Controversial - Ghrelin is actually a GOOD thing!
Please, please don't take my posts on this topic the wrong way. As proof that I am not trying to upset people, I am absolutely going to have WLS within the next month or two, either VSG or RNY. But I do think the truth is important, and it seems to just be accepted as gospel without questioning that ghrelin is a bad thing the body makes or overproduces only when you are obese - and this is simple not true based on the research. Researchers are looking, as we speak, to find ways to INCREASE ghrelin in order to realize the broad health benefits associated with it.
I'm not at all upset or taking the posts the wrong way. I was just saying that I never noticed significant benefit from the antidepressant characteristics of ghrelin pre-op and if I had to overeat to get a boost of NPY...well, surely I can find another solution for calmness...even if the solution is not being calm sometimes.
Best of luck to you in your surgery!
Lindsey
Hope you don't mind me putting my 2 cents in, but ghrelin is also produced elsewhere beside the lining of the fundus. It is produced in the pancreas and also the hypothalamus for the growth hormorne. Each area it is produced in has a different reason to aid, or HINDER in our cases, our physiological functions. So from what I understand we are still ok. If ghrelin has a tendency in aiding depression and anxiety and that part has been removed for me, maybe I can go off my effexor now!!! Probably not though, at my age that is not the hormone affecting mine! LOL
Always love to be updated on any medical issues, especially regarding the WLS...so thank you very much and I will keep checking it out.
Always love to be updated on any medical issues, especially regarding the WLS...so thank you very much and I will keep checking it out.
Thanks for your comments! Just to re-clarify, only 20% of ghrelin is produced by those other parts of the body. So when all is said and done, VSG patients have a 60% reduction in ghrelin even years after surgery. As for RNY patients, the studies are much less consistent as to the long term ramifications on ghrelin levels, but it may be that laporascopic RNY lowers ghrelin more than open RNY surgery because the vagus nerve bundle (that innervates the ghrelin producing cells in the stomach) is usually severed -- which may help add to total weight loss.
As an aside, the Band actually INCREASES ghrelin, which is one reason it is a lously choice for long-term weight loss (even though it sounds so appealing when first presented to people). The research is clear that restriction only plays a modest t role at best in long term weight loss. Also as an aside, It is also clear that malabsorption has virtually no impact on weight loss from (proximal) RNY surgery -- yet people are still being taught that it does by surgeons for some reason.
As a final aside, RNY patient lose more weight than VSG because the surgery drastically increases energy expenditure (EE) after eating, resulting in a 31% in resting EE (think metabolism). The sleeve, by contrast does not increase EE, even though it does reduce hunger, so not quite as much weight is lost (but it is an easier surgery). In a study, the RNY rats lost twice as much weight as the same obese rats fed the exact same small amount as the RNY rats but without the RNY surgery (called pair-fed), because of the huge increase in EE. This was the finding of this 2009 Harvard study (best WLS study I've seen):
http://www.nature.com/oby/journal/v17/n10/full/oby2009207a.h tml
As an aside, the Band actually INCREASES ghrelin, which is one reason it is a lously choice for long-term weight loss (even though it sounds so appealing when first presented to people). The research is clear that restriction only plays a modest t role at best in long term weight loss. Also as an aside, It is also clear that malabsorption has virtually no impact on weight loss from (proximal) RNY surgery -- yet people are still being taught that it does by surgeons for some reason.
As a final aside, RNY patient lose more weight than VSG because the surgery drastically increases energy expenditure (EE) after eating, resulting in a 31% in resting EE (think metabolism). The sleeve, by contrast does not increase EE, even though it does reduce hunger, so not quite as much weight is lost (but it is an easier surgery). In a study, the RNY rats lost twice as much weight as the same obese rats fed the exact same small amount as the RNY rats but without the RNY surgery (called pair-fed), because of the huge increase in EE. This was the finding of this 2009 Harvard study (best WLS study I've seen):
http://www.nature.com/oby/journal/v17/n10/full/oby2009207a.h tml
No one should take PERMANENT WLS lightly (I don't count Crapband as permanent WLS sorry)...I think majority of peeps don't! Its so cute you lookin all this stuff up and are real concerned. Thanks for sharin the links..Ive read some of em. Will read thru em all tho later
When it was time for me ..MEDICAL INTERVENTION ....I looked at all the SURGERIES ya know THINK TWICE and CUT INTO ME ONCE....and how each one would work in my lifestyle, risks, costs, long term comps, maintenance... not so much the ghrelin even tho all permanent WLS alter ghrelin right! Grehlin reduction for me was just gravy! 70% of circulating hormone ghrelin in the fundus. The next largest amount almost 1/3 in the duodenum/small intestine. Thereafter, hypothalmus, pituitary, pancreas, and recently finding ghrelin produced in the glomeri of kidneys in lab rats so maybe humans too!
Yes ghrelin IS a good thing! wholeheartedly agree....especially for them little kids..essential for growth! like that 11 year old in Mexico that had VSG...tsk tsk
As an adult don't need no more growin!:
I also WHOLEHEARTEDLY agree....
my HEART is much more needed than 70% of my circulating grehlin thank you Hypertension resolution with VSG 3 years ago!!
my ENDOCRINE & METABOLIC system is much more needed than 70% of my circulating ghrelin: thank you Diabetes II and Hyperlipidemia off the charts for 15 years! .......resolution with VSG 3 yrs ago
My SKELETAL and MUSCULATURE are much more needed than 70% of my circulating ghrelin...
thank you mobility and resolution of chronic plantar fascitities with VSG 3 years ago.
