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I have reactive hypoglycemia also. It is true that each surgeon/office will have their own ways of doing things. You're comment: "portion sice and calories ect and there reply was as long as I stick to the bariactric place then calories and portion size will never be an issue" - I submit there will be an issue. You can pile that plate and still are getting too many ounces of food. I can say right now, we have veggies only rather than fruit (carbs) and veggies and salad. Carbs, we don't have that, we have fruit. There's one issue I can see. The only carbs we get are in the fruit and we are to go for low calorie fruit (meaning not bananas or grapes). Berries are what they discuss.

1. Iv been eating like this for about 6 months now. 2. 5 foot 11inch (180cm) male. 3. The only thing I do suffer from is reactive hypoglycemia which means when I eat cars my body produces to much insulin and my sugar levels drop very low that's why I try to avoid cars. When I spoke to the hospital last I was talking to them about portion sice and calories ect and there reply was as long as I stick to the bariactric place then calories and portion size will never be an issue

I was told 80 grams of mozzarella a day was OK that's why I split it over 2 meals and I was having home made air fryed chips instead of the seafood sticks but I suffer from reactive hypoglycemia so I tent to avoid potato as much as I can and switched to seafood sticks and the advice I was given from the hospital also was a boiled egg is a perfect snack between meals

Aww, thanks! I'm glad it helped! It is amazing at how sensitive and reactive our tummies are post-op. They definitely have opinions! How are you feeling now with another week having passed? Early out things can change so quickly looking back on it but in the moment feel like they take forever. I blame it on the "drinking water like it is your only job" thing, the day seems to stretch on sooo long when you have 64oz worth of baby sips to take! 🤣

TL/DR: Worried about losing weight by not eating enough. | Looking for tips to reach protein/calorie goals when not hungry. | Looking for others' experiences with lack of hunger this far out in WL Journey. ------------------------- I meet with my nutritionist for check-ins about every 3 months. For this last one, my 9-month, she told me not to be upset if I hadn't lost, as a stall was expected. Yet, I had lost just as much as I had been. We went over what I had been eating & she wasn't concerned about content but suggested increasing variety. [I'm a meal repeater 🤷‍♀️] Though, she again warned me that it is now especially likely that I would stall since I hadn't yet. Since that appointment, I've still been losing weight. I know it might appear strange to worry about meeting the goals we are here to meet, but my nutritionist is big on trying to relearn the natural cues of the body. So, as they are absent, you can notice pressure in your stomach, sighing, or a runny nose as indications of fullness. As indications of hunger return, you can utilize them to increase portions within the parameters of slow eating and not exceeding controlled sizes. The thing is, I don't know that the initial increase after, you know, the literal wounds healed, I have really expanded much more. I don't really get hungry until 'early-bird dinner' time. So eating during the day is purely done out of obligation. [& if I'm being truthful, there are times when I forget entirely until after work.] So obviously, that leads me to try to have all of my calories in one 'meal' in the day, which I have to eat over a couple hours [even if it is small] if I don't want to get nauseous or actually regurgitate. [The regurgitation has improved slightly over the last couple of months. I had a very reactive stomach that required me to prolong my dependence on protein shakes. Pre-surgery, I don't think I came even close to needing to vomit since pre-school 🙁.] To be fully upfront, I have not counted a single macro or calorie or weighed a single food item during my entire journey. I've tried tracking before in my weight-loss journey, and it was not healthy mentally for me. I realize that I may be under goals rather than over them, but straightforward counting of calories is just not something that would be part of a successful journey for me. So, all of this is a longwinded way to say: - Is anyone else struggling to eat enough this far out? - What helps you to reach your protein/calorie goals when you don't really want to eat? - Any other tips/tricks/specific brand or meal suggestions?

