Question: I am considering the RNY procedure and would like to know with a RNY, how is it even possible to regain weight back? If you dump from any excess of processed foods that break down into sugar and sugary food itself, how could this happen? Does the small pouch created eventually expand over time? I understand I may feel times of hunger down the road, however if I am eating the right foods, and the right way (Protein first and no liquid with meals) will I eventually require more food to feel full over time? I am a high volume eater, so this key for me to understand.

Thanks in advance for the support!

First, you would no longer be a high volume eater. I am 16 months post op and eat between 1/2 cup and 1 cup of food per meal with a small healthy snack once or twice per day.

The reason people gain their weight back is:

1: they go back to eating lots of sugary, carbs and processed junk food.

2. You can literally eat around the surgery by eating small amounts all day long.

In order to not gain weight back you literally have to follow the plan for the rest of your life. Yes, once in a while we all indulge however we account for it by tracking and making sure the remainder of our day we follow the plan.

I can pretty much eat anything I want to but I now choose not to. Honestly your tastes change so much after surgery. I have no want to ever eat fast food or junk food. My body craves good Protein, fresh veggies and fruits.

But, I had to work towards that. For me it started at the pre op stage. Once I went through that I did not care to gorge myself on sugary, carbs and junk food.

Hopefully I answered your question.

Djmohr, thank you (again!)....can you discuss more about #2 "eating small amounts all day long"....do people feel hungry that they need to do this, and if so, are they eating the bad foods or healthy choices? I thought the point of the RNY is to limit capacity. How could one eat small amounts all day long if your supposed to be actually full? So confused. ....

Also, a bit about me: I am maintaining a 50lb weight loss for almost 3 years now. I gave up sugar, sweets, bread, pastas, etc long ago, and eat high protein and high unsaturated fats. I do like my whipped cream and occasional fro-yo, but other than that...quite strict with food choices, but could never eat like a "normal" person. Always a high volume eater, still struggling with a bmi of 42. Apparently one can gain weight even eating the healthy stuff too....:-(

@@ForeverHealthy I am about five months out from RNY. Many people find months after surgery that they can eat a little bit of the wrong foods all day long. I can eat a lot more chips or crackers than I can Protein. And I get hungry again way faster on those foods than protein. So yes, sticking to the plan is key. I can eat about 2.5 oz of meat at a time and a few bites of veggies. That keeps me full for hours and I feel a hell of a lot better when I make good food choices.

After surgery, some people choose to moderate or abstain or some combo of the two when it comes to off-plan foods. My nutritionist has told me wheat crackers are ok as long as I have some protein with them, like cheese. I sometimes have cheese and crackers as a snack. A little indulgence once in a while helps me stay on track. Other "problem foods" I'm abstaining from completely, like soda, diet or not.

I understand it's also possible to stretch the pouch, so it's important to stop eating when you're full. It's been helpful for me that when I'm satisfied, the food doesn't really taste good anymore so it's easier to stop. I have had to have some pep talks with myself about not trying to squeeze in a few extra bites to meet my protein goals.

I hope this helps!

It does GPmed....thank you!!!

my surgeon said although pouches can stretch, it's not all that common. People usually gain weight because they don't follow the plan, like the above posters said. They start eating simple carbs again (which make you hungrier faster), they graze all day, and/or they don't wait long enough after eating to start drinking (which washes the food out of your pouch too soon).

You will probably never be able to eat half a pizza again (or an entire pizza) in one sitting. Your stomach is much too small for that. But you can have a piece one hour. And another piece an hour later. And another piece an hour later. And so on until you've pretty much devoured an entire pizza over the course of a day. *That's* the kind of thing that makes people gain weight.

After surgery, the part of your stomach that process fats and sugars has been cut away and consuming fats or sugars can quickly lead to dumping. But your body is adaptive and after about a year, your intestines learn how to take up the slack and process fats and sugars.

After surgery, one of the unexpected surprises was that I lost my hunger. It was not difficult to lose weight when hunger was not constantly, incessantly gnawing at my bones. But after a year or two, hunger does return but just not with the same voracity that I experienced prior to surgery.

I asked my nutritionist why do some people lose weight after surgery only to gain some or all of it back later. She said it was due to grazing, which I would interpret as snacking.

I am 32 months post-op RNY. I have written a couple short articles. One covering the weight loss stage and one covering the maintenance stage.

http://www.breadandbutterscience.com/Surgery.pdf

http://www.breadandbutterscience.com/Surgery2.pdf

Got it catwoman....makes perfect sense!!

James, gpmed, catwoman, and djmohr: thank you so much for sharing all of your guidance, experiences and perspective, not to mention support! I am truly grateful. Thank you all! James- I will definitely read those articles!

I talked a lot with my NUT about regaining weight before I had surgery, because I absolutely did not want to go through a major surgery just to end up back at my old weight or heavier. Some of the things she told me were that some people don't follow the plan even from the get go. She had one guy try to eat a hard shell taco in the puréed stage and nearly killed himself. Then when he got out of the hospital, within a week he had eaten a whole king size snickers bar. His total disregard for following the rules meant he not only didn't lose weight, but he gained weight. The guidelines are given for a reason. Part of it is so your body can heal, but part of it is also to change the way you eat so that you are successful long term. If you start out eating the insides of a soft taco today and in a year or two progress to just eating the whole damn taco and then down the road to two tacos...there are extra carbs and calories in that. To be successful we need to be as vigilant at day 100 and 900 as we are at day 1. Dumping is also not a given. I have had dumping only once and that was from Protidiet vegan chili. I honestly don't know what if anything it would take me to dump, but I'm so afraid of the idea that I'm not even going to try to find out! lol we need to keep that mentality going forward even after a year or so has passed and our bodies adapt to the ability to process fat and sugars again. The biggest reason people regain weight, though, is from failure to change their original bad habits. They go back to eating candy because they find out they can and it's what they always did before, or they start eating potato chips before bed again, or eating cake with gobs of frosting. It's a very short time really to put all your demons to bed and pick up new habits for life. It helps to have a good accountability and support including a NUT and psych should things goes in a negative direction so you can course correct and get back on track. You can be successful, but this operation is a tool and nothing more or less. You get out of it what you are willing to put into it.

Thanks Sajijoma!