Same crap on the RNY board

Getting a bit boring over on the RNY board, so I stopped looking.  I'm not going there anymore.  I saw one too many posts about the intestines growing an ability to better absorb calories as an explanation for why people regain their weight.  How about this: if you are gaining weight, you are eating too many calories.

I have spoken to the guy who did my surgery extensively about this idea and he says has never seen it - and he does hundreds of RNY procedures each year.  The surgeon's opinion is that there is no mechanism for the gut to even know that the bypass has happened, as nothing has been removed.  The surgery is permanent, there is no significant malabsorbtion of calories and if you gain weight at any point - pre or post op - it is from eating more calories than you burn.  Period.  He cautioned me that it is quite normal to worry about getting heavy again, but that the surgery is not a diet and the effects last as long as you live.

His anecdotal evidence indicates that only 1/3 of his patients have any sort of regain and then only because they loosen their discipline and start eating higher calorie foods.  Many people that do regain do it from drinking high-calorie beverages like soda and alcohol.  You only need to attend a couple of support group meetings to see this.

My own experience is in line with his - I lost 200+ lbs and have no trouble maintaining that loss now, even at 27 months post-op.

 

Our local group / doctors, talk about a 10-15 pound "bounce" at the bottom as your body readjusts, but alot of that is 'water' weight as your levels normalize.  IOW, you don't see it on your waistband, just the scale.

At 18 months out now, my lowest ever was 195 for a day or two, I saw 208 once since then but settled at 202-205.

The only legit thing I have heard is that the Cilia does 'grow' in the part that is not bypassed, and so instead of 20% absorbtion, you eventually get back to 100%.

That being said....THEN it comes down to calories in/out.  If you eat / drink 2500 calories a day and "burn" 2000, you will gain weight over the long term.

The biggest benefit of RNY is the ABILITY to exercise and enjoy it as much as the rest of those durn "naturally" skinny people!!  Since I can exercise, it is EASIER to stay active and burn off the crap that I DO eat/drink.

It is possible that I could still manage to overwhelm that exercise...but harder.  It is MORE likely that if I quit exercising and get lazy and KEEP eating like I was exercising I will gain weight.

SO...all of the above basically means....YEP, I agree 100%!!

Thanks for that!

As far as I can tell, there are no scientific, peer-reviewed studies that try to answer the question about why bounce-bac****urs.  There is lots of supposition. The self-appointed experts are dishing out advice that somehow RNY is less effective over time due to a change in how food is digested, in an attempt to explain the bounce back effect.  I do not think this is based in fact and I think it is bad advice.  I have discussed this with my surgeon and he was not aware of any studies either.

There is a lot more going on with RNY than just that which is in the digestive tract.  The brain is involved also -- as the hormonal mechanisms that regulate hunger and satiety are altered in ways that are not yet fully understood.  As for the gut, there is nothing to trigger anything to regrow or adapt in the intestines, since nothing is removed, it is just not used anymore.

There is no scientific evidence that RNY is somehow less effective over time for large numbers of people.  Perhaps people on the RNY boards are having other issues that are causing them to eat and drink too much or eat and drink the wrong things.

Though we have no studies to ascertain the root cause scientifically, enough anecdotal evidence exists for ASMBS to state that the gastrointestinal tract may adapt over time allowing better absorption of food:

http://s3.amazonaws.com/publicASMBS/GuidelinesStatements/Gui delines/asbs_bspc.pdf

"For the operations that have a malabsorptive component (Roux-en-y gastric bypass and Duodenal switch), the gastrointestinal tract may adapt over time to its new anatomic change. This adaptation may allow for better absorption of the consumed food, especially fats reducing the benefit of the surgery. Unfortunately, nothing short of further surgery can avert this adaptation effect. However, once again adhering to eating small meals high in protein may limit this effect." (Bariatric Surgery: Postoperative Concerns, pg. 6, ASBS Public/Professional Education Committee - May 23, 2007, Revised February 7, 2008)

The 20 lbs bounce at 18 months post-op RNY "may" be normal.  However, what is not normal is the inability to maintain 70% reduction of excess weight past 5 years post-op.

My 2 cents,
Mike

That is opinion, not fact, as they say. They use the weasel word "may". The self-apointed on-line rny experts should do so also. They should not speak with authority they don't have.

I'm only 10.5 months out but I think your comments are good.  I'm am so tired of all the "drama' on the RNY board.  It's like it is only for women now.  I wish the men's Forum would pick up like it was last year at this time.

 

Jim

I'm hoping I can get more input from this forum...I was on a different message board and it there seem to be a bunch of sensitive women that complained constantly over minor crap...and then when I questioned them (in an effort to help them out), I was labeled as "insensitive" and "lacking communication skills...smh!  At any rate I'm also hoping that the men's forum will see more activity...

Not to hijack you thread but how was life on the AT?

Hey Paul!

The 30-day AT trip last September didn't happen, mainly because I became insanely busy at work, having managed to turn my little company around.  Now I am looking at actually digging out of the financial mess I've been in the last few years - so I guess it is a good thing that I am so busy.

That does not mean that I have stopped climbing though!  I just made a quick winter climb of Mt. Whiteface in the Sandwich Range, complete with snow shoes, brining my 4000-footer total to 20 peaks - I have 28 more to go for the NH highest.

I've switched to a mostly vegan diet and driven my weight down further (now 190), giving me more capacity for longer-duration hikes and the ability to carry more on my back.  If I can sneak out for 10 days some time this season (a possibility as I am hiring people left and right), I will attempt the 100-Mile Wilderness on the AT in Maine - I good a hike, fairly remote and strenuous.

I'll also be climbing as many additional 4000-footers as I can, but I have already finished the highest ones, including Washington and the other Northern Presidents...

How are you doing with the Iron Man insanity? :)

-Joe

7 years out and I can say that most of what matters is the total number of processed carbs in. I can eat just about all I want of anything else. I've never pushed processed carbs and sugars all that much ,but it seems if you take it to extreme and don't exercise, you WILL gain weith.

Best Wishes,

 

Dave