Could Abdominal Surgery Have Affected Gastric Bypass RNY? Will Blue Cross/Blue Shield of Michigan Cover Revisions

Had Gastric Bypass 1993 & maintained weight loss. 2007, I underwent several abdominal procedures. Initial exploratory, Dr found adhesions & did lysis. Within days, bladder & uterus fell & had to be repaired. I had appendectomy, hernia repaired, & a hysterectomy within next 4 months. Since then, I have been able to eat more & am hungry. I watch what I eat, but have gained 45lbs in 3 yrs. At dad's funeral in March, siblings didn't know me. Was Bypass affected maybe? Does BCBS cover revision?

Doctor Answers 1

Weight Regain After Gastric Bypass

It is unlikely that your multiple surgeries have caused you to regain some weight.  Patients that regain weight after gastric bypass, in my experience, fall into two categories:  5% anatomical/medical problems and 95% behavioral problems. 

About 5% of gastric bypass patients will develop some anatomical problem with their surgery that seems to allow them to eat more and see their hunger return.  Although pouch size and it's effect on long term maintenance of weight loss is controversial it is often cited as a reason that patients regain weight.  Other potential anatomical issues would be a dilated gastrojejunal anastamosis (the connection between the pouch and the intestine) and gastric-gastric fistula (old stomach grows back to the pouch).  Although not anatomic, patients can also develop thyroid problems or be placed on medications that lead to weight regain.  These problems can be easily diagnosed by doing bloodwork and endoscopy and generally require a revision operation or medication change in order to fix.  Revisional surgery is often covered by insurance companies but it is policy independent so you have to check your individual policy.

The other 95% of patients that experience weight regain after gastric bypass generally have fallen back into old habits.  These habits would include things like grazing (eating small meals throughout the day or snacking regularly), drinking with their meals, reintroducing liquid calories, lack of exercise, and poor sleep habits.  The good news is that these problems can be fixed without another surgery you just need to get back in to your program!

Corpus Christi Bariatric Surgeon

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