I have some questions for those GB veterans out there or anyone else that may have this info. And....maybe nobody can give me this answer except to ask my surgeon, but I will give it a shot.

Based on the below information: that came from http://www.bariatricpal.com/page/info/roux-en-y/roux_en_y_gastric_bypass.html

Do these specific hormones stay decreased permanently after surgery? or can they increase over time many years later?

For those veterans, do you have increased hunger over time years later? The reason why I ask is because I have known a few people who have gained weight after bypass and was curious as to why and wasn't sure if it was related to feeling that hunger again similar to pre-op and if it was hormone related.

• Hormonal:1 2 changes in your hormones after RYGB can decrease hunger.
  • Ghrelin: a hormone that causes hunger and whose levels decrease after RYGB
  • PYY: (neuropeptide YY) a hormone that reduces hunger and whose levels increase after RYGB
  • GLP-1: (glucagon-like peptide 1) a hormone that reduces hunger and whose levels increase after RYGB

I'm not claiming to be an expert, but the way I understand it is after surgery your hunger goes away. For some people permanently, but for others it could return anywhere from 6-12 months after surgery - but, it's a different kind of hunger, not the 24/7 Hunger that we all know from before surgery.

In terms of gaining weight later on, the way I understand is that there are two types of malabsorption we encounter - malabsorption of nutrients, and malabsorption of calories. The malabsorption of nutrients is permanent, which is why we have to take Vitamins the rest of our lives. The malabsorption of calories is temporary, and at around the 2 year mark your body re-adapts and starts absorbing most, if not all, of the calories again. So, some people aren't aware of that, and don't keep an eye on their diets (by bringing in too many carbs, sweets, alcohol, etc.), and those extra calories can add up.

The other thing is that weight loss happens most in the first 3-6 months, and then starts tapering off. My NUT drew my a graph that showed the tapering off, and even said that after it tapers off, it eventually bumps up a bit and many people will regain 10-20lbs back.

Not sure if that helps, but that's about all I know.

I can only speak from my current experience and share what I have learned from some of the veterans.

My hunger returned right around 5 months post op. It is not the same as that gnawing hunger I used to get and it literally only takes a few bites full of food and I am full. If I eat Protein and fats, I stay full longer. If I eat foods like yogurt, pudding, salads without those fats or Proteins I get hungry again within a couple of hours.

It is very easy for me to get full and stay full. It is not as easy to deal with head hunger. I have to do other things to get my mind off of it. Head hunger is much worse than real hunger for me.

I have learned that when I do feel hungry the first thing I try is drinking 8 oz. of Water. Sometimes dehydration can make it feel as if you are hungry. If that doesn't take care of it, I will then grab a snack of cheese, nuts, Jerkey, apple with Peanut Butter. This is if it is between meals.

You asked why people gain their weight back. From everything I have been told, the number 1 reason is grazing. Instead of eating 3 meals and a snack. They simply eat small bites all day long. You can eat around your surgery by doing this and pretty soon you are back to eating too many calories.

You cannot stretch your pouch but after a period of time your brain allows you to tolerate larger portions of food. If you have the wrong foods on your plate you will gain weight. I have done a lot of reading about this.

This is why bypass is not a miracle cure at all. I feel like I fight every single day for every pound I have lost. You have to educate yourself so that you understand the things that can help you or hurt you.

I know when I have had too many bad carbs in a day that I am going to get on the scale and be disappointed. Some days I choose to indulge in something and I am ok with it but most days I make better choices for myself.

The reality is you are in control of how well you do and ultimately how you maintain it. The surgery is a phenomenal tool that will make it much easier for you to control but you have to do your part. If you do, you will be successful.

I am so glad I did it, I am close to my goal and I have vowed to never be as sick as I was ever again. I now have the tools in my toolbox to ensure that does not happen.

Although I have not had my surgery yet...I did ask my NUT and surgeon and both told me that the bottom of the natural stomach is where the hunger hormones are created and when the new pouch is made there is no longer access to that part so hunger goes away.

I am hoping permanently but will have to wait and see.

@@geronimo -Thankyou for the insight. I had no idea that after 2 years that our body readapts, so the dumping syndrome effect goes away too? Your explanation was very helpful! @Djmohr- I currently have been really focused on my nutrition and which foods that I am eating more of. Fitness pal has shown me that I tend to go over my fat intake more than I like to. I am trying to balance that but it has been difficult. I tend to eat low carb, high protein most of the time. Nuts for snacks and cheese is one of my weaknesses. I agree head hunger is terrible. I have a pack of sugar free gum and mints on hand at all times for that in addition to a 52 ounce jug that I take with me everywhere I go to fill it with ice water. I usually fill it twice in the same day, but more when I do Zumba. Congrats to being close to your goal!!!! @pmanley- if the bottom of the stomach is where the hunger hormones are. ...and it is still technically attached since it stays inside the body creating digestive enzymes, do they go dormant? I may be asking questions that are too hard to answer, but am wanting to know how it works before I do this. I have a follow up appt next friday I may have to toss these questions at him too.

I am 8 and a half years post op. I didnt feel any hunger pains till 3 years later and they are different for me it is in the lower stomach area. The juices from the old stomach dump straight into the intestines so if there is no food in them you can feel gurgling or pinging sensations.

Great thread!

Good question.

I'm only a month post op but I'm in a pretty good place, hunger wise. I get hungry and enjoy food but I can't eat much but what I eat fills me up. That was the scenario I was hoping for pre-op. I would not want to have no hunger, which would make eating a difficult chore. The worst scenario, I would imagine, is being hungry and not being able to satisfy your hunger with the amount your stomach can hold.

Edited September 20, 201510 yr by zackly

Oh and @@zackly is right, trying to eat or remember to eat when you have no hunger is in fact a chore.

In the beginning I would actually forget it was mealtime altogether. Hours would go by and my husband would say, did you have anything for lunch yet? Shockingly I would say, oh my goodness no and I am not even hungry.

The bad part about that is you can really mess up your new metabolism by skipping meals and you absolutely will not get your Protein in. You will get sick with malnourishment without the right nutrition.

I like that I actually feel hunger that is tolerable and I especially like that 1/2 cup of protein dense food fills me and keeps me full for hours.