UnderTheCaliSun

Hi all, Mounjaro has been AMAZING for me! Like @Tupelo and @vsgchickI lost the regain from hitting menopause and I have lost additional. I am down to 138 lbs which is my lowest weight since college. I'm not underweight at all. I worked my way up to 7.5 mg and that was my sweet spot. I hit maintenance and have slowly stepped my way back down to 2.5 mg. I was still losing on 5mg as I stepped down but so far I haven't lost anymore on 2.5. I'm on my second month of maintenance at 2.5 mg and I bounce between 138 and 141 depending on salt intake and Water weight but I'm very happy with my weight and size. Once my coupon runs out in June, I'll likely transition to something else as I cannot afford the retail pricing for semiglutide or terzepitide. The difficulty is that my BMI is now 23 so I would not qualify under insurance for obesity medication. We are submitting info for a PA under Insulin Resistance, PCOS, Nonalcoholic Fatty Liver and preventative/maintenance of WL after surgery to see if we can get either Mounjaro or Ozempic approved. I am hoping to stay on Mounjaro. It works amazing for me and I never had any big side effects. I agree that if this had been around before my surgery in 2018, I probably would not have had or needed surgery but I also believe that it is HIGHLY effective for those who have had any regain after WLS. It gives a very similar feel to that first 90 day restriction.

To follow up, I did start HRT this summer and instead of gaining, I actually lost 7 lbs and my worse symptoms of menopause subsided but I quickly realized that any further weight loss was going to be really hard. My doctor prescribed Moujaro and is a big fan of it (who knew?). I started it right after I posted this thread and I'm already down 20 lbs. Holy smokes! The appetite suppression and restriction (yes, I do feel it much more now) is crazy. I relate it to the feeling I had about 90 days out from surgery. I can eat what I want but just not very much of it and I'm rarely hungry. I didn't expect to lose so much weight so fast and I really only want to lose another 10 lbs so I doubt I will hit the max Mounjaro dose. I'm currently on 5 mg with no side effects beyond nausea the day after my shot.

If this medication had been around when I had surgery, I don't know if I would have needed to have WLS but I am thankful it's here for me now. My doctor loves it to prevent recision surgery and regain in patients who are 36 months or longer out from their past surgery.

7 minutes ago, vsgchick said:

Hi! I was sleeved in 2014...original loss was 185 lbs. Regained 40 lbs during the pandemic. I started Saxenda in January of this year and lost 35 lbs. I moved to Mounjaro last week (off label, as I am not diabetic) because I was tired of Saxenda's daily injection. I don't view GLP-1s as a pouch reset, but they definitely help turn off the "food voice" in my head. I am on the beginning dose of Mounjaro, so haven't experienced the full power yet. I still have decent restriction, so capacity wasn't my problem. Slider foods/snacking caused my weight gain.

I know medication isn't for everyone, but I honestly believe GLP-1s should at least be mentioned to WLS patients dealing with regain. I see it as a 1-2 punch for me.

Thank you! I appreciate your response. I would love to hear more about your transition to Mounjaro as you take this journey. I really like how you phrase it as turning off the food voice in your head. My friends says the same thing. She calls it a reset, not because it actually shrinks her stomach but she seems more physically aware of her restriction again. Maybe it is because the emotional food voices are more quiet? I don't know but GLP-1's do seem like a great tool for previous WLS patients. Have you had any new side effects that you didn't have on Saxenda?

Thank you Sleeve_Me_Alone, yes, I have studied the medication and talked with my doctor. I understand how and why it works but I would love to hear more personal experiences with it especially from people who had previous WLS.

My friend has had mild side effects. She gets nauseous the day of and after her shot but she has learned to wear a sea sick patch which seems to fix that. She hasn't had any other side effects except for the one time she over ate. She said the result was the same as when she overate after surgery. It was awful. She hasn't done that again and she considers that a good side effect for her. I am hoping to find others who have experience too. It's a new medication so there may not be many. I'm currently on Metformin and will stay on that indefinitely so this was of interest to me but the costs are high. I Just thought I would ask. Thanks!

Hi everyone!

I have a friend who had WLS a decade ago and regained a bit of weight. She recently went on the new medication called Mounjaro to try and re-lose that weight. She has done very well but said the most amazing thing that she found was that it reset her pouch. She said the restriction is back like it was right after surgery. She is encouraging me to use this mediation to reset my pouch.

