After a discussion with my GP on Friday I'm considering gastric bypass. I'm 38, 340lbs, I've been obese all my life and nothing has worked to help me lose weight. I eat right, I eat 1500-1800 calories a day and I exercise and still nothing. I tried going as low as 800-1000 calories but was just so ravenous I couldn't keep it up.

I'm terrified that surgery won't work either.

My doc is referring me to a surgeon - he said that appt will take a few weeks -I'm in Ontario so there's only a handful of MDs who do the surgery and they're limited to the number of surgeries they can perform weekly so appts take longer to get. After the initial consult I should be scheduled for surgery with a year.

I know I'm thinking way too far ahead but what do I do if the surgery doesn't work??? I know it's a tool and not a quick-fix-magic trick. I'm hoping it'll help set me up to make permanent lifestyle changes and not only help me lose weight, but keep it off. I'm tired of the losing & gaining game.

For those who've had the surgery - are you finding a yo-yo effect or has it been steady weight loss? And how do you maintain once you reach goal weight?

I seriously considered it, didn't do it but its for my own nutty reasons.
WLS works - if you work it. You are 100% correct that it is a tool, it is
not a magic cure or a license to eat whatever you want. Its hard work, but
it does work. You sound like the perfect candidate - nothing else is working
for you even though you really seem to be trying. You must be prepared to
be vigilant about your health for the rest of your life. You must commit to adequate protein and vitamins or there can be serious health consequences. Once you have lost the weight the journey is not over, there are things you have to do to maintain your health. If you have been sticking to an eating plan - whether its working or not - it seems to me that you are the kind of person who can make WLS work. For people who do not succeed - 99.9% of the time is that they failed their surgery, not that the surgery failed them. Best of luck to you.

Surgeries can fail, but if you do your research beforehand and truly know what you're getting into, you'll be better prepared for success. There are four different surgeries currently widely performed (band, RNY gastric bypass, VSG, and DS), and that's because no one surgery is the right one for everyone. Research, research, research! It's the best thing you can do for yourself. I like to start on PubMed for medical studies and statistics.
Ouch! Surgeries do fail, and more frequently than you might think. This might happen for mechanical reasons (lots with the band, such as slipping, erosion, disconnecting, etc., and some with the gastric bypass, such as stretching pouch and/or stoma). A surgery might also not be successful for someone if they choose the wrong procedure for themselves, which also happens quite frequently. Someone might choose the band because it's "less invasive" or less expensive initially or whatever their reasoning, but if that person isn't a volume eater to begin with, then a restrictive-only procedure likely isn't going to be very helpful.

Thank you, both.

I have been doing non-stop research since my discussion with my GP last week and I've researched the surgical team as well. I like the physiological changes that occur after RNY - hormone changes, ghrelin reduction. I think that will benefit me most. I'm actually now getting excited about this idea because of the research I'm doing - and I'm researching both the good and the bad. I know there's a chance at failure but Im really starting to believe that THIS is my tool. This is what will finally help me lose weight.

There is SOME evidence that ghrelin decreases after gastric bypass, but there are also a few papers that say that it goes up after a couple of years.

http://www.ncbi.nlm.nih.gov/pmc/arti...6/?tool=pubmed

and about the surgeries failing - or the patients failing - it's a matter of huge debate these days. As Jilly pointed out, things happen - pouches and outlets expand, bands slip, etc etc etc. some surgeons blame these events on the patients, but other surgeons think it's just a 'natural' progression. So, there's a growing [slowing growing!] body of literature on revisions.

don't get all excited just yet. Focus on doing your best - day by day - and see what happens. I'm considering a revision, but frankly, i think my outlet is NOT stretched out [i still throw up occasionally].

jiffy-what do you mean by a revision?

A revision is an additional surgery after a performed WLS doesn't work well enough for a patient. I've seen people have a revision from band to VSG, from band to RNY, from RNY to DS, from VSG to DS, from band to DS, and from older surgeries (like VBGs and old stomach staplings) to DS. Of the procedures currently available, the DS is just about the end of the line as far as WLSs go. Of course, you could also have a revision of a surgery to simply alter it in some way, such as having the common channel shortened in an RNY (going from a proximal to distal or extended RNY).

Jilly - the ghrelin info came from studies that I looked up at the University medical library BUT I also found studies that said the opposite. So I have to look into it more.

I won't consider a VSG because of the amount of weight I have to lose. As for the DS - I haven't researched that yet - I'm still reading info on RNY. I want to be sure that I have all the info I need to make the right decision and to be sure I can have a good conversation with the surgeon.

I'm being referred to Dr. Hagen and he has a spectacular reputation but it is my body he'll be cutting into so I want all the info I can get my hands on.

Edited at add: even though I'm not considering VSG I will still research it because that's more info I can have to better make a decision. For RNY the research data goes back about 14 years - I hope I can find stats & info for at least 5 years for DS & VSG. Banding isn't covered by our provincial ins and I can't afford the $20+K that it would cost.

things like tightening up the stoma or reducing the pouch size are also considered revisions. one of the things that's happening is that some docs will do a restrictive procedure first - like the VSG or the band - and LATER add a malabsorption component - either the gastric bypass or the DS.