Weight gain post-op

Question
Hello Steven,
I am 3 1/2 years post-op. I had gastric bypass on November 10th, 2010 and lost 260lbs. Over the past 6 months I have gained close to 40lbs and am terrified I will regain all my weight back. I don't know why but I find myself mindlessly eating. It seems like I am falling back into all my old habits I had before surgery. I am also afraid that I have stretched out my pouch because I can eat a large amount of food at one sitting without getting sick or experience dumping. In fact, I have never experienced "dumping". I need some help or advice on how to get out of this destructive path I am taking. I am scared to death I have failed or ruined my surgery. Any advice or help would be greatly appreciated. Thank you.

Answer
Relapses are common and can be caused by any number of reasons. I can tell you that if you had unreversable gastric bypass surgery, it is unlikely that you have been able to "stretched your pouch". It is more likely that you have been able to gain weight by eating more often in amounts that do not cause discomfort.  As I'm sure that your surgeon explained, the surgery is nothing more than a tool to help you execute a healthy eating style. The rest is up to you.

Getting back on track is simple; you must change the way you eat...... again.  You've done it before, you can do it again.  I would suggest that you "mentally" execute your original plan.  Pick your "surgery date" and make a reservation at a hotel. Then, follow the same preparation for surgery that you did the first time around. You "prepared yourself for the surgery mentally once before; do it again. Then spend the night at the hotel.  When you return home, do it as if you were coming home from the hospital again. Remember, several days to a week of clear liquids. Then graduate to liquids for a week to ten days. Then move on to solids.  Remember; you must control your portions as you did before. When eating full foods, NO liquids 30 minutes before, during and up to 30 minutes after meals. Front load your meals with protein so that you'll get enough. If your doctor suggested B12 supplements before, do that too. Along with any other suggestions that your doctor provided following your surgery.

All this "homework" is goal oriented; you will not be able to do it fully, AND SUCCESSFULLY, without being prepared MENTALLY, and without one-hundred percent concentration. And that's what it takes.  You used a key word that set off all the bells and sirens for me. You used the term "mindlessly". How do you turn that around? You become "mindful" of all actions, activities and eating.  Low or no sugar, low or no fat. High levels of protein and supplements as directed.  

As always, you should check my suggestions through your physician. If you are told that any of these suggestions are not advised by your physician, always follow your physician's directions. Remember; I am not a Doctor - I am simply another patient like you.

Prepare yourself mentally and FOCUS!  You'll get (back) there.

Good luck,
Steve

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