Have they tested you to see if you are having issues with reactive hypoglycemia? This usually kicks in 1-4 hours after a meal, but since you've had a bypass it is possible it could kick in faster for you if your food is transitioning faster. I've seen FB groups for bariatric patients that have this issue. I've noticed it often happens years out from surgery... I used to have issues with this before bariatric surgery, even on a low carb diet. Eating small meals often with fat and protein paired with your carbs is usually what they advise to treat it, along with other dietary adjustments. Personally if I don't eat every 2-3 hours, I aggressively crash energy wise. It is very pronounced. I have to carry snacks with me everywhere to prevent me going past that 3 hour mark or I look like the Energizer Bunny without his battery! LOL

Following up with a GP is good for general health, but following up with your bariatric surgeon is crucial if you are still having complications from bypass. There are a number of things that can be causing your symptoms, some that can be easily corrected by procedures during an endoscopy. As far as the blood spike, do you mean your blood sugar? Some people that have bypass can develop reactive hypoglycemia which can definitely make your blood sugar levels bounce around and cause fatigue and such. I'm sorry you are feeling bad!

Check your blood sugar when this happens. This sounds like what happens to me and it is reactive hypoglycemia and happens if I eat too many fast digesting carbs. My glucose will go into the 50’s and I need to eat 5- 10g or so fast acting carbs to raise it back again. (But not too many or it will keep swinging) This is something I have developed since having sleeve surgery over 10 years ago and the only way to control it is with diet and not eating high sugary volume of stuff.

There is a good reason to avoid the RNY revision if you can - the reactive hypoglycemia and marginal ulcer (and all of the medical care limitations that stem from it) issues, but it's not the end of the world, either if that's what you need. It's a common procedure that's been done in one form or another for 140 years, so its quirks and features are well known (but I would rather avoid its quirks if I can). I would certainly get a second, and even third, opinion on it, as while the sleeve is a fairly straightforward procedure most to do these days, repairing one that isn't working correctly is not necessarily so. Most bariatric surgeons started out with the bypass, so that is their comfort zone and they often prefer to go back to the familiar when things get a bit complicated, while there are some who have gone deeper into the sleeve and specialized in it and related procedures, such as the DS, and they are more comfortable doing things that others wouldn't do. We sometimes hear on these forums that "you can't do a Nissen (fundoplication) on a sleeve as there isn't any fundus left (well, not much) yet there are some who routinely perform them. Between that and meshing, there are options, and an RNY doesn't necessarily fix the potential recurring problem, as it, too, yield a small stomach pouch that is subject to herniating. If possible, for a second opinion, I would seek out a surgeon who does the DS (duodenal switch) as that is a good proxy for one who is well experienced with dealing with sleeves, and is more comfortable with more complex procedures as well. If they recommend an RNY revision, too, then that's a pretty solid confirmation of what's appropriate for your specific case.

Gold and silver are softer and therefore more porous on a microscopic level, and can "pit", meaning bacteria or other irritants can cling to them. They can also flake off into the open wound, and are more reactive with body fluids. They're generally fine for a healed piercing (which can take a few weeks to several months depending on what kind of piercing it is), but because they're not as hard and non-reactive as something like surgical steel or titanium. I worked, unfortunately, at a Claire's in a mall for several years when I was in college, and I know that stores like that push gold as being "safer" when really it is "more profitable". I had nothing but problems with piercings done in gold with a piercing gun. I have since gotten SEVERAL more piercings done with a single-use hollow needle at a piercing parlor, and have had none of the same issues. The right establishment should almost feel like a medical office.

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!!!

We had Chinese about a month ago, or so. I had Hunan Chicken with steamed rice and Chicken Lo Mein. I did not eat the fortune cookies. I didn't dump. But, I took very small amounts and, like you, I definitely stopped before I was full. I don't dump, but I do get reactive hypoglycemia. So, if I'm going to eat something high in carbs, I know that I'm going to have to eat something low carb and high protein within 2 hours, or my blood sugar will crash.

