From an Australian surgeon,

here it is:

http://mercybariatrics.com.au/obesity-surgery-2/weight-regain/

Basically it confirms why some people gain weight due to unhealthy eating and drinking.

That was very interesting! Although I feel he put to much emphasis on sleeve size and the correlation with regain. I feel pretty much the same amounts can be eaten years out as a natural progression, so at that point, size doesn't matter (snert). He did say this though, which I whole heartedly agree:

"However it’s not just about capacity. It’s also about frequency of eating and making the wrong choices of food. Reluctance to exercise will compound the problem."

@ That's really interesting, thanks for posting it.

Does anyone else find it a relief to see more medical research referring to elements of weight gain that are out of the patients control now? I mean, of course I know there are many things that are IN our control that we can do to keep our weight down, but hearing more about the hormones and genes that influence our need for food takes away some of the crippling guilt I have been carrying all my life.

Jo x

@@JJCool

Oh, totally!

That's why I get so mad when the uneducated still insist it's as easy as "calories in/calories out".

Yeah, to a certain extent. But our bodies are much more complex than that and tend to disagree

Yes, the food choices are so important, as grazing or eating the wrong foods, and drinking lot of alcohol make people re-gain weight.

I am still in weight-loss stage, once I reach my goal weight then go into maintenance, I now know that I will need to be mindful, always.

Before I knew much about WLS, I thought that once the stomach size is reduced, or by-passed, the hunger will be permanently removed, and the weight will be easily maintained.

I now know differently, bummer! Basically it is a life-long process ..... eating healthy foods, with good Protein

@@JJCool,

I read that obesity is a disease, and certain hormones make it worse.

I have a thyroid disease, and I can't control thyroid hormones, only through radioactive iodine that destroyed my thyroid, and now with thyroid replacement hormone, for life.

So, what this surgeon says, I agree with that it is impossible to control hormones without intervention.

@ It's true, after the surgery you will have to commit to a healthy lifestyle to lose the weight and maintain it. However from my experience (I'm only 7 weeks out, so I'm not much of an expert) I can say that it's easier than before the surgery. I do feel hunger now still but it's different and somehow easier to manage. I think the surgery takes away SOME of the willpower element and that does help.

Of course you can still find a way to eat around the surgery if you want to or if you get complacent. But I think it would be hard to regain to the max weight that we (well me, as mine is quite a big number) once had.

So definitely still worthwhile

Jo x

@ Doh, I read your message as that you were in the pre-op weight loss stage, not the weight loss stage. So ignore me, you would know all that already!

Oops - Jo x

interesting article. I have no idea what size my stomach is. maybe a question to ask out of curiosity when I have my six month check up on Friday/

A couple much larger studies have shown that bougie size does not matter, and a smaller bougie increases complications. The issue isn't the bougie size, it is if the sleeve is properly formed. He kind of outted himself by admitting he used larger and switched to smaller later. That doesn't mean that smaller works better, more than likely his technique at doing sleeves improved with time. They just use the bougie as a guide when they cut, so if they are close or further away from the bougie that is all on them and their technique. The differences in sizes is still very minimal, you can't blame regain on the bougie size, unless you can't make a properly formed sleeve.

@@JJCool

No problem ! Yes, I am bit over 5 months post op. My stomach can't tolerate bad foods, such as chocolate, muffins, scones. Tried them before and I felt ill!

I could however eat ice-cream and frozen yoghurt, and I realised that when I had those sugar laden slider foods, my sugar craving came back, and I wanted more and more. Consequently my weight-loss stalled.

I decided to stop buying this stuff, substituted with berries and melons for my after dinner treat, and my weight is peeling off again.

I wonder if you are getting enough Proteins in your food plan, as 7 weeks out the hunger often goes away.

And Snacks, I was having regular snacks at that time, with my beloved Cruskits and cream cheese with some salmon.

@@OutsideMatchInside

This makes sense. Thanks for your post and picture.

@@JJCool

I wonder if you are getting enough Proteins in your food plan, as 7 weeks out the hunger often goes away.

And Snacks, I was having regular snacks at that time, with my beloved Cruskits and cream cheese with some salmon.

To be honest I think it might be acid. I'm in the 'just monitor it for a while' stage before my bariatric team will try altering my PPI to fix it. But still, it works just like hunger! Luckily it's not toooo bad and I can control myself

Jo x

@@JJCool

Yes, acid can mimic hunger.

I had to change scripts, as my reflux was quite bad post op. I was put on Rabeprazole, but it did not help.

Nexium was suggested to me, from my OZ sleeve forum.

So my surgeon gave me script for Nexium 40mg, and this worked! Nexium is quite long lasting, and it successfully removed all my acid issues.

I am now trying to wean myself of it, very gradually.

Hope the new script works for you, as at 7 weeks out, with more normal diet with enough Proteins my hunger was completely gone. I only felt hungry if I went over 4 hrs without eating.

Now I can go for many hrs, and I don't feel hungry.

Anyway, good luck with everything.

I'm off to bed, time to catch few zzzzzz

What a great article.!!

Makes me feel a little better knowing there are so many factors that may contribute to weight gain.

I'm looking forward to my "fizz" scan next week. At least I'll finally know what the problem is with my 6 month weight stall.

I have to learn to stop focusing on the negatives & get my mind in a more positive frame of mind!

Sent from my iPhone using the BariatricPal App

@@rose1504

Yes, there are many factors involved in weight loss or gain.

Please let us know what your scan results show.

Good Luck!

I am wondering if I took myself Off Nexium too soon. I was supposed to be on it for 12 months post op, as initially I had really bad reflux.

I have been off Nexium now for 2 months, and I noticed that I am getting really hungry lots since then, and my nose runs like a tap.

I have been reading up on Silent Reflux, and I do tick off few boxes, even with sore throats in some mornings.

I thought that once I got to 6 months post op, my stomach healed and that I lost the restriction.

I was also prescribed 1/2 dose of my thyroid hormone replacement, and felt the Thyroxine level was not adequate, hence more hungry often, hunger that is almost painful, loss of energy, allergies and runny nose, and general blah feeling.

My thyroid med is higher again, and I am feeling better, however the hunger and wanting larger meal portions did not go away.

I may go back on PPIs for a while again, and see if this will make any difference.

@@rose1504 hope you get your answer soon, and feeling/thinking more positive attitude will certainly help.