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I am really sorry to hear about your struggles. It is so tough when you don't get the same results other people do. I hope you find what helps you. Here is my story as there may be some information that is useful for you:
I had my VSG on 8/10/2020. It never killed my appetite or made me feel full easily the way it seems to do for most people; this was disappointing. Nevertheless, the VSG did put my diabetes into remission and it did stop me from getting the ravenous hunger that I had previously gotten whenever I lost significant amounts of weight before.
I lost 35 pounds on the pre-op diet and managed to lose about another 60 pounds after surgery until about January 2021, although I was almost always at least a bit hungry. (I went back to intermittent fasting 16 hours per day from two months post-op, and that helped me continue to lose weight even with hunger, and I calorie restrict to about 1200-1400 kcals/day now.) In late January I was put on Topamax for nerve pain, and secondarily to prevent migraines. It worked extremely well for my these problems for me -- as well as amitriptyline which I used to take until I realised that it could make you gain weight.
And Topamax also did help take the edge off my hunger! There wasn't a massive change, but I didn't feel like I was having to fight hunger all day long any more. Yes, there is a range of experiences to surgery -- hunger does NOT always go away! So that was great. My starting weight was 265 and I am now at 150. I am extremely happy with that.
But I am having side effects and had to drop the Topamax from 20 mg to 15 mg per day two months ago after I was briefly hospitalized with constipation and had some mildly impaired kidney and liver function. Migraines have come back (with a vengeance), some nerve pain (but the lower dose is still taking at least 50-75% of that away), and I think it is still having some effect on hunger, although it is hard to quantify.
Honestly, I am worried. It is May and I have been on Topamax for about 4 months. My doctor says I can stay on it long term if the side effects (kidney pain and severe constipation) don't become too much, but it is looking like I will have to come off it soon. I don't want bad hunger to return! It has been nice not thinking about food constantly. I have been trying to manage hunger/metabolism by eating lots of raw leafy vegetables, fish, and taking Omega 3 and probiotics. I no longer eat wheat or corn, and I limit sugar, artificial sweeteners, processed food, rice and vegetable oil. With luck, these are helping with the hunger more than the Topamax now, so if and when I have to stop it, maybe (I hope!) I won't notice too much of an effect on hunger. But I don't know.
Good luck! I hope you find the best path for you!
Want2beMe, First off full disclosure, I never needed to try a pill after i had surgery. Since you have this available, i would use it, topramax is known for being successful at several different things..including migraines and diet control. I would suggest you do a multi pronged approach and even include intermittent fasting...of a sort.. You would need to work this carefully to get your protein in and limit carbs with topramazx and the surgery / tool you have in place. None of us became obese by not consuming carbs. Th lower you can cut your carbs the more successful weight loss you should see.
do an internal inspection and find WHY you are eating. We often eat as a control for stress...and many factors can cause that.-much of it can be out of our control. Do not add stress with fixation on the numbers. Work your program, cut your carbs..Know that as you cut the carbs to a baseline of 20-50, increase your protein, .. You will loose on the rate you are supposed to loose.. that is individual to each of us... Do an exercise of some sort on arising and the last thing before sleep.. i use isometrics before sleep.. to get metabolism up and keep up during several of sleep hours.
You are worth it, This is your tool.. follow your surgeons guidelines. avoid slider foods., consider: avoid all sweeteners. the artificial ones trigger appetite in some people... diet drinks, zero drinks are suspect.. if you avoid all for a week to 10 days., f this is something you are having... then have one you can note the effect it has or not on you...