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Dang! Yeah. I was the same way. I had issues not even a year out from my sleeve and was also on Ragland and Prilosec for a year after my sleeve. Nothing seemed to help long term. Unfortunately, my surgeon who had been working with me since 2017 knew after nothing else worked that I needed a revision. I had maintained my weight loss so she believed me when I was seeking help for reflux and severe dumping. Plus one of my teeth broke and another one isn't far off. Once I showed her my teeth she realized something was really up. The issue was we had to prove to my Insurance that it was medically necessary and that my symptoms could be proven on a series of test to prove it wasn't elective. I had to have a HIDA scan done to test my liver and gallbladder function, which was normal. I had to have a flouro swallowing study done, which was normal except for the hernia. I had a ambulatory swallow study done that showed my esophagus wasn't emptying properly and that I had severe GERD on top of a failed gastric emptying test. The most important test was my GERD test out of all the above. If I didn't get a positive test for GERD, my insurance wouldn't cover my revision. The other test just helped build my case. I'm not sure what your surgeon will require but if your acid reflux is as bad as mine you'll need that GERD test. I also had and failed the BRAVO . so as a alternative I had to have a 24 hour ambulatory ph test thst i originally denied, where they put a tube down your nose into your stomach with a monitor you wear the entire time that monitors your swallowing and acid reflux . It's more accurate than the BRAVO, and as awful as it sounds, it wasn't fun but it's doable. I'd suggest getting that test done and eating badly and eating spicy food w wine if you have it done lol. if you are paying out of pocket it may be up to the surgeon. But if you need to prove your case with insurance you'll need that GERD test . The 1st surgeon didn't listen to me so I saw one of his partners who was a women, who listened and helped me out ALOT. You know your body. Just do not go in complaining about your weight as the main issue for revision, . Make sure that it's noted as your last concern so they'll hear you out, and how even eating properly causing you discomfort.It was a long process. Hopefully it's worth it. Just be consistent and like i mentioned , that Ph test will be the determining factor and most important test to have if all else fails..

Did you go from a sleeve to RNY? If so, how are you doing, did it eliminate the GERD? Any more weight loss? How much? Good luck!!

Not yet....probably going to wait another year to make sure my weight levels off then start looking into it 🥰

He didn’t give me figures but the gastroenterologist said he was surprised I lost any weight at all. The stretching came from all of the stents they tried to place (about 4 until they went in and SEWED one in place!). I don’t think there is any stretch this time round.

Ugh. I see I will have to lobby the head of HR to include more insurance options next year. I don't mind paying more for better health insurance to get bariatric surgery covered. I just wanted to get it done in 2021, not wait until 2022. I wonder if I should start documenting the 6 months of medically supervised weight loss now in anticipation of hopefully a new medical insurance option in 2022 that will cover it. Or would the six months have to start once the policy is valid?

Yes, the Doctor told me about this (and I've read about it as well) but I have been at a healthier set point for a very long time (10 years) and am confident I can get back there again. I know it takes a long time to "reset" your set point, but I know it can be done and I'm willing to really work hard to avoid the surgery. I like that my surgeon is challenging me to lose the weight so that I don't have to have the surgery - I really appreciate his honesty. (He said that although the two surgeries are frequently done together, it still means there is more risk, and having only one of the surgeries is preferable.) Thank you for your response -- everything everyone has said has been excellent "food for thought" (ha ha).

I had a lap band under United Healthcare PPO in 2008, lost 250 pounds, then had to have it removed in 2018 due to terrible acid reflux, Kaiser insurance. Have gained over 100 pounds back. Now I want to have RNY gastric bypass, and was set to get this going through Kaiser but got derailed due to COVID. Now I just started a great new job which I am very excited about, but the downside is that they only offer one insurance option, Blue Cross Blue Shield of Alabama. I have to start the whole insurance process all over again, in fact find new doctors again, but today I called the customer service number for BCBS of AL and asked about bariatric surgery and they told me that it is not covered on my policy! Has anyone ever had this experience, and were you able to find a way to get bariatric surgery covered under appeal? I really want this surgery but the out of pocket costs are pretty bad. I can't believe that this isn't covered in any form. Help!

