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This article changed my whole outlook, I hope it is insightful for you. Long but worth reading! I am working with a coaching client who had put on about 30 extra pounds since reaching her I am working weight-loss- surgery goal. One of the actions she chose to take to begin to work on her problem was recording what she was eating. After two weeks of setting that goal and not meeting it, I suggested she explore what else might work for her. "But I want to record what I eat!" she said. "I'm just too embarrassed to write it down and share it with you." I assured her she was going to be sharing this information with someone who well understood her problem, someone who had been battling the food demon her whole life, as well. "Okay, so if I take my embarrassment out of the equation," she reasoned, "I'm still left with not wanting to admit what I'm eating. I don't want to give up the foods I love. I want to eat them anytime I want!" In the next breath she blurted out, "Why is it so hard to stop eating? I want to be thin. I don't want to go back to not being able to get out of a chair!" Eating anything you want, whenever you want, is not freedom. If you really think about it, eating with free abandon does not feel like freedom for people who struggle with compulsive eating. In fact, being a prisoner to food thoughts and mindless eating 24/7 can be miserable. Trapped by cravings and food thoughts, a person will conduct their daily business and make their daily decisions based on the eating they want to do. "I can't go to the play tonight," you might say. "I am not feeling well. I think I'm coming down with something." But, what you are thinking may be, "I want to eat the rest of the bread I bought today. With butter! But, I'll have to pace myself. It will take me all evening to eat it." Does this scenario paint a picture of a person who is experiencing freedom? Or does the bread have then trapped? After weight loss surgery, many people get into the habit of grazing, or eating small amounts frequently. That's what my client was doing. She mistakenly believed grazing was a way to be free from the shackles of dieting and food plans. And she hated diets and food plans! Unstructured eating, however, can quickly lead to eating unhealthy foods in unhealthy portions. (Yes, even if you tell yourself you'll never go back to the unhealthy foods you used to eat.) A rebelliousness exists inside most overeaters, and they don't want to give up their freedom to choose what to eat and when. Step back, though and give yourself the "Dr. Phil" treatment. Ask yourself, "And how well is my rebellious attitude working for me? It's time to live in the solution. Many people who struggle with their weight never lose obsessive thoughts about food, but that's partly because they are not living in the solution. The people who are the most successful at breaking free from the burden of unhealthy eating, have transitioned from being rebellious (reactive) to responsible (proactive). They spend some time planning. They establish a routine with boundaries around their eating, so that they don't get carried away. Ironically, when you add some structure to your eating by making a food plan for the day, an amazing sense of freedom can set in - freedom FROM compulsive eating. So, if you're struggling with obsessive food thoughts and overeating, make a food plan today. Write it down and refer to it often. Give yourself the gift of one day of freedom from overeating. Oh, and the "rebellious" client I've been working with has lost 6 pounds already. She told me, "I'm amazed at how much less I obsess about food now that I make my plan every morning. I just write down what I'm going to eat for the day, and then I go live my life." Want to Reprint this Newsletter? If you'd like to reprint any part of this newsletter, do so with the following credit: From Small Bites, the email newsletter for the National Association for Weight Loss Surgery. Inc. All rights reserved.

Early on I had 'meat sweats' a few times right after eating, and the dizziness and would need to lie down. It's sounds like reactive hypoglycemia https://www.google.com/url?sa=t&source=web&rct=j&url=http://www.eigerbio.com/resources/Goldfine-2016.pdf&ved=2ahUKEwj12ZTU94niAhUNvKwKHU2qAx8QFjASegQICBAB&usg=AOvVaw3_1GW7msGkeuZlxOShhfXR

I have hypo thyroids and I'm trying to figure out would it help me or just be a waste of time?

Hi Coops, Well, here is what I would try if you are interested, and remember, it's never too late and I believe you can do it. Let us know how you do. Good luck! Kickstart yourself with 2 or 3 days of just liquid Protein shakes. I found this sort of "reactivates" my sleeve and gets my head back on. It's hard to do after eating somewhat normally, but it does get the restriction fired up again (at least for me). Start writing everything down again - MFP or other Measure your food. I have started eyeballing things, not a great habit to get into... Get that Water in! 64 oz minimum, you know the drill. The same old routine: firm protein first, then vegs, then carbs. Plan out your exercise regime. Maybe split your time between cardio and strength training. Cardio will burn fat, strength training will build muscle, which will raise your metabolic rate over time.

dumping syndrome is pretty rare with sleeve, but it does happen to some people. However, it occurs very shortly after eating - like within an hour or so (usually less), so yours might be something else. Reactive hypoglycemia (sometimes called "late dumping") happens to some people who've had bypass - not sure about sleeve. Similar symptoms (well, the rapid heart rate, anyway - and dizziness), but that happens two or three hours after eating a bunch of sugar - but that doesn't sound like what you have, either. Not sure what's going on. Maybe you should check with your bariatric clinic and see if they know what might be causing it. I'm wondering if maybe you've developed an intolerance to certain foods or something (??).

