I was reading your May issue asking for people
to respond who had gastric bypass surgery 7 years ago. My surgery was
October 2001 and I lost 156 pounds. It was great when I was losing,
but I couldn't handle all the changes and within 2 years started to
regain weight. I have regained all but 35 pounds of what I lost. I
regret that it has happened and I'm trying to work on it. It's slowly
coming off again.
Yes, it happens, more often than we would like to
think. In the March 2008 issue of General Surgery News*, it is
estimated that between 10% and 15% of patients need revisional surgery
because of inadequate weight loss.
Many of these patients had gastric bands inserted
years ago. These are different than the Lap Bands today. But over and
above this, there is an increasing number of patients who have had
gastric bypass surgery, Lap Band surgery, duodenal switch surgery or
sleeve gastrectomy surgery who want revisions often from one type of
surgery to another.
These revisions are the most complicated and
dangerous surgeries. Patients have a higher risk of
complications and death because many have significant scar tissue and
problems created by the first surgery. They also have higher BMI’s
because of the failure of their first surgery.
Revisional surgery has received little attention
and there are no guidelines or standards. And there are several
approaches to revisional surgery. Some patients want to try another
surgery, for instance there are those who have been unsuccessful with
Lap Band surgery or gastric bypass surgery who want to have duodenal
switch surgery because patients tend to lose more weight with duodenal
switch surgery. Gastric bypass surgery patients may want to have the
about this in my Oct 1 2007 Newlsetter) that makes the pouch and stoma
smaller by using an instrument that goes down the throat to pleat the
pouch and stoma tissue. Patients can have their stoma made smaller
through sclerotherapy which scars the stoma with acid so that scar
tissue makes the stoma smaller. Or patients can have a band put
around the pouch to make it smaller.
I had surgery in 1994. At the time of my
surgery I weighed 463 pounds. I lost 250 pounds and was down to a
weight of 213 pounds, regained back up to 300 and lost down to 190.
Then I regained again. I am maintaining about a 125 pound weight
loss which at 338 pounds keeps me in the morbidly obese category. I
have since had 3 sclerotherapies since my stoma is totally stretched.
I have been told this happens a lot with long term post-ops. I always
felt hungry and my portions got bigger. My pouch is in tact so there
is no staple line disruption.
The last time I had sclerotherapy it worked
for about 30 days. I just had it again two weeks ago and so far I get
full fast, and I stay full for at least 3 hours. If it holds, I can
continue losing weight. I have lost 5 pounds in the last 2 weeks.
While it is true that not all weight regain stems
from physical reasons. Most of us suffer from emotional eating issues
and many are not able to control it. While much attention is given to
the surgery itself, far less attention is paid to the mental health
aspects. Surgery addresses half the problem and patients are often
left to fend for themselves when they aren’t able to control eating or
emotional issues stemming from losing a huge amount of weight.
“All patients deserve a second chance,” says Dr.
Robert Brolin, Director of Bariatric Surgery at Princeton University
but cautions that patients be screened for compliance and
psychological issues so the patient doesn’t need a third surgery.
While the percent of people who regain weight
after their surgery may be even much higher than the 10% to 15%
suggested by the General Surgery News article, there are many
long term success stories as well. I don’t want to leave you thinking
that all surgery fails long term, because it doesn’t. Here is just one
of the long term success stories that I received:
I had my RNY surgery on August 15, 2001
(almost 7 years ago) and have lost 255 pounds since then (from 420
pounds to 165 pounds). I have maintained that weight for almost 4
years now and do go up and down as much as 5 pounds each month. My success
comes from the fact that I was able to finally conquer my addiction to
food and to changing my lifestyle through good food choices and
exercise. My weight loss surgery gave me the tools to accomplish this
and I and my family will be forever grateful that I was given the
opportunity to have this surgery done and the vast improvements it has
made in my life.
There are no guarantees. And because one person
is able to maintain a weight loss and another isn’t does not mean that
one person is “good” and the other person is “bad.” We are each
individuals and our results will vary. But we can never give up the
Christina. “More Bariatric Surgery Means More Revisional Procedures.”
General Surgery News, Vol. 25:3, March 2008, p. 1, 15-16.