It’s a symptom of ‘mild dumping’ you have experienced I think. I experienced this a lot in the first few weeks and especially as you begin to learn what foods your new tummy likes and what it dislikes rather loudly too. I’d say it’s due to the advocado most likely. Swap to say a very soft poached egg instead. Try adding advocado in a few days to see if it settles better next time. Just because it didn’t quite settle today means your tantrum provoking baby tummy wasn’t quite liking what you fed it but that’s not to say it will not like it in a few days or in a week or a month for example. new tummy means many foods may cause this slight ‘hypo’ feeling even though you may have eaten these foods prior to surgery with no problems. your tummy is new. Brand new like a babies tummy - yet to try food for the first time. Like some babies will vomit, nappy soils a plenty, be colicky or dislike the food - your tummy should be considered like the babies. this feeling you have described is exactly what we all experience. Dumping is like a blood sugar hypo - in bed sweating / cold / shivering / sometimes with loo trips and vomiting and tummy pain but sometimes not. it can last for mere minutes to 5 hours and nearly always zonks you so groggily that you need to sleep. Energy drain and lethargy is instant. This doesn’t mean you’ll have extra sensitivity to dumping either - it’s literally your new tummy telling you it didn’t quite like what you ate. I hope this info and my experience helps you feel reassured. ❤️🥰

I had bypass and I dump on sugars mostly. I agree with the above posters. I have an early warning system of seeing halos and then spots before my eyes. I find it helpful to get protein quickly to cut the sugar reaction. It happens 15-45 minutes after eating the offensive food. I’ve also had a delayed sugar reactive episode from eating a cup of ramen. It was 2 hours later and felt like dumping. Basically, your body will tell you what you need and what to avoid.

Best of luck with your revision surgery! I did the same thing for the same reasons a year ago. My biggest issue was a hiatal hernia that had caused great pain and difficulty eating. I also had pretty bad reflux. It seemed like recovery was about the same the second time around, although I was seven years older. I did not lose as much weight after the bypass, but probably because I didn't have nearly as much to lose. As has been said, be careful to chew thoroughly and you still might find some foods that cause you challenges for a while. Just go slowly and if something causes issues wait a while before trying it again. The pouch does react differently than the sleeve and it takes a while to learn how to deal with it. Two things that you may or may not experience after the bypass are dumping syndrome (your body reacting to sugars) or reactive hypoglycemia or late dumping (your body overproducing insulin in response to a meal). I was lucky not to experience dumping but do have issues with the reactive hypoglycemia. I noticed that I lost weight for about 3 months after the revision, then stopped. One difference for me this time is that if I gain weight it seems to stay around, where often times with the sleeve I would gain a couple pounds then lose them easily. Not sure whether this means that my metabolism wants to be at a higher set point weight. I didn't really do the revision to lose weight, and I'm still 15-20 pounds lower than when I had the revision, but it is something I've noticed. Also, my experience is that although the surgery helped tremendously with reflux, for me it's still not gone completely. I'm still taking omeprazole daily, and if I eat certain things in the evening I might still have a reflux issue late at night. I can completely control this by not snacking at night.

Yes I’m learning to be very discerning of condiments it would seem I’m also experiencing the reactive hypoglycemia reaction to even minimal sugars. Though I think this might be separately more in line with what the other poster had mentioned “the protein sweats” though possibly related to needing to slow down as it occurred most noticeably with grilled chicken :) Regarding heart rate what’s interesting is my resting heart beat has dropped from mid 60s to upper 40s//low 50s (doctor said not to worry), but I haven’t checked my pulse during sweats specifically I will do that.

I'm 16 months post op and I have baked a few things here and there...I have reactive hypoglycemia (aka "late dumping") so I know better than to have more than a bite or two or I'll end up face planting on the kitchen floor again. It's an excellent deterrent from overindulgence, as much as it sucks.

Unfortunately I can't take these medications as I have reactive hypoglycemia and these medications cause a drop in blood sugar. thank you for the suggestion though. [emoji3526] Sent from my SM-S908U using BariatricPal mobile app

