Once I got home I took half of one pill because my husband forgot to get the Tylenol and I had to wait for him to get it I the store but after that i managed without it. With my sleeve I work up and refused pain meds and was fine the next day. In fact i almost forgot I had surgery when I was out front and asked my husband to pass the basketball to me. So night and day difference in recovery but it wasn’t horrible. Just not expected. Anyways, I’m sure that once I get closer to goal I will be tempted by less desirable food choices and it won’t be as easy as it is now but I honestly do feel like it will be different this time. For one, I have more support but also, I am actually changing my entire lifestyle this time. I am even looking for organic and cleaner ingredients in my food instead of just processed junk that’s diet friendly. I feel great and I want to continue feeling this way for a long long time. That got kinda long, sorry. I really hope some of it helps.

I love that he updates his practice with current research and never makes weight regain a moral failure.

I believe the original poster has already had their surgery, but for anyone else who is reading this as someone else who has had a sleeve and needed a revision, if you do not have a strong medical reason for choosing one surgery over the other, and you’re choosing between the sleeve and the bypass I would’ve gone with the bypass to avoid meeting to take a PPI. my only reason for going with the sleeve and giving it a try, knowing that I may have to revise was because I’m on mental health meds, and we were concerned about the absorption. The sleeve was obviously a better option for that. However, I believe it’s like 26%, I read somewhere, of sleeves that need to be revised for Gerd or inadequate weight loss/ regain. The risks with the bypass are slightly higher, but in my opinion, not enough to have to end up revising because the revision surgery in itself is riskier than either procedure plus it’s a second surgery so twice the chances to experience the risks. If your doctor offers the SADI as a virgin surgery that complicates things a bit because the risk are lower for Gerd than the sleeve and the weight loss is higher and more durable than both research has found so far but it’s a little newer, and comes with its own set of sure and long-term risks that may not have been figured out quite yet. It does have a higher no absorption, so the risk of malnutrition is slightly higher than the sleeve and bypass but lower than the DS. Long story short, there really isn’t a perfect option, only a perfect option for you.. The biggest thing to keep in mind with all the surgeries is that any risk of complication is drastically lower than the risks of staying obese.

I am firmly behind using every tool at your advantage to tackle regain: Tracking portions, exercise, joining a support group, checking in with your previous or new weight management team and use of the new anti obesity medications.

Dr Matthew Weiner has done a few podcast and has been speaking about regain with sleeve on his social media a lot lately. May be worth checking them out if only for some information to consider. He does prescribe GLP -1s for many of his sleevers and says this is a path many will have to go down as regain is common with sleeve. Have you been in contact with your surgeon (if they are still practicing nearby) to discuss options? Have you considered revisiting your dietician too. May be worth tracking what your eating and drinking too just to ensure your not missing something. It’s easy to become complacent about food choices, portion sizes, frequency or meals, etc. or not meeting protein & fluid goals as time passes. Have you had any medication changes? What are your activity levels like?

Well your not totally off base if your okay with the bypass. It’s a little more aggressive so it carries with it a little more risk than the sleeve. The reason they do the sleeve I believe is because it’s a bit safer and it is adequate for many people to lose and keep it off but there are some (like me) with regain that need a revision and some that need revision because of GERD and other complications. I would ask the surgeon what percentage of patients need revision because of inadequate loss and/or regain and what percentage for GERD. I believe I read somewhere that it’s 26% need revision but I would definitely not swear to it and I am not sure if that was just for weight or for complications too. I think even if you do end up having to wait it is a good call to get all of your questions answered and feel confident in your decision that it is what’s best for you.

Haaaa hello fellow champagne drinkers! 🍾 Veuve Cliquot all the way here. But I wouldn't say no to any of the others Sorry we've gone off piste a little. I have drunk carbonated drinks from very early post op. I don't *think* it made a difference to my rate of loss or to anything actually. But I was never told to avoid them. Although - full disclosure - I have regained 12lbs from my lowest weight at the start of this year, so maybe I'm not the poster girl for carbonation!

