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Ghrelin and Sleeve Gastrectomy LSG is a relatively new bariatric operation which was designed as a restrictive procedure. Recent studies challenge this classification showing accelerated gastric emptying after LSG [58]. However, another study of patients undergoing LSG showed no difference in gastric emptying compared to preoperatively and therefore the controversy remains [59]. The fact that the fundus of the stomach, the main location of ghrelin-producing cells, is excluded in this procedure led to speculation that ghrelin could play a role in the mechanism of action. Three studies confirmed a decrease in fasting ghrelin levels after LSG [54, 57, 60]. A prospective, double-blind study comparing RYGB and LSG confirmed a significant postprandial suppression of ghrelin postoperatively, while there was no change in the RYGB group [30]. In the same study, the marked suppression of ghrelin levels after LSG was associated with greater appetite reduction and excess weight loss during the first postoperative year compared to RYGB [30]. An even more recent prospective randomised comparison of LSG and RYGB confirms that both operations reduce fasting and meal stimulated ghrelin levels, significantly more so after LSG, so resection of the fundus has more impact on the ghrelin levels compared to just bypassing it [61]. Conclusion The role of ghrelin in the success of bariatric and metabolic surgery remains to be further elucidated. Some of the findings of the initial studies have not been confirmed in more recent investigations. Different gut hormones as well as having an incretin effect have been implicated to be key players in appetite control. However, the hypothesis that ghrelin might play a role in the mode of action of metabolic surgery has been crucial in the development of the field. The weight loss as well as the remission of type 2 diabetes experienced after metabolic surgery is not exclusively attributed to pure restriction or malabsorption any more. A lot of research is focused on exploring the hormonal and metabolic changes after metabolic surgery as well as the mechanism of action. From this article: Ghrelin and Metabolic Surgery

Katrina, you're doing real well with the weight loss. Better than most. I don't understand what your concern is. You will not have the kind of weight loss that happens right after surgery. Everyone slows down after that initial wave, and then we have to deal with stalls. It's on everyone's road to success. Try not to worry.

your stomach should be able to hold 3-4 oz. But, you will get sick if you over eat, or eat too fast, so just follow doctors guidelines and you will be fine.

How exciting. Best of luck.

Good for you! You did your research, and you won't be sorry.

i am not looking forward to this at all !

I confess that I had one nice big cookie the other night. It was worth it.

I will think good thoughts for you. My wife (ex) got pregnant once she stopped stressing and worrying. And then it just happened.

Thanks so much. The irony is that I got sleeved because they wouldn't operate until I lost 50 lbs. Now that I have lost it, they want my body to stabilze. So they postponed it until October. Meanwhile I have been living with this non-stop pain. But you know. You do what you have to do. Whatever it takes. :confused1:)

Good for you. You picked yourself up and started over. Luckily, before it became a problem. Good luck with those remaining lbs.

You might want to rephrase that. Best of luck.

Call your PCP and tell him he sent you to the devil. Naw, just say that the cardiologist was extremely rude to you and it's not a good fit. That you have no confidence in him because he contradicted your PCP. Have him quickly set up an appt. with another cardioligist. You don't have to put up with that kind of crap.

Congrats. And to a speedy recovery.

Theoretically it should help. But it all depends on what type of back problems you have. I have had three back operations. I fell on my back when I was 18 and I have had problems ever since. Most of my life I have been thin. I was thin through 2 of the 3 surgeries. They most likely should have fused my back with the last surgery, but they didn't. I was hoping to have that operation this month, but the surgeon wants to postpone it to Ocotber, after my weight has stabilized. Okay, here is goes. My back has hurt as much thin as much as fat. I have lost 57 lbs and it hasn't helped my back pain. If I stand up for more than 10 minutes, the pain breaks through my pain pills. So like I said, it just depends on what is wrong with you spine. I have had bulging and burst discs, and I have spinal stenosis. I am hoping that when I get my back fused, the pain will be manageble. But nothing is guaranteed. I hope this helps.

I have Kaiser and I had to pay $650 deductible.

Dealing with insurance is maddening. Call them and see if you can be on a cancellation list. You might get it moved up that way. Best of luck.

An article in Shape magazine mentioned that if you're craving something sweet, it may help to have a small portion of something spicy, like salsa. Somehow it tricks the tastebuds and makes the craving less intense. It's worth a try.

Good for you! Keep it up Angie, you'll reach your goal in no time.

Thanks Tiff. I noted that under comorbidities they state " including but not limited to". I remember there was some posting that said there were only three comorbidities accepted, and I thought that wasn't true. It depends on the insurer.

You mentioned you are taking a generic. Try asking the pharmacist if there is another brand that has a smaller pill. I have done this before. Your insurance should pay if, as in this case, you cannot medically take the pill you are prescribed. It's worth a try. And don't bother asking the doctor, they dont' usually know. My doctor is the one that recommended me going to the pharmacist to begin with.

Yes, most likely everyone. It's good you have this forum, or my doctor recommended a support group to got to. This forum feels like that to me. Try not to worry. You will be fine.

They are good for add'l protein. I started having some at 4weeks out. They kinda just melt when they hit your stomach.

yep 800 a day

4 weeks may be fine, but you may be fatigued. It all depends on how things go, how fast you heal, and how strong you are. You might be cutting it close, but others may have a different take. Congrats! And best of luck.

I did, but I was too wiped out to do anything but try and rest. But, you're young, it may be a piece of cake for you.