"No surgery lets you malabsorb simple carbs"
(deactivated member)
on 2/12/11 12:27 pm - Woodbridge, VA
on 2/12/11 12:27 pm - Woodbridge, VA
I never wanted dumping, but I ended up with a negative effect from starchy carbs, anyway - GAS. Fat or not, carbs get me every time. Of course, for me, it's not all carbs. I'm fine with candy, oddly enough. And ice cream. But hand me rice, pasta, bread, potato anything, cake, cookies...best also be handing me some Gas-X with it!
Excellent post, Jenna! I'm a bit of a math geek & loving to the DS math too. Someone gave me a multi-variety cheesecake sampler that one buys from the deli with 8 slices - regular slices.
One piece has:
Calories: 425
Fat: 27
Total Carbs: 42
Fiber: 1
Sugar: 24
(that's 7 complex carbs & 24 simple sugar carbs)
Protein: 5
After applying the DS math, I absorb
Calories: 175
Fat at 20% absorption, Fiber not absorbed, Sugar absorbed 100%, Complex Carbs absorbed 60% & protein absorbed 60%.
That's 41% of the total calories!
One piece has:
Calories: 425
Fat: 27
Total Carbs: 42
Fiber: 1
Sugar: 24
(that's 7 complex carbs & 24 simple sugar carbs)
Protein: 5
After applying the DS math, I absorb
Calories: 175
Fat at 20% absorption, Fiber not absorbed, Sugar absorbed 100%, Complex Carbs absorbed 60% & protein absorbed 60%.
That's 41% of the total calories!
HW / SW / CW / GW 299 / 287 / 160 / 140 Feb '09 / Mar '09 / Dec '13 /Aug '10
Appendicitis/Bowel Obstruction Surgery 8/21/10
Beat Hodgkin's Lymphoma! 7/15/2011 - 1/26/2012 
Ran Half-Marathon 10/14/2012
First Pregnancy, Due 8/12/14 I LOVE MY DS!!!
(deactivated member)
on 2/12/11 10:05 pm - Woodbridge, VA
on 2/12/11 10:05 pm - Woodbridge, VA
How did you get 7 complex carbs and 24 simple sugar carbs when there are 41g net carbs?
Okay, as I type this, I assume it was a typo intending to say 17 complex carbs :)
I still don't think it's that simple - for example, if something uses white flour, it is neither technically sugar nor a complex carb. Net carbs minus sugar does not necessarily equal complex carbs because there are lots of refined/white carbs that are not classified as sugar for the purposes of a nutrition label.
Okay, as I type this, I assume it was a typo intending to say 17 complex carbs :)
I still don't think it's that simple - for example, if something uses white flour, it is neither technically sugar nor a complex carb. Net carbs minus sugar does not necessarily equal complex carbs because there are lots of refined/white carbs that are not classified as sugar for the purposes of a nutrition label.
Good point. You're right, and it's not even that simple, because "complex carb" doesn't necessarily mean "harder for your body to digest".
It's true that very fibrous carbs are digested slower--and I have no problem believing that we malabsorb these to a degree. Some allegedly "complex" carbs, though, are absorbed by your body even faster than some sugars--check the glycemic index of certain types of cooked carrots and potatoes, for example. I do not believe we have any substantial malabsorption of those things.
That's what's great about Jenna's analysis, I think. It doesn't rely on any guesswork about what is a true "complex" or "good" carb, nor about any assumptions of our malabosorption level of these. She just flat out says we're going to absorb all of the sugar, but look at what else we won't absorb.
It's true that very fibrous carbs are digested slower--and I have no problem believing that we malabsorb these to a degree. Some allegedly "complex" carbs, though, are absorbed by your body even faster than some sugars--check the glycemic index of certain types of cooked carrots and potatoes, for example. I do not believe we have any substantial malabsorption of those things.
That's what's great about Jenna's analysis, I think. It doesn't rely on any guesswork about what is a true "complex" or "good" carb, nor about any assumptions of our malabosorption level of these. She just flat out says we're going to absorb all of the sugar, but look at what else we won't absorb.
Thank you, Jenna, for all of your sensible contributions to the board! Jenna, I have a question or two for you.
Five years ago I had RNY. I wanted the dumping since sugar is my absolute downfall. I found instead that I still want the sugar, and I dump every time I eat sweets, but I don't dump severely enough to stop me from eating them. I just get heart palpitations. Now milk, that's another story. I get severely nauseated to the point that I have to go vomit it back up to get relief. I don't touch milk.
I didn't even consider the DS at the time because my insurance considered it experimental, and I believed them. Also, someone once posted here on the OH main board that with the DS you can eat everything you want and still lose weight. The way she worded it made it sound too good to be true and I, being a skeptic of such things, believed it was too good to be true, and that furthermore, it was a downright dangerous surgery to have. This was my thinking at the time.
