27 months out - 47lb weight regain

[Guest guest]

Dear Fellow Post-Ops,

I have lurked on and off over the last 2 years or so, but have never

posted, and actually just " rediscovered " this group. I am 27 months

out from my proximal (very proximal, I think) lap RNY with Dr. Michel

Gagner at Mt. Sinai in New York City. Dr. Gagner is a brilliant

surgeon, so please understand that nothing I will say in this post is

any reflection on him. I am a 5'9 " , very youthful (most take me for

33-35), 46 year old woman with a history of dieting, and losing and

gaining, since 12 years of age, though real obesity did not set in

until I graduated from college at 210lbs. I have never had any

serious health issues around my weight, with the exception of joint

and lower back pain.

My highest weight ever was 350lbs, for a very brief time back in

1997, after a very traumatic time in my life. Most of my adult life

has been spent between 220 and 275, with brief lows of 180 and some

brief surges upwards as well. I went into surgery on March 1, 2001

at 310lbs and rapidly lost 100lbs in 6 months, and continued to lose

another 25lbs in the next 5 months, bringing me to 185 (but only for

one day!). For the next 9 months I maintained steadily a weight of

between 187lbs to 198lbs. This was relatively effortless, but I was

getting tons of exercise in the form of 2 hours daily of biking to

and from work.

Last June my dear dad passed away. This past November 4th, I had my

final court date for my (undesired) divorce. From this date until

now, I have put on 28lbs, and prior to that I had slowly put on

19lbs, for a grand total gain of 47lbs since last July, weighing in

at 232lbs this morning. At Christmas I weighed 207 - and that's only

5 months ago. I am terrified that I will just keep on gaining until

I am back up to where I was. Even at my current 232, I " carry my

weight well " , and I don't look fat, just " pleasingly plump " . But I

feel enormous, and I know what I look like under my clothes! I also

know how quickly I could be back up to 300lbs - in the blink of an

eye.

The amazing miracle of the surgery to me was that for the first year

I had no desire whatsoever to overeat, to eat the kind of junky,

binge foods that had been my staple throughout my life. Not only

that, but I actually was satisfied with the small amounts I was

eating. I was never hungry, I could have cared less what I ate or

when. I was so excited to be out biking, running, being physically

active again, enjoying being out with friends, hiking, etc, that food

seemed a very distant thought to me. Whereas before the surgery, I

was extremely particular about what I ate, what restaurant, what

dish, what binge foods, what food I took into a movie - after the

surgery, none of that mattered, for more than a year. It wasn't

until my father died and then the difficulty and pain of my

separation and divorce, that I started using food to comfort myself

again. It started slowly, but then insidiously took hold in my life

and in my thoughts again. The obsession had returned. I didn't need

to eat huge amounts, but the feeling of never having enough and the

fear of not having the food I needed/wanted became the driving force

of everything again. The worst part is that the desire and craving

for my sugary/salty binge foods has returned in full force, even

though in my heart that is NOT what I want. I have tried dieting:

Atkins, Fat Flush, All Fruit, All Meat, Optifast, Nothing, Small

Portions - but the overwhelming urge takes over everything.

I want to explain something: I have a very active and full life. I

have been richly blessed with many friends, a wonderful church

community, a good job, my basic health. I am intelligent, social,

vivacious, reasonably attractive, fashionable, traveled, multi-

lingual, and educated. I am an opera singer who has performed

throughout Europe and the US. The reason I say all this is because

of the misconceptions that so many people have of what " type " of

person struggles with this problem. We are perceived as lazy, jolly,

sloppy, undisciplined, happy with the way we are, slow, stupid, etc.

I am so confused and concerned with how to deal with this current

state I am in. A friend of mine who had the surgery at the same time

I did, and who has also regained, is seriously considering having a

conversion from the RNY to a BPD with my surgeon. He feels it will

be successful for her, although he has never done it before. The

other possibility is to have my proximal converted to distal. But my

surgeon says that there are no guarantees that any additional weight

will be lost with either surgery, and that with the distal revision,

the protein deficiency is so severe in most cases, that intravenous

protein is necessary. Of course, with the BPD, you have the

nutritional issues, but also the flatulence and stinky poop issues.

Although, from what I understand, those who have the BPD simply do

not regain their weight at all. The last option is to have a lapband

put on and change nothing about my RNY.

All of this finally brings me to the point of my post: does anyone

have first-hand knowledge of any of the above scenarios? Has anyone

been through this and gotten a handle on it? I keep telling myself

that " I can do this " , and " I should be able to do it, especially with

the surgery tool " , but in the meanwhile, I continue to gain. I think

the most discouraging thing is that I feel that I am mentally back in

the same place where I was prior to the surgery, even though

physically I am still maintaining a 78lb loss. But it was 125lbs!!!

I just don't know what to do. I am so scared that I will once

again " diet " my way back up to my top weight. The simplest thing

would be to just " stop " , but I don't seem to be able to.

I really need to hear from folks who have dealt with this and what

you have done. Any and all insights are welcome!

Thanks for enduring this quite lengthy post!

Lap RNY 3/1/01

310/185/232