Hello,

I’m new here and hoping to get some insight. On September 02 2025 I had my psych evaluation. She asked me my goal weight (220) then said I need to go over it with my doctor because sleeve to bypass revisions don’t have big weight loss. Right now I’m 5’6 and weight 276.

My psychologist floored me and I’ve been numb ever since. I never heard of this before. Now I wonder why my surgeon or PA (physician assistant) didn’t tell me. Can someone please let me know if they were told the same or beat the statistics?

Based on the usual results of sleeve-to-bypass renovations, it sounds like your psychologist was forcing you to face reality. She suggested talking to your doctor about your desired weight because, on average, revision surgeries don't lead to as much weight loss as primary procedures.

Speaking with your surgeon or PA about this is very worthwhile; they can explain predicted outcomes based on your lifestyle, prior surgeries, and general health. Although the range can vary greatly, many people do achieve or come near to their goals.

For sleeve-to-bypass revisions, you can also follow other people's experiences in support groups if you'd like to know how your expectations compare.

I was told the same thing that revision surgeries do not tend to yield as much weight loss as virgin surgeries. Sleep to bypass is the more common one, but ask your doctor about a sleeve to SADI revision. My surgeon had actually just started doing them but was straight forward about that and told me that he would not change the size of my sleeve so he did some tests to look at mine and it still looked good so we went with that option. I totally trusted this surgeon to not attempt it if he was not confident he could handle it but I was warned that if I had a complication he would stabilize me and I may have to be moved to another hospital where a surgeon who was more experienced with the surgery could help. I was okay with that so long as I knew we had a plan. T)3 Sleeve to SADI does statistically yield a greater loss and a longer lasting loss than sleeve to Bypass BUT not all surgeons do them and it is somewhat new so there may be issues that they find that just haven’t happened enough yet for them to notice. Also, I have yet to find a single physician, family, gynocology, cardiology, nephrology, oncology, hospitalist, etc who has heard of it so it could present some obstacles in them not knowing how the surgery may relate to other medical issues. Basically I have to do my own research ahead and call my surgeons office quite a bit. I tell them what’s going on and ask could this have anything to do with the SADI and what does the specialist need to know. When I had colonoscopy and endoscopy the surgeon called the gastro doc and explained my surgery. I always just tell the doctors it’s a modified duodenal switch and it has one anastomosis (or connection) instead of two. If they still look confused I say it’s sort of a combination of the sleeve and bypass because my stomach is sleeved but they also changed up the intestine. If they are doing anything going in there, like my gastro doc, I ask the surgeons office to make sure they understand. (Not sure all surgeons will do this though on your request. The other doc may have to reach out to get the answer). I was actively treating for cancer though, so they knew I couldn’t have any setbacks. I was neutropenic any even stepping into a hospital was risky for me, so they got why I was scared to have them do something to cause even a minor infection. Anyhow, some doctors who have done the SADI for a while will even resleeve your stomach giving you that same restriction again. My surgeon said he didn’t feel that the risks that involved were worth it for the minimal additional loss and that he did not feel comfortable doing it. We did a barium swallow, gastro emptying and upper endoscopy to get a real good idea of what shape my pouch was in and it was okay. I can eat a small normal portion but not a whole serving. Like I can eat 4 inches of a sub but nothing else. I actually feel like it was good to not be reliant on the restriction to make me lose because that goes away and I feel like that’a part of where I regained last time. I didn’t change what I ate as much as I should have because I was losing anyways by just eating less. Then restriction let up and I was still used to eating junk too often and could now eat larger quantities of said junk. Okay, this is getting pretty long. The short answer is yes your psych was correct that your expectations need to be reeled in a bit. Some people lose more and some less than average but the sleeve to bypass had an expected range that is less than a virgin bypass. If you are not thrilled about the average result, ask about that SADI. It may be an appropriate option for you.