This is something I read ever so often:

"I'm getting a revision - but NOT because of weight REGAIN!!!!"

Like, users on here are so very eager to point out and make sure everyone knows that they're not getting their revision because of "weight regain" or "insufficient weight loss". So, in a "supportive" community people needing a revision make sure to let everyone know in advance that it's because of reflux or other things but NOT because of weight issues. Wow.

Don't get me wrong. If someone is getting a revision it's absolutely fine to tell people why if you want to. In fact I think it's indeed very important to talk about revisions because of complications like reflux etc. since having surgery is no piece of cake and **** happens all the time (e. g. look at what happened to Alex only recently). However, what rubs me the wrong way is this "but NOT because of weight issues", as if that would be something... dirty or naughty or something to look down upon.

I'm not even sure how that makes me feel exactly. Angry? Sad? Pissed? Disgusted? Anyway, I can't help but being struck by the sky-high judgement level within the WLS community when it comes to struggling with weight/food issues after surgery and needing a revision because of weight regain or because of not-making-it-to-goal-weight (goal weight being of course BMI below 25).

Very curious about the reactions coming my way now.

8 hours ago, Leademo said:

How can you tell if you need a revision?

I think this question is not easy to answer in many cases. Reflux is a common reason people are getting bypassed after having been sleeved or banded. Lack of weight loss or weight regain is another. However, I don't know what the most common reason is.

Anyway, it's always a question of "What does the patient want and what does the patient want to live with forever and what risks is the patient going to take by having another surgery or by not having another surgery". So decision to get a revision can for sure take its time.

I'm still on the fence if I should take the risk of another surgery (hiatoplastic, gastropexia, maybe even changing the anastomosis, depending on what they see during surgery) or if I should live with it the way it is and get control gastroscopies yearly. Since there is no guarantee that everything will be fine and dandy after another surgery, I'm very hesitant and regardless of what I will choose in the end, I won't rush it (luckily there doesn't seem to be a need to) and nothing will happen before January or February anyway regarding another surgery. I simply need time to come to terms with all of this.

"The process of a revision". I'm not sure what you mean here. Insurance issues? If so, it seems to depend on insurance and the reason for revision if that is a major hurdle or not. I can't contribute anything useful to this since insurance system in Germany is quite different from that e. g. in the US. However, everything revision starts with a visit at the surgeon's office and then you go from there.

8 hours ago, Leademo said:

I’m sure I just need to get back on track.

This is definitely not a "just". Finding a way to be at your desired weight without having to struggle every day to fight regain is IMO the requirement for long term success with WLS. This is usually a highly individual process, often (mostly?) including some trial and error.

What do you think was the reason you went back to "old habits" as you phrased it? Dieting burnout? Emotional eating? Something else? A combination of many things?

I needed revision. NEEDED. I make the distinction for anyone who is in my shoes and contemplating revision. I did regain 50 lbs but it was purely because of high dose steroids for 5 months. The journey is different when it’s weight regain revision vs medical revision.

I asked about revision surgery on another forum and I had a similar reaction to the responses.

They made me angry because I felt that they were condemning me for weight regain.

I went back and realized that they weren't condemning me. They were just telling of there experience of getting back on track without surgery as the surgery is not as helpful the second time around.

But it is a very touchy subject and I was extremely hurt and I did not get any answers to my question which was have you had revision surgery and what was it like. Which is a difficult question to get answered.

I advise people to approach people seeking revision for weight regain with extra compassion. It is a very painful subject.

Also I would LOVE to see threads where people who need/want revisions and don't have medical complications explain how they were able to get it done.

Too often you see GERD + weight gain = revisions but not everyone develops reflux and regains. It can be either/or/none.

What about the percentage of patients with no issues at all and the band/sleeve/etc just wasnt very effective on them. Or start at a very high weight with the sleeve then need to go on to the DS/SIPS.

I think that could help others see that sometimes is no just about you doing everything right or wrong

5 hours ago, GreenTealael said:

Or start at a very high weight with the sleeve then need to go on to the DS/SIPS.

