Question:
I ran across this in some research reading, can anyone explain the last sentence?

The nutrition of 200 patients after Roux-en-Y gastric bypass for morbid obesity was followed for 6.7 years. During the first 2 years their food intake was severely restricted, resulting in an excess weight loss of 69 +/- 14%. At an average of 3 years after surgery they began to regain weight significantly (p less than 0.04) due to nutritional adaptation. In the following years caloric consumption stabilized at an excess weight loss of 48-56%. However, they had continuing meat intolerance with 51.0, 60.3, 59.5 and 55.1% of them avoiding meat during 0-12 months, 13-24 months, 25-72 months and 73-96 months after surgery, respectively. We conclude that after Roux-en-Y gastric bypass there is nutritional adaptation lasting as long as 2 years, when a characteristic nutritional behavior is adopted which persists for years    — [Anonymous] (posted on March 26, 2001)

March 26, 2001
I think what it is saying is that in the first 2 years, our tummies are restricted by volume and our absorption is restricted by the bypass. This is the time when we are supposed to be relearning how to eat...this is also what is known as the "window of opportunity". Beyond that, our new behavioral patterns (limited grazing, eating beyond the limits of the pouch, high fat and high sugar foods) maintain the weight loss, as our stomachs and metabolism have adapted to eating less food and absorbing less nutrients. In other words, those patients that have maintained a healthy post op diet beyond the window of opportunity, have been successful. Looks like good news to me!
   — Allie B.

March 26, 2001
I Agree! Sounds pretty good to me!
   — toni D.

March 26, 2001
I am not sure where they get the part about meat. Would you email me with the source of this information (who did the research and where published). Thanks.
   — Jilda H.

March 26, 2001
Some of the docs doing these surgeries early on literally starved their pts by not supplementing adequately. In effect, the body tries to "reach" for the nutrition that it IS offered and tries to make it work. So, the pouch stretches to try to accomodate its former volume and the part of the intestine that is left "intact" will elongate and stretch to try to extract more nutrients from the non-digested foods offered. The body will ALWAYS try to right itself. You can see that these pts could not eat enough meat to get enough protein on board and actually, we never will be able to. But the body will try like mad to adapt to whatever situation we put it into. So, you buy a malabsorptive surgery, but then try to undo the malabsorptive portion by FORCING it to try to absorb. I know many docs still say you will return to normal after 1 yer, 2 years--whatever their theory is. Personally, I've had to do this surgery twice, and I do not WANT to return to normal. I have paid dearly for my small pouch and malabsorption. The LAST thing I want is for it to be undone by poor nutrition on my part.
   — vitalady

March 26, 2001
What they mean, in a nutshell, is that at least half the patients still could not tolerate eating meat as long as 8 years after the surgery. But the last sentence means that in the people who developed better eating habits, only half of their weight was gained back. I have read that too--- after two years, there is some rebound weight gain, but in most patients, they only gain half of their original weight back, instead of all of it and then some, as in most diets. And what is termed a success by whoever is in charge of this stuff says that keeping off 50% of your weight for 5 years or more. And people who have this surgery do that. Which is why insurance companies are paying for it.
   — marlo T.