Why am I having such trouble losing weight after my RNY?

Question
I had RNY on 2/25/08.  I took a six month health/surgery educationclass with Kaiser to qualify for my surgery, during which time I also had to lost 10% of my weight.  I went into this class at 308 and left at 276 on 2/4/08, so I lost 32 pounds in six months.  I had my surgery exactly three weeks later and weighed 271 the morning of surgery.  I lost 15 pounds within the first week being out of the hospital then unexplainably stalled for weeks.  I'm now five months out and am now at 236, so so far I've lost 35 pounds in five months.  That's 7 pounds a month on average.  I went to see my doctor in early June and was 242.  I've lost only 6 pounds in the past eight weeks.

I feel like I'm banging my head against a wall, because I just don't understand it.  I've been back to see my doctor NUMEROUS times.  I've changed protein intake, changed carbs, changed calories.  Whatever he tells me to do changes the results for a week, then everything comes to a screeching halt.  I've recently stopped exercising because I was feeling so stressed out from following the rules to a T, and then feeling so defeated every time I measured or stepped on a scale.

I've tried shocking my body by eating even less than I already am.  That works for a few days, but as soon as I add any more food, I'm back up to my "set" point of 236.  I just dont understand why this got HARDER after surgery and not EASIER??!  It all made sense and weight loss was like clock work beforehand -- eat a certain amount of calories, drop pounds, drop inches.  It was like ABC.  But now it's like your body no longer goes by the rules even though YOU do!  It would be one thing to continue doing what you're doing because the incentive is the results you see.  But it's quite another to keep doing something and get absolutely nothing in return.

I really need some help here.  I'm nearly tired of trying, and I'm scared to death that this is all I'm going to lose with this surgery, and that I've just wasted a whole lot of time.  My mind is all consumed with weight loss every day.

Answer
Sheryl,

The sort term failure after gastric bypass is very small - meaning that most people do lose their initial weight and if they are going to have a problem it is with weight regain later.

When you stop losing weight at 5 months, there is a definite likelihood  that something else is not right - this could be a problem with the procedure, or another issue such as diabetes or thyroid disease - but it sounds like something is not right.  You say in your email that you have already gone back to your doctor - but I would encourage you to seek another professional consult.  If you can't find another Kaiser doc to review your case, then I would go outside Kaiser to a private surgeon at a Center of Excellence in Bariatric Surgery.  Be sure to tell them in advance why you are coming, ask about fees, and make sure the doctor you are seeing in skilled in revisional procedures.  

Please let me know if I can provide any further information.

In Health,

Dr. Jacques

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