I have maintained my weightloss for the most part but with menopause, I've regained about 20 pounds, mostly in my lower tummy which is never where I used to carry weight. I do admit that with the years passing, my restriction isn't what it used to be but it's not gone. I was thinking of trying this but wondered if anyone else has tried it and what their experience has been?

Thanks!

FOREVER... for me, I start retaining Water and will gain a few pounds if I don't get in at least 65oz a day but I function best drinking more than 85oz and will lose that water weight taking in 100oz. But I count my Protein Drink, coffee, tea and water. If I have a glass of wine, I count that too but it is a small price to pay for feeling so good.

On 1/25/2020 at 3:02 PM, MarinaGirl said:

I had MGB in TJ in April 2017 and it resolved my acid reflux, which was very severe pre-op. Life was great, lost a lot of weight, but 10 months post-bypass I developed bile reflux. I knew it was this because I would throw up greenish-yellow liquid, and then it was confirmed via EGD, along with Barrett’s Esophagus. My gastroenterologist and PCP were unfamiliar with bile reflux and did not know how to treat it, no medicines they recommended helped, but I found a great out-of-state bariatric surgeon (who also specializes in complex revisions) who was able to treat me. In July 2018, he repaired a hiatal hernia and performed a Nissen Fundoplication on me and since then I’ve had zero acid or bile reflux issues, which have been confirmed via EGD (2 of them post-op). He considered revising me to RNY but during surgery he was able to do some magic so that I didn’t need that extra procedure.

And as the final step in my weight loss journey, I’m scheduled for plastic surgery in mid-Feb 2020.

Wow! I had no idea one could have a Nissen after an MGB. I had a Nissen and they took it down to do my MGB. I haven't really had any issues since but I've prepared myself for the potential of bile reflux. I thought a revision to full gastric bypass was the only option. I'm glad to hear this. I didn't know a Nissen would be effective for bile reflux since it creates tension at the esophagus and bile needs to be stopped before it enters the stomach.

Thank you for the info. Can you share which doctor did it?

On 11/20/2019 at 3:04 PM, Superman84 said:

What exactly is the difference between RNY and MGB?

With RNY, you bypass the stomach and reattach at two different places. With MGB, you bypass the stomach but reattach at only 1 place. There is less intestinal re-routing and it takes less time in the operating room. The MGB has much less chance for dumping and is generally safer. It does pose the risk of bile reflux but there are ways to help avoid or minimize that with the anti-reflux stitch and watching portion sizes. RNY has less chance of bile reflux but a greater chance of dumping.

There is no perfect surgery. You can get bile reflux after having a gallbladder out. It happens more than people realize but you don't see the medical profession against removing a gallbladder. I don't know why some won't recommend the MGB for that reason. Overall, it is a safer surgery than RNY.

I don't take Zantac, Ranitidine does not work for me. I do take Omezperole and it works well but I don't have to take it every day. Tums actually works the best when I need it.

Has anyone found a safe diuretic to take after surgery? I get awful bloat during my period and it is more noticeable since I've lost all my weight. It's actually uncomfortable. Perhaps, it was just as uncomfortable when I was much heavier but I didn't notice it. My fingers hurt and I can't wear my wedding ring. I'm nervous to try a Water pill because I don't know how my body and stomach will react to it. Has anyone found a positive solution that works but is safe for people who have had WLS??

I've always done that to some extent. I have had reflux for decades so drinking while I eat was a necessity to help move things down. I try not to but I usually have a few sips because it makes me feel like things don't get stuck. I wait only 15 minutes after a meal to drink. I've hit my goal and am doing great so it didn't seem to have any problems. I would talk to your doctor about it.

4 months out! salad is one of my favorite things. I counted the days until I could have one. It was about 4 months out and I chewed really, really well. I have had no problems. In fact. a huge salad is one of the few things I can eat in volume. It freaks me out how much salad or veggies I can eat in a sitting but I pretty much chew to the point of liquifying it so I get to really enjoy a lot of bites. I eat my salad first before my Protein because it takes up no space. Now I use feta cheese, greek olives, cucumbers, grape tomatoes and chickpeas on a nice bed of lettuce for a daily salad. I add chicken, shrimp or tri-tip for protein. I change up dressings to change the flavors but salad is one of my favorite meals now and one where I can enjoy quite a bit of it.

I didn't have sleeve surgery, I had MGB and I can eat anything now. BUT there is no way I could eat most of the stuff I can have now at 2.5 months out. It took me a good 6 months to work up to it. At 2.5 months, I was still on soft foods and slowly introducing more solids but it had to be solids that I could basically liquify with my chewing. I didn't tolerate a lot that wasn't liquid for awhile.