I just had the most aggressive phone call with my surgeon, Dr. Cirangle. I had my sleeve done Monday (5 days ago) and left the hospital on Tuesday. I was given liquid pain meds (hydrocodone-something) - and it was prescribed as 10-25ml every 4-6 hours. I was taking the meds on a reactive basis and on Weds, the IV drugs clearly left my system and I was in horrible horrible pain. I called his office, his physician's asst. almost scolded me for not taking the pain meds as subscribed and that I should take them regularly every 4 hours if I was in that much pain.... BEFORE I got pain. So I did. Exactly as told and as it was prescribed on the bottle. I took my last dose this morning around 4 AM and my husband went to the pharmacy to get the refill. They said they couldn't refill it until Monday. So I called the Dr. Cirangle and was berated and told that I was taking too much and that I shouldn't even be in pain 5 days post op. I did the math. 1 pint = 473ml Prescription called for 25 ml every 4-6 hours. 473ml/25ml = 19 doses 24 hours a day/4 hours = 6 times a day I should take the meds 19 doses, 6 times a day = the medicine should last me for 3.16666 days. I'm on day 5. He said it was supposed to last for 10 days. Am I missing something??? And at day 5 should I not be having sharp pains where I can't stand up, roll over, or bend over? (He says no.) I have discoloration/brusing like color around the area that I have the pain. No where else do I have this discoloration. I'm supposed to have a follow up this week. AND I never want to see him again. I feel so violated after being so vulnerable to trust and be open to him only to be screamed at and told to "stop being so dramatic." Feeling totally alone and so upset. There's one thing to not have bed-side manners... it's another thing to be a complete asshole to your patients who are reaching out to you for help.

I never had any heartburn/stomach acid issues... until I had my sleeve done in July. Once I allowed my omeprazole prescription to lapse (I didn't want to stay on it long term due to potentially serious long-term complications from the drug), oh boy... I was miserable. Heartburn, that awful taste of bile if I 'threw up in my mouth', I was having serious second thoughts. It was especially exacerbated by late-night eating or fried, fatty, or dairy foods. Rather than go back on a PPI immediately, I first asked my doctor about alternatives to PPIs, and they suggested I try out Pepsid AC 1-2 times a day (once daily plus one additional proactively/reactively depending on a meal in question). It's actually made a huge difference. If I feel heartburn coming on or I'm about to have a spicy/fatty meal, I pop one (not exceeding 2x per day), and within 15 minutes or so all is well. It's been 2.5 months off PPIs and I'm surviving. Being one that historically has indulged heavily in both very spicy and fried foods, it's definitely a struggle to rein in those impulses... Keep in mind that h2 blockers like Pepcid don't decrease stomach acid production as much as PPIs do, so depending on your individual situation, Pepcid might not be effective. As always, consult with your physician, but there are options for controlling stomach acid, not to mention dietary changes.

This is Reactive Hypoglycemia. I have the same experience as well with the same symptoms you have experienced. I have been dealing with this since the 18mo mark from my Sleeve surgery. I'm at the 5 yr mark and still experience it. Do some reading on this. I also spoke with the Diabetic Dietician about this as she was well versed on this issue. The solution is to eat 15 grams of carbohydrate that is easily digested and your symptoms will subside. After that, follow with protein. I now carry the glucose tablets with me just in case. Sometimes I feel like it comes out of no where now that I'm better at navigating this. Good luck, it can be very frustrating.

My webpage documents my first year out only. }Have you gain any weight at all even if you manage to lose it in the 7 years? Oh boy! It is incredibly easy to gain weight. At one point, I was up 27 lbs! I worked really hard and lost it. Right now I'm up 8 lbs so I'm back to working it off again. It's way harder to lose now {Have you gotten preggo during the 7 years? No {Can you eat more then ever or do you limit your food intake? I can eat a lot if left to my own devices. I still need to use journalling to keep the weight off and to lose. I have to account for every bite. It's too easy to eat mindlessly. That's what gets me in trouble. {Do you exercise? I am extremely active. Mostly walking. 3 miles is a slow exercise day for me. {Have you had any plastic surgery? None. I've lost 140 lbs or so. I've learned to live with my wrinkles. I'm 42. {How do you feel now compare to 7 years ago body wise health wise mentally physically? Physically awesome. Health is awesome. I have some issues like osteopenia, reactive hypoglycemia and anemia but they are easily managed. To not get out of breath by simple tasks, to shop in normal stores, etc is wonderful. Body image is totally screwed up Dawn