Now, five years later, I wish I had had the DS. Of course, without my RNY experience I may not have learned how important proper nutrition is...but I digress.
Anyhoo, here's my question/worry: I was told by my doctor that at about two years out from RNY the body gets very efficient at using calories and there is a typical weight gain of about 20%. If you think about it, you eat less after RNY, you lose weight because of it, but then two years later, when you're able to eat more, you have to eat EVEN LESS in order to maintain that loss!
That just cheezes me off!!
So now, I'm in a position where my body has adapted to the decrease in calories and I'm wondering if it's too late for me.
What do you think?
Lynda
Five years ago I had RNY. I wanted the dumping since sugar is my absolute downfall. I found instead that I still want the sugar, and I dump every time I eat sweets, but I don't dump severely enough to stop me from eating them. I just get heart palpitations. Now milk, that's another story. I get severely nauseated to the point that I have to go vomit it back up to get relief. I don't touch milk.
I didn't even consider the DS at the time because my insurance considered it experimental, and I believed them. Also, someone once posted here on the OH main board that with the DS you can eat everything you want and still lose weight. The way she worded it made it sound too good to be true and I, being a skeptic of such things, believed it was too good to be true, and that furthermore, it was a downright dangerous surgery to have. This was my thinking at the time.
Now, five years later, I wish I had had the DS. Of course, without my RNY experience I may not have learned how important proper nutrition is...but I digress.
Anyhoo, here's my question/worry: I was told by my doctor that at about two years out from RNY the body gets very efficient at using calories and there is a typical weight gain of about 20%. If you think about it, you eat less after RNY, you lose weight because of it, but then two years later, when you're able to eat more, you have to eat EVEN LESS in order to maintain that loss!
That just cheezes me off!!
So now, I'm in a position where my body has adapted to the decrease in calories and I'm wondering if it's too late for me.
What do you think?
Lynda
From what I have read in your posts on here and the revisions forum, your situation seems standard for a failed RNY, and I believe revision to the DS will benefit you.
I am having revision for complications not including regain. In doing my research I have seen articles stating that the weight loss after a RNY to DS revision is a bit slower than an initial DS. That isn't really a concern though because the weight does come off. It is not too late for you. Your situation is do to surgical failure: your surgery has failed you, not the other way around. I hope you can get a revision that will help you overcome this.
Yehuda
I am having revision for complications not including regain. In doing my research I have seen articles stating that the weight loss after a RNY to DS revision is a bit slower than an initial DS. That isn't really a concern though because the weight does come off. It is not too late for you. Your situation is do to surgical failure: your surgery has failed you, not the other way around. I hope you can get a revision that will help you overcome this.
Yehuda
Hi Lynda,
I'm so sorry to hear about your experience with the dumping. My cousin has RNY and she has the same issue with "sorta" dumping (she also has Reactive Hypoglycemia and seizures to boot). It doesn't deter her from sweets, but it makes her feel vaguely unwell much of the time.
I am no expert, but I definitely don't think it's too late for you. There have been studies showing that the DS has great success as a revision surgery from RNY. We also have a number of patients here who've done wonderfully with that revision.
I do think you might find yourself at a slight metabolic disadvantage as compared to a virgin DS. If so, maybe you would lose a little more slowly or have to low-carb a little harder to get to where you want to be (but maybe not!).
As you know, the DS is malabsorptive in a different way than the RNY, so it has a more lasting metabolic impact. Although the body may try to compensate somewhat for the macronutrient malabsorption over the years, it never goes away completely like the RNY.
Anyway, these are definitely valid and important concerns you have, and I think its important to address them with your surgeon. If you've not been to Dr. Keshishian's website, he has some fantastic articles and studies up there about RNY to DS revision.
Jenna
I'm so sorry to hear about your experience with the dumping. My cousin has RNY and she has the same issue with "sorta" dumping (she also has Reactive Hypoglycemia and seizures to boot). It doesn't deter her from sweets, but it makes her feel vaguely unwell much of the time.
I am no expert, but I definitely don't think it's too late for you. There have been studies showing that the DS has great success as a revision surgery from RNY. We also have a number of patients here who've done wonderfully with that revision.
I do think you might find yourself at a slight metabolic disadvantage as compared to a virgin DS. If so, maybe you would lose a little more slowly or have to low-carb a little harder to get to where you want to be (but maybe not!).
As you know, the DS is malabsorptive in a different way than the RNY, so it has a more lasting metabolic impact. Although the body may try to compensate somewhat for the macronutrient malabsorption over the years, it never goes away completely like the RNY.
Anyway, these are definitely valid and important concerns you have, and I think its important to address them with your surgeon. If you've not been to Dr. Keshishian's website, he has some fantastic articles and studies up there about RNY to DS revision.
Jenna
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