Initial evaluation of a failed bariatric operation requires a careful nutritional evaluation, psychiatric evaluation to make sure emotional, stress eating, is not the cause. Next an evaluation of the anatomy based on an upper GI looking at size of the sleeve, in addition a solid phase study looking at transit time of the food bolus. Based on this information there are several options available. None are as effective as initial surgery and all revision surgical option are at a higher risk profile for the patient than the original operation.Therefore, we are always cautious to proceed to surgical options when the initial surgery was ineffective. Depending on the cause of failure your doctor and you can decide what is the best choice. The following options can be considered depending on your doctors comfort with the procedure and your reason for not acheiving your weightloss goal. 1. Placement of a gastric band over your sleeve, 2. Plication of the sleeve, 3. Re-sleeving the sleeve, 4. conversion to a gastric bypass, 5. Conversion to Duodenal switch operation.