I am discouraged. My surgery was March 30th, I lost 28 pounds but this week somehow gained 7 pounds. My cycle is on but I don't understand. I'm feeling so depressed. Sent from my STK-L21 using BariatricPal mobile app

I know it feels hard now, but they've been telling me the time will fly by. I started this process at the end of January and I will probably have my surgery in July or August because of the insurance requirements and backlog of surgeries due to covid. In the meantime, I've been trying to "walk the walk" and lose some weight now. At least it gives me something to focus on. I also spend way too much time on these boards heh heh heh.

I initially thought I had to lose weight for my insurance and I was really freaked out, but it turns out they don't require it; but I'm still going to lose as much as I can now, because then it's just less I have to lose after surgery. I'm not totally carb-phobic - I often eat steel-cut oatmeal with a banana and unflavored protein powder for breakfast. I'm not a big rice, pasta, or potato fan, except for risotto and french fries, which I don't eat too often now. I used to make dishes that were low in protein and higher in carbs, and I've just reversed it, and honestly, it was a lot easier than I expected. One thing that has helped me is to have veggies (cucumbers, red/orange/yellow bell peppers, etc) washed and chopped ready for snacking in the fridge so I don't eat something higher in calories like cheese or chocolate or chips (I don't have much chips or chocolate in the house, but I have a little bit left). I often eat the veggies plain, but sometimes I get bored with plain veggies and add tzatziki (you could use hummus too!). Also, I found that adding artificially sweetened drinks like Starburst No Sugar Packets (found at walgreens, walmart, and dollar stores - basically Crystal LIght) satisfy my sweet tooth. It also helps me when I THINK I'm hungry but I'm really thirsty and I am sick to death of water.

I'm still in pre-surgery phase, waiting to schedule a surgery date at this point. I've been seeing a bariatric therapist for a few months now after initially failing my psyche eval. I have made some choices to start eating better gradually. This hasn't included calorie counting or anything yet. It's just things like choosing not to eat out as often, using smaller plates, or keeping healthier snacks on hand that I know will still be friendly after surgery. Through therapy I've also been working on cooking more and making sure the meals have a portion of protein and a good bit of veggies. We're also focusing on addressing the mental desire to overeat, where that stems from, and alternate coping mechanisms. This has all resulted in sort of gradual change that is focusing on improving behaviors, but not in a way that feels like a "diet", and I have lost some weight while doing so. Not nearly as much as I know I'd drop via calorie counting and all, but what I'm doing now feels more sustainable.

I thought all the weighing and measuring what a bit "too much" also, blah, blah, blah. What I finally had to come to terms with was that I needed to do something different. Now, having done it for months, it is easier to recognize what a true portion or amount I am eating if I am not at home. I can't say that I've heard about using volume measurements rather than weight. But Lizonaplane makes a very good point about calorie-dense foods like cheese and sauces. I am a sauce-o-holic. Measuring dressing or any kind of sauce keeps me accountable. It doesn't mean I am totally choosing to not have any, it just means I am not mindlessly bathing my food in it. I also use a smaller plate and a small salad fork and baby spoons (my old baby spoons have been repurposed at 55 years old). The smaller utensils help me remember to take smaller bites.

