Question:
Does your body eventually accomodate the bypassed intestine

and stop malabsorbing calories/nutrients to any degree or entirely? I believe I read some where that eventually your body learns to adapt to the new rerouting of the intestines and you loose some (or all) of the ability to malabsorb. Does anyone have any insight on this? Thanks. -Kim    — KimBo36 (posted on January 5, 2002)

January 5, 2002
The short answer is Yes. At least partly. The body will do EVERYTHING it can to normalize. Hence the stretching of the pouch, with or without our help (eventually), but I think you might be referring to hypertrophy of the common channel?
   — vitalady

January 5, 2002
My surgeon recently answered this question for RNY patients in a support group meeting. The malabsorption of calcium, iron, and vitamin B12 persists for life because the section of the bowel (duodenum) that is responsible for absorbing these nutrients has been bypassed. The malabsorption of calories in the roux limb stops at about 18 months post-op. The pouch will always be smaller than your normal stomach which will limit the amount of food that you can eat at any one sitting. However, at about 18 months post-op, calories will begin to be absorbed by the body just as they were pre-op. Therefore it is extremely important to develop improved eating habits during this "honeymoon" period....3 meals a day, no between-meal snacks, and no high-calorie/low-nutrient junk food. The surgery has not "failed" those patients who regain weight post-op....those patients have "failed" their surgeries by continuing or returning to their old eating habits which contributed to their morbid obesity to start with.
   — Diana T.

January 5, 2002
I'd love to see the scientific evidence of greater absorbtion over time. It makes logical sense that malabsorption of calories varies over time, but I have a hard time believing it goes back to the way it used to be. I am not a believer in blaming the patient. Some people do have surgeries fail. And in my case, I've been told to eat more than three meals a day. Let's not blame ourselves for another failure so quickly. Maybe sometimes the disease of obesity is persistent, just as cancer can be. That means more agressive treatment, not more guilt. If the body is absorbing more, we must work with it. But if it's absorbing enough to take us back to an unhealthy weight, then the disease is back. <p> One of my great insights when I began this research was that dieting and following all the rules wouldn't cure the disease. I don't know why we think that changes post op. YES, follow directions. But let's not see post ops who regain in the same light we were viewed as pre ops. They are not lazy or stupid or gluttonous. Just battling a very persistent disease. My heart goes out to all of us in the battle.
   — kcanges

January 5, 2002
The body works hard to normalize as much as possible. After about a year to 18 mos the body adjusts. The metabolism is already slower so if you eat enough high calorie foods all day you can and will regain weight. I know, I did it. I finally accepted the the surgery was not a panacea. I took responsibility and changed for the better. I lost the regained weight and finally made it to goal. Hugs..Rita in Vermont RNY 3/31/94 463/185
   — vt_rita

January 6, 2002
Our bodies adapting to absorb more calories, I have read this explains some folks weight regain at 5 plus years. Now I decided I will have another surgery if needed to stop the regain that may occur in 5 to 7 years. But hopefully by that time there will be a safe and effective diet drug. I needed a solution today, and will leave tomorrows problems for another day. I want to enjoy life NOW!!!
   — bob-haller

January 6, 2002
This is the first I've heard of this and I am extremely concerned and upset. I am concerned because if the pouch is stretching out, the malabsorbtion of calories discontinues, and metabolism has gone to hell, how can we possibly keep this weight off? That's a serious and legitimate concern that I plan to address to my surgeon. I did a lot of homework both pre op and post op and I was never, ever told that malabsorption of calories was temporary. Another thing that seriously upsets me, and doesn't make too much sense is why would they bypass the intestine thus leaving the patient unable to absorb certain vitamins if the fat and calorie malabsorption is temporary? It seems to me that the benefits do not outweigh the risks involved. Even with old surgery most got the weight off (without bypassing the intestine) They couldn't keep it off. If we are left without our malabsorption after the 18th month mark, what advantage are we at? It seriously doesn't make any sense to me and I plan on looking into this further.
   — Jeannet

January 6, 2002
My understainding is that its a slow process after 5 years and doesnt necessarily affect everyone. If we learn good food choices and become more active then our tool, just like a somewhat dull knife will still work. Perhaps not as good as immediately post op but still usable.
   — bob-haller