"No surgery lets you malabsorb simple carbs"
This phrase often comes up when different surgery types are discussed. I have seen posters explain that they chose RNY for that reason, because they felt that dumping was their only tool against their carb habits/craving. I have also seen comments that basically advocate "if you like Atkins way of eating--high protein/high fat--then the DS is for you, but it won't help you much if you like carbs".
For the benefit of any pre-ops researching, I'd like to explore this notion a bit more, and explain why I actually think the DS is a smart choice for those who favor simple carbs.
Here's the thing that those conversations tend to overlook: simple carbs very often come paired with a substantial bit of fat. With the DS, although we don't malabsorb the simple carbs, we do malabsorb 80% of any fat that comes along with them. In terms of net caloric impact, this makes much more of a difference than you might imagine. I am convinced that it is the reason the DS has the most durable results in terms of loss.
Below are a few examples that illustrate what I mean:
A Krispy Kreme glazed donut: 12 g fat, 22 g carbs, 2 g protein. Calories: 200. DS absorbed calories: 114. (Only 57% of total calories absorbed.)
Two Reese's Peanut Butter cups: 13 g fat, 24 g carbs, 5 g protein. Calories: 210. DS absorbed calories: 129. (Only 61% of total calories absorbed.)
An entire pint of Haagen Dazs Dulce De Leche: 68 g fat, 112 g carbs, 20 g protein. Calories: 1160. DS absorbed calories: 610. (Only 53% of total calories absorbed.)
3 Pepperidge Farm Milano Cookies: 10 g fat, 21 g carbs, 2 g protein. Calories: 180. DS absorbed calories: 106. (Only 59% of total calories absorbed)
In the examples listed above, you can see that as a result of our malabsorption, we would absorb only about 1/2 to 2/3 of these calories, even though they are primarily "simple carb" foods. Think about this over the course of a week, a month, a year. Those calories do make a difference.
Now, please understand that I am NOT ADVOCATING that DS post-ops make a regular diet out of these items. Doing low-carb, high protein especially during rapid loss is the way to go (both for nutritional needs and to optimize your weight loss). Even with our malabsorption, eating too much of this stuff will absolutely lead to insufficient loss or regain.
My point is that we should keep in mind that we are all human. As pre-ops, I think a lot of us want to make deals with ourselves that we can't keep. We promise ourselves we'll go without ever eating x, y, or z again, if only we can be skinny and healthy. I'm here to tell you, realistically, it probably won't play out that way. There is a reason why diets have a 98% failure rate in the morbidly obese.
So, if you accept that this is going to be the rest of your life, and you ARE going to allow yourself to indulge reasonably in moderation (and maybe sometimes slip up and overindulge), the DS is the most forgiving surgery that exists. Especially when we select treats like the items above that combine fat and sugar.
On a personal note, I never favored the atkins way of eating as a pre-op. I always favored high-carb, low-fat diets. I loved desserts and sweets--the sweeter, the better. I would see people push away their dessert and say "that's too rich" and I thought they were full of **** How could something be too rich??
Well, the DS has changed my tastes. I still have a sweet tooth for sure, my threshold for them is much lower. A much smaller amount tends to satisfy me. Now I'm the person who pushes away the ultra-chocolate cake after several yummy bites, and although I can't bring myself to say it out loud, it is too darn rich.
I just want to put out there for pre-ops worried about your relationship to sugar: this is doable. As long as you make smart choices most of the time, you will still be able to enjoy the heck out of foods.
For the benefit of any pre-ops researching, I'd like to explore this notion a bit more, and explain why I actually think the DS is a smart choice for those who favor simple carbs.
Here's the thing that those conversations tend to overlook: simple carbs very often come paired with a substantial bit of fat. With the DS, although we don't malabsorb the simple carbs, we do malabsorb 80% of any fat that comes along with them. In terms of net caloric impact, this makes much more of a difference than you might imagine. I am convinced that it is the reason the DS has the most durable results in terms of loss.
Below are a few examples that illustrate what I mean:
A Krispy Kreme glazed donut: 12 g fat, 22 g carbs, 2 g protein. Calories: 200. DS absorbed calories: 114. (Only 57% of total calories absorbed.)
Two Reese's Peanut Butter cups: 13 g fat, 24 g carbs, 5 g protein. Calories: 210. DS absorbed calories: 129. (Only 61% of total calories absorbed.)
An entire pint of Haagen Dazs Dulce De Leche: 68 g fat, 112 g carbs, 20 g protein. Calories: 1160. DS absorbed calories: 610. (Only 53% of total calories absorbed.)
3 Pepperidge Farm Milano Cookies: 10 g fat, 21 g carbs, 2 g protein. Calories: 180. DS absorbed calories: 106. (Only 59% of total calories absorbed)
In the examples listed above, you can see that as a result of our malabsorption, we would absorb only about 1/2 to 2/3 of these calories, even though they are primarily "simple carb" foods. Think about this over the course of a week, a month, a year. Those calories do make a difference.
Now, please understand that I am NOT ADVOCATING that DS post-ops make a regular diet out of these items. Doing low-carb, high protein especially during rapid loss is the way to go (both for nutritional needs and to optimize your weight loss). Even with our malabsorption, eating too much of this stuff will absolutely lead to insufficient loss or regain.
My point is that we should keep in mind that we are all human. As pre-ops, I think a lot of us want to make deals with ourselves that we can't keep. We promise ourselves we'll go without ever eating x, y, or z again, if only we can be skinny and healthy. I'm here to tell you, realistically, it probably won't play out that way. There is a reason why diets have a 98% failure rate in the morbidly obese.
So, if you accept that this is going to be the rest of your life, and you ARE going to allow yourself to indulge reasonably in moderation (and maybe sometimes slip up and overindulge), the DS is the most forgiving surgery that exists. Especially when we select treats like the items above that combine fat and sugar.
On a personal note, I never favored the atkins way of eating as a pre-op. I always favored high-carb, low-fat diets. I loved desserts and sweets--the sweeter, the better. I would see people push away their dessert and say "that's too rich" and I thought they were full of **** How could something be too rich??
Well, the DS has changed my tastes. I still have a sweet tooth for sure, my threshold for them is much lower. A much smaller amount tends to satisfy me. Now I'm the person who pushes away the ultra-chocolate cake after several yummy bites, and although I can't bring myself to say it out loud, it is too darn rich.
I just want to put out there for pre-ops worried about your relationship to sugar: this is doable. As long as you make smart choices most of the time, you will still be able to enjoy the heck out of foods.
Jenna- leave it to you to post such a well thought out organized response to the question of carbs. Excellent. The only thing that I would like to add is that for me, I have a much reduced need/craving for sugar when I am really up on protein. I recently added 2 protein shakes to my regular eating regime and found that I was much less hungry and had reduced cravings throughout the day. I was a person that wanted to eat not drink my protein and worried that an excess of protein would be harmful for wt. loss- where in the hell I came up w/ that misguided idea I will never know but since adding the shakes my appetite is stabilized and so has my 3 yr. out wt. regain.
why anyone would want dumping is way beyond my comprehension....I am sure if you as the RNY to DS patients here they would agree with me, love your post, well written, I find for me I constantly have to defend my decision, but hey it is my life and my body......WLS will always be a challenge for a reason or another......
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