Malabsorption with the RNY/ Weight regain after WLS sugery

Hi,

Through this website and others, its been said or implied that the malabsorption part of the RNY doesn't last forever? Is that true? And if that's true how its that possible? Is it just your body readapting?

If true why do we have to take vitamins/minerals more than an average person if our bodies are absorbing 'normally' again.

From what I've researched and seen on forums that the first year or two is considered the honeymoon phase and that it will get more difficiult to lose weight after that. Whether that has anything to do with malabsorption or not...why does it get more difficult if your following healthy guide lines? I understand losing more weight the first six months, on liquid/pureed diet, and body healing.

For people *****gain some of their weight,after losing weight from weight loss sugery, is losing weight any harder than any other person who hasn't had bariatric surgery?

I'm also curious about people who are in the maintaining phase. What is your calorie intake? From what I gather after surgery were put on a calorie restriction of 800 or less? is that correct?

Any insight to any of this would be much appreciated. Thank you.

From what I have always heard, our intestines grow new villi which help our bodies absorb more calories, the further we get out. But this does not help us absorb more nutrients (not sure why) so we must continue to take vitamins and supplements. The further we get out, the more we can eat.

I am almost 8 years out and so many of my friends who had surgery the same time as me have had huge regains. As the saying goes, the surgery is just a "tool". You MUST remember that. I learned good healthy habits during the first 2 years that have helped me maintain my 200 pound loss. I consume around 2000 calories a day, but I do not think I am the norm. From all my years here, the average seems to be somewhere between 1200-1700.

I weigh myself a few times a week. If I am up 3, I cut bac****il I lose it again. If I am not careful I know I could easily gain much more and then I would feel overwhelmed. 3 is much easier to lose than 30. To lose, I take responsibility and stop making excuses. I cut back to 1500 calories a day and lose it in a few weeks. We can still lose further out, but it is much slower than it was in the beginning. I assume it is because we are now absorbing all of the calories we consume.

Thanks for the reply.

Do you find if you need to lose a few pounds that trying to lose that weight is like before if you haven't had surgery in the first place?

I understand that weight loss slows down, and I read on these type of forums of people having difficulty losing any regain weight and I wonder is it harder than anyone trying to lose weight (who has't had surgery) or its just more difficult than it use to be in the beginning after surgery?

Again thanks for your insight, I appreciate it!

I joined Weigh****chers many times pre-RNY. I started going again right after New Year's to lose my holiday weight. I would say I lost at pretty much the same rate as pre-op.

The 'honeymoon period' of rapid weight loss generally occurs during the first six months to a year. That's when you will find it easiest to live with a significantly reduced diet while your body continues to repair itself from the trauma of surgery. Once outside that 12 month window however, you will be able to consume pretty much anything you could eat previously however during the 12 - 18 month window, your smaller stomach will lead yo to settle for smaller portions at any given sitting. There is nothing to stop you from eating all day long however. Another useful side effect that will stay with you until about the 18 month window is the grief arising from "dumping" if you consume too much of anything that you really shouldn't either as quantity or selection. Personally, I found fatty foods were difficult to stomach for the first 18 months to 2 years. Two years though and the weight will begin to return if you haven't found your new basal metabolic rate. It will have reduced significantly from what it once was and you have to be careful not to exceed your new threshhold unless you really step up your activity level.

A normal sedentary male of my height (5'9") weighing in at 184 lbs who does as little as I do besides exercising my fingers on either the keyboard or the remote would need 2000 calories a day to maintain at 184 lbs. If one were to exercise vigorously for only 20 mins a day three times a week (or even 30 minutes every day of moderate activity) my set point would be 2400 calories and that extra 400 calories daily would allow the occasional misstep, or intended treat. But many formerly overweight people have long established poor eating habits and a completely sedentary lifestyle; based upon the results in the first year, there may be a tendency to continue relying on the surgery as a mechanism to keep your weight in check. That is a sure-fire recipe for a major weight regain.

That still sounds pretty simple though, who couldn't satisfy that measly activity requirement and maintain on 2400 calories a day? Immediately post surgery it would seem impossible for you to ever consume that much daily again. Unfortunately there is a huge catch that isn't really discussed because there hasn't been a lot of research even though there has been plenty of anecdotal evidence. On May 2, 2016 the front page of the New York Times introduced the world to this sorry tale about what happened to the contestants from Season Eight (2009) of NBC's "The Biggest Loser". Read the article here.   It discusses the results of a limited scientific study by a federal researcher of what happens to people over as long as six years after they had lost large amounts of weight with intensive dieting and exercise.  The results are scarey. He discovered that the reason 13 of the 14 contestants regained weight over the six years following the broadcast, and four were now heavier than what they were before the competition could be sourced back to the fact their metabolisms remained significantly lowered even six years out from the show. These people no longer had conventional metabolisms with most burning 400 to 600 calories daily less than a person who had never gone through extreme weight loss. One contestant who's initial and lowest weight tracks quite close to my own now needs 800 calories per day less than a person of similar current weight, size and activity level. For a desk bound, lazy guy like me that would mean anything over 1200 calories a day (which really isn't much at all) immediately goes to my a$$. :( Personally I have found my own set point to be slightly less than 1400 calories daily but haven't had much success in staying within that limitation because I refuse to obsess over what I'm eating next ....... and I like the odd beer. :D

That's why you will need to find your new setpoint and try to live within it. It will not be easy and that's why the success rate five years out is not something the professionals like to advertise, about 20% do not achieve their desired weight loss or eventually regain it all back. You don't hear much from them since they don't usually frequent forums like this which tend to be populated by new people like yourself or longer term successful patients who sometimes shame recidivists much like reformed smokers tend to do ......... I was successful so it must be all your fault, just stop eating!

Good luck with your journey.  

I have read the article about the biggest loser. It's a very discouraging article.  I've come to realize through research and forum like these that your new set point, is most likely going to be lower than a person who is at the same weight and hasn't had surgery.

I was just interested in what people are consuming calorie wise after a few years post surgery.

Thank you for your input.