After 10 years of no issues, why am I all of a sudden sick and gaining weight?

Experiencing weight regain, malnutrition, anemia, and severe dumping syndrome years after a Roux-en-Y gastric bypass can be concerning, especially when it seems to have developed suddenly. Since you have been consistently taking vitamins and iron supplements but still struggle with deficiencies, your body may not be absorbing nutrients properly, which can lead to persistent fatigue and contribute to poor food choices and lack of exercise.
Dumping syndrome that has worsened over time, regardless of diet, could indicate changes in how your body processes food, possibly due to anatomical changes in your digestive system, rapid emptying of food into the small intestine, or worsening insulin fluctuations. If your weight gain continues despite efforts to eat well, it may be linked to metabolic changes, malabsorption issues, or hormonal imbalances.
Given the severity of your symptoms, a comprehensive evaluation with your bariatric surgeon and a specialist in nutrition or endocrinology is essential. You may need lab tests to assess iron levels, vitamin deficiencies (B12, folate, vitamin D), and hormone levels. A detailed review of your digestive function, including imaging or endoscopic evaluation, can help identify complications such as strictures, bacterial overgrowth, or changes in how your stomach empties.
Addressing malnutrition and anemia effectively may require alternative treatments such as iron infusions or different formulations of vitamins to improve absorption. Managing dumping syndrome might involve modifying meal structure, macronutrient balance, and possibly medications to slow gastric emptying. Since your energy levels are affecting your ability to exercise and maintain weight, working with a healthcare team to correct these underlying issues will be key to regaining control over your health.

Hello, 
I'm sorry you are having a hard time,
The first thing is that you must evaluate yourself with your bariatric surgeon to review your case and then proceed to check you.  There are a lot of factors that can be and should be considered before giving any exact information. Make sure to discuss this with your primary physician. Keep in close contact with your surgeon and go to support team. Here are a few tips to improve your energy:1.Try to avoid artificial sweeteners. Artificial sweeteners can be 300x (if not more) sweetener than real sugar.
2.Rest. When the body is tired it looks for energy (it is trying to do us a favor) and it knows the the quickest way for energy to get into the body is via sugar. Ever notice that when you are tired you crave processed carbs and/or sweets? This is why. The next time you feel like you need to rest, do yourself a favor and rest.
3. Add more natural sweet food. This one is especially true for my dieters and low carb peeps. When we have a diet very low in carbohydrates and sugar we tend to want sweets. By simply adding some nutritious sweet foods to your day you can cut that craving way back. Some great examples are sweet potatoes, squash, brown rice, oats, and carrots. An idea of a yummy snack might be carob chips and coconut with nuts mix.
4. Protein. If you find yourself craving sugar, just take note of how much protein you have been eating. If it seems high, try cutting back. If it seems low, experiment with adding some more in. I’m telling you, being interested in ourselves is one of the best ways to figure out what our bodies need.
5. Add non-food sweetness. It can be a simple as a phone call with a dear friend, a walk, a girls night out, a great book, etc. The options are endless, but the key component is that you remember to keep yourself on the top of your own list.
I hope these tips help you! :)
My Best Wishes,