Band > Sleeve now what?

[Debaria 6]

Hello - I am a past Lap Bander. My band eroded and I ended up having it out. I then have sleeve surgery in 2013. The sleeve was much better than the horrible band. My start weight was 103 kg (227 pounds) the lowest I got down with the sleeve was 80.3 (177 pounds) I am 5 ft 6.5 or 169 cm. I am now putting on weight and have gone up to 86 kg atm.....(189 pounds). I exercise regularly. I do have a problem with sweet things and I find I am always hungry.

I now find I am seriously thinking I might need a Bypass. However is that too extreme my BMI is currently 30. I was scared when I had the sleeve (cutting off most off my stomach was a horrifying thought!) I am even more scared of the By Pass - there seems to be a lot of people with complications from the By pass out there.

Am I crazy and is having a 3rd weight loss surgery pushing my luck?

[NeedaBreak4Me 1,755]

I think a 3rd surgery for 6kg is a little drastic.... have you tried going back to basics? Are you tracking your food? Reaching Protein goals? Whats your diet like?

In my opinion.... 6kg weight gain in 3 years is not bad at all... you can get rid of that with 2 weeks of following your original pre op diet...

[Debaria 6]

I think a 3rd surgery for 6kg is a little drastic.... have you tried going back to basics? Are you tracking your food? Reaching Protein goals? Whats your diet like?

In my opinion.... 6kg weight gain in 3 years is not bad at all... you can get rid of that with 2 weeks of following your original pre op diet...

I never got near where I should be with the sleeve. To,get to the heaviest end of recommended weight range I need to loose 14 kg. I have no problem eating protein and always eaten protein first. Snacking on carbs is more my issue.

[NeedaBreak4Me 1,755]

Well the fact you have had two surgeries, i highly doubt you would have major weight loss with a 3rd. The shock value of reducing calories is gone, and your metabolism would have adjusted to it.

I know for certain that weight loss is slower 2nd time around, so i would imagine how much slower it would be a 3rd.

Sorry i am not trying to be a negative nelly, but thats just how our bodies work.... its a fact that you lose slower and slower with each revision, and being a lower BMI also works against you.

Perhaps try your pre op diet again? Cut out carbs and sugars and stick to high Protein and see how much you can achieve doing that. Are you exercising?

[Debaria 6]

Thanks for your opinion - I am still only thinking about it. I am having a follow up with Dr from the clinic where I had surgery. I will be interested in what they say. I don't know if they will see it as a 'failed' sleeve? I excercise 4 times a week so that is not an issue. My issue is carbs/sugar......

[NeedaBreak4Me 1,755]

Yes.. good idea.. a follow up with your surgeon would be good.. perhaps a follow up with the dietitian would be a good idea too.

You seem to know what your issue is, have you tried not having carbs and sugars? Have you asked yourself honestly why you still have them when you know that is what is hindering your weight loss? I know thats a obvious question.. but if that is an issue with the sleeve, it will still be an issue with the bypass... and if you are relying on dumping... not everyone dumps.... ????

[FrankyG 1,450]

None of the following is meant to sound mean or critical (please don't read it that way - just being honest and trying to hit points you may not have considered or might be in denial about).

It's great that you're exercising because it's going to make you feel better overall, but weight gain/loss is 90% food and diet related.

My doc said that all people will lose even eating absolute crap for the first year, but they will regain if they don't take the time to throw out all they know about food/eating and relearn how to properly eat healthy and figure out correct (small) portion sizing.

Your problem seems to be that you're eating things you shouldn't (simple carbs/sugar) and possibly eating too many calories, and that is causing you to regain (simple carbs and sugar are usually high calorie, low nutrition slider foods that make it really easy to overeat).

Are you tracking every bite and sip of food/drink? You probably should be measuring and tracking all of it, especially since you're regaining. You likely are overeating and eating foods low in nutrition as well. It would give you a much better idea of whether the failure is your sleeve or more likely - a disconnect with what and how much you you actually eat. I imagine even consulting another surgeon, they'd like to see how many calories you're consuming and what those calories are made up from to make a truly honest opinion about whether another surgery is a good step for you or not.

Simple carbs and sugar are known to cause you to crave them all the more once you start eating them regularly, so that would explain the feelings of hunger. (you're not really hungry if you are eating good protein/complex carbs and getting enough calories - it's cravings or head hunger)

I would think the answer is counseling with a therapist familiar with food addictions, and a serious mental reset regarding your relationship with food, not more surgery.

I'd suggest you go back to the beginning of a sleeve diet - do a week of Protein liquids, then mushies, then onto solids. Get your Water and Protein and eat good veggies and healthy complex carbs in moderation. You need to research healthy meals and throw out the crap foods and seriously dedicate yourself to resetting your whole food relationship.

That's what we are supposed to do during the honeymoon phase of the sleeve (roughly the first year). If you didn't get your diet stuff down cold, then you won't do well over the long term. It's a sad fact, but most surgeons aren't really driving that point home. The weight loss effects won't last if you regularly eat crap foods. The surgeries allow you a measure of control for you to get back to basics without the gnawing hunger and drastically reduce the portion sizes in the beginning... so you can lose weight and relearn how to eat properly.