It takes time. It is really important that you give your pouch time to heal. I think you will prevent it from being so sensitive later down the road if you give it time to heal properly and not try to eat things it isn't ready for.

Listen to your body, and take it slow. Everyone has a different journey but your body will tell you when it is ready for something new.

On 5/31/2019 at 11:29 AM, NYCGAL000 said:

has anyone experienced by Bile reflux with the mini and if anyone can tell me your experiences with this surgery and if you lost a lot of weight with it, that would be great. I am scheduled to have it after having a sleeve a few years ago in a month. thanks!

Also if you can tell me any issues you have with foods that are hard to eat after the mini.

I had severe acid reflux before I had my mini. I had a hiatal hernia too. That was fixed and my mini was done last year. I have since lost 120 lbs. I don't have any acid reflux, none at all. I may have had one small episode of bile reflux last fall but I'm not sure. It didn't last but 10 minutes and went away with a few swigs of mylanta. I don't take any medication for reflux but I'm prepared to take Nexium if need be. They sell it pretty cheap at costco and I have a friend who gets bile reflux after she had her gallbladder out. She said Nexium works very well.

As for eating, I can eat anything. I don't dump, I don't crush pills. I just eat very small amounts of food 5 or 6 times a day and stay on my healthy diet. I had a small piece of cake at a wedding and a cadbury egg at Easter but I have lost my sweet tooth so I don't crave that stuff anymore. It was really satisfying to allow myself a treat and find that I didn't want to finish it all. I just was not interested. I really love meat, veggies and fruit. I drink a Protein Shake every morning. I use a straw daily. I take my chewable vitamins and so far I have no complains. This was the best decision I ever made.

My philosophy is that nothing is perfect. I can either deal with the health issues that come with being obese along with how uncomfortable I was and that I hated my appearance OR I can deal with the very few health issues that might come with WLS. So far, it is one episode of something (maybe bile reflux) and a lot of extra skin. I"m good with that trade off.

I hope that helps!

My doctor said it is ok to use a straw. He said there is zero scientific evidence that it has any ill effect. It won't stretch your pouch and there is no evidence that we take in more air than we should. He said zero, it is old, out-dated information.

I've been drinking from a straw all day every day since 2 weeks post-op. I have sensitive teeth and won't drink without one except for warm drinks. I'm down over 100 lbs. The straw has not hurt me and in fact, I get far more Fluid in each day when I use one. I struggle to get fluid in on days that I don't.

I have coffee daily. In fact, I only stayed with Decaf the first week. I drink 16 oz of coffee every morning. I mix in unflavored Protein collagen and a tablespoon of Creamer. I drink it 30 minutes after my Premier Protein drink in the morning. My doctor has no issues with it and my body is happier.

On 1/12/2019 at 5:28 AM, tawny said:

Hi Retty- curious how things are going for you a few months later? I’m 2 weeks post op and have all your same concerns about lack of restriction and weight loss...

It's pretty normal to not feel much restriction right after surgery. I freaked myself out with how much and how fast I could drink my fluids including Protein Drinks, Soups etc... at first. I didn't get much help during the pureed stage other than I went longer in between meals.

However, once I moved toward solids, the restriction was evident. Hang in there, you will find that particularly with meats, you will get full fast. At about 5 or 6 months when all the internal swelling has gone down, you will find a new level for restriction and be able to eat a little more in one setting but not a lot more. Now that I'm farther away from post op, I don't eat as often during the day. I have 3 meals and one snack plus my liquids. If I get hungry, I eat a spoon of Peanut Butter and I'm good for a few more hours.

With weight loss, I lost a lot the first week and stalled for several weeks after surgery. Everyone is different but I tend to lose for 2 or 3 weeks and stall for a week or two and repeat. I'm down almost 100 lbs so the surgery did work. You'll find your own losing pattern and it will become predictable for you, just stick with the program.

2 hours ago, ummyasmin said:

It's a cure for acid reflux but there are some studies which suggest you may be susceptible to bile reflux instead. My surgeon has me on omeprazole for life because of that. But it cured my acid reflux.

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So far, I'm still having great results. It was my understanding that it is a cure for acid reflux as it does bypass the stomach. The only difference is that you can develop bile reflux. I haven't yet and definitely keep an eye on it and so far so good. It is one of my worries but I felt it was worth the risk because there were too many risks with a full bypass. Does Omeprazole help with bile reflux? Should I ever develop it, I'd rather just take that than have a revision. I thought one of the ways you could tell the difference between acid reflux and bile reflux is that bile reflux does not respond to PPI's or antacids like acid reflux does. Do you know if there is any truth to that?

