Question:
Why am I gaining so quickly?

I had lap-rny abiout 3 1/2 yrs ago. About 6 months ago I started PACKING on the lbs!!! I really don't eat that much and could proably exercise more but....I know this surgery was a tool but if my stomach is suppose to be so small and things were re-routed shouldn't I be able to maintain now. I have heard horror stories. Please, please give me some responses. I can't continue like this!!!    — Thea A. (posted on December 14, 2006)

December 14, 2006
You do need to count calories and exercise at this timeframe. The tool is there to assist but it is all us right now. Also calorie count should be around 1200 to maintain. I got this number from my nutritionist. Depending on exercise it may be higher than that. I am suggesting to you what I am going to do.....start the diary back up see what I am presently eating and doing...then see what I can do differently. Make a plan!
   — dcox94

December 14, 2006
Unfortunately, I may have some bad news for you. Many people are told to be very diligent about eating all their protein and taking all their vitamin supplementation when they have their surgery, but they are not told WHY. Sometimes it's just too hard to get in all the protein, the shakes aren't all that appetizing, or you figure that if you don't eat as much as they say, you may even lose more faster! As for supplementation, let's face it, it can get VERY pricey. But there's a problem. If you DON'T eat your daily quota of protein and take your supplements, as well as get into good exercise habits, you WILL gain weight after the honeymoon period is over. It's almost unavoidable. If your body is starved for that protein and supplementation, your intestine starts to adapt. It is a process that was discovered in people with short bowel syndrome and applies to those of us who have been "re-routed" too. The villi (spongy wavy tissue in the intestine that absorbs protein/nutrients) will compensate for being starved for what it needs by getting much longer and larger to make up for the intestine that was cut out. In some cases intestines have even grown and lengthened significantly to be able to absorb as many nutrients and protein from what you DO eat so that you don't get sick. It's called hypertrophy. It negates the malabsorption effect to the point that you are now absorbing ALL the fat/calories/carbs/sugars you consume now instead of less than half like you did before. As well, if you get into bad habits such as grazing, it can be a real disaster. The only thing you really have going for yourself at this point is your small pouch - you can't count on "I know I ate a cheeseburger but I only really absorbed half of it" denial crap. Go back to basics. Get in all your protein and supplements to HALT HYPERTROPHY IN ITS TRACKS. Eat small meals that are protein-rich (keeps you full longer) about 4-5 times per day. Track your food intake on fitday.com or sparkpeople.com - you may be surprised at how many calories you're taking in. Try to amp up your exercise. Three half-hour sessions of cardio per week are doable, and you should incorporate some strength training too. Don't drink water for a half hour before you eat, during your meals, or for an hour after you eat (you will stay much fuller longer). That's really all the advice I can give. It really irks me that we aren't told about this at the time of surgery. But you can reverse it - you just can't be lazy or complacent about it anymore. Not being fat is something you'll need to work on now - you can't rely on the surgery anymore. But at least you're not 300+ pounds in getting started!
   — j_coulter

December 15, 2006
Thea... the answer to your question is in your own question.... exercise more.... and consistently... also start measuring things again... I bet you have increased your portion sizes with/without realizing it... go back to basics...
   — Kari_K