Hi, I'm new!

I had a sleeve in 2008 and it gave me GERD. I ended up gaining more weight than I lost due to severe anemia and pica. Then I did keto and lost 225lbs but it still isn't enough. I also have a hernia but it isn't really impactful.

I told my doctor that I want revision surgery (but i didn't mention gerd or the hernia, just weight loss) and he is like, "see a dietitian." Also I do not have the same doctor or even live in the same area as I did in 2008.

Literally any advice or comments are appreciated here.

I think if you frame the reason you want a revision as "weight loss" it's likely you will not have much support, because weight loss from revision is often not much. Your best bet is probably to work with a therapist who specializes in eating disorders and bariatric issues. Especially since you developed pica after your first surgery.

While it makes sense to get a revision if you have GERD (not sure about the hernia!), you should keep in mind that you may not lose very much.

Also, you can try some other remedies for GERD, like not eating 3-4 hours before lying down, sleeping with the head of your bed elevated, etc.

Good luck, and mega-congrats on losing 225lb!!

Talk to your doctor again and tell him/her about the GERD. Don't ignore the GERD as it can lead to Barrett's esophagus and possibly even esophageal cancer.

I'd also tell him about the hernia for sure. I went back to my surgeon 7 years after my sleeve with severe hiatal hernia symptoms. He did an EGD, and as soon as I woke up told me he saw the hernia and had scheduled my revision surgery for the following week. Hernia and GERD are two very good reasons to revise to bypass as it should help with both.

As others have said though, don't expect as much weight loss with the revision as with the original surgery.

One other thought, I had great luck using my sleeve with a combination of time restricted feeding and keto. I only ate between noon and 6pm (lunch at noon, dinner by 6pm, no snacking) and generally followed keto guidelines. This is the insulin control diet regimen recommended by Dr. Jason Fung. I dropped 20 pounds in a couple months and found it was easy as since my sleeve I didn't have a great deal of hunger.

You need to tell them about the GERD. You need to have an endoscopy to check for damage to your esophagus.