I'm starting to doubt my decision to have the VSG rather than the Bypass. I keep hearing that the sleeve leads to an inevitable regain and I'd rather not do this surgery just to gain it all back if the bypass is better for long-term weight loss. Because it's the NHS and they only offer two surgeries I can only get VSG or bypass. I only chose the VSG because I fear the complications my mum had with the bypass. Is it inevitable that I will gain it all back? Is it too late to change my mind about the surgery? I really don't know what to do!

for most, it doesn't have to be this way...i am 6 yrs out and i still go out yo eat and go to dinner parties and have coffee and dessert. if anything, i probably go even more than pre-wls cuz i live to get dressed up and go out and socialize more now. and yes, its almost always centred by food and eating and drinking. i think the further out u get it gets a little less angsty cuz u have learned to trust yourself around food and know your limits in autopilot. i order whatever i feel for and generally just have a taste of it and the rest is generally eaten by my meal companions or becomes a take out box. or compost if it wasn't very good. i particularly like to go out with lots of people cuz then i get to taste all their stuff too. and yeah, we will rate the food in order of preference, critique them and discuss what could be better or left out, take pics for our IG, etc lol. i gave a bucket list of restaurants i am going trough locally and abroad. in fact i am on vacay right now and we came with a list of restaurants and bars and cafes and snack joints to try and have gone through almost all of them plus a few extra we thought would be interesting. i'd estimate we've visited (and ate at!) 40+ restaurants and bars in the last 9 days. and this doesn't even include the multiple food stalls we sampled at the 3 food festivals/night markets we went to. and for those that may be wondering, no, i did not regain all my weight back (i've stayed below goal weight since achieving it at 7 months post op, im 6 yrs out next month). aside: also may be worth noting that my travel companions are all normal sized and never had weight problems in thier lives (except maybe one of our group who is diabetic). i guess what im trying to say is that food and food-centred social situations and vacations can still be enjoyed (im probably an extreme proof of this) and we dont need to miss out and feel deprived if we dont want to. you can eat that burger (just maybe not the whole thing and definitely not 3 of them). and the beauty of eating less is you can have a taste of your friend's fries, a peice of your partner's steak, a sushi off ur kid's plate, a forkful of pie from the stranger at the other table...lol anyway, thats just my very looooooong speech on foodie-ism and food enjoyment years on the other side.

Mine was because of regain post sleeve. My surgeon said that the sleeve is a really great procedure and it works great for so many people but obesity is complex and some people just need a little more of a metabolic change to be successful. I have the added complexity of bipolar disorder and anxiety. The depressive episodes and the anxiety cause me to make less healthy choices and some of the meds that go with it that cause weight gain as well. I went with the sleeve because of the meds and it causing less absorption issues and it was certainly wise to try it first but it just wasn’t the right choice for me. I just revised to SADI three weeks ago and according to my NP I am doing great in terms of loss for a revision and my recovery. I certainly feel great and I am not craving sweets which was another reason I think I regained. It’s not at all common according to my surgeon (usually it’s the opposite and sweet cravers stop craving them) but post sleeve I went from a savory person to one that craved sweets. During the liquids stage post sleeve my cravings were for various deserts. Post SADI I am craving Fish Tacos and apples with Nut Butter so I think that may have reversed itself which will make things sooooo much easier.

I am one of those regain stories and my best advice would be to stay involved here and at any in person groups available to you. Also keep your follow ups with your team. They keep you accountable. If you do start to regain, reach out here and reach out to your team, and don’t let shame keep you from asking for support. I thought I would be chastised by my team when I finally did go back but they were nothing but kind and compassionate. They said obesity is complex and we just needed to approach it from a different angle. All they wanted was to help. Also, most of the people that regain don’t regain all their weight by eating bigger portions of healthy food. It’s when the bad food choices start to creep in that the pounds really start to add up. Having a healthy level of concern about regain will work to your advantage but don’t worry about it so much that you aren’t enjoying your fantastic healthier body right now. Congratulations on your loss and keep doing what you’re doing.

ah, then i totally misunderstood. my bad, sorry! i was under the impression you were feeling healthy...i see know that you are totally not. with all your ailments, i would go back to your doctor and request some help! not sure this is something your nutritionist can take help you more than you doc can with if all your labs coming back satisfactorily..(besides the anemia, but this is par for course as you mentioned...) (also. maybe cut back on the workouts until you regain your strength??)

