James Marusek

I am 3 years post-op RNY gastric bypass surgery. Before surgery, I really loved food and it was difficult after surgery. Because post-op I really hated food. But now that I am 3 years post-op, my tastes have begun to return. So my wife made me "Sausage and Apple Stuffed Shishigatani Squash" and it was magnificent. She used a recipe for Sausage and Apple Stuffed Acorn Squash substituting Shishigatani for Acorn Squash. pumpkin which was developed in the Bunka era of the Edo period (1804-1818) by Japanese monks. This is one of the rarest and most historic varieties. The fruit is ribbed, warty and uniquely shaped: like a bottle gourd. They are dark green, turning to tan at full maturity. The fine-grained flesh has a delicious, nutty flavor. This is a famous vegetable in Kyoto cuisine, though it is rare and hard to find even in its native Japan. Well it seems to grow pretty well in Indiana, provided the weather is good. http://www.rareseeds.com/shishigatani-or-toonas-makino-pumpkin/

I am 3 years post-op RNY gastric bypass surgery. It is my impression that this term applies more toward RNY than sleeve. Generally the honeymoon period is the period around a year in length after RNY surgery when you no longer feel hunger. Prior to surgery, hunger was constantly continuously gnawing at my bones. When I was eating, I was already focused on my next meal. After surgery hunger was completely gone. It wasn't hard to lose weight when hunger was not gnawing at your bones. Therefore this is called the honeymoon period. After about a year, hunger returned but it was less intense than prior to surgery. (I do not know if sleeve patients also lose their hunger after surgery.) There are two phases to weight loss surgery. These are the "Weight Loss" phase and the "Maintenance" phase. The goals and objectives for these two phases are different. They require a different strategy. I transitioned between the two phases at around 7 months. But sleeve patients can stay in the "Weight Loss" phase for much longer, sometimes 2 years. They can achieve the same total weight loss as RNY patients. This is an article that I wrote about the Maintenance phase. http://www.breadandbutterscience.com/Surgery2.pdf In general, you want to maximize your weight loss during the Weight Loss phase. Bread, Pasta, rice are complex carbs and you should stay away from these during the Weight Loss phase. In the Maintenance phase their use should be limited to around 1 meal with complex carbs a day.

Congratulations with your surgery. During the early stages, when you are restricted to liquids, there is a desire to eat solid foods, especially foods that you chew. This is part of our digestive process. Chewing releases some digestive fluids in our body. Therefore this part of the process is disrupted. After surgery I completely lost my hunger. This was not noticeable until I transitioned from Full Liquids/Pureed stage into the solid food stage. The three most important elements after RNY gastric bypass surgery are to meet your daily Protein, Fluid and Vitamin requirements. Food is secondary because your body is converting your stored fat into the energy that drives your body. Thus you lose weight. Weight loss is achieved after surgery through volume control. You begin at 2 ounces (1/4 cup) per meal and gradually over the next year and a half increase the volume to 1 cup per meal. With this minuscule amount of food, it is next to impossible to meet your protein daily requirements by food alone, so therefore you need to rely on supplements such as Protein shakes.

I am 3 years post-op RNY gastric bypass surgery. According to my surgeon's plan the first 4 weeks I was on full liquids, the next 4 weeks on pureed foods and it wasn't until Week 9 that I transitioned to solid foods. This was to give my stomach time to heal from the surgery. So I am wondering if you are rushing the transition to solids a little too soon?

Since you are at the beginning of this process, I would recommend three things. 1. Take a good before photograph of yourself, so that you have something to compare to after surgery. Many times we are blind to our obesity. We do not see ourselves. Therefore when the weight begins to drop off rather dramatically, we question if this is really happening. Photographs are a good visualization of our success. Many people carry a before and after photo with them, just to remind themselves of their success. 2. Walk 30 minutes each day, every day until surgery (or equivalent exercise). Walking helps the recovery process go smoothly and minimized the pain levels from surgery. 3. Wean yourself from caffeine and carbonated beverages now. After I gave up my 6 diet coke a day habit, I suffered from a week of severe withdrawal syndrome consisting of severe headaches and body aches. I was miserable. You don't want to combine the effects of caffeine withdrawal with the effects of surgery.

