The truth about GRHELIN!

[SLEEVE 0]

I guess I am a little disapointed in myself for subscribing to the notion that with the VSG surgery the grhelin is 'cut-out' with the stomach. Maybe this was started by a doctor and perpetuated through all the 'sales agents' till everone now belives this to be true. I guess you cannot alway believe everything you read.

Nevertheless, please note the following reprint of Dr. Watkins of Cincinnatti who understand how Grhelin actually works:

Ghrelin, the hormone, gets a lot of attention these days.

Here is what we know about ghrelin:

Ghrelin is one of many hormones involved in appetite. We are learning that appetite is a very complex system and part of our body's survival mechanism. The brain wants us to breathe and eat - these two items are at the top of its list! The drive to eat is a very powerful biological drive.

Ghrelin is a feedback hormone and pressure in the wall of the stomach is what suppresses it. In other words, when you eat, the food activates pressure receptors in the wall of the stomach and ghrelin levels go down. If you haven't had the pressure receptors in your stomach activated for a while, ghrelin levels rise and so does hunger.

The most important way to suppress ghrelin levels is PRESSURE. Cutting out stomach that produces ghrelin doesn't eliminate ghrelin. The parts of the stomach that are left can produce lots of ghrelin but if there is pressure (food in the smaller stomach) then ghrelin levels will be low.

After gastric bypass, ghrelin levels go way down even though the entire stomach remains. After Lap Band surgery ghrelin levels are suppressed in general and get low after eating and the food creates PRESSURE in the small gastric pouch. It is the pressure reducing these levels since the entire stomach is still there.

Keep in mind that the ghrelin levels are a small part of a very complex system. When you talk to plication patients they have reduced appetite particularly after a small meal since the food creates pressure and activates the pressure receptors in the wall of the stomach.

There are probably many pharmaceutical companies working on an "anti-ghrelin" drug but it is likely that even if such a drug is created and works, the other hormones involved in appetite will increase over time reducing its effectiveness.

All this to say, the best way to reduce appetite is to stretch the wall of the stomach and if a stomach surgery has been done to reduce its size (band, bypass, plication, stapled sleeve, etc, etc) then you will get appetite reduction on smaller calories. One of the reasons weight loss operations work so well is that you are reducing appetite through normal biological channels, not a drug with side effects and decreased effectiveness over time.

Many people worry about ghrelin levels. The important question is, "does the operation reduce appetite?" If the answer is "YES" then you have a very powerful operation for weight loss regardless of ghrelin levels. We know that weight loss operations are suppressing things that float around in the blood stream that are yet to be discovered.

Vince Lombardi once said, "I don't give a #$&%! about statistics as long as we WIN!"

Brad Watkins MD

Now that i know what Grhelin is all about I am thinking of switching to the Sleeve Plication surgery instead of the VSG.

[TexasT 99]

As someone that's had a lap-band and sleeve, I can say that I was constantly hungry with the band, but not so much now with the sleeve. My doc explained that ghrelin is produced in the whole stomach, but the larger number of the "pumps" are in the portion of the stomach that is cut out. Ghrelin is also produced in the pancreas, so you will always have some no matter what surgery you have.

[LilMissDiva Irene 3,282]

I'm in exactly the same stance as TexasT. I also had the lap band and my hunger was unreal. I would eat, it would either get stuck or I'd feel "full" but I would STILL be hungry. Yes it was REAL hunger too, so I don't want any feedback saying it was all in my head. I know the difference.

Anyway good luck to you in whatever surgery you choose. I hope it works out for you, really. However FOR ME and my sleeve, we will do excellent. My hunger is nearly 100% gone. That is no myth.

[vicki s 146]

Thanks guys for the responses after the initial post because i have the band and am being revised to the sleeve on 11/1, and I am always hungry with this band, so if my ghrelin is down due to pressure from the band, then i am in trouble, cause its not working.....glad to hear everyones stories about how the hunger went away after revision from band to sleeve....~Vicki

[Tiffykins 673]

I'm in exactly the same stance as TexasT. I also had the lap band and my hunger was unreal. I would eat, it would either get stuck or I'd feel "full" but I would STILL be hungry. Yes it was REAL hunger too, so I don't want any feedback saying it was all in my head. I know the difference.

Anyway good luck to you in whatever surgery you choose. I hope it works out for you, really. However FOR ME and my sleeve, we will do excellent. My hunger is nearly 100% gone. That is no myth.

