Appetite suppressants (prescribed) 2 years out...

[McButterpants 2,846]

Hello all.

I have been absent from this form for a few months - I needed a little break, I've been so busy with work (traveled 10 out of 13 weeks) and, well, life happens.

So, I went to my 2 year follow up - a suspected gall bladder issue forced my hand. I was procrastinating going for my follow up because I've gained 17 pounds from my low weight. I was ashamed and didn't want to verbalize what I just wrote here. If I avoid saying it out loud, it's not as real. So I have been experiencing some discomfort when I eat and felt like I had to go in to get the gall bladder checked out.

My doc is awesome - I knew this, but I was embarrassed. She made me feel comfortable and I kind of unloaded on what's been going on. I've been snacking/grazing, not exercising like I should and think I have a problem with acid (which leads to more snacking). She ordered an upper GI and an ultrasound which happens next month.

She suggested appetite suppressants which alarmed me. My knee jerk reaction was "Really? I thought I wouldn't have to do that ever again!" She said this is "perfectly normal" at this point. We can use it as a jump start to get yourself back on track - it may not be a long term thing.

So I came here - my good old support system to ask…Has anyone else been thru this? What are your thoughts on suppressants? I'm researching more on my own, but would like some thoughts from my fellow veterans.

What say you?

[psychprof 141]

Hello all.

I have been absent from this form for a few months - I needed a little break, I've been so busy with work (traveled 10 out of 13 weeks) and, well, life happens.

So, I went to my 2 year follow up - a suspected gall bladder issue forced my hand. I was procrastinating going for my follow up because I've gained 17 pounds from my low weight. I was ashamed and didn't want to verbalize what I just wrote here. If I avoid saying it out loud, it's not as real. So I have been experiencing some discomfort when I eat and felt like I had to go in to get the gall bladder checked out.

My doc is awesome - I knew this, but I was embarrassed. She made me feel comfortable and I kind of unloaded on what's been going on. I've been snacking/grazing, not exercising like I should and think I have a problem with acid (which leads to more snacking). She ordered an upper GI and an ultrasound which happens next month.

She suggested appetite suppressants which alarmed me. My knee jerk reaction was "Really? I thought I wouldn't have to do that ever again!" She said this is "perfectly normal" at this point. We can use it as a jump start to get yourself back on track - it may not be a long term thing.

So I came here - my good old support system to ask…Has anyone else been thru this? What are your thoughts on suppressants? I'm researching more on my own, but would like some thoughts from my fellow veterans.

What say you?

Which procedure did you have? I have nothing to offer as I'm just beginning the process but I'm interested in your experiences.

[swimbikerun 1,038]

@@McButterpants I just want to send my best wishes for you. I don't care what happened and it doesn't matter. Just hoping you will be healthy again soon.

[Babbs 14,680]

Hi! Nice to see you back!

I've used them in the past, (phentermine), and I'm in the minority because I have nothing against using them short term to jump start weight loss. And it will.

Problem is, you know once off of them again, if you don't continue to portion, eat healthier and not snack so much in between meals, the weight will come back. But since you already know the basics of the surgery, you will go back to them and keep the weight off after. Maybe it is the jump start you need again?

You will get mostly negative comments about these medications, but honestly, I wouldn't hesitate to use them again under a doctor's care and short term to lose a little regain.

[glitter eyes 1,398]

Welcome back!! I have used prescription appetite suppressants in the past and they work for short term fixes and if your doctor thinks they are a good idea it could be worth a shot. Sometimes all you need to get back on track is a little nudge and they may be just the thing.

When I took them I didn't have any of the jittery side effects and tolerated them just fine.

Down the road if I felt I needed them to get back on track I would not be adversed to taking them.

Good luck you can do it!! Keep us posted.

[Djmohr 6,965]

Welcome back!

I have to say if you need something to get you jump started I say go for it!

The hardest thing about losing weight is honestly getting started.

Then I would reset as if I had surgery yesterday and work the process that you already know works.

My biggest fear is what you are experiencing. You work so hard and then gain weight again. I know that building new habits is the only thing that will work long term.

I wish you the very very best of luck! I hope that you are able to get things moving again.

[parisshel 1,892]

I seeing nothing wrong with adding additional tools to your weight loss toolbox as you continue your post-op life. I remember when there were more bandsters on this forum and I remember several of the veterans posting about using appetite suppressants when after a certain amount of time with the band. I remember reacting like you, thinking "Hey! I got the band so I'd never have to deal with my appetite again!". But many veterans of WLS find that appetite does rear its head after a certain amount of time, and it's not just head hunger. It is your body overriding those wonderful initial effects of the WLS.

The good thing is that when you use the 1-2 punch of your WLS + medication, you'll have a super tool. You've already got the WLS in place, and the medication will be like "topping" off your surgery, hopefully. Kind of like re-igniting it.

Don't feel bad. Use everything you can to keep your weight loss going (or get back on track).

[FrankyG 1,450]

No judgement here either. You do what you need to do to stay or get back to healthy.

I would also suggest at some point looking into the 5 day pouch test as a way to reset your eating habits and get back to where you were in the beginning. You can see the basic overview here: http://www.5daypouchtest.com/plan/theplan.html

I did it (on the 4th day actually) because I'm a year out and realized I was starting to crave stupid things and grazing a bit too much, and it really helped me to stop the carb/crap cravings and get back to how I'm supposed to be eating.

[MichiganChic 3,262]

@@McButterpants I am at three years post op, and went for my 3 year check this week. I am up about 5 pounds from my lowest, which is very alarming to me. I asked for something for my appetite, and he prescribed Belvieque. I am going to start taking it today.