I have been taking 5000 I.U. of Vitamin D3 after my RNY surgery. After surgery, there is so many extra Vitamins that you will take, there probably isn't a wrong or right way to take these. The important thing is to have at least a 2 hour separation between the minerals Calcium and Iron. Because these two don't mix. Also the number of Calciums that you take daily need to be spaced out throughout the day.

Good luck on your upcoming surgery. I recommend you do three things. 1. Take a good before photograph of yourself, so that you have something to compare to after surgery. Many times we are blind to our obesity. We do not see ourselves. Therefore when the weight begins to drop off rather dramatically, we question if this is really happening. Photographs are a good visualization of our success. Many people carry a before and after photo with them, just to remind themselves of their success. 2. Walk 30 minutes each day, every day until surgery (or equivalent exercise). Walking helps the recovery process go smoothly and minimized the pain levels from surgery. 3. Wean yourself from caffeine and carbonated beverages now. After I gave up my 6 diet coke a day habit, I suffered from a week of severe withdrawal syndrome consisting of severe headaches and body aches. I was miserable. You don't want to combine the effects of caffeine withdrawal with the effects of surgery.

Two things come to mind. 1. As your meal volume increased after surgery, if you concentrated on consuming high Protein meals, then you can begin to offload the number of protein supplements (protein shakes/protein bars) that you are consuming to meet your daily protein requirement. These supplements not only contain protein but also extra calories. This helped me break a few stalls along my weight loss. 2. I am 3 years post-op RNY gastric bypass surgery. At around 7 months post-op, I transitioned from the weight loss phase into the maintenance phase. The goals and objectives of the maintenance phase are different than the weight loss phase. And it takes a different strategy. Sleeve patients tend to be in the weight loss phase much longer than RNY patients. Some loose weight for 2 years and achieve the same weight loss as RNY patients. This article describes my experience with the maintenance phase. http://www.breadandbutterscience.com/Surgery2.pdf I probably don't need to remind you that if you want to achieve your weight loss goals, then you need to follow the plan the surgeon's office gave you. It sounds like you are already beating yourself up already about this.

I am 3 years post-op RNY gastric bypass surgery. I underwent a 6 month diet and exercise program in order to qualify for the surgery. This is a requirement dictated by my health insurance company. The answers to your question are Yes and Yes. Are they trying to see if you can lose weight on your own? Or are they trying to see if you have the ability to follow a program since you will have to after surgery? In the past some individuals had surgery, lost weight and gained it all back. Others did not lose any weight at all. Many times this can be attributed to individuals ignoring the surgery plan guidelines. During the 6 months I kept a food journal. I began reading food labels and caloric breakdown at restaurants that I ate at. I attended bariatric surgery support group meetings. I walked 30 minutes each and every day. I gave up my 6 diet Coke a day habit (no caffeine/no carbonated beverages). I lost 20 pounds. Another reason why weight loss is important prior to surgery, is to give the surgeon some room to operate in. When I was obese, everything was packed in there very tight. This gave him some operating room to work with.

Good luck on your surgery and check back with us when you are on the other side.

There are two phases to weight loss surgery. The approach for each phase is different. This is the approach I am using in the Maintenance phase. http://www.breadandbutterscience.com/Surgery2.pdf

The only case that I remember that is almost as extreme as yours is a woman who had her pouch sewn so incredibly small that she was eating thimble size meals. Many, many a day and still not able to get her daily volume in. Her hair was falling out. Her teeth were falling out. She was a wreck. Back to basics. The three elements that are key are fluids, Vitamins and Protein. If you can tolerate Water, then meet you daily Fluid requirements with water. Preferably filtered water, not tap water. Please keep experimenting until you solve these three. Your surgical team needs to be involved in solving your problems.

