Phentermine...

Well I went to a bariatric surgeon last Monday to see about revision. The upper GI shows my pouch is still small and I will have an endoscopy on July 31. He said he does not think a revision is necessary and he gave me phentermine, appetite suppressant (amphetamine derivative) to help with hunger. Today I weigh 189 and I was `198 at my appointment Monday. It really made me not want to eat at all, and I pretty much didn't. Not only that but I only slept two hours each night. I could really tell I was having the effect from an amphetamine type prescription. It also made me clench my jaw very tightly. I am not taking this anymore. I know that once I stop it, the weight will return because that is the reason diet pills do not work. They work while you take them and once you stop, it returns. I just don't feel good about taking this type of drug, so I am not going to.

Small pouch means good.  So back to basics- proterinsd + fast + limited carbs. 

I lost 12 lbs in the last 2-3 months. 

Hi,

I want to doc last year to get checked out and make sure all is well internally from my RNY done in April of 2008.  I had an EGD and got the all clear.  I have kept off over 100#, but bounce 20 - 30 up and down and I never got to goal.  If I could just get and stay under 200, I would be happy (debatable, LOL).  I did return to the WLS support group, took the nutrition class (which was amazing what I learned since my own surgery) and have attended other support groups.  He also referred me to a weight loss doc they were getting at their practice, but I ended up going to a more established one and did get the Phentermine, Topiramate combo.  I did increase the dosages after a couple months and went off them at six months or so.  I did lose 26 pounds and loved the way I looked in my clothes - no "x" in my sizes!  I will say the combination of the support group, the meds, the documenting of all my food at myfitnesspal all helped me to lose at a regular pace.  Probably the biggest thing would be to not snack between meals and I am addicted to eating before I go to bed (which the meds helped with).  Here I am six months later, 20 pounds back on...arghh...

Sorry for such a long story, but your story really resonated with me...on Wednesday I went to an Endocrinologist now at the practice of the Bariatric doc I went to last year.  I went to him primarily because my Ferritin was 11 and is now below 7 - this is the first I have had a problem with low ferritin since post op.  He went over all my labs with me and recommended that I go back on Metformin which I was on for a few months before my weight loss surgery.  I could go on and on, but he explained to me why my diabetes needs to be treated and that the insulin production is getting in the way of the weight loss - he said that the surgeons do not arbitrarily take people off the diabetes meds now because they have learned it causes problems years down the road...I did tell him about the weight loss drugs from last year and he recommended that I go back on them, but to take 1/2 the dose I was taking and he really stressed to use the time on the meds as a time to "get it together" with the eating and utilize all the tools, the foods, the support, therapy, whatever it takes to realign the mindset.  I am going to see their dietitian if my insurance will cover, otherwise I have a consult at the base, but the focus on obesity might be better than the focus on military service.

We are going to work together to bring up my iron with meds I am already taking, just take a lot more and with every meal - I really want to avoid a transfusion and know that part of the reason I am eating is due to the fatigue.  My insurance covered some of the cost, amazingly, so I am going to see how it goes.

I did feel like the endocrinologist looked at my whole self and not any sort of quick fix.   He said that there are other options if the meds do not get me going and we can see what happens - he also said that my body just might prefer to be at the weight I am right now.  Personally, I think I would just keep gaining, it is just at this weight I really come to terms with the fact that the weight gain is out of control, to be perfectly honest.

Please keep in touch - I wanted to let you know what I was doing as well as put it out there and be accountable to what I need to do, especially in the area of choosing what and when I eat/drink.

Louise