I'm one of the lucky ones that never experiences true hunger, EVER. I was constantly hungry with my band. I would eat, be "full" for about an hour and then here came the hunger, AGAIN, once that lovely food fell through the craptastic pouch that the band offers. I know not every sleeve patient loses all of their hunger, but those patients are few and far between all of us that have lost all of our hunger.

[Tiffykins 673]

Ohhhhh and just for shits and giggles, here are some published research articles that show scientifically how the ghrelin plasma level is reduced in VSG vs. the Band and vs. RNY. Both procedures that leave the fundus intact.

http://www.ncbi.nlm.nih.gov/pubmed/18376181?ordinalpos=12&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

http://www.bernhard-ludvik.at/download/pub/2005_ref61.pdf

Best wishes on whichever surgery you choose.

[Fleur de lis 2]

I will say that I am rarely hungry as well. I sometimes get a little rumbling reminiscent of when I had a bigger stomach, but my hunger level doesn't get to the levels it got to pre-op. It stops at the rumbling and usually if I don't pay attention to it, it goes away.

[Oregondaisy 2,021]

I will say that I am rarely hungry as well. I sometimes get a little rumbling reminiscent of when I had a bigger stomach, but my hunger level doesn't get to the levels it got to pre-op. It stops at the rumbling and usually if I don't pay attention to it, it goes away.

I do get hungry sometimes. It's not that really starving kind of hunger. My stomach growls a little bit to remind me it's been hours since I have eaten. Most of the time, I am not hungry at all. There have been many times that I have forgotten to eat dinner.

I am thankful for that because when I was in the hospital with pancreatitis, I could have nothing by mouth for 4 days and I was never even hungry.

[ssg_1976 0]

I think someone posted this same topic on the OH Sleeve board.....

[NtvTxn 1,262]

I haven't been "hungry" since June 10th - I had surgery June 11th. It's wonderful. My 'new hunger' is an empty feeling that I get once in a while. It started not quite two months ago and is not a daily thing. I hope this lasts forever!

[Kim 1]

I get hungry or should I say my stomach growls a bit but whenever it does its because it has been 3 1/2-4 hours after I ate and time to eat again. I love having my sleeve it is the best thing I've done I just wish I would've had it years ago.

[sleeve 4 me 910]

All I can say is I NEVER get hungry...EVER.

[juliarh 35]

I don't get hungry either and I forget to eat all the time.

[Filosophia Scandinavia 1]

I THINK THIS IS THE MOST INTERESTING PART - I didnt know that:

"There are probably many pharmaceutical companies working on an "anti-ghrelin" drug but it is likely that even if such a drug is created and works, the other hormones involved in appetite will increase over time reducing its effectiveness."

If the other hormones "take over" over time - then the reduced hunger from the operation will decrease over time? Has anyone in this forum been operated for 5-10 years or more?

But we still have the smaller stomach, if the antighrelin effect subside. Will the feeling of hunger then be the same, as many with the lapband experience?

[LilMissDiva Irene 3,282]

Sleeve4me: I know right??? I was just thinking this right now. So, for Breakfast I'll have an EAS Myoplex Carb Control shake for about 110 Cals. Then for lunch I have one pouch of Quaker oatmeal Hi Fiber for about 160 Calories. I really don't snack at all in between this simply put, I'm never hungry. If by chance I do get hungry (which does happen MAYBE once a week) I'll have a low fat string cheese for an additional 50 Calories. So I'm able to live my life on 270 and up to 320 Calories until dinner time with no hunger? Yeah, I'll take it!

When was the last time I've ever been able to do this low calories with little to no hunger? THIS is the ONLY time!! I was starving to death with my band!!!

I THINK THIS IS THE MOST INTERESTING PART - I didnt know that:

"There are probably many pharmaceutical companies working on an "anti-ghrelin" drug but it is likely that even if such a drug is created and works, the other hormones involved in appetite will increase over time reducing its effectiveness."

If the other hormones "take over" over time - then the reduced hunger from the operation will decrease over time? Has anyone in this forum been operated for 5-10 years or more?

But we still have the smaller stomach, if the antighrelin effect subside. Will the feeling of hunger then be the same, as many with the lapband experience?

I have heard over time the hunger does return. However when I do hear this I always ask the person who had the surgery "Is it anything like before surgery"? The answer has been "NO" 100% of the time.

I can live with even half my hunger returning someday. Right now my hunger sensation is almost just a little hollow feeling in my gut - maybe a little rumbling. Really nothing to even become any worrisome or bothersome in any way. It's also always only if I haven't eaten in 5 or 6 hours too. By all means, I SHOULD be hungry by then!!

Anyway, it's really hard to explain unless you have the sleeve. It really DOES cure hunger - again... NOT A MYTH!!