I am unable to lose unless I eat around 800-900 calories a day, and I maintain on about 1450, and I gain at 1550. I've been trying to get and stay under 1000, but I haven't been able to do that for more than 2-3 days at a time, so I feel like I need a jump start, too. I don't want to take them forever, but I do want this five pounds off before it becomes 10 or 20.

My doc said he has never prescribed this to anyone, but I am happy he was willing to hear what I'm saying. When I first had surgery three years ago, I felt like someone flipped a switch off and the crazy drive to eat was gone. In the past two weeks, I feel like that switch got flipped back on. I've been fighting against it, but it feels like the weight is going to start packing on, and not in proportion to the calories I am consuming. I know that sounds crazy, but I know my body.

So, I don't feel bad about it. I feel like I have to do whatever I can to protect what I've worked so hard to achieve. I wish it were easy for me like the first 2 years, but this is my reality. You aren't alone, and be glad you are acting before your 17 pounds becomes 27.

What did she prescribe?

[gowalking 10,790]

...and this is why I stay on these boards. Even if I don't post anything, I don't leave. I've seen too many vets disappear and just like @@McButterpants, it seems they do so when things go south. As much as we like to think folks are successful and fade away into the sunset, and their lives, I am even more convinced that a large portion go away because they are struggling.

I refuse to do this. I'm still about ten lbs. heavier than I was at my 'happy place' of 115 but every morning I remind myself it's a new day and do my best to stay on track.

Glad to see you here again @@McButterpants and hoping this suggestion by your doctor helps you to get back on track. This just shows me that the fight against bad choices is a daily struggle and some days we do well and others not so much.

If I've said it once, I'll say it a hundred times. Don't tell me that food is not an addiction. We're all addicts and the hunger monster is always lurking.

[psychprof 141]

I don't have a ball in this game yet so please disregard if you need to, but I've been doing a lot of reading on this (at this point it's all I can do--my program keeps canceling my pre-op appts). The literature seems very clear that after the first 6-12 months, WLS patients should expect to be at the same place they were pre-op in terms of head and real hunger, and that the surgery won't fix those things permanently. Since that's the case it's up to us to develop and maintain those habits that will keep us healthy. I am very grateful to be learning from all of you so I can prepare for those days in my distant future.

In the past, however, I can perhaps share what I've been prescribed.

1. Adderall. This is for my ADHD but works wonders on appetite.

2. Topamax. This is a powerful anticonvulsant that works on your nervous system, typically given to epileptics. It is the most effective of all of the medications I have been given in terms of weight loss. I dropped 30+ in a few weeks on it. It has serious side effects though. It made me stupid. I couldn't remember words and forgot everything.

3. Naltrexone. This is a medication typically given to fight heroin addiction, but some doctors are using it off-label for binge eating. It works on the addiction center of your brain. It's pretty effective, but makes me nauseous.

4. Metformin. This is a diabetic drug that helps your body use insulin efficiently. Some people (without diabetes) find it aids weight loss. I did not--for me it just made me sick.

[Kindle 8,667]

Welcome back, nice to see you! I'm right at 2 years, too, so I know how easily that snacking/grazing urge can kind of creep in. And life has also been pretty shitty for me this 2nd year out. One thing that has worked for me, to stop weight gain, drop of few extra pounds and get my head back in the game is to go back to basics. At first just switching to strict Protein and veggies after a particularly carb heavy weekend or holiday did the trick. But then I discovered simply going back to my liquid preop diet was even more effective. If I feel out of control of my eating habits or if I pop even 1 pound above my bounce range, I go back to the beginning. I stay on the strict liquids until I drop back to the bottom of my bounce range.

Sticking with liquid Protein shakes and broth for a couple days helps in 3 ways.....clears the carb cravings, kind of tightens up my sleeve's restriction, and shows me I still have to willpower to do this. I find it empowering. A lot of people seem to get the same results with the formal 5 day pouch test. In fact I just did a couple days of liquids (still getting 60-80g protein/70-80oz fluids every day) so I am headed into the holidays at my lowest weight ever. I will snack and eat sweets guilt free next week!

The other thing is your gallbladder. After 2 years I finally had mine taken out. Full of stones. Other than 4 seriously painful attacks, I didn't really have any symptoms in between the attacks. But it turns out I was having low grade acid issues because of it. Didn't realize how uncomfortable I was until I wasn't anymore. And I find myself not as "snacky" in the evenings.

Good luck with whatever you end up doing!

[James Marusek 5,244]

The strategy in the "Maintenance" phase is different than in the "Weight Loss" phase. This short article describes my personal experience with this phase. http://www.breadandbutterscience.com/Surgery2.pdf

[CowgirlJane 14,259]

I have gone through the raging return of appetite. I feel bad for saying this, but the uptick around year 3 post op was even worse for me. Nobody offered me appetite suppressant but I would be very open to it.

I am back at goal (bounced 10# over this summer) but I am still 18# ,over my lowest weight. Nobody in my medical world thinks I should be at that low weight. I think it is important to recognize that your long term maintenance weight is very likely to be higher than your lowest.

I don't know your situation but be ruled by good health not just the scale.

I visited a NUT at my 3 year mark and she gave me strategies that help. I keep educating myself on how to best maintain and manage hunger and it works for me. Even so, I would consider the meds if my doc suggested it.

[CowgirlJane 14,259]

So far acid has not been a problem for me but I know from my lapband days how much that discomfort can contribute to bad choices. I would have an afternoon ice cream or frozen yogurt to soothe myself..... there are better ways to address it so really glad to hear your surgeon is investigating that. In the meantime, are you on a PPI?