catwoman7

I don't know if there's anyone active on here at the moment who has (but you never know!), but i just googled him. He seems to have pretty good reviews...

I'm currently taking a graduate-level nutrition course on obesity and weight loss, and this article is pretty typical of the stuff we have for readings - i.e. written in highly specialized language that you'd practically have to have a chemistry degree to understand! Fortunately, I'm not taking the course for credit, because I sure wouldn't want to be tested on these articles! at any rate, I do know that with sleeve, the fundus part of the stomach is removed, and that's the part where most of the ghrelin is produced, so hunger levels go way down (because the ghrelin level is what lets the brain know that your body needs food. If the level is low, your brain knows that you need to eat, and you feel hungry. If the ghrelin level is high, then nope - not hungry - don't need to eat). Ghrelin is produced in other parts of the stomach as well, but a majority is made in the fundus, so levels automatically go way down - and stay low - once that part of the stomach is removed. the fundus isn't removed in RNY (in fact, none of the stomach is removed - it's just sectioned off), but I don't know how just having the major center of ghrelin production in the part of stomach that is no longer used affects ghrelin levels in your blood. I don't think researchers necessarily know that, either. Maybe it does, maybe it doesn't. Although most RNY patients lose their hunger as well. But they think it could also be due to the actions of some of the other hunger-related hormones, like leptin and GLP-1. They do know that RNY causes leptin levels to increase (and leptin is a hormone that causes a feeling of satiety. I can't remember what exactly GLP-1 does, but it has a role in hunger and satiety, too). At any rate, there have been research studies on RNY patients who are a year out, and their ghrelin levels are very low compared to "normal" people. So suffice this to say, ghrelin levels are abnormally low in RNY patients, too - but not for the same reasons that they are in sleeve patients. It could be that the major ghrelin-producing area is now in the remnant section of the stomach - or it could be that changes in some of the other hunger-related hormones could cause changes in the ghrelin level. (Or maybe it's due to a little of both...)

pretty normal fear - I'm guessing most of us had similar thoughts before going under the knife. However, the mortality rate on RNY is 0.3%. Those are actually excellent odds - lots of common surgeries - like hip replacement surgeries, for example - are less safe than RNY. Years ago weight loss surgeries were pretty risky, but they're just not anymore. Techniques have changed, and they're so common it's almost become a routine surgery. Anyway, at those odds, you have a 99.7% chance of sailing through just fine - and you will. your chances of a premature death by staying obese are actually much greater than dying from the surgery.

do they have to be in person? Unjury (the protein company) offers weekly virtual support groups and they do send receipts to you if you attend. They have one group for people pre-op to one year post-op, and another group for people over a year out (although people sometimes attend the "wrong" group - the leaders don't really care...). You can check to see if your insurance company or surgeon (whoever is requiring support group attendance) will accept that. I would imagine some do since they send people who attend a receipt afterward. Here's the info: https://unjury.com/resources/weight-loss-surgery-unjury-cares/

P.S. I don't think gaining all your weight back is that common, but it DOES happen if people aren't careful. A majority of us do have that 10-20 lb rebound in year 2 or 3, though. And I've known a few people who've gained 40, 50, or 60 lbs (due to old habits). It's easy to do if you don't watch it.

you're one of the lucky minority whose hunger never came back. For most of us, it comes back sometime during the first year. I was hoping I would have been one of the people whose hunger never came back, but no - unfortunately not. It was so much easier those first few months when I was never hungry and didn't give a flip about food!

you can gain weight with any and all types of weight loss surgeries if you let old bad habits creep back in. Weight loss surgeries are just a tool, and you have to keep up with your part of it for it to work. And they work extremely well as long as you follow the rules. a rebound weight gain of 10-20 lbs during year 2 or 3 is VERY common. That's more your body settling in to a weight it's comfortable at. If you're diligent, you'll stabilize there - or you may even lose some or all of the rebound if you work at it. But when old habits start up again, you can definitely gain weight again - sometimes a lot of it. And sometimes all of it. what WLS mainly does is control how much you can eat AT ONE SITTING. This is an example I've used a lot: Before I had surgery, when my husband and I ordered a pizza (always a large...), we'd each eat half of it. I can't do that anymore. I can eat 1-2 pieces. It's physically painful for me if I try to eat more than that. But it would be very easy to eat 1-2 pieces at 5:00 pm, and another 1-2 pieces at 8:00 pm, and yet another 1-2 pieces before bed. So....half a large pizza. THAT is the kind of stuff you have to watch out for - that, and mindless snacking (planned snacks are fine - but mindless snacking has consequences...). so to respond to your question about whether or not maintaining after two years is difficult, yes, it is. I constantly watch what I eat. If I notice the number on the scale starting to head north - esp if it gets above my "oh crap" number (the number I do NOT want to ever go over again), it's all hands on deck until it's back under control. So yes. Obesity is a very complex, chronic condition, and we do have to keep working at it to keep the weight from coming back. But the surgery DOES make that easier. There is no way I could have ever lost over 200 lbs and maintained that loss for several years (well, mostly - I did have a rebound) without this surgery.

yea pasta tends to sit in my stomach like a brick - and I can feel the effects for a long time afterward. I can handle a little of it - like 1/2 cup (100-ish ml) - but more than that and I'm miserable.

yes - it is. They have a Keto version, too, but the protein level in that one isn't as high.

