More than 200 thousand people in the U.S. Had weight loss surgery last year and experts say an estimated 10 to 15 percent could benefit from revisional surgery down the road.
Pictures are a reminder Ramona Maltby doesn't need from her life-long struggle to lose weight.
"If it's out there, I have tried it," said Maltby.
In 2005, weighing 278 pounds, she had gastric bypass surgery and lost 100 pounds within a year.
"My quality of life completely changed," Maltby said.
But her weight plateaued while she wanted to continue loosing and she started to gain a little.
"You don't have that same feeling that you did in the beginning where you absolutely could care less whether you ate or not," said Maltby.
So last month, Maltby had another procedure called stomaphyx.
It's a non-invasive, out patient procedure.
Her surgeon went in through her mouth, down her esophagus, and into her stomach.
"That stomach you make it smaller and by pulling tissue over the connection between the stomach and the small bowel it actually slows the time for the food to empty," said bariatric surgeon Dr. David Ward.
Allowing patients like Maltby, or others who've gained much more, to feel full longer so they eat less and lose weight.
And because the surgery is incisionless the risk of complications is low and the recovery is quick.
Maltby was back at work the day after surgery and says she once again has the control she needs when eating."
"My goal was to lose another 30 to 40 pounds and i've lost 14 and a half," Maltby said.
But some bariatric surgeons question whether patients should be offered another surgery.
"Obviously these patients are looking for something, particularly the ones that have gained a lot of weight back, but it's unclear whether any procedure will offer them a long term solution," said bariatric surgeon Dr. Greg Dakin.