I want to clarify something here for those that are following along at home. A random blood sugar test can be used to indicate diabetes, but just because your blood sugar is less than 200 mg/dL, does not mean that you don't have diabetes. An analogy would be this: if you weigh over 600 pounds, you are definitely obese. Just because you weigh less than 600 pounds does not mean you are not obese. I'm diabetic, but my blood sugar was never over 200 mg/dL any time I checked. As I mentioned, it's much more common to use A1C and fasting blood glucose tests to diagnose diabetes. Fasting is good because blood sugar fluctuates throughout the day. It should be at its lowest point after an 8 to 10 hour fast, so for most people, this is first thing in the morning. The other common test most diabetics are asked to do is "postprandial". This means after a meal. Now timing after that meal is subject to some debate, but typically 2 hours after eating is used as the "standard" for diabetics. For everyone, even non-diabetics, your blood sugar will start going up roughly 10 minutes after starting to eat. While this is heavily dependent on what and how much you ate, in a non-diabetic, your postprandial blood sugar should peak within about an hour of eating and should be back to normal in 2 to 3 hours. For diabetics, this normally does not happen as fast, so the peak blood sugar concentration is typically closer to 2 hours after eating. In short, most type 2 diabetics are asked to take a postprandial reading 2 hours after eating. Both fasting and postprandial readings are used to determine how well the disease is managed. For example, a high fasting blood glucose test might indicate that your diabetes medication needs to be adjusted. Another example might be if the post prandial reading is actually lower than the fasting number. If this is a consistent trend, it might indicate reactive hypoglycemia.

Do you know what all an endocrinologist tests for? It’s not just hypo and hyperthyroidism, right?? I am in maintenance and struggling big time. I feel like the only way to maintain my weight is to be on a diet (and hungry) for the rest of my life cause I add in a few calories and I gain. I feel like there is something going on with my hormones that my primary doc is missing. I see him today and plan to ask a lot of questions. Just wondering what conditions cause weight gain that I should be questioning him about.

My doctor once told me I have reactive hypoglycemia and well that's unfortunate that it could get worse now that I've gotten wls. I've episodes pre-op for a few years and my doctors solution was "make sure you eat regularly and stay away from the triggers when you don't".

I had an issue with that about a year after WLS. They checked several things because they said there could be any number of reasons - low blood pressure, reactive hypoglycemia, inner ear imbalance, or even at UTI! They didn't find anything, but my PCP suspects it was probably glucose-related, and my glucose level just happened to be normal during the work up. So she suggested I eat something every three hours - preferably a protein. I haven't had that issue since, so that might have been it - or at least it was for me. I know a lot of people experience that because of low blood pressure, though - that seems to be the most common culprint. hope they figure yours out!!

I thought I was dealing with reactive hypoglycemia and so did my surgeon's NP. However, my rockstar dietitian took a chunk of time with me to really tease things apart. She wasn't 100% convinced it was hypoglycemia and agreed with my purchase of a cheap glucose meter. Her guess was that it was dumping syndrome, but delayed because I was going to bed after eating the triggering food and waking up due to the symptoms. 2 nights ago I purposefully ate a triggering food without eating any protein. Sure enough I woke up drenched in sweat and feeling horrible.... blood sugar was 100 so not hypoglycemia. So yeah, dumping syndrome.... Then last night I wasn't thinking and ate some high fat and high carb food right before I headed into work and oh my...... Work was difficult last night and had to sit down quite a bit (I do after hours janitorial work). I'm thinking the symptoms I thought was hypoglycemia is really due to low blood pressure. The pain of the muscle cramps is very real and wore me out. It's 12 hours later and I'm still sore. I really need to change my diet, AGAIN. uggggg..... On a much more positive note, the reason I had the revision has been fully resolved, no more dangerous reflux and no more esophageal spasms due to the reflux. The reflux was so bad it was starting to create pre-cancerous changes in my esophagus. I'll be having another endoscopy in a month or two to confirm how much healing has taken place. My team and I are absolutely thrilled with the additional 30 pounds of weight loss. If I loose more, great, but I'm 100% happy with where I'm at right now. I'm probably the healthiest I've been in my whole life. It's been close to 30 years since I've been in the low 160s (and I'm only 44). I'm comfortably in size 8 pants and M shirts, my dream sizes when I started this whole journey 8+ years ago.

I experienced something very similar the first couple of weeks. I felt a lot of pressure and often had to stop until I burped or it passed before taking another bite. I think that's pretty normal - your stomach is still very swollen and healing from the surgery, so its going to feel a little reactive.

Do you mean hyperglycemia? Hypo is low BS but at 301 it’s high?