Here is a link to an article on reactive hypoglycemia post–gastric bypass. https://www.ridgeviewmedical.org/services/bariatric-weight-loss/enewsletter-articles/reactive-hypoglycemia-postgastric-bypass The three most important things after surgery are fluids, Vitamins and Protein. Since you said that "when I drink Protein I throw instantly", have you tried MILK. 32 ounces of 1% milk fortified with 1 cup of powdered milk will give you 56 grams of protein. You cannot drink this all at once but spreading this out throughout the day will help you meet your daily protein requirement.

The three most important elements after weight loss surgery are to meet your daily Protein, Fluid and Vitamin requirements. food is secondary because your body is converting your stored fat into the energy that drives your body. Thus you lose weight. You are at least 10 weeks post-op. If you can't keep Water down, you may have a stricture. If you are unable to meet your daily protein, fluid and vitamin requirements, you need to seek medical attention and resolve the issue. Your problems may be caused by dehydration. They may be caused by a lack of Vitamins and minerals. It may be caused by reactive hypoglycemia. The fact that you were dizzy and took soda (sugar) rested and then felt better does point towards reactive hypoglycemia but you may have a whole slew of problems to deal with.

I don't know about this condition and have no medical experience. Hyperthyroidism is excessive thyroid hormone production. Hyperthyroidism is most often caused by Graves disease or an overactive thyroid nodule. My thoughts are: After weight loss surgery, your fat cells will be broken down. These cells contain not only fat but also chemicals and hormones. This can produce a hormone flush. These chemicals and hormones will be flushed from your system through your kidneys and expelled through your urine. Fluids make this process happen seamlessly. So after surgery, pay close attention to meeting your daily Fluid requirement, otherwise you may experience a flush of hormones that can affect your emotions. So I was wondering since the weight loss process can inject many hormones back into your system if this might appear to mimic an overactive thyroid. If that is the case, when you transition from the weight loss phase into the maintenance phase, this condition might settle down.

After weight loss surgery, your fat cells will be broken down. These cells contain not only fat but also chemicals and hormones. This can produce a hormone flush. These chemicals and hormones will be flushed from your system through your kidneys and expelled through your urine. Fluids make this process happen seamlessly. So after surgery, pay close attention to meeting your daily Fluid requirement, otherwise you may experience a flush of hormones that can affect your emotions.

Congratulations on your weight loss of 172 pounds. There are two phases to RNY gastric bypass surgery. These are the Weight Loss phase and the Maintenance phase. I was in the weight loss phase for approximately 7 months and then I slid into the Maintenance phase. The goals and strategy for these two phases are different. They require a different approach. This is my perception of the Maintenance phase. http://www.breadandbutterscience.com/Surgery2.pdf Weight loss in the Weight Loss phase is achieved after surgery through volume control. You begin at 2 ounces (1/4 cup) per meal and gradually over the next year and a half increase the volume to 1 cup per meal. With this minuscule amount of food, it is next to impossible to meet your Protein daily requirements by food alone, so therefore you need to rely on supplements such as Protein shakes. One thing to do now at this initial stage is to assess your protein intake. Your protein requirement is met by a combination of the protein from your meals combined with the protein from your supplements (protein shakes, protein bars). Since your meal volume has increased, that also means that the amount of protein from meals is increasing, especially if you concentrate on consuming high protein meals. Therefore you could be able to reduce your reliance on protein supplements and the calories they contain. I went from 3 protein shakes a day, down to 2, then 1; and finally zero when my meal volume increased to 1 cup per meal at a year and a half.

Prior to surgery, I was taking four types of prescription medicine to control my high blood pressure and diabetes. Those conditions went into remission when I had RNY gastric bypass surgery 3 years ago. So the extra cost of the Vitamins and supplements that I take after surgery are comparable to the cost of the prescription medicine that I am no longer taking.

