How?

I am only three months out so please don't bite my head off for asking this question.

I read that people gain weight a few years into gastric bypass.

How does that happen?  My pouch is small and while it is becoming less sensitive I can't overeat.

How does the weight come back on?

No head biting here, I don't like the taste! Anyway, the surgery that we had works in 2 ways, restriction (the small pouch/stomach) and malabsorption (we don't absorb all of the calories that we eat because of the bypassed intestines). In time the pouch gets larger so we can eat more and we start to absorb most of the calories from the food and drinks that we have. If those adjustment didn't happen we would wither away to nothing!

Some people start to gain because they go back to their old bad eating habits because they didn't learn the new healthy way to eat during the initial time of the restriction and malabsorption. You can, in time and with constant over eating, stretch the pouch to a much larger size so that it holds more food. 

This surgery really only helps us lose the weight, it is up to us to keep it off. This is not a diet, it is a tool to aid us in the weight loss. Most people always have a good amount of restriction but you still need to watch what you eat, exercise and take your vitamins because we will never absorb all of the ones that we need from our regular diet.

Does that help?

You can lose wt with any WLS. BUT, it takes a lifestyle modification to maintain your wt loss.  Old habits are hard to break.  Portion sizes increase, eating wrong foods, not exercising, etc. make wt gain possible. Surgery ALONE will NOT "flip a switch" in your body for permanent wt loss. DAVE

This is SUCH a great question and one I asked myself in the beginning of my own WLS journey. Now, it's all so clear to me how easy it would be to gain weight right back. In addition to over eating and enlarging the pouch, an easy way to gain is to develop a rather common habit called "grazing". Eating small amounts of food all day instead of eating distinct meals. I have great restriction so I cannot eat more than a few ounces of dense protein in a sitting BUT as soon as I get a little more room in my pouch, I can eat a little more, and a little more. A handful of nuts here, a protein bar there. On an emotional-eating day, I have literally had to talk myself out of intentionally eating less-dense foods that will slide through my pouch and not filling myself up with a meal so I would be able to continue eating all day-- essentially filling up through one end as it slides out the other just to fill an emotional need. That's an extreme example and , thank goodness, it doesn't happen regularly. But grazing kind of mindlessly and out of habit is something lots of folks struggle with.

 

Like the others have said, grazing is the big thing. I am only 7 months out, but have read enough and have talked to people who have gained again and that seems to be the biggest problem. You should really develop a new life style during the early months and stick to a diet you can live with for the rest of your life. I don’t think you can stretch your pouch that much, but you sure as heck can eat a handful of this, a handful of that, a pinch of something while you are cooking etc. If you drink with meals you will dilute the dense foods and wash them out of your pouch much faster. Then you will feel hungry and can eat more. If you keep doing things like that you will gain your weight back and all this will be for nothing. Be sure to measure everything and log it so you know what you are eating each day. This is a rest of your life thing and we are not in a race. If it takes you years to get everything off you want that is fine in my opinion.   

Great post! Thanks to all of you that answered!

Thanks for the info.