Well this time they didn’t operate on my stomach but with my sleeve I was for sure not able to eat what I could pre surgery. I always felt like I could eat more than others at any given stage but I never tested it too far beyond what I was supposed to have. At like 6 months out I was eating about what everyone else with a sleeve could (maybe a tad bit more) and at 3.5 years out I could eat like 4” or 5”’ of a sub but probably would’ve been full if I had stopped at 3” Not that I had them often but that was a question they asked me to get a good idea of capacity and it is pretty standard and easy to visualize. Lots of people do feel extremely full on next to nothing very early out, just means more inflammation. Also, they make the stomach a pretty standard size with the surgeries but I don't think they can control how much stretch our stomachs have. That’s not anything I got from a Dr. just my own guess to explain why we are not all the exact same at the same stage. I really hope you enjoyed your crab. I found a skinny scampi recipe that I’m gonna try making the sauce to dip mine in. I know that I won’t eat much at this point but I want to find the healthy recipes now while I’m not p hungry because last time I didn’t and i think that was part of why I regained. When I could finally eat more and my body was hungry I hadn't changed what i was eating enough to maintain the loss. Then at a certain point I just gave up trying. I am such a picky eater I have been really scouring the web for recipes. A friend of me said that making tacos with ground turkey tastes the same to her so I plan to give that a try when i can have them or taco salad.

I think when you go on vacation if you just tell them you had stomach surgery they will understand. Don’t have to get into what it was specifically. Just says special diet prescribed by doctor. Or even it’s delicious but I already ate. All they really care about is knowing that it’s not because you are dissatisfied with the food. I was a savory person before my sleeve too. I had kind of a unique change to where I craved sweets which was another of the things that contributed to my regain. It’s pretty uncommon according to my dr. Post SADI I don’t feel like I am craving sweet as much. Perhaps because I know I can’t have the sweets I really would want but hopefully because that reversed itself again. We shall see. I know that I have been craving fish tacos which is really weird for me. I barely even ate fish pre surgery or post sleeve. Just made myself like once a month because I know its good for me. I don’t think the caffeine restriction is really about how you will feel when you have it. It’s more about affecting your healing and I think I also heard something about it causing irritation or GERD.

@Mspretty86 I maybe have clarified that I did not get pregnant. I just regained. I’m sure that if you were to gain a reasonable amount with a pregnancy under your teams care you could take it off between breastfeeding and diet. I was just saying that getting enough calories after you are like 6 or so months out shouldn’t be an issue that you would just have to eat more times a day. Many of us gain way more that is really necessary to support a healthy baby anyways.

Well I had some circumstances (some out of my control but some that ultimately were) that all added up to my regain but it boiled down to unhealthy choices and increased portion sizes. Just don’t do that and you should be fine. Sticking with the support groups should be a huge help. I stopped posting here and going to my my appointments when I started gaining too much because they couldn’t offer much for me in terms of options and I was embarrassed. It was a bad decision since that was when I needed support most.

I had a VSG on 7/8/2013, with that I experienced a leak that nearly killed me. I lost 80lbs total, but slowly regained nearly all the weight I lost. With the sleeve I had GERD that caused a gastric bleed in 1/26/24. I have seen all the consults that will be needed for acceptance. I am still scared but excited as well. I have told my immediate family ( my husband & kids). I don’t feel comfortable telling my brothers. They will be less than supportive. None have any weight issues. Although I am sure they love me, I need to make the best decision for myself. Am I wrong for the decision to keep this decision private?