I lost over 200 lbs but I had bypass. But I just wanted to say that it took almost two years for me to lose all that. My weight loss REALLY slowed down after I hit the year mark (near the end, it was like 2 lbs a month!), but it all came off. I was stalling a lot more frequently that second year, too. So many times I thought "well, this is it...", and then I'd drop a couple more pounds. Just stick with it! Your body might not be done losing yet.

that rapid weight loss seems to affect people's inner thermostats. Sometimes it's temporary, sometimes it's not. Mine was temporary - I think it just lasted a few months. But I know some people who are years out who are still freezing all the time.

Nope. It's expensive and the recovery can be painful, but it was worth every penny and all the pain.

carrots wouldn't be considered slider foods. Slider foods are things like ice cream, popcorn, and various other junk food that you can eat a lot of, and most have a lot of empty calories to boot. I eat baby carrots when I'm trying to ward off a potential binge. Reason being is that if I eat enough of them, they often irritate my stomach so much that the last thing I want to do is eat more. Not only do i not want to eat more carrots, but I don't want to eat ANYTHING! carrots are very nutritious and have very few calories. They also don't go down all that easily - as in comparison to something like ice cream. So definitely not a slider food.

yea I've become a real Ratio fan.

we started out at about the same weight, and I didn't even lose that much in a MONTH (I lost 16 lbs the first month). So you are doing fantastic, actually. Most of us seem to lose somewhere in the 15-25 lb range the first month, so you're way ahead of pack... and yes, as summerseeker said, weight loss slows way down after that first month. The big initial drop is mostly water.

I'd go to urgent care. I've never heard of people reacting to the surgery like that, but some people are allergic to certain meds or to the surgical glue or tape they use. Are you taking ursodiol? (the med some surgeons put their patients on for a few weeks to help prevent gallstones). Hives can be a side effect of that (not a common one, but I know it's a side effect because I was one of those people who got hives from it). Or it could be some other med you're reacting to. Just check with your PCP or go to urgent care. I reacted to either the surgical tape or glue when I had plastic surgery (although I didn't react to it with my RNY, oddly - but maybe it was different brand of tape/glue) - they put me on prednisone for a few days so I'd quit reacting to it. With the ursodiol I was taking after my RNY, the PA at my bariatric clinic just had me quit taking it. anyway, I doubt it was the surgery per se - but it could be some med or something that you're reacting to. They'll know what to do.

most people lose their hunger for several months (up to a year) after surgery, so it's not likely that you'll start feeling hungry any time soon...

weight fluctuations are normal - they're due to things like water retention and how full your intestines are. And yes - weight loss does slow down quite a bit after the big drop the first month or so. Plus you may be dealing with occasional stalls, too, which are also very common. If the fluctuations are playing with your mind too much, try weighing just once or twice a week - then you'll be more focused on long-term trends and won't be distracted by the daily fluctuations.

liquids go right through you so no - not bad. Your stomach will tell you if/when you're drinking too much/too quickly. I would have been able to drink that much in four hours, too, when I was a few days out.

my insurance company had some requirements, but my surgeon only required a two-week liquid diet right before surgery, a letter of support from my PCP, and all the common tests (sleep study, bloodwork, EKG - plus I had to have a cardiac stress test since I was over 50 years old). The three- or six-month supervised diet thing is usually a requirement of insurance companies - although I suppose some surgeons might require that, too. Mine didn't.

what keeps me on track is never, ever wanting to be morbidly obese again. That's not to say I don't have an occasional day when I really blow it. I do. But I get back on track the very next day.

I should add that there are different scales for measuring ferritin (and a lot of other blood values), so what's low on one scale might not necessarily be what's low on another. Your doctor will know if it's a problem and what to do about it. Mine was 168 on my last lab - although at one time it got down to around 30. I was able to bring it up with supplements - but some people malabsorb iron supplements and have to get infusions instead. But again, your doctor will know what to do.

yes - ferritin is the amount of stored iron you have in your system. 7 is crazy low. You're probably in infusion territory, but I'm not a medical professional. Your doctor will know what to do...

oh duh - I didn't realize that was the same thing! Having had probably 20 cats in my life time, I'm very familiar with the high BUN/normal creatinine thing!

I'm not sure if that will necessarily cause problems, but you'll probably be dealing with loose skin again after you lose weight...