My MENTAL HEALTH is much more needed than 70% of my circulating ghrelin ..thank you major depression, and 15 years of anti-depressants .....resolution with VSG 3 yrs ago...NEVER on a single Stepford Wife pill again. I emote regularly and mostly ,-) appropriately. Return to self-esteem, confidence, receptive to kindness and inturn more kind towards others, open to new experiences and challenges, planning and goalmaking because I HAVE a future, receptive to compliments, and photo taking, no longer isolative or seclusive, sex exudes me, gettin hit on by old goats, WHEN IM OUT WITH DH!!...at my age...says alot! lmao!
Ghrelin is overated...in terms of MY grand picture ,-)
When it was time for me ..MEDICAL INTERVENTION ....I looked at all the SURGERIES ya know THINK TWICE and CUT INTO ME ONCE....and how each one would work in my lifestyle, risks, costs, long term comps, maintenance... not so much the ghrelin even tho all permanent WLS alter ghrelin right! Grehlin reduction for me was just gravy! 70% of circulating hormone ghrelin in the fundus. The next largest amount almost 1/3 in the duodenum/small intestine. Thereafter, hypothalmus, pituitary, pancreas, and recently finding ghrelin produced in the glomeri of kidneys in lab rats so maybe humans too!
Yes ghrelin IS a good thing! wholeheartedly agree....especially for them little kids..essential for growth! like that 11 year old in Mexico that had VSG...tsk tsk
As an adult don't need no more growin!:
I also WHOLEHEARTEDLY agree....
my HEART is much more needed than 70% of my circulating grehlin thank you Hypertension resolution with VSG 3 years ago!!
my ENDOCRINE & METABOLIC system is much more needed than 70% of my circulating ghrelin: thank you Diabetes II and Hyperlipidemia off the charts for 15 years! .......resolution with VSG 3 yrs ago
My SKELETAL and MUSCULATURE are much more needed than 70% of my circulating ghrelin...
thank you mobility and resolution of chronic plantar fascitities with VSG 3 years ago.
My MENTAL HEALTH is much more needed than 70% of my circulating ghrelin ..thank you major depression, and 15 years of anti-depressants .....resolution with VSG 3 yrs ago...NEVER on a single Stepford Wife pill again. I emote regularly and mostly ,-) appropriately. Return to self-esteem, confidence, receptive to kindness and inturn more kind towards others, open to new experiences and challenges, planning and goalmaking because I HAVE a future, receptive to compliments, and photo taking, no longer isolative or seclusive, sex exudes me, gettin hit on by old goats, WHEN IM OUT WITH DH!!...at my age...says alot! lmao!
Ghrelin is overated...in terms of MY grand picture ,-)
That is very well put, indeed! As I said in my initial post of this thread, losing the excess weight is by far the most important health benefit of all!
My concern is really just that there are some mistruths being perpetuated out there, by surgeons who heard them years ago and have no need to update their knowledge base, as well as by patients who heard them (usually from their surgeons).
Here are a few major mistruths which I've tried to address in this thread:
(1) Excess ghrelin is the reason we are obese, and ghrelin is bad for our health.
- No, based on the latest research, morbid obesity is most likely due to a dysfunction in the duodenum of the small intestine. And ghrelin is good for our health. If there were a way to lose all the weight and have very high ghrelin, that would make us the healthiest. But, in the absence of that ideal option, it may be that we have to accept unnaturally low ghrelin in order to lose the weight.
(2) RNY surgery causes long-term weight loss due a combination of (i) restriction and (ii) malabsorption of calories.
- Wrong on both counts! Based on the best research, RNY causes long-term weight loss because of (i) decrease in appetite not due to restriction and (ii) drastic increase in resting energy expenditure (aka metabolism). The malabsorption component is irrelevant to proximal RNY weight loss, and this has been confirmed across multiple studies.
(3) People regain weight because their pouches stretch.
- If this were trure, the lap-band would produce major long-term weight loss, but it doesn't. By contrast, without any restriction at all, a simple sleeve inserted into the duodenum of the small intestine to move absorption further downstream produces drastic weight loss (almost on par with RNY) without malabsorption of calories -- and it cures diabetes, high blood pressure, high cholesterol, etc (but they won't let you leave it in permanently as of yet). The point is that long term, major weight loss has everything to do with altering the body's fundamental homeostasis (balance point) for weight -- and not much at all to do with motivation, will power, stomach size, ability to 'push away from the table', or 'portion control', or exercise. This is why over 95% of people with morbid obesity fail at diets and exercise (let's just round off and call it 100%). It is like asking someone to breathe 25% less per day, and then to exercise more to help the process -- impossible! Same re food if you have the disorder of morbid obesity -- exercising more will just make you eat that much more and then some. The VSG and RNY surgeries address the homeostasis issue, and that is why they work long-term, not because of restriction (which may help at first, but not long term). If people regain the weight from VSG or RNY, it is because the homeostasis solution failed to work, and there is research on why this might happen for some but not others. Don't blame yourself for becoming fat is the message -- it is an physiological disorder.
My concern is really just that there are some mistruths being perpetuated out there, by surgeons who heard them years ago and have no need to update their knowledge base, as well as by patients who heard them (usually from their surgeons).
Here are a few major mistruths which I've tried to address in this thread:
(1) Excess ghrelin is the reason we are obese, and ghrelin is bad for our health.
- No, based on the latest research, morbid obesity is most likely due to a dysfunction in the