Question about regain...how it happens
I'm still a relative newbie...less than 3 months from RNY...so I get that what I'm experiencing now isn't the same as what life/my appetite/my willpower will be a year or two from now. I'm wondering if someone or someones can help me understand how one can end up with a lot of regain, cuz right now it puzzles me.
This is what I THINK I understand now...very simplified: People regain when, over time, their pouch (or perhaps more precisely their stoma) stretches and they find themselves eating a lot more food (calories) than they burn. If they drink with meals, it also washes food out of the pouch faster, so that they get hungrier sooner and eat more often than needed for maintenance. Combine this with making poor choices of foods...ie. too many simple carbohydrates, which burn off too fast and prompt you to eat more and to some degree, too-much fat, boosting calorie count too high for what you're burning each day.
Is that more-or-less right? If so, then it seems to me that the volume of food you put in your pouch over the course of a day is critical. And I'm having a tough time imaging being able to eat enough food to cause regain. That's not based on how full my pouch feels now, but on the sheer amoubnt of TIME it would take to eat enough. As it is now, I feel as if I spend a good part of my day eating...breakfast smoothie, lunch, afternoon snack, late afternoon snack, dinner. To eat MORE or more often, because I was eating the wrong stuff and getting hungrier sooner, would mean pretty much eating non-stop all day.
And if THAT's right, it seems as if it might be almost hard to regain...IF you stick with eating low-carb/high protein foods. And if you don't stick with eating them, it seems like you'd be feeling pretty lousy long and maybe even getting sick long before you regained most of the weight you'd lost.
As I said....I'm a newbie, so I may have this all garbled. So, I'm asking for clarification and edification, not criticizing anyone or suggesting that what I think now is really true. But I'm a little spooked by the idea of how easy it might be to regain and hoping that if I really understand what CAN go wrong, I can avoid it.
This is what I THINK I understand now...very simplified: People regain when, over time, their pouch (or perhaps more precisely their stoma) stretches and they find themselves eating a lot more food (calories) than they burn. If they drink with meals, it also washes food out of the pouch faster, so that they get hungrier sooner and eat more often than needed for maintenance. Combine this with making poor choices of foods...ie. too many simple carbohydrates, which burn off too fast and prompt you to eat more and to some degree, too-much fat, boosting calorie count too high for what you're burning each day.
Is that more-or-less right? If so, then it seems to me that the volume of food you put in your pouch over the course of a day is critical. And I'm having a tough time imaging being able to eat enough food to cause regain. That's not based on how full my pouch feels now, but on the sheer amoubnt of TIME it would take to eat enough. As it is now, I feel as if I spend a good part of my day eating...breakfast smoothie, lunch, afternoon snack, late afternoon snack, dinner. To eat MORE or more often, because I was eating the wrong stuff and getting hungrier sooner, would mean pretty much eating non-stop all day.
And if THAT's right, it seems as if it might be almost hard to regain...IF you stick with eating low-carb/high protein foods. And if you don't stick with eating them, it seems like you'd be feeling pretty lousy long and maybe even getting sick long before you regained most of the weight you'd lost.
As I said....I'm a newbie, so I may have this all garbled. So, I'm asking for clarification and edification, not criticizing anyone or suggesting that what I think now is really true. But I'm a little spooked by the idea of how easy it might be to regain and hoping that if I really understand what CAN go wrong, I can avoid it.
HW 270, SW 257, Surgery date: 4/25/12... 
I am a relatively newbie too but i am 11 months out. What your saying is exactly the way i see it. you let your old habits creep back in and you allow things like drinking with your meals and such is what i believe is the problem. And eating out and eating the wrong foods will cause regain. Mind you the malabsorbtion is going to go away. In other words if you eat 1000 calories a day you may only be absorbing 500 of those calories but when it goes away what you eat will be what your body absorbs. That usually happens around 18 - 24 months. Looks like you got your head on your shoulders right and i am confident you will keep remembering what you need to do and before we know it it will just be the way life is. 
Laurie says: Be who you are and say what you feel because those who mind don't matter and those who matter don't mind ~~~ dr. suess
Oh, Grasshopper, you have much to learn-and you've come to the right place!
The reasons you state for regain are accurate. There are others too, such as medications, but most of the regain is brought on by the issues you mentioned above.
Right now, you cannot even imagine being able to eat around your surgery-but after the passage of time, your ability to eat more and more often increases, as does your appetite. That is why it is critical that you change habits now while it is easiest to adapt. After a year, and even more years, it would be very difficult to change habits AND be hungry at the same time. I suspect that is why so many fail to lose the regain.
Little changes in how we lose weight-it is still a matter of calories in vs. calories out. Once you hit goal weight, as long as you burn what you consume each day, you will stay at that weight. Seems simple? Yes, it is. But it is not always easy.
By the two year mark, most people can eat what "normal" people should be eating as far as portions are concerned. For example, you probably can't even eat 1/2 of a Lean Cuisine now. But, over time, you'll easily be able to eat the whole thing, and still may be hungry an hour or two later. That is normal, and that is the desired result. The key is to make sure you eat things that are high in protein. Making good food choices is critical to long term success.
The other factor that is extremely important and too often overlooked or ignored is exercise. If we move our bodies regularly (an hour a day at least 5 days a week) we build muscle. Muscle mass increases metabolism-your body needs more fuel to support muscles than it does to support fat. So regular exercise gives your body the ability to burn more fuel, thus giving you the ability to consume more fuel-which means you are less likely to become hungry and make bad choices.