Now I know it's true!! :faint: I have a friend that told me a similar thing and I didn't want to believe, but when I would have to resubmit or call several times b/c the insurance company said they didn't have the info, it did raise my curiosity. Like I said in an earlier post, I feel like I have to fight to get my honest claims paid and paid in a timely manner in which does not affect my credit rating. This attitude that so many of us have experienced, shows that consumers are forced into a reactive mode instead of being proactive in most cases. It's no wonder some people feel it necessary to put quarters or sand in their pockets. They are just playing the game that insurance companies create. I'm not condoning these actions and hope that I'm never in a position to choose. What if one of my children needed a life-saving procedure? You can bet the house, barn, AND the land that insurance would have everything they needed to approve any such issue regarding my family. I would walk on Water with the help of the Lord if I had to. Bottom line.....insurance companies hold too much power to determine our health care. The sad truth is that some of these people that make final decisions are not properly trained in EVERY field that they are covering. This is wrong and should be fixed. Anyone have any ideas?

I've been reading that reactive hypoglycemia is pretty common for WLS patients that are 18+ months out. I've been having episodes of it and finding that I need to eat more frequent meals and a snack before bed. I have it when I'm sleeping and wake up with horrible night sweats.

You will probably need to reduce your meds as your weight comes down so best see your GP and discuss! Might be you can step down to just the metformin initially which should not cause hypos.

Hi Everyone, Love the posts, I too have hypo and am on levothyroxine. I am very curious about the Armour and will ask my doctor. I'm scheduled for my surgery on the 26th, can't wait. Finally, some help! It's comforting to hear other's stories ... Serifa

I'm not trying to play devil's advocate per se. Is he more reactive with other things? I could do the most amazing thing and my DH would only notice if it involved the very small world of things he pays close attention to. If there's something I particulary want him to notice, or I particulary need a compliment, his "usual self" might hurt that much more, and I might feel like he's purposefully ignoring it. Especially when to me, it might be the center of my universe, and to him, it just isn't something that really matters. (I tend to think much more like a man than a woman, so I just want to offer up another perspective.) That said, lots of insecurities come and go with relationships, including relationships where some significant physical change happens. I don't have enough hands, fingers, toes or hairs on my head to count the marriages I've seen end over what seems like a physical change, but in 100% of those cases there has been something else going on. (Hmm, kinda like obesity, no?) Even secure marriages will still ask, "What if?" Have you talked to him about it? What did he say?

Thanks everyone. I went to PCP today and I am Hypo. I start on meds tomorrow morning. I have psychologist appt 12/1 and surgeon 12/6. Really hoping this doesn't prolong surgery. Sent from my Z988 using the BariatricPal App

I'm looking into having the lapband surgery next month and am wondering from most of you out there, is it really worth it and will I be happy with the results? I've finally convinced my husband to let me have the surgery. I've lost some weight on my own, but can't seem to get the rest off! It's been 2 years and I'm slowing creeping back up. I need to lose about 80 pounds and have tried everything. The doctor finally said that he would do it. I have hypo thyroid, so my metabolism is very sluggish...I just look at food and gain, if you know what I mean. Will I throw up alot? There are just so many questions. Please advise. Thanks so much, Luisana

I've checked a few sites, and vomiting/nausea isn't listed for reactive hypoglycemia. It's more dizziness, weakness, palpitations... You should probably get that checked out regardless. I'm not sure what's going on - but even if they end up suspecting hypoglycemia after all, it'll still be a good idea to get it checked out. edited to add that I did just see a reference to nausea as a symptom, but that's to the hypoglycemia that diabetic patients sometimes get. Reactive hypoglycemia (RH), that some RNY patients get after the first year or two post-surgery (and it's usually NOT related to diabetes), sounds like it's a little different. Are you diabetic? I think you should probably contact your PCP so they can do a workup. Something isn't right. Plus the RH that RNY patients get is a reaction to sugar. It's sometimes called "late dumping", although it's actually reactive hypoglycemia rather than true dumping. But you said you don't eat sugar. That's why I'm thinking there's something else going on here...