The SADI is a modified version of the DS where when they bypass a portion of the bowels they only need “Single Anastmosis,” which means connection and is the first two letters of the acronym SADI, instead of two anastomosis that the DS uses. They are both almost a combination or the sleeve and bypass to simplify it. They combine the sleeved stomach for restriction with the bypassed intestine for malabsorption. In terms of least to most aggressive it’s sleeve, bypass, SADI, then DS. The SADI is fairly new and is considered to be a relatively safe option with that single connection lessening the risk for leaks by at least half and overall risks are less than the DS considering the weight loss is not a lot less. Like the DS it can be done in one surgery or in two steps beginning with a sleeve first and then completing the bypass portion In a second operation later (often after a patient loses enough weight to make the bypass portion safe or as in my case if they do not lose adequate weight or experience regain after the sleeve). You may also see the SADI referred to as the modified switch or SIPS surgery. And the -S in SADI-S just means with sleeve as in when the two components are done at the same time in one operation.

What do you mean. Did you reach your goal and start to regain or is it something else? I see you are about 40 pounds from your goal now so it certainly seems doable to turn it around if it’s regain. My first piece of advice as someone who regained all their weight and just had revision surgery a week ago is to reach out to your team. My second step would be to reach out for support here or otherwise and you have already done that. I did neither because I was too embarrassed and you can see where that led me. When I finally did reach out to them I wished I had done it sooner because they treated me with nothing but compassion and just wanted to help. For me the only real option was revision but you should have plenty others. My guess is their first plan of attack will be to go back to the basics. Reading labels, Logging your food and counting macros. Protein first, smaller portions and reaching your fluid goals. Seems like from your profile you are pretty active anyways but trying to Incorporate more activity if that has slipped a little. Just go back to it like you are just out of surgery. Well past the staged return to eating I guess but fairly early out anyways. Some people even start with the “pouch reset” Of a liquid diet for a week or two although most say that there is no real evidence that does much to reset anything. Make an appointment with your team now and start logging what you are doing for a week or so giving them a starting point and let them advise you of what you need to work on. There are other options now if diet alone is not enough but if you enjoy healthy eating anyways its likely portion size has increased a little more than you realize and that’s something you should be able to change. Once you do figure it out try to make changes one at a time if necessary to make them more manageable. Set lots of small goals to keep yourself motivated But most importantly keep reaching out to your support networks such as posting here as well as keeping in touch with your team. Your sleeve is still there. It will be a little harder than it was the first time but people have certainly done it. You have already taken the first steps Of recognizing the issue and reaching out here just keep taking steps and before you know it you will be losing again. Keep us Posted on any ups and downs so we can cheer you on. You can do it!!

I was sleeved in March of 2015 (HW 405, SW 357, LW 238, sustained 260 for a few years), had some regain where I hit 315, so I went on a hybrid Optifast/Numetra diet through a program at Kaiser (my then insurance in California). It worked well, I dropped about 50 pounds and was happy with that, but then I had some mental health issues including some passive ideation, so I decided to move across country (technically back home) to Delaware and share a living space with my brother and his wife and pets. Since that move I've gained back the 50 pounds I lost, I have another hiatal hernia, and severe acid reflux/GERD so now I'm on the path to revision to bypass. Thing is, I never wanted bypass, that's why I had the sleeve in the first place, the reworking of my internal plumbing scares the heck out of me! I've known a ton of people who've had it with no issues, but I've also known a couple who passed away from complications (granted, that was 20 years ago, and I know things have improved medically since then). But the idea of having dumping syndrome, and malabsorption, and needing to take vitamins and supplements forever - UGH - I'm freaking out!! 😨😖 I have an anxiety disorder (SAD & GAD) and my anxiety has been through the ROOF the past few weeks! My surgery date is August 26 - 13 days from today! - and I started my pre-op diet the other day (Monday), but part of me wants to cancel everything! However, there is a part of me that can't wait for the relief from the GERD. I guess I'm not asking for anything here, mostly just venting my anxiety. 🤣

