WLS article: I guess it's all in how you read it.

I found this article posted in the Failed WLS forum. (Don't ask me why I was there. I sometimes have a bit of a morbid streak.)
It was posted to show that there is science now explaining why WLS fails.

http://www.lenoxhillhospital.org/press_releases.aspx?id=2106

What's interesting is that I read the article, and what I came away with was

1.) stay away from simple carbs, as a lifestyle change, not for X number of months.

2.) try to spread your calories out over the day, every two or three hours.


The doctor running the study was looking at regain, and found that among patients several years out from WLS,

"... (though) many patients could still eat less than before the surgery and become full faster, they would rapidly become hungry and feel light headed, especially after consuming simple carbohydrates, which stimulate insulin production .... The data gathered during the trial and the subsequent glucose tolerance testing verified that patients who underwent gastric bypass surgery and regained weight were highly likely to have reactive hypoglycemia, a condition in which blood glucose drops below the normal level, one to two hours after ingesting a meal high in carbs."

To me,that doesn't sound like WLS failure, it sounds like "stay away from meals high in simple carbs".
And try to keep protein and complex carb snacks available, too, so you're not going hours without eating.

Another good reason to treat all simple carbs like sugar - the pointiest end of the pyramid.

 Thanks for posting this.  As a revision I know all to well that the surgery didn't fail me, I failed the surgery.  No one forced me to eat the large quantities and refined carbs.  I thought that having surgery would assure that I wouldn't regain weight.  I was wrong.
This time, if I do nothing else, I plan on staying away from the refined carbs.  I am an addict and I know that I can't do them in moderation.
The funny thing is, there have been periods of time in my life where I was able to lose 100+ lbs and keep it off for a while and guess how I did it?  By eliminating refined carbs.  I really don't eat any different now then I did then.  The only difference is that I had lost the ability to do it anymore.  My appetite was big and I was always hungry.  For now, at least, I do not have that hunger and it is easy to stick with the way I am eating.  I finally realized what a tool means.

Exactly my thinking.

Do you mind if I ask what surgery you revised from? I went into my first consult looking for a sleeve; I'm curious about other people's experiences with different surgeries.

 I had a DS, which I managed to outeat.  I know it's supposed to be better for weight maintenance but it was no match for my carb addiction.

 I am wondering did you start with DS or revise to DS and from what.

 I had a DS in 2002.  My surgeon didn't do them very well apparently and I had a very large stomach.  I managed to lose all my weight and then I started regaining after a few years due to my overdoing of carbs.  I regained 100lbs and had problems with vitamin deficiency and diarrhea and gas problems.
The surgeon that did my surgery and the hospital I had it at no longer will do the DS because there have been a high rate of long term complications due to the higher malabsorption so they were very happy to revise me to lengthen my common channel and reduce my malabsorption.  My surgeon also offered to make my stomach into a RNY pouch since I had regained so much weight and I agreed to it because I was afraid of gaining even more.  I figured that if I could regain 100lbs with malabsorption I could really do damage without it.
In hindsight I probably would have done better with a longer common channel and a smaller sleeve.  I seem to do better with more restriction.  I may not have had so many problems if I had a more experienced surgeon but in 2002 there weren't a lot of surgeons that had experience.  I would have also done better if I had been more compliant with my food and vitamins.  I have become very diligent about both now.

that was my take from the article, too.

That is why I will continue to treat my RNY as a tool. If you don't use it right (simple carbs), the tool can't work right. Simple as that. This isn't a cure-all so you can eat everything you want. Especially with the RNY we know there will be limitations to our eating.

Thanks for sharing!

A matra that worked for me...simple carbs bypass my bypass.

To my way of thinking it isn't just the simple carbs, it is all carbs.  When I was type 2 diabetic and testing my blood sugars incessantly, even the "good" complex carbs (whole grains etc.) cause significant rises.  It doesn't take long for your body to turn complex carbs into simple carbs with the accompanying insulin rise.  The only carbs I trust at all are those embedded in non-starchy vegetables.  Our bodies are perfectly capable, when absolutely necessary, of converting protein into carbs - but it is a slower process without the insulin jolt that ingesting carbs gives you.