In Germany there is the possibility of a planned second surgery in the case of very heavy patients. So it's not seen as a revision but an already planned second surgery.

People get a sleeve resection first as the initial part of a BPD/DS, lose some weight with that and then a year later get the full DS. I don't know how common that really is though.

5 hours ago, GreenTealael said:

I think that could help others see that sometimes is no just about you doing everything right or wrong

Even if there was "something done wrong" by the patient (I don't think we need to go into detail here) - some people need a second chance. Period.

I'm sometimes appalled because of the level of judgement on WLS boards when it comes to this issue. Maybe we all should remember that we weren't successful in the past, often countless times, when it comes to losing weight and maintaining weight loss.

Edited November 6, 20196 yr by summerset

On 11/2/2019 at 8:11 PM, JessLess said:

In my friend’s case, he had lost 100 lbs, but still weighed 400 and was regaining. I think he needs to figure out why he won’t stop binging on fattening food, but I support him and his choices. Regaining 15 lbs. sounds like something you can work on without surgery if you feel like you can and want to.

I think your friend possibly got the wrong WLS from the start. 500lbs seems like a lot for the sleeve.... But, i'm new to the sleeve, so i don't know. What i do know is, he needs a better Dr. and/or Phy. Dr. Before he gets another WLS. My ex sister in law had 3 WLS's. Her first was Lapband in Mex, then Lapband in the states, then GB in the states. No counseling for the first, regained and revised, but she regained yet again. The last dr did the GB.... and yes, regain again. The dr.'s need to make sure patients are getting more counseling.

24 minutes ago, BayougirlMrsS said:

No counseling for the first, regained and revised, but she regained yet again. The last dr did the GB.... and yes, regain again. The dr.'s need to make sure patients are getting more counseling.

Do you know for sure she didn't have any counseling?

I'm asking because "counseling" and/or "therapy" are no more magic weapons than WLS itself is. This might not be something people want to hear, but: NO therapy, be it medical or surgical, has a 100% success rate.

Why do so many people at least seem to think that WLS simply must have a 100% short and long term success rate if there is only enough therapy and counseling and stick-to-your-plan-advice-from-veterans when it seems to work so poorly without surgery? Do many patients think (despite claiming so often it's not) that WLS is the magic wand that brings the 100% success with reaching and maintaining a normal weight after all for all patients if they only "try hard enough"? I find that hard to believe that people with sometimes a lifelong experience in obesity treatment can be that naive and/or gullible.

"You just need to try hard enough" - I guess that's something we've heard too much already throughout the years or even decades. WLS success rates are already extraordinary as they are compared to everything else available, though surgeons and patients often define "success" quite differently.

8

32 minutes ago, summerset said:

Do you know for sure she didn't have any counseling?

Yes i know at 100% there was None. She never got to the reason "why" she eats.

I'm asking because "counseling" and/or "therapy" are no more magic weapons than WLS itself is. This might not be something people want to hear, but: NO therapy, be it medical or surgical, has a 100% success rate.

My comment was for people who continue to have WLS and no success. Whether it's 1lb or 100lbs. I had the band and maintained a 89lb loss for 7+ years. And in all standards, i was still a success even after i regained 30lbs after being unbanded for 2.5+ years.

Why do so many people at least seem to think that WLS simply must have a 100% short and long term success rate if there is only enough therapy and counseling and stick-to-your-plan-advice-from-veterans when it seems to work so poorly without surgery? Do many patients think (despite claiming so often it's not) that WLS is the magic wand that brings the 100% success with reaching and maintaining a normal weight after all for all patients if they only "try hard enough"? I find that hard to believe that people with sometimes a lifelong experience in obesity treatment can be that naive and/or gullible.

Because they don't do their research and don't get to the "Root" of their issues. Not saying that counseling is a 100% for success or failure..... but people that tend to have more counseling come to realize the reasons they gained weight more than people who don't. Look at the post, so many people saying stuff and i'm like, did you just wake up one morning and say.... i'm going to have WLS and it will solve all my weight problems. I really think there are people like that. Then when the first WLS fails, they get another and another.... never getting to the "why"....