I haven't had surgery yet, but I had the same choice to make so figured I'd share my experience. Keep in mind everyone is different and my choice is just mine. I'm not suggesting that you should make the same decision or anything. So I have had issues with heartburn and I went into my surgery consult set on Gastric Bypass because of that. However, the surgeon recommended, due to my weight, Sleeve because it's less risk of complications. At my weight, the amount of actual loss would be about the same. My nurse then stepped in on my behalf and got an endoscopy to check out my heartburn issues. This was because I am self pay, and I can't really afford to do a sleeve, only to have to get a revision later, so she wanted to see if we could find a root cause of the heartburn/GERD. Endoscopy revealed I had a medium sized Type III hiatal hernia. While the hernia could be repaired during surgery, it also meant I had a good chance of needing a revision in the future if I went with Sleeve. Not guaranteed, but still a high probability. Since I'm self-pay and I definitely don't want to find myself in a position where my heartburn/GERD have gotten worse and I can't pay for a revision, we decided it would be best for me to go with Gastric Bypass. Gastic Bypass is a mal-absorption procedure in addition to just restrictive, so I will have to be extra sure my vitamins are okay, and it is more at risk of complications during surgery/recovery due to multiple incision sites. That being said, overall risk is still really low, it's just higher when compared to sleeve. Definitely weigh out the options, talk honestly and openly with your medical team about risks and complications. Hopefully you can come to a decision that works for you Best of luck!

I weigh all my food. It takes just a few seconds and it really makes a huge difference in your calorie counts. If you're off by one tablespoon (15g) on your salad dressing that's 70 calories. An extra oz of cheese is 115 calories. It's adds up so quickly! I also agree with a previous poster about using smaller plates. I have heard though that after surgery we're supposed to be using volume measurements, not weight, because of the size of the stomach. That's going to give me serious anxiety!

Our program didn't have an RD at the time, so I was mostly winging it by reading and using common sense *what we know we should be doing, dietwise.) I did consult a couple of times with a fitness oriented RD that was associated with our PCP who did give some useful advice, combining my needs, her experience and the surgeon's program guides. One of the good reads that I found were some books by Dr. Michael Colgan, who is a sports nutritionist. Particularly useful is his Sports Nutrition Guide (All New! - as of twenty years ago, but nutrition science hasn't changed that much over time, only "diet science" changes with the fads.) A nice part of it is that he has a chapter 3-4 pages typically) dedicated to each micronutrient, what it does, where do we get it from, and what are the appropriate levels we need, often with comments about how specific activities may require more of this or that nutrient than average. These are quite distinct from the RDAs that we normally see published which are typically oriented toward avoiding deficiency disease rather than optimum function. He may have a newer edition (mine is published in 2002) or a follow on title - he doesn't seem to be afraid to change his views as newer validated science comes along. Check Amazon to see what's newer.) He also has a short booklet on "The Right Protein for Muscle and Strength" that is also useful, and may be a good counterpoint to some of the more promotional sources found in magazines pushing supplements.. Sorry, I don't have any particular online sources, but there are a couple of other guys on here who are more into that who may chime in on this. there is a popular notion that we see that it is impossible to build muscle mass while in the deficit required for weight loss. I don't like like words like "never" and "impossible" but I do find that it is very unlikely to do so - minimizing muscle loss during the loss phase is usually the best that can be hoped for, and then rebuilding. We did have a retired NFL guy in our doc's group who may have done that - if anyone can he would as he already knew on a professional level how to do that kind of workout (he just hated it and was glad he didn't have to do it anymore once he retired - that's why he ballooned to 500 lb and realized it was still part of his job! Got himself down to a 4% BF before letting himself go, and crept up to 6!) He also had the time to dedicate to doing as much work as he needed to, which most of us can't do. Good luck - it sounds like you are well on your way to good success. It may not be a direct route to where you want to go, but you can get there,

I am happy to hear that im not alone in the insurance/ diet classes phase! Good job you for trying to reduce carbs and sweets its hard! My nutritionist wants me to lose about 25 - 30 lbs by month 4 so thats why i feel that i have to hurry up and clean up my diet ASAP. Also my insurance says I cant gain any weight which is a little nervewrecking. The only way i know that ill not gain weight and reach that 30lb weightloss is starting my diet full force. Mainly protien, mainly vegetables, and gold carbs like brown rice, oatmeal etc..

