Expert: John Pilcher, MD - 4/27/2007

Question
At age 25, weighing 400+ I had intestional Bypass..with which i dropped the weight..to 180..7 years later, i had it reversed due to complications, gained 80 lbs. in a year and my surgeon then performned gastric bypass.. mid 80's. That held my wt. in check til i hit about age 40 and it has been creeping on gradually ever since, presently at 250. Digesting meat and fibrous foods still some problem..but i live w/ it..

My question is ..whne i had this done..i was basically 'turned loose' by surgeon, very little support..etc..learned what to do and not to do the hard way.

I'm wondering if 30 years down the road with this..if I there is some proceedure to help me..get my weight back down to 170 and keep it there for my "senior years" . I have dieted twice in the ensuing years and brought wt. down to 18o or so..but alas it keeps creeping back..

I've read the surgery is considered a success IF you don't regain more than 20 % of your origional wt. so at 25olbs today, I guess that's good..because I'd for sure be dead..

any advice? considering by history, easy ability to regain wt.,age of 55, etc...

I'd welcome your advice and opinion

thanks-you
,

jim

Answer
Jim,
You may not be surprised to know that there is not a simple answer to your question.  I can give you three facts, and then a suggestion:

1)  Your situation (JI bypass long ago, reversal, later gastric bypass, current problems) is not exactly common, but not rare either.

2)  There are several potentially reversible causes for your gradual weight regain - some are managed through education and habit change, some through surgery.

3)  Medical professionals feel strongly that bariatric surgical patients have a much better chance of lifetime success if they are followed by physicians who are routinely involved in bariatric surgical care.  "Lifetime success" means not only that you have a lower weight, but also better health, including good nutrition through the intake of selected supplements and by having your physicians check for potential areas of deficiency.


My suggestion is that you identify and begin follow-up with a quality bariatric surgical program in your area.  The easiest way to find such a program is through the website for the American Society for Bariatric Surgery, where there is a member locator function at
http://www.asbs.org/html/about/membersearch2.html

If you have a choice of several programs, your best bet is with a program that is designated as a Center of Excellence - a program has to be serious about bariatric surgery for the long term in order to meet the requirements for this designation.

I am very optimistic that you will get real help if you get engaged with such a program.

Best wishes,
John Pilcher, MD