another question- please help ?

hi all,
wondering if anyone can answer this... i understand what can happen to the pouch after gaining following rny, but is it at all possible for the malabsorption effect to stop working???????

Yes, after about 2 years the body begins to compensate for bypassed intestine and you start absorbing more fat and calories.  Thus... the honeymoon phase.

 The research I have done has shown that if your original RNY was proximal, which most were,  you will absorb more a few years out from your original surgery.  The body is a miraculous thing, it will learn to compensate for the malabsorption part of the procedure.  The small intestines will actually grow back some of the villi (the fingers that absorb nutrients and calories) over a period of time.  It will probably not ever go back to being able to absorb the total amount that you could pre surgery but it will be enough to have an effect on your weight loss or maintenance if you are not carful.  Hence the term wls is a tool.    Many surgeons are now going to a more distal or extended bypass  with RNYs.  I talked to many doctors when I was researching my revision and they all said one thing in common, that the body has great power to overcome many things but that it can only overcome up to a certain amount before the bypassed amount becomes greater then what the body can compensate for.  This is probably one of the things that make the DS have such good long term statistics. 

You will most likely always malabsorb and need extra vitalmins etc. And you will always malabsorb some of the foods you eat. But if you are eating a lot, then percentage wise, you would still absorb more when you eat more.
If you  absorb 75 out of 100 calories, for ex, then eating 2800 calories would mean you absorb 2100 calories out of it. So you can't count on malabsorbtion if you take in too many calories.

RNY is a nutrient (i.e. vitamins) malabsorptive operation, but is not really an energy malabsorptive one. What appears to be calorie malabsorption is, in part, a metabolic effect of duodenal exclusion. While the honeymoon phase is just that, the nutrient malabsorption is life long.

John D Husted, MD