There is no WLS that is a magic bullet-they all require change and compliance on our part if we are to be successful for life.
The reasons you state for regain are accurate. There are others too, such as medications, but most of the regain is brought on by the issues you mentioned above.
Right now, you cannot even imagine being able to eat around your surgery-but after the passage of time, your ability to eat more and more often increases, as does your appetite. That is why it is critical that you change habits now while it is easiest to adapt. After a year, and even more years, it would be very difficult to change habits AND be hungry at the same time. I suspect that is why so many fail to lose the regain.
Little changes in how we lose weight-it is still a matter of calories in vs. calories out. Once you hit goal weight, as long as you burn what you consume each day, you will stay at that weight. Seems simple? Yes, it is. But it is not always easy.
By the two year mark, most people can eat what "normal" people should be eating as far as portions are concerned. For example, you probably can't even eat 1/2 of a Lean Cuisine now. But, over time, you'll easily be able to eat the whole thing, and still may be hungry an hour or two later. That is normal, and that is the desired result. The key is to make sure you eat things that are high in protein. Making good food choices is critical to long term success.
The other factor that is extremely important and too often overlooked or ignored is exercise. If we move our bodies regularly (an hour a day at least 5 days a week) we build muscle. Muscle mass increases metabolism-your body needs more fuel to support muscles than it does to support fat. So regular exercise gives your body the ability to burn more fuel, thus giving you the ability to consume more fuel-which means you are less likely to become hungry and make bad choices.
There is no WLS that is a magic bullet-they all require change and compliance on our part if we are to be successful for life.
I agree with Kim about exercise. My surgeon went to a weight loss surgery conference for surgeons last week and she told me a study was done that found that those who exercise and build muscle do not gain the weight back as frequently as those who do not exercise. They did a show of hands of which surgeons emphasize strength training and exercise after surgery, and only 3 of the doctors raised their hands! She was surprised and said that may contribute to why so many people regain.
That.... and the RNY itself.
Some of us develop Reactive hypoglycemia. I know I have it . My body most likely makes too much insulin. Not only that - my blood sugar (BS) can crash (get to low -) if I do not eat enough. And then I had no choice but to eat carbs to bring my blood sugar up (like yesterday). I have no choice - I have to eat 6-7 times a day. I am still able to control the regain - but it is hard work every day. Very fine line between enough to help my BS and not too much to cause regain.
Some days - I can limit what and how much I eat - but some days - my BS gets too low and I just crash... and have to eat...
google
hypoglycemia and reactive hypoglycemia.
Some of us develop Reactive hypoglycemia. I know I have it . My body most likely makes too much insulin. Not only that - my blood sugar (BS) can crash (get to low -) if I do not eat enough. And then I had no choice but to eat carbs to bring my blood sugar up (like yesterday). I have no choice - I have to eat 6-7 times a day. I am still able to control the regain - but it is hard work every day. Very fine line between enough to help my BS and not too much to cause regain.
Some days - I can limit what and how much I eat - but some days - my BS gets too low and I just crash... and have to eat...
hypoglycemia and reactive hypoglycemia.
Hala. RNY 5/14/2008; Happy At Goal =HAG
"I can eat or do anything I want to - as long as I am willing to deal with the consequences"
"Failure is not falling down, It is not getting up once you fell... So pick yourself up, dust yourself off, and start all over again...."
I have the hypoglycemia and reactive hypoglycemia and it makes me crazy because I never know when it is going to happen. I now carry a test kit with me (I am not diabetic, nor was I before the surgery) because I've seem my blood sugar go from 129 after a meal to 58 in 20 minutes! I try to really watch the carbs and I too eat 5-7 small meals per day.... but sometimes it hits, and it is so evil!
From my understanding it is very easy to eat around your surgery. If you graze all day on bad choices then you will gain. For example, I am 14 months out. Without thinking I was grabbing a spoonfull of reduced fat peanut butter throughout the day. It was more out of habit than hunger. I noticed my weight was stalling and I had gained a few pounds. I cut out the grazing and am back at my previous weight.
The farther out you are it is easier to eat higher fat foods and carbs. It is also easier to eat more than before. Hunger will also return. At this point I have to be conscious of everything I eat and exercise10-15 hours a week. I also have to be very careful with my choices.
The farther out you are it is easier to eat higher fat foods and carbs. It is also easier to eat more than before. Hunger will also return. At this point I have to be conscious of everything I eat and exercise10-15 hours a week. I also have to be very careful with my choices.
10 to 15 hours a week? My god, if I have to exercise that much, I think I'd rather go back to being fat. Mind you, I'm doing much better than ever before....a brisk walk of 35-50 minutes a day, at least 4 times a week and an average of 10,000 steps every day. I"m losing and I'm feeling healthy. I can imagine at some point adding an hour or two of biking or something on weekend days. But 15 hours a week, would leave me no time for anything but work and exercise...and I'm not going there.
HW 270, SW 257, Surgery date: 4/25/12...
Wellll...that's some of it. You also have to factor in that:
-the intestines grow longer villi capable of grabbing macro-nutrients (carbs, fat, protein) from your food. So you absorb more of your calories
-at lower weights your resting metabolic rate is lower than when you were bigger so you don't need as many calories to exercise, survive, etc.
These factors along with non-compliance can contribute to weight gain.
-the intestines grow longer villi capable of grabbing macro-nutrients (carbs, fat, protein) from your food. So you absorb more of your calories
-at lower weights your resting metabolic rate is lower than when you were bigger so you don't need as many calories to exercise, survive, etc.
These factors along with non-compliance can contribute to weight gain.
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