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One Year With Mini Gastric Bypass: My Journey, Thoughts, and Tips!



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On 12/7/2021 at 12:37 AM, Guest said:

The surgery: what is it, how does it work, what does science say about weight loss and complications with MGB?

What is it?
There’s nothing ‘mini’ about the MGB. The name was given by Dr. Rutledge who invented it in 1997 to describe its simpler configuration compared to Roux-en-Y gastric bypass.

Basically, the stomach is divided and a long, narrow pouch is created (a little like the sleeve), but the rest of the stomach is left in place (like with RNY). A loop of the small intestine is then connected to the pouch, and that’s it.

There’s one connection point – one anastomosis – and unlike the sleeve, the food travels directly down into the intestine, as the pyloric valve is bypassed. The bypass is anywhere from 150cm – 350cm (3 to 9 feet), though recently most surgeons do 150cm to avoid malnutrition later on.

Here’s a diagram:

image.thumb.png.e34d371be4807971a7b606ce240fe582.png


How does it work?
As with all bariatric surgery, there are things we know and things we don’t know. We obviously feel full faster due to the smaller stomach, but because it’s ‘open’ in the bottom to the intestine, and this anastomosis is not especially narrow, we can usually eat pretty large amounts fairly soon after surgery.

My personal experience is that I’ve only felt I ‘had no more room’ a few times, and always with minced meat, weirdly enough.

The big trick is that you feel satisfied very quickly, because the food lands undigested pretty far down the intestine. It’s like the feeling after a huge Christmas dinner. Technically, I could eat more, but I feel stuffed (and satisfied). So I don’t.

We have at least 3-4x the malabsorption of RNY, so there’s some calories being flushed right out. Personally, I can see when I eat a higher-fat meal that some of it goes through undigested (sorry for theTMI).


How much do you lose?
Unlike what people think, there are tons of studies out there documenting that weight loss is generally greater after MGB than after sleeve and RNY. Not a single study out there shows less weight loss with MGB when comparing MGB and RNY.

Excess Weight Loss (EWL) ranges from mid-60s % EWL to the 80s after one year (a few studies show even higher WL, but those are generally from cohorts of fairly low-BMI study populations).

All-in-all, weight loss is excellent and looks like it’s long-term durable in the studies. Especially when compared to the sleeve.

Complications?
For some reason, there’s a ‘feeling’ among American bariatric surgeons that MGB carries a higher risk of stomach cancer. This is not true, and it has been studied. A few patients experience bile reflux, but this is a lesser concern with the Spanish ‘anti-reflux stitch’ most MGB surgeons now use. Mine did as well, and while I suffered heavily from GERD prior to surgery, this is no longer a problem.

Long-term, malnutrition is an issue, so take your Vitamins. Think of Vitamins as being generally a good idea for sleevers, mandatory in the beginning for RNY’ers and then see how your labs develop as the years pass, to very important for MGB, also long-term, and life-or-death for our duodenal switch friends. This reflects the malabsorption – none in sleeve, a little in RNY, a moderate-to-significant amount in MGB, and a lot in DS.

Thanks for the elaborating the entire journey! A big massive congratulations on your success that has been inspiring... That was a brilliant read and it mirrored my journey too to a large extent. I'm now 6 months post op and I have lost about 29kg or 64lbs in total. I feel like a different person altogether! I have more energy and my knee pain is virtually nonexistent. I have another 36lbs to go and I'm not bothered about how soon this happens or it happens at all! I chose mini gastric bypass for the same reason that you mentioned and I have no food intolerances or dumping. I don't get these contemptuous looks when I go to the gym or a yoga class anymore... I'm not self conscious when I go clothes shopping either. I don't really feel like I've had a surgery on many occasions as I have had little or no issues post op.

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
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    • KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
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      https://alluniqueguide.com/java-burn-coffee-reviews/
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