One thing no one has mentioned is about your question about losing weight without the surgery: I can lose weight really easily, but I can't keep it off. WLS resets your "metabolic set point" so it's easier to keep the weight off, though many people regain some weight. I've previously lost 50 and 100 lbs, but both times gained almost all of it back within a few years. I'm having surgery to give myself a better chance to keep weight off.

you are right. There are so many things that factor into your rate of weight loss that you have little to no control over, such as age, gender, starting BMI, genetics, metabolic rate, what percentage of your body is muscle, etc. The only two factors that you have a lot of control over is your how closely you stick to your program and your activity level. If you're good with those, then you'll lose the weight, whether fast or slow. I was a slow loser from the get-go, but I was very committed to my program, and I ended up losing all of my excess weight (over 200 lbs). In the end, it has more to do with your level of commitment than it does your rate of weight loss.

I always weight a few pounds more at night than I do in the morning. Don't freak out - you didn't actually gain 5 lbs today! It's going to be gone in the morning.

Sleeved Nov 2017 then Revised July 2019 (for GERD, hernia, sleeve torsion etc) Almost immediately after no more issues with GERD. I developed a stricture early out but it was dilated and resolved. I initially lost more weight (around 15lbs) but it wasn’t where I or my surgeon wanted me to be so I gained it back. My weight may fluctuate a few lbs on either side of my goal but that is usually due to events I wasn’t hungry immediately after surgery but that’s normal for me, hunger returned and it was no big deal as I had already had a return on hunger a year before with VSG. Some people (myself included) have a experienced a change in restriction from VSG to RNY (less, more or different restriction) I actually had an easier recovery with the revision. It was a short learning curve with new bathroom habits. Overall very satisfied.

I was sleeved this past Sunday 5/16, and everything is going great. My program has a nutritionist aspect attached, but I'm interested in finding a third party nutritionist who will help me focus on my specific goals and needs after I am given the clearance to pursue a regular diet and full activity. I'm 41, and I was sleeved at 334. I am not diabetic, and have no co-morbidities aside from mild hypertension and hyperlipidemia. I've been active as a powerlifter, as well as having run 2 half marathons (albeit at a non-healthy weight). I am interested in working with a nutritionist/dietician who will be part of a team to help me to maintain the strength I have, while losing excess body fat, and increasing my work and aerobic capacity. Anyone have any recommendations for online/zoom nutrition counseling that might fit this need? Thanks!

Thanks for sharing. The reason I am asking is because I need to lose pounds in a fairly short period of time, which includes the two-week liquid diet phase, so I am trying to create realistic milestones. So, while the surgeon's objective is different, I am trying to factor it into my weight lost timeline (and strategize how to make this requirement probable!) Thanks again!

Hello! I'm just wondering if anyone is scheduled for a revision from sleeve to bypass in June, later on or has already had it done? My revision surgery is scheduled for June 14th for GERD, rapid gastric emptying, hiatal hernia, and difficulty swallowing! I won the post op sleeve surgery lotto. I got it all! 😅🤣.. I'm a little nervous and starting to get anxious. So yeah..😬.. If you've had a revision, I want to hear from you. Tell me your story and your experience after your revision. Were your issues resolved? Did you lose any weight? Were you hungry? Tired? Whatever. Let me know your thoughts and if it was worth it... 😊😊😊

I think I lost about 20 lbs on it, but that's going to vary a lot between people. and the two weeks is torture enough - no way would I want to do it longer. the purpose of it is to shrink your liver so it's easier for them to get in there and do the surgery. I don't think they really care how much weight you lose (although you'll lose some...)

Hi! Welcome to forums! You will find a wide range of answers to this one as everyone is sooooo different. With that said, I lost 11 lbs in 2 weeks. I had 2-3 protein shakes a day, and nothing else. Also, I started off at 235 lbs on day 1 of liquid diet (5'2" female, was 46 at time of surgery)..oh, and I didn't lose any weight prior this.