This topic revolves around the challenges faced by someone who has undergone an ileostomy reversal and is struggling with weight gain, particularly around the midsection. Despite maintaining an active lifestyle and eating less, the individual finds it difficult to lose weight. Here are some pieces of advice and insights shared by others who might have faced similar issues:

1. Apple cider vinegar for weight loss:
- Some suggest trying apple cider vinegar in capsule form, which can be found in places like the vitamin aisle at Walmart.
- However, be cautious as one person experienced a strong odor from their ileostomy, which a doctor linked to changes in gut bacteria. The odor went away after stopping the vinegar.

2. Broader metabolic assessment:
- It's important to consider factors like age-related hormonal changes, a slower metabolism, and possible insulin resistance.
- Re-evaluate what "eating healthy" means, as many foods marketed as healthy today might be nutritionally altered.

3. Professional or medical routes tried or planned:
- The prescription appetite suppressant Phentermine was tried but not well-tolerated.
- A consultation with a nutritionist is planned to explore more personalized dietary advice.
- Starting a commercial weight-loss program like Optavia, which has reportedly worked for others, is also being considered.