Question:
What percentage of calories are malabsorbed with RNY?

Anyone know how many calories are lost through malabsorbtion? I can't gain weight, and have lost too much, I'm at BMI of 19 and am looking like a bag of bones. I need to find ways to put on weight, but in my figuring of how many calories to eat every day I don't know what is lost through malabsorption, any ideas?    — shannon W. (posted on December 6, 2002)

December 5, 2002
I believe that I saw on one of those Discovery Health shows on the gastric bypass that we absorb only 80% of the calories and nutrients. Based on that, you would probably have to eat 3000 calories a day to absorb 2400. <p> Have you talked this over with your surgeon and your nutritionist (if your surgeon has one on staff). Otherwise, maybe your primary can get you set up with a dietician that can get you set up on a high-calorie diet that is pouch-friendly...JR
   — John Rushton

December 6, 2002
Shannon, I'm sorry to hear about your struggle. I wish you luck in reaching a good healthy weight for you!<P>As far as the malabsorption question goes, I think the answer may depend in part on what kind of calories you're consuming. In other words, I think we malabsorb protein a little more than we malabsorb simple carbs and sugars, because we start absorbing sugars and carbs even while still chewing them. For protein, it's gotta travel further down the system before we start absorbing it. You might ask your doc or nutritionist if this is true or not.
   — Suzy C.

December 6, 2002
I saw a GI doctor during the time I was getting consults + clearances with all the specialists needed for my surgery and he told me (generally speaking) that I would only be able to absorb half of whatever I eat post-op. Now, I imagine this would also vary depending on which version of RNY you have done, distal or proximal, right? Good luck to you!
   — thumpiez

December 6, 2002
hi there, im not sure how many we malabsorb but i have heard that we absorb alot of the intake of carbs and 100 percent of the sugars. we dont absorb fat the way we used to. also recently my surgeon told a friend of mine that when she was 2 years out shed really have to watch it as we start absorbing more as time goes by. i wish you the best of luck. maybe increase your carbs or the number of times you eat a day until your weight stablizes to where you want to be.
   — carrie M.

December 6, 2002
It depends on how much small intestine was bypassed. I had 150cm or 5 feet bypassed. This means if I eat 1000 calories I absorb about 600. That also means that I malabsorb 40% of all of the vitamins and nutrients I get from food. If you have a bony look your body has started to break down your muscle because there is no more fat. To keep the muscle and in your case re-build it you need to get in more protein. A lot of people say they can get in 60 grams a day no problem without supplements, however, they do not realize that they are not absorbing 60-80 grams. Also, protein can not be just absorbed, it needs to be broken down into peptides first. It goes through our system too fast to completely do that. That's why the best protein supplement for us is a combination of 100% whey with whey peptides. That combination is the only source that will be immediately absorbed at almost 100% no matter how much intestine is bypassed. Go to www.protein-solution.com
   — Linda A.

December 6, 2002
I agree with previous poster. My surgeon has my protein daily goal at 70-90 grams by food.
   — Karla K.

December 6, 2002
You didn't say what type RNY you had, or how much protein you're getting in a day. If you've lost muscle, sounds like that might be on the wimpy end. I would not encourage you to eat junk, simply because you want to build muscle, not fat. Ice cream would work fast, but it won't give you what you want.
   — vitalady

December 18, 2002
Protein is comprised of amino acids. Our bodies is capable of producing 12 but we need to obtain 8 amino acids from our diet. To produce a useable protein molecule there must be an exact number of each of the amino acids - excess amino acids are discarded. For instance if you need 2 units of amino acid X to every 1 of amino acid Y and your food source contains 3 of X and 2 of Y - you will only build 1 protein molecule and discard the rest. What you have to keep in mind is how much useable protein is found in your 60 grams of protein source. Eggs have somewhere around 94% of usable protien Milk 82% while beef only has around 68%. So if you are eating 100 grams of beef you are only get about 68 grams of protein while the same amount of eggs will produce 94 grams. These are not exact figures but you can get the idea. Also note how eggs and milk have the most usable protein - this is probably because they are the building blocks for life not the maintenance of life. Also as far as protein goes... there is a dynamic equilibrium wherein your body will only use what your body needs to replace cellular material. If your body only need 60 grams to replace cells then that is all your body will process - excess is discarded or broken down for energy in absence of carbohydrates or fats. Dynamic Equilibrium is is why protien drinks for body building doesn't work.. intake of 150 grams of protein while the body is only losing, due to muscle breakdown / buildup, 80 grams, or so will result in 70 grams being discarded. I'm not a biologist so my figures may be off... Take Care, Be Well, and Be Happy!
   — John T.