"You just need to try hard enough" - I guess that's something we've heard too much already throughout the years or even decades. WLS success rates are already extraordinary as they are compared to everything else available, though surgeons and patients often define "success" quite differently.

23 hours ago, BayougirlMrsS said:

Because they don't do their research and don't get to the "Root" of their issues.

I think sometimes people simply don't want to know. Thinking about the possibility that this "last chance" won't finally bring salvation can be a real hope-crusher because: if this doesn't work either, what then?

Sometimes I also think that "the roots of our issues" with weight is that we can't get away with eating that much as some other people can and that willpower is not coming from a bottomless well (yes, I know...most likely not a very popular opinion). And at some point it became a vicious cycle, a point many other people will never reach.

The older I get (and the more people my age I have seen gaining weight over the years), the more I'm convinced that many people might not have "that evil trauma or issue" in the past that needs to be worked through. Changing countless habits and sticking with new ones that might be a real hassle? Needs too much willpower in the long run.

Ah, just rambling a little here, sorry ... I think people in my environment gain a little more weight year after year and this strikes me in an odd way.

On 11/6/2019 at 4:30 AM, GreenTealael said:

Also I would LOVE to see threads where people who need/want revisions and don't have medical complications explain how they were able to get it done.

Too often you see GERD + weight gain = revisions but not everyone develops reflux and regains. It can be either/or/none.

What about the percentage of patients with no issues at all and the band/sleeve/etc just wasnt very effective on them. Or start at a very high weight with the sleeve then need to go on to the DS/SIPS.

I think that could help others see that sometimes is no just about you doing everything right or wrong

I’m glad we have the revision forum. Is it addressing some of the things you listed?

1 hour ago, Healthy_life2 said:

I’m glad we have the revision forum. Is it addressing some of the things you listed?

I hope so! I hope people find they can open there

19 hours ago, summerset said:

I think sometimes people simply don't want to know. Thinking about the possibility that this "last chance" won't finally bring salvation can be a real hope-crusher because: if this doesn't work either, what then?

Sometimes I also think that "the roots of our issues" with weight is that we can't get away with eating that much as some other people can and that willpower is not coming from a bottomless well (yes, I know...most likely not a very popular opinion). And at some point it became a vicious cycle, a point many other people will never reach.

The older I get (and the more people my age I have seen gaining weight over the years), the more I'm convinced that many people might not have "that evil trauma or issue" in the past that needs to be worked through. Changing countless habits and sticking with new ones that might be a real hassle? Needs too much willpower in the long run.

Ah, just rambling a little here, sorry ... I think people in my environment gain a little more weight year after year and this strikes me in an odd way.

I certainly agree with you. My views are more towards the people that didn't have the band fail them... like people that had a band erosion or slip like myself (not by bad band management). I'm still trying to figure out how the Sleeve fails people??? In fact i'm going to start a new thread asking that very question.

I come from the very south of Louisiana and everything and i mean everything revolves around food. I know with out the "wantpower" i would have gained a whole lot more than 30lbs.

1 hour ago, BayougirlMrsS said:

I'm still trying to figure out how the Sleeve fails people???

Honestly? No idea. I don't have a sleeve but an MGB and I don't understand how people can gain large amounts of weight back, maybe gaining it all back, maybe gaining it all back and then some.

Why?

Because I feel like I don't know how to do this. I eat (from my point of view) a lot, I often eat until I feel really full, I also don't shy away from calorie rich food, I'm not living in the gym... so I wonder how much and how often people would need to eat way above what feels comfortable in the stomach to gain that much weight. I can't imagine that all of this can be blamed upon "going back to old habits".

I personally think that WLS has different impact on different people. Not only in the sense of who gets to a normal weight and how fast and/or how easy they go there, but also in the sense of how hard or easy maintaining is for them.