I consider myself an expert when it comes to autoimmune rheumatic diseases. First- let's talk your prednisone: See an endocrinologist. Pronto. I was taking 60 mg of pred a day for years. There was no weaning off, because any time I got down to 20-25mg, I literally could not function. In any capacity. Enter the endocrinologist. Because the prednisone does just as much (if not more!) damage than good, my adrenal function was gone, I had prednisone induced glaucoma as well as prednisone induced diabetes. I needed off the meds ASAP. She prescribed me ORAL hydrocortisone. It mimics- and tricks- your body into believing it is prednisone, and is MUCH easier to wean off of than the prednisone. It took a total of 2.5 months vs over a year or longer if it were the prednisone. Do this. Again, ASAP. Ask for it. Second- methotrexate, either by pill or injection: pills made me sick, puking, typical chemo side effects. The shots did not, and they actually work much more effectively than the pills, so if given a choice, it is a once a week teeny tiny needle. Side effects- don't bother paying attention to them. The benefits far outweigh any possible adverse effects. You will need regular blood work to monitor your liver enzymes. Again, I have been on a very high dosage, so mine were often screwy. Third: I can't imagine any surgeon doing WLS or ANY elective surgery while you are on either of these meds. I had to "wash out" before I could have my surgery, meaning get all traces of the meds out of my blood system and stored reserves. Both drugs make you more susceptible to infection and the prednisone especially makes healing hard. And keeps weight on. Again- seeing an endocrinologist will get you off the pred by using oral hydrocortisone pills. Usually PMR goes away after a year or so. I wonder if you don't have true rheumatoid arthritis? The tests- a sed rate and C-reactive Protein screen are used for PMR as well as other autoimmune arthritis diagnosis. Just a thought. So- don't worry about side effects of the methotrexate and get off the pred!!! Sent from my iPhone using the BariatricPal App Hi am just seeing this now. Thank you for responding. I did get off prednisone about 8 months ago. But it started to come back and about 2 months later I couldn't take it and went back on. My rheumatologist says cut down till I feel pain. Then start methotrexate. Shots. So I can continue to get off prednisone. I did have all the testing done. They did suspect fibromyalgia ms. Lupus RA etc Till all tests were done. I will look into seeing an endocrinologist. I did tell the dr about prednisone. He said it was fine and I may lose slower. I am now 9 weeks out and lost 20 pounds. 10 more the week before surgery. I was "only" 201 day of surgery. I would like to lose faster but. I really want to get off the prednisone. Thank you and why doesn't my rheumatologist k ow about this? Sent from my iPhone using the BariatricPal App

Hi Jen: Are you seeing a Rheumatologist? If not you might want to consult one to help with a diagnosis. I went to doctors or 14 years, most of them told me that my symptoms were all in my head. It wasn't till I sat down one day and wrote down everything I though was a symptom and when I was done I had 2 sides of a piece of paper. I went and saw a new Rhematologist and gave him the paper with the symptoms, he spent an hour and a half with me going over everything and then sent me for a million x-rays and tons of blood work and some other tests. He had told me he thought I had reactive arthritis. I went home and looked it up and thought hum, that doesn't sound too bad. When he got my results he told me I have Ankylosing Spondylitis! I said what the HELL is that I can't even pronounce that. It is also a form of arthritis and is an autoimmune disease with no known cure. I also have a secondary diagnosis of rheumatoid arthritis , along with Fibromyalgia. He is constantly testing me though for Lupus, that's what they thought I might have in the beginning, but it is hard to diagnos. Don't give up on a diagnosis, only you know your body and you need to keep pressing the doctors for a diagnosis, not just arthritis of unknown origin. I am pre-op right now, but will be getting sleeved in July. My doctors say it should help with some of the issues I have. Also when you have one autoimmune disease, it is possible to have more than one of them. I hope you get a clear diagnosis in the near future it will help put your mind at ease when you have a name to what is causing you so much troiuble. Sorry for the long post....Jill

I suffer from hypothyroidism which was never there untill the birth of my daughter. Since then its been a struggle for me and weight which prior I had zero issues with. I'm concern how my hypo will play out with me losing weight after VSG. from the few people in other networks I've heard their meds have decreased, and they seem at least some to lose weight at a slower rate, than someone without hypo. Would love any who has hypo and had wls to please give me some insight thank-you and GOOD MORNING TO ALL LET TODAY BE A PRODUCTIVE SUPPORTIVE DAY!