Dr. Mary Hickson from Plymouth University in Plymouth, UK, and colleagues published a preliminary food intake. * Acyl.-ghrelin: activated form of ghrelin * GLP-1:glucagon-like peptide: when glucose levels in the blood rise, GLP-1 induces the pancreas to release insulin and thus promote normal glucose levels. * PYY: Peptide YY is released in response to feeding and reduces appetite. Analysis of the hormonal levels in the women in each age group showed that, compared to the 60-79 age group, the 80+ group demonstrated a higher level of PYY than did any other age group. http://acsh.org/news/2016/08/08/appetite-control-in-the-elderly-might-help-the-young-control-eating/ My mother is in her 80's. Her doctor treats elderly patients. A few years ago, he described aging anorexia in the population in their 80"s. It is very common. So perhaps by studying this condition in the elderly, it might someday provide a useable approach to Hunger Control.

There are two phases to weight loss surgery. These are the Weight Loss phase and the Maintenance phase. This is my impression of the Maintenance phase. http://www.breadandbutterscience.com/Surgery2.pdf

I had RNY gastric bypass surgery, whereas you had sleeve. I found softer foods such as chili and Soups went down much easier that harder foods such as chicken and steak. When I am on the go, I will eat chili and Wendy's, so I recommend it. But after surgery, your body needs time to heal and I think this might be a problem at 2 weeks post-op. So you might have to wait awhile yet. I developed a high Protein version of chili and soups that I used after surgery. The recipes are at the end of the following article. I would make up a pot of chili and use it all week. http://www.breadandbutterscience.com/Surgery.pdf

Good luck on your surgery and let us know if we can be of any help.

Sounds like things are moving right along. Here are two things that might help. 1. Walk about 30 minutes every day from now until surgery. It will help the recovery process go smoothly. 2. If you haven't given up caffeine yet, do so now. I had a 6 diet coke a day habit prior to surgery. I went cold turkey when I started the long process. I suffered through about a week of caffeine withdrawal syndrome (severe headaches and body aches). So it is better to get over this early and not compound it with the effects of surgery.

Researchers in the United States and Australia conducted a meta-analysis of 174 studies published between 1980 and 2016 that examined the effect of exercise on five chronic diseases: breast cancer, colon cancer, diabetes, heart disease and stroke. Study authors observed that, to a certain point, the more a person exercised, the lower his or her risk of all five conditions. But the sweet spot for health gains occurred when individuals had a total activity level of 3000-4000 metabolic equivalent (MET) minutes a week, according to a news release. Benefits halted beyond an activity level of 4000 MET minutes a week. http://www.foxnews.com/health/2016/08/10/researchers-identify-amount-exercise-needed-to-lower-risk-5-diseases.html So what is an MET and how do you compute it? http://www.cdc.gov/nccdphp/dnpa/physical/pdf/pa_intensity_table_2_1.pdf So if I walk 30 minutes per day, that would be around 100 METs per day and I do it every day. That would give me around 700 METs for the week. That is not much of a dent towards the activity level they indicate is optimal. So I guess that: Researchers’ results, which were published Tuesday in The BMJ, suggest current World Health Organization recommendations for a minimum total physical activity level of 600 MET minutes a week across different domains of life may be insufficient. The ideal amount of METs requires a lot of exercise. I guess if someone was solely focused on physical activity/exercise to stay healthy, one would have to spend an inordinate amount of time exercising each day. But if you combine diet (weight loss) and exercise, perhaps that same sweet spot could be achieved in a more balanced approach.

@@fatgirlsvelte said "The statement "half of the population receiving this surgery are women", isn't really true. Most of the individuals receiving weight loss surgery are women. I am not sure of the statistics but it may be 4 to 1. I don't know why because obesity is shared somewhat equally between men and women. ​The majority of the individuals in my class are men. Perhaps it is different nationally? I'm quoting verbatim what was said, and can't speak to the blanket statement. SoCal KP may have an arch, who knows. " Eighty percent of patients who undergo bariatric surgery, which involve procedures that either limit the amount of food that can be consumed or reduce food absorption, are female, despite equal rates of obesity among American men and women. https://health.ucsd.edu/news/releases/Pages/2015-04-29-men-less-likely-to-have-bariatric-surgery.aspx