Maybe once you've got that stuff down well, you can add back in some sugar treats for very special occasions, but they should never, ever be something you eat regularly again. But maybe, if you can't control yourself, it might come down to eliminating them completely if you want to stay healthy.

I know it's sucky that you aren't doing so well right now, but you can get stuff figured out if you're willing to do the hard work. It might be worth it rather than going to another surgery and hoping that it does all the work; because it won't. You have to do it, the surgery(ies) are just a tool, but they won't work if you don't commit to using them properly.

Good luck!!

Edited July 23, 2016 by FrankiesGirl

[deekel8 72]

Hello - I am a past Lap Bander. My band eroded and I ended up having it out. I then have sleeve surgery in 2013. The sleeve was much better than the horrible band. My start weight was 103 kg (227 pounds) the lowest I got down with the sleeve was 80.3 (177 pounds) I am 5 ft 6.5 or 169 cm. I am now putting on weight and have gone up to 86 kg atm.....(189 pounds). I exercise regularly. I do have a problem with sweet things and I find I am always hungry.

I now find I am seriously thinking I might need a Bypass. However is that too extreme my BMI is currently 30. I was scared when I had the sleeve (cutting off most off my stomach was a horrifying thought!) I am even more scared of the By Pass - there seems to be a lot of people with complications from the By pass out there.

Am I crazy and is having a 3rd weight loss surgery pushing my luck?

Just a quick tidbit: the sleeve started out as a stepping stone to bypass. And sometimes is still used that way. They sleeve a person, and then later on go back and do bypass.

Sent from my VS990 using the BariatricPal App

[OutsideMatchInside 10,166]

@@FrankiesGirl is right, weight loss is 80-90% diet related. @ Gave you the right tips about getting back to basics.

If you are eating carbs and sugar, and snacking, a 3rd surgery is useless for you. You can do all of that with bypass too.

I'm not even sure you can revise from the sleeve to bypass, the revision from the sleeve is DS and no reputable surgeon would do that surgery on you with so little to lose.

Work on your diet, if you gave up carbs/sugar/snacking you could lose. A surgery can't do all the work for you, you have to contribute.

@@deekel8 The sleeve is the first step of the DS, not bypass. The sleeve was used for people that were too heavy for the long surgery that bypass requires.

[ProudGrammy 8,322]

Am I crazy

@@Debaria

YES !!!!! LOL

lapband eroded

conversion to sleeve was a great move

BUT - NO WLS will be successful if you don't follow all the rules

we have learned many things that we must follow

having a 3rd surgery isn't the solution (IMO)

sounds like you need to be helped/reminded with the rules mentioned

retaught and relearn to help you

ask any and all questions

we are here to help you get back in step with program

one foot in front of the other,. one day at a time

i can feel it my bones, you will be a success

"DO or Do NOT, there is NO Try" Yoda

best of luck

kathy

[James Marusek 5,244]

There are two phases to weight loss surgery - the Weight Loss phase and the Maintenance phase. I am 3 years post-op RNY gastric bypass. This is the approach I used in the Maintenance phase. http://www.breadandbutterscience.com/Surgery2.pdf

[Djmohr 6,965]

I am with everyone else on this one. A bypass is not going to help you if you are eating a lot of sweets and slider foods. Trust me, I have had bypass and there are days when I simply want something I shouldn't have. I believe in everything in MODERATION. If I want a few crackers I track them and know that it will take care of the craving but leave me feeling hungry in short order.

You need to go back to basics and cut all that stuff out if you struggle to moderate it.

[Debaria 6]

I appreciate everyone's opinions and thoughts. I understand what to do regarding food, I have been on this weight loss journey for a long time. It's just very disappointing. I understand Protein first. I am not sure whether my stomach has stretched or has always been on the larger side. I seem to be able to eat more than friends I know who have been sleeved. In my head I think it might be larger due to damage from band. What would a surgeon consider a success or failure of a sleeve? Is it 50, 60 , 70 % of excess weight?

[NeedaBreak4Me 1,755]

You will be able to eat more with the sleeve as you have had the band.... the band causes dilation of the esophagus which reduces our sensitivity.. in turn this enables us to have more food due to the reduced pressure.

I am the same, i could have half a cup straight out after revision to the sleeve... even now i have no issues drinking 1 litre of Water in one sitting, i can gulp Water with ease....

I could probably have 1 cup of food if i really tried.. but i don't allow myself to try, i measure out my food and don't eat till i am full.... i eat till i am satisfied and not feeling hunger... as an ex bander weight loss is lower too.. and yes it is very frustrating!

You have not failed.. you have succeeded... you are close to goal... you are not as far away as you were before.. remind yourself of that... look how far you have come.. not how far you have to go....

Review your habits honestly, we all can fall into habits that work against us.. its what we do to change them that makes all the difference... go back to basics... it does work...

[Debaria 6]

Thankyou. Aussiegirl81. I am similar to yourself - can eat a cup no problem and gulp down Water no problem. I am 3 years out from my sleeve and with a BMI of 30 classified as obese. That doesn't feel like a success. I am trying to be good with my food and will see what Dr says in 2 weeks. I have no idea what they may say. Probably eat more Protein ( I eat plenty of protein) cut down carbs....... All the usual things........maybe they will suggest checking my sleeve size? Then what - sleeve revision - bypass or nothing?