Q&A: Dr. Boyce on weight gain, loose skin, vitamins and pouch stretching

Written by Derek Boyce and medically reviewed by Dr. Stephen Boyce, MD

In this “video” Dr. Stephen Boyce answers questions submitted by Bari Life customers.

Dr. Boyce has more than 30 years of experience in bariatrics and has more than 7,500 bariatric surgical procedures under his belt. He consults with Ethicon Endosurgery, a medical device company and teaches other surgeons how to perform the Duodenal Switch.

Timestamps:

0:39 – I have been regaining weight 5 years after my gastric sleeve and it seems like I can eat way more than I used to. Can I get a redo-adjustment of y gastric sleeve or should I get the duodenal switch?

1:38 – My weight has fluctuated between 171 to 186. I can never maintain at a specific weight. How can I stay at one specific weight?

2:08 – How do you lose while on steroids? I have been on prednisone since March. I keep losing and gaining the same 5 lbs. I’m constantly hungry. I try to keep on plan, but hunger trips me up. I exercise or walk.

2:57 – How do I know when I’ve reached my good weight after gastric bypass surgery?

3:36 – Post op, after pandemic I have gained 50 lbs. It is so hard for me to lose it. You did sleeve on me in 2014, would the bypass be an option? I have several connective tissue disorders and would love to lose the weight regain. I have chronic RA along with scoliosis and I am not able to exercise, or walk any distance. What would be your suggestion to do? I would like to lose 70 lbs.

5:21 – Hey I’m 13 years post RNY gastric bypass and lost 90 lbs in the first year, since menopause hit I’ve gained back 30 pounds in the last few years, I’ve been told my bypass doesn’t work anymore for weight loss! I’m kinda devastated because my whole insides have been rerouted and dependent on vitamins for the rest of my life, so what can help me? I’m 59 years old with arthritis. Thanks.

7:29 – I had a sleeve gastrectomy last November 2020. I was around 400 pounds (my height is 6′ 2″), and I lost around 20 pounds before surgery. Since then I have reached a weight of 330 pounds around may. Then my weight loss stopped. I would like to lose another 50 pounds. Do you know if I can do it or has my weight just stabilized to 330 pounds?

8:86 – I have gained back about 40 pounds and want it off. Is there a procedure to make my pouch smaller? RNY procedure about 12 years ago. I have made big changes to my diet now but not much success losing this weight.

10:21 – Post-surgery 2-part question. Is it true that the stomach stretches out after the sleeve gastrectomy and what is the key to maintaining your goal weight years after the sleeve surgery?

11:50 – I had surgery in 2013 and have done well. I am now 65 and starting on Medicare. Over time my loose skin over my lower abdomen seems to have gotten looser and more bothersome. Is it common for this area to become worse over time after weight loss has stopped? Does insurance pay for removal?

13:05 – What types of surgery do you perform after weight loss to help with loose skin? How long after weight loss should you wait?

14:29 – After having bariatric surgery and when counting total carbs for a day are you supposed to count every carb that comes in all that you consume for the day? Example bariatric calcium chews, crystal lite sweetener…etc.

15:09 – Do I have to take vitamins, what kind and for how long after the surgery?

15:53 – I had SADI-S on May 10th, 2021. I have been taking my Just One Multivitamin with Iron on a daily basis. I take this in the morning before food, usually with coffee. My question is, given that due to the loop, we don’t digest foods as well, would it be more effective to take the pill at night, to maximize the chances of a slower digestion process, therefore an increased chance of absorbing as much of the vitamin as possible?

17:08 – What has changed since my surgery date 9/28/2005 as far as daily supplements required or recommended to avoid deficiencies of which I have several. I don’t seem to be absorbing much orally.

18:45 – What should one add to the Complete Bariatric Vitamin Tablets to cover prenatal needs? Can you take a regular prenatal vitamin at the same time as the tablets?

19:37 – After your stomach has healed after gastric bypass like 2-3 months if a person started smoking would she develop adhesions or problems from smoking cigarettes?

20:21 – I have severe pain in my left side. Nothing shows up on any x-rays taken. Would a hernia show on X-Ray?

20:59 – I had PD-DS in May 2009 and am wondering if my body will adapt and change the absorption rate?

22:38 – I have a question about pain management. I am 65 and have chronic joint pain in my legs, hips, knees. I only take Tylenol at this time. Are there any anti-inflammatory medications that I can take? Thank you.

24:06 – After my RNY surgery, my iron has dropped. My hematologist suggested it was caused because the surgery bypasses the area where my iron is made??? Could that be? I have had several iron infusions.

25:11 – I had BPD surgery in March 2012. I have been having some stomach issues. Someone told me to drink 2 oz. of Aloe Vera juice every morning and it would help with stomach issues. I want your advice on this matter.

25:51 – Is revision surgery an option for gastric sleeve patients who have severe gerd/acid reflux? I’m 2 and half years post sleeve. Dr. Boyce was my surgeon.

27:01 – What procedures are available for post VSG (5+ years) when weight gain occurs?

28:06 – Hello, I am 5 weeks post sleeve. My question is I can never get answers on taking medicine. Is it ok to swallow pills? Should I avoid extended-release medicines? Can I take allergy medicine? Please help.

30:32 – I’m 10 months out from gastric sleeve. Within the past month, I’ve developed an aversion to meat. Beef, chicken, turkey, pork…all make me nauseated and sometimes I vomit. I’m eating small bites, 3-4 oz. portions, taking my time, grilling or baking…still can’t stomach it. Is this typical? And what, other than protein shakes, would you recommend to get my protein in? Thank you!

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