You say above that "granted, they are right." Respectfully, your friends and family are 100% wrong and don't have a clue what they're talking about. Obesity is not caused by a simple lack of willpower. If it were as simple as eating right and getting some exercise, none of us would be here right now. You didn't supply your height and weight details, but based on the list of ailments you've mentioned, I'm guessing you have a significant amount of weight to lose, like well over 100 pounds. It's very hard to lose more than a small percentage of your body weight and keep it off. About 95% of people who lose weight through calorie restriction and going to the gym regain the weight. Not because of a lack of willpower, but because there are complex systems in our bodies that work hard to keep us at a weight our bodies have decided is right for us. Unfortunately, in those of us with obesity, that desirable weight has been set much too high. Fighting against that is extremely difficult. That's not to say that surgery will fix your issues with food. It won't. You will still have to do all the work on your mental and physical health to lose the weight and keep it off. You will have to eat right. And exercise. And work on your food addiction by modifying your behavior, hopefully with the help of a professional therapist. You'll need to track your food intake for months if not for life, and there will probably be foods that you will never be able to eat again, either because they make you ill or because they trigger bad behaviors that you need to avoid. You'll have to learn a whole new way of cooking and eating. You'll have to be careful of transfer addictions. Sometimes you will feel left out when everyone else can eat things and you can't. You'll have to defend your choices to people who have no idea what they're talking about and no filter on their opinions. Surgery is frickin' difficult. But, it's effective. It changes your hormonal balance to make your body want to be at a healthier weight. If you follow the rules, you will lose weight and keep it off. Your physical health will improve. Your body will feel better. But you do have to follow the rules, and the rules are challenging. You have to be ready for it, and even when you think you're ready, it's common to make mistakes and to struggle sometimes. You'll need a support system and the confidence that you've made the right choice for the long term even when it sucks in the present moment. If you decide surgery is right for you, you will need to believe in yourself enough to look your family and friends in the eyes and invite them to either support your decision and help you, or else they can feel free to shove their negativity into the orifice of their choosing. This is your life, your body, and it's your right to decide what you need to live the best way you possibly can. No one else has to wake up with the pain you feel in your joints, hip, and back. No one else has to struggle through the day and have their options limited because of their size and health. No one else has a say in what you do to improve your situation. But I will tell you this. There are probably some people in your life who will not think this is true. They will not appreciate you stepping out of your role as the obedient one and standing up for yourself and not doing what they want you to do. They will feel threatened. They will not like it when you lose weight, and they will say mean and nasty things about how you cheated and took the easy way, because if you succeed at this, they will feel like it takes something away from them. They are the ones with the problem, not you. They may try to sabotage your efforts and make you feel bad about yourself. Again, they are the ones who are wrong. But that doesn't make it easier in the moment. So make sure you have people to talk to who support you. I wish you the best of luck. You're young and you deserve to have an awesome and long life full of good health and happiness. Don't let anyone else take away your chance at that. Finally, here is a video that I highly recommend to help with your decision:

it's very common to have a 10-20 lb regain in year 3. It's not inevitable, but it's very common. And no, one day of bad eating when you're in maintenance is not going to affect your weight - I'm sure most of us long-timers have those days once in awhile. But if you go back to your old eating habits, you WILL gain a bunch of weight back (and maybe close to all of it). The trick is to be able to recover quickly from a bad day and get back to your regular plan ASAP (like...the next day). This is a lifetime battle (made easier by WLS, but still...a battle).

I think so too! I will be that sucess story! I'm just reading so much on other people's mistake so I am ready for it. My worry is like 1-2 year post op and the regain stories. Like is it 100% because of poor food choices? And for them to regain, it must have been ALOOOOT of poor choices for many many days. Because surely u won't regain from one bad day of eating.. these are the thoughts that keeps up... THE FUTURE Hehe