OMG! When I read ur post it seemed like I had written it myself! I had RNY done back in 2003 at 374 lbs. In May 2006 I reached my lowest weight of 186, a total weight loss of 188 lbs. I was fortunate enough to have had an excellent experience with the surgery, a lot of credit due to the great prep and care w/ Aetna healthcare. In October 2007, I noticed my weight had been fluctating a bit, and I had put on about 27 lbs, mostly due to an effort to quite smoking. At first I didn't panic, just hit the gym xtra hard and became xtra diligent about what I ate. I quickly dropped 15 lbs, bringing me to 198 right before Thkgiving holiday. I had given myself permissiont to put on a few lbs during the holidays, so in January 2008 I weighed in at 206. Then in a seemingly sudden way, I packed on 20 lbs in a month, with no drastic changes to my dieting or exercise habits. I had a new job and therefore new coverage. . . w/ Kaiser. Let me warn u that I have extreme prejudice towards Kaiser b/c as u mentioned, what's so typical of Kaiser is a seeming unwillingness to treat any problems with some sense of urgency. I had labs upon labs done, been referred to a dietician to address my rapid weight gain, which now has my weight at 236 (a # that actually reflects a recent weight loss from 249). I am anemic and have low vit D levels, and my weight is constanttly fluctuating. I have since cancelled my Kaiser coverage due to my extreme dissatisfaction with their care, and am seeking an individual plan through my former network Aetna. I was actually born at Kaiser and spent 18 years as a patient until my coverage under my mom's plan expired, and at no time during that period did they make any efforts at colloborative weight control beyond their short-sighted repeated mantra "exercise more and watch ur portions." Well, except for the physician directed weight loss diet I was put on as an infant (yes as an infant!) b/c of being an apparently "morbidly obese" newborn. . . at almost 10lbs The sad part is some Kaiser patients will never know how good healthcare could and should be, as they will never experience true care outside of the Kaiser bureaucratic, callous, medical tyranny. . . ( told u I have extreme prejudices, lol). i would say, if it's at all possible, try a different doctor outside of Kaiser. I admit I am a bit defeated b/c of the rapid weight gain, but I still try to look on the positive side, at least I have maintained a loss of 138 lbs, which is a lot more than I would have been able to do w/o the surgery.