Hi, pretty Juli - Thanks for your response. I should know better than to make ambiguous, melodramatic statements like I did, as if everyone here knows my story. Let me explain a bit. I hope this doesn't come across as defensive or even more melodramatic! I moved home from FL eight years ago, which was 6 months after my Dad's heart attack. He had heart bypass surgery just a few months after I moved to Columbus. Since that time, I've witnessed my precious Dad be diagnosed with one obesity-related disease after another, and observe as he suffers through each day and is hospitalized about once per month. My Dad has heart disease, type-2 diabetes, inflammed/fatty liver, obstructive sleep apnea, congestive heart failure, hypertension, high cholesterol, and depression/anxiety. My Dad is only 61 years old. As for me, my body has already failed me once. I have (had?!) Graves Disease, which is autoimmune hyperthryoidism (dx Nov 2002.) I went through three years of roller-coaster riding on meds (cycling back and forth between hyper and hypo, with occassional moments of bliss in a 'euthyroid'/normal state.) When I started to experience the eye symptoms that often accompany Graves (e.g., they started to bug out of my head), I elected to have a total thyroidectomy. Well, it's a good thing I had the surgery because there were two little secret microcarcinomas that only God knew were there. I had thyroid cancer, but it was stage 1 and the thyroidectomy is the treatment for that. Thyroid disease has been a real strike against me in the weight management department. I've gained about 10# every year since I was first diagnosed with Graves. I can very clearly see my future in my Father's struggles. I have hypertension, anxiety/depression, high cholesterol, and a fatty liver already... and as of last week I have added obstructive sleep apnea to my resume'. I don't want to have to continue living with this burden... with this daily fear of what comes next for me health-wise. I am only 38 years old, and I long to be as active -- and as 'at peace' with my health -- as I was before Graves. (I ran a 5k race every weekend when I lived in Orlando!) I view the LB as the tool that will help me to regain my health and avoid 'the family curse.' I don't feel like I'm viewing it as 'the diet of the month,' but I'll talk to my LB program psychologist about that just in case. I know that life will always throw me curve balls, like you said. I long for the day when I can confront them without the added burden of being 'a sick person.' Thanks again for your response and for the opportunity to explain my melodramatic statements a little better. Y'all will probably be hearing a lot more from me in the weeks to come. I've failed my first month of the pre-op program miserably, but I'm renewing my focus now and 'using my resources' to stay focused. I really think/hope that starting to use the CPAP machine will help improve my frame of mind and this dark spiral of anxiety/depression that I've found myself in lately. :thumbup:

Nothing as severe as yours but I get horrible hypoglycaemia when I eat carbs/sugar. But it’s addictive and the world is full of it so October succumb - sometimes accidentally but often just through weariness! Anyhoo - for me low carb works. If I’m eating Keto I’m fine apart from cramps and palpitations. banana’s definitely spike my sugar and set off cravings - I try to stick to berries and yogurt. hope you get some help with this - hypo can be terrifying and feeling ill all the time is what we wanted to leave behind!!!

In previous posts I had mentioned being sick and feeling like garbage since November when I had the flu. I found out from my gyn that I most likely had H1N1 and some E virus. I couldn't remember what the "E" Virus was to look it up when I got home. To make a long story short I was searching Mono for a student today. While reading about it I found its medical name. You may already know it, but yes it is the mystery "E" Virus that my GYN said was acting up on me again. Okay, so I get it now. The swine flu causes lung and tummy problems, cold chills and fevers that last for weeks. The mono reactivated itself and caused even more fatigue and muscle weakness. My iron was never anemically low. I was just down from the Mono. If you have ever had mono you know there is no way for your body to be able to burn fat and now way to survive on just a few hundred calories a day when you are that sick. My cravings were truly from the food being needed to heal my body. I posted on face book and twitter a couple of weeks that I felt like I could run five miles. That was the first time I felt normally since Thanksgiving. At this point I am just glad to understand what my body has been going through and why I have stopped loosing weight As always to read more you will need to go to my blog. http://tinkrisegrind.blogspot.com/2013/02/the-long-winter.html

I've read some posts about folks dealing with reactive hypoglycemia at about 1 year + out. Im a little over a year out and now struggling with it. Ive read several links explaining what it exactly is. What I'm asking with this post is what are some of your personal remedy foods and emergency Snacks? I could use some ideas. Protein pairing seems to be key.

I just went to my 6 month post op, and the NUT talked about reactive hypoglycemia. She said is is common among sleevers, and the symptoms are similar to dumping syndrome. What happens is that we eat more sugar/carbs than we are used to, and then our bodies respond by releasing extra insulin. For some reason, the body will release way more than needed, and then low blood suger happens. shakes, sweating, diarrhea, and light-headedness are some of the symptoms. Sounds like that's what happened.