This topic is about a 55-year-old woman from Australia who has a permanent ileostomy due to Crohn’s disease. Since her surgery in December 2009, she has gained 30 kg and is feeling down about it. She is reaching out to see if others have experienced similar weight gain and how they have managed it. Here are some insights and advice shared by others:

1. **Medical Check-Up**
- It's important to see a surgeon or an ostomy nurse to rule out any surgical or metabolic reasons for the weight gain. They can also help review your diet, especially your fiber tolerance.

2. **Weight Gain After Surgery**
- Some weight gain is common after inflammatory bowel disease surgery because the body no longer burns calories fighting inflammation. After periods of malnutrition, the body might store calories more aggressively.

3. **Diet Strategies**
- A low-carb diet can be effective. One person lost weight by cutting out breads, potatoes, and fruit, focusing instead on meat and vegetables, which also reduced gas and abdominal pain.
- Adjust your diet to be low-fiber and ostomy-friendly, especially soon after surgery.
- Limit sweets and high-calorie treats, saving them for emergencies.
- Consider structured programs like Weight Watchers or Slimming World for portion control and support.
- Gradually try new foods to see what your ileum can handle.

4. **Portion-Control Aids**
- Some have used Sensa, a sprinkle-on appetite suppressant, to help reduce portion sizes. It requires application before each bite, which can help you eat less.

5. **Behavioral and Alternative Methods**
- Hypnosis has been used successfully by some for weight loss, with added benefits like reduced gas and less abdominal pain.
- Stay active with walking, gym workouts, or taking the stairs. Any movement is beneficial, especially if heavy exercise is challenging.

6. **Surgical and Health Risks of Excess Weight**
- Excess weight can lead to complications like peristomal hernias and bowel blockages, which may require additional surgery.
- Even if overweight, dehydration is still a concern and can harm the kidneys.

7. **Mental and Quality-of-Life Perspectives**
- It's important to accept changes in body shape and focus on living, laughing, and enjoying life.
- Being heavier but pain-free is often preferable to the severe illness experienced before surgery.