New Data on failed WLS and why white stuff is the devil

I found this article (link on bottom of the page) posted on the Failed WLS forum yesterday and have read this article 4 times now.  Yes, they are talking about RNY, but further down in the article they talk about VSG and DS (those with a pyloric valve). 

What I get out of the article is that we VSGers are at a 4 fold risk for increased insulin production, and reactive hypoglycemia than we were pre-surgery starting at 6 months post op when we consume simple carbs and sugar. The RNY patients have a 20 fold increase....YIKES!  Because of this, we  risk regain, but not as bad a an RNY patient.  So, sugar is the devil to us.  If we were sensitive to sugar and other white stuff BEFORE surgery, we are 4 times more sensitive post surgery.  Do you think I am coming to the right conclusion about this article and what it means to us VSGers?

I had brisket this morning for breakfast, 3 ounces with a TBSP of BBQ sauce.  After I ate it, I was super stuffed.  I ate to fast and didn't realize that the last 2 bites should not have been eaten.  Anyway, here it is an hour and a half later and I am experiencing low blood sugar and I feel hungry again, even though I can tell my tummy is actually still full.  I am 9 months post-op.  This has been happening a lot lately.  I didn't understand why until I read this article.  I see that I am going to have to cut all forms of simple carbs out of my diet, even though they are eaten with protein like a little BBQ sauce, or ketchup.  I can see a huge difference in how I feel and how my hunger level increased just from that small amount of BBQ sauce (and it was made with no HFCS).  Moderation will not work, total abstinence is necessary for successful weight loss and future maintenance in my case.  Maybe some of you can handle a little bit of the white stuff, but I'll bet many of us cannot go down that road.

P.S.  My cousin had RNY yesterday, I'll have to show her this article in a few months.....but not right now, she's still in the hosp.  Her daughter had RNY last week.  But, when the time is right, they need to see this info.

Here's the article.

http://www.lenoxhillhospital.org/press_releases.aspx?id=2106

There is a HUGE difference between 4 fold and 20 fold increases. People definitely have varying sensitivities to simple carbs and many WLS folks were diabetic or prediabetic prior to surgery, so that sensitivity is still present, albeit, in remission.

This is the key statement from that article:

“Based on these results, I believe that bariatric procedures that preserve the pyloric valve lead to better physiologic glucose regulation and ultimately more successful long-term maintenance of weight-loss," said Dr. Roslin."

Thus, we have a higher chance of successful long-term maintenance of weight-loss. Simple carbs are not good for anyone, much less, someone with diabetes, prediabetes, or a WLS person.

Some people do need total abstinence and other people may be able to handle a tablespoon of BBQ sauce.

If your tummy feels full, but you are hungry, isn't that the definition of head hunger? The further out that we get, some hunger does return. If you think you have low blood sugar, perhaps, you should test it, just to make sure.

I wouldn't panic after reading that article. It just substantiates why I chose the VSG over the RNY. I was very concerned about the hypoglycemic aspect of the RNY.

Gail

Good information, i am going to contact my Dr now to make sure i keep my pyloric valve. I'm sure i am. I am bummed now though because I was supposed to have surgery tomorrow and the anesthesiologist postponed it because my potassium is too low. I have to have at least 5 days of potassium supplement before he will approve. Now my surgery is set for Aug 4th.

I'm confused.  You can't lose your pylorus valve with a VSG. Are you afraid you are scheduled for RnY somehow?

A four-fold increase sounds scary but you  have to know what the risk was before to know if 4x the risk is a big deal or not. I mean, if the risk of something is 0.005 % and it increase 4x, the is still less than one quarter of one percent.

Personally, I have bbq sauce and the like with my meat all the time and I've never had an issue. I even eat simple carbs all by themselves (aka fruit) with no issue. I do have an issue with a certain protein bar I consume during exercise that has 22 g of sugar. It's okay in the middle of exercising, but if I have it by itself in the afternoon, it puts me in a carb coma (so I don't that any more). But it doesn't make me hungry particularly faster that I can tell.

I don't think any food is evil. It's all about choices and what works for you. Sure, if you are allergic to pecans, then they are evil for you. But they aren't inherently evil. It's the same with small amounts of simple carbs. It depends on how your body reacts to them and everyone is different that way.

 while I understand that ice cream is not evil, exactly, I sure regret it when I eat more than a tiny amount. some cherry vanilla is about my favorite tasting food on the planet and yet it makes me feel SO bad!

Ice cream and froyo are my treat foods. But I can't eat more than 4 oz. (give or take) or I or at least get bad GI distress. So I'm automatically limited and I don't mind. That's a serving so I'm being forced to only eat a serving.

My surgeon told us in a meeting that insulin sensitivity actually INCREASES after the surgery, and that's why some people can actually get away with eating more carbs, but that this increase eventually goes away.

This is why he said that he is SURE that people who are eating too many carbs with a VSG will eventually have weight regain, and low carb is for life.  Abstinence is something I do anyway for my health, the best weight loss and maintenance, and for my emotional peace.

How much is "low carb?"  How much is too much? I know during the losing phase it was around 40 carbs or less, but long term? I stay away from rice, potatoes, bread, pasta, sweets, chips, etc., but what about the carbs from Greek yogurt, skim milk, veggies, and a little fruit? I do agree, that weight regain will occur with an excess amount of carbs, but how much is too much?

Gail

Technically low carb is anything under 200 g. But it really depends on what your total calories are. If you are only taking in 1200 calories, then 200 g of it from carbs is a lot! It depends on what activity level you have and what kind of activities you do too.

For example, I take in around 2000 calorie a day on average (though it varies depending on what part of the year I'm in) and I do endurance sports. So my carbs tend to be around 175 g a day on average but some days they are as high as 300 g. However, on those days, my calories are more like 2500-3000. Even with 175 g of carbs a day on average, that's about 35% of my calories from carbs, which most people would consider low-carb. (South Beach Diet recommends 40% of calories come from carbs, for example and it's considered low-carb.)

If you only consume around 1200 calories a day, 35 % is only around 100 g of carbs.