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A decade after gastric sleevectomy I am gaining weight steadily inspite of my best efforts. Don't know where I will stabilize. If I do drastic dieting feeling very weak, ultimately I came to the conclusion - how I feel is more important than how I look but it doesn't solve the original problem. Request feedback from others.

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I too have gained weight and I don’t know why. I can still only eat a little bit. I do drink wine every now and then but I have no idea what it is. I’m 72 years old so I don’t know if it’s got something to do with metabolism or what. I was 198 and I got down to 110 but felt good at 117 and I’ve slowly gotten up to 140. Everybody says I look good but I know that when if I the 20 pounds less I felt much better anyway there’s nothing I can do about it. I’ve tried everything. It’s been six years since I had my surgery.

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You didn't provide a lot of detail regarding your diet or activity level, but I'd be willing to put money on a couple of things:

  1. A relatively large percentage of your diet is made up of highly processed foods.
  2. You are not very active.

Let's start with diet. You need to understand that it's not just about calories in vs calories out. Diet quality can be a huge factor in whether or not you can successfully maintain your weight at a lower level. If you do eat a lot of processed foods, start making really small changes and focus on just one sustainable change at a time until that change becomes the new normal for you. You can then move on to another sustainable change. Slow sustainable changes are the key, not quick-fix diets.

As far as physical activity is concerned, there is significant body of evidence now that the vast majority of successful "weight loss maintainers" get an average of 60 minutes of physical activity per day. Yes, this is more than the typical recommended amount, but it's probably needed. (Discussing why is too big a topic for this reply).

More detail would help. I hope you get it figured out.

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Dr Matthew Weiner has done a few podcast and has been speaking about regain with sleeve on his social media a lot lately. May be worth checking them out if only for some information to consider. He does prescribe GLP -1s for many of his sleevers and says this is a path many will have to go down as regain is common with sleeve.

Have you been in contact with your surgeon (if they are still practicing nearby) to discuss options? Have you considered revisiting your dietician too. May be worth tracking what your eating and drinking too just to ensure your not missing something. It’s easy to become complacent about food choices, portion sizes, frequency or meals, etc. or not meeting Protein & fluid goals as time passes. Have you had any medication changes? What are your activity levels like?

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I am firmly behind using every tool at your advantage to tackle regain: Tracking portions, exercise, joining a support group, checking in with your previous or new weight management team and use of the new anti obesity medications.

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I had the sleeve and I started gaining just months after I reached goal. I was too embarrassed to reach out for help and ended up gaining it all back and had no choice but a revision. Good on you for reaching out here. My biggest piece of advice is to reach out to your team and get an appointment. Start logging your food again if you haven’t been and give them an honest picture of what you are eating so they can help you make tweaks. Also if you have a fitness watch, pull it out of the drawer and get a real picture of you current activity level. I thought for sure that my team was going to be so harsh on me and make me feel awful but they couldn’t have possibly been more understanding and all they wanted to do was help. For me the only real option was revision but for you some tweaks in your food and exercise may help, could be hormones so they may want to check that, weight loss medications in tablets or the newer option if the GLP-1 injections may even be an option. The other suggestion of support group meetings is a really good one too. I am doing so much better this time around because I am reaching out for support anywhere I can get it. This time I told more people so I have more people cheering me on and I have the in person support as well as on here and I am going to see the NP more of they than they usually require. I know that I need all the help that I can get. lol.

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