This topic is about the experiences, concerns, and alternatives related to undergoing bariatric surgery after having an ostomy or ileostomy. The person sharing their story has faced significant weight gain due to increased appetite, hormonal changes from menopause, and emotional eating. This has led to challenges with their stoma and overall health. Here are some insights and advice shared by others:

1. The person has gained 80-90 pounds, resulting in a BMI over 35. This weight gain has created a pronounced "inner-tube" of fat around the mid-abdomen, making it difficult for adhesive wafers to stay flat, leading to frequent leaks and skin issues.

2. These leaks and skin problems have made it difficult for the person to leave the house or work. They have been referred to a bariatric center, where they were considered a candidate for surgery. Weight-loss drugs were also offered, but they are expected to result in only a modest weight loss of about 40 pounds in a year.

3. The person has tried four supervised diet programs, losing some weight but then plateauing and regaining it. Menopausal hormone changes have made weight control even more challenging.

4. Non-surgical programs suggested include:
- Weight Watchers, Nutrisystem, and Overeaters Anonymous, combined with food journaling, portion control, and gradual exercise.
- Addressing emotional eating by finding hobbies or support groups to replace the comfort previously found in food.

5. A commitment to lifestyle changes is crucial even after bariatric surgery:
- Long-term success requires ongoing dietary changes and regular physical activity.
- Be prepared for the possibility of excess skin and additional surgeries.

6. Seek professional, individualized nutrition guidance:
- Work with a registered nutritionist or the bariatric center’s dietitian to create a plan that considers ostomy output and medication interactions.

7. Utilize local and online support resources:
- Attend in-person support groups at the bariatric center.
- Connect with other ostomates in your area through the center’s social worker.

8. Research surgeons and hospitals thoroughly, as quality can vary widely.

9. If surgery is not an option or is delayed, inquire about newer pharmaceutical options, such as injections, offered by some bariatric programs.

10. For those with curved abdomens, one ostomate suggested using the Coloplast SenSura Mio Convex Flip flange, which reportedly offers 4-5 days of wear time without odor issues.

11. One person advised caution against surgery, suggesting finding an experienced local ostomate mentor instead.

12. Several members offered encouragement and well-wishes.