@MarinaGirl That's a bummer. I hope your revision to full bypass helps you. Did you have the same surgeon do both or a different one and who did you use for the MGB?

@MarinaGirl Did you get the anti-reflux stitch done to prevent the bile reflux? To my knowledge, only a few surgeons do it. I know that bile reflux is a known risk of MGB but the new stitch procedure is supposed to prevent that. This was one of my concerns when I had the surgery. I had the stitch done. I wasn't going to have the MGB without it. So far, it works but there's no guarantee it works long term.

I would love to know if you also had the stitch done and how long after your MGB did you develop the bile reflux?

Not at all but I agree that it's hard to compare unless you have had both. However, I've been completely pleased with my MGB and surprised at how quickly I recovered.

I start my day with a Premier Protein drink. If I don't, I struggle to get all my Protein in. I just can't eat enough to do it. I follow that up mid-morning with a boiled egg or greek yogurt, sometimes hummus and cucumber slices. I have coffee 30 minutes after breakfast.

My pouch is like Iron. I seem to tolerate everything so my choices are limitless but I definitely feel restriction so my portions are small. I don't want to stretch my pouch out so I tend to eat 5 or 6 very small meals a day. I always eat protein first, always. If I don't, then I can eat more food which is not good. Protein fills me up to the point that I often can't eat anything I paired with it.

If I get scared that I might have stretched my pouch out then I do a liquid only day the next day and that seems to reset it and help me feel the restriction. I've only over eaten twice and felt miserable both times. Tight chest, painful stomach and felt like the food was overflowing in my stomach back up my esophagus. It was awful.

That's still quite a large breakfast. I had surgery 4/27/2018 and the most I can eat for breakfast would be 1 boiled egg and a taste of avocado. I might be able to eat 1.5 boiled eggs but I think I would feel sick at this point. I'm surprised that you can eat 2 eggs AND avocado on a toast cracker especially only being 12 weeks out from surgery. For me, it would be either the eggs or avocado cracker but not both. However, I don't eat bread/crackers/cereal because they are slider foods. I don't have any problem eating them but there isn't any nutritional value to them so I avoid plus I tend to want to drink after a starch to wash it down and that just defeats the purpose of my surgery.

I would probably still eliminate the cracker part since it's basically bread which is still a slider. You mentioned you have a mug of coffee? Do you take that with your breakfast? If you are drinking with meals, even just a little bit, that could be a big reason that you aren't feeling restriction and are able to eat more.

I agree N0VA, if you get where you want to be, it doesn't matter. I just find it interesting that so many doctors don't recommend it or perform it. It just seems like such a viable option. Lots of sleeves get converted so I don't understand why they don't just recommend it in the first place. Personally, I don't know many people that have had it. I have met a lot of full bypass patients and sleeve patients. I rarely meet an MGB person.

Why don't more people get the MGB? I had mine on April 27th and it has gone so smoothly that I often forget I have it. My friend has a different surgeon and he is resistant saying that there are more complications and risk of reflux. However, they are bypassing the stomach so there can't be gastric reflux and there is a technique or stitch that they can do to prevent or minimize the risk of bile reflux. It seems with only 1 connection that the risks are smaller. Why do so many surgeons not offer this. I absolutely love mine!

My recovery has been great and so far I've lost over 60 pounds and that includes a 3 week stall. I absolutely feel restriction which is great and what I want. I do feel hungry and sometimes starving but I can eat a snack like a boiled egg and then I'm satisfied and full for hours. I don't dump and have no heartburn or reflux. I know my surgeon did the stitch to prevent bile reflux and so far it works. It seems that I can eat anything but just in smaller portion sizes. I only count Fluid and Protein. I stopped counting calories because it is a real effort to exceed 1000 at this point. Maybe because my favorite things are tri-tip steak and salad or scallops and veggies. When we eat out, I've learned to order al a carte or just bring home the leftovers for another meal or two. Most important is that I don't dump. That really terrified me. I can eat sweets but I've found that I have no interest in them anymore. One bite is all I need and I'm done. I had a small piece of cake at my niece's wedding and I didn't get sick but I didn't want more either. It was nice for a celebration.

Is my experience unique? I still have 50 lbs to lose and at some point I know it will slow and be more difficult but isn't it that way with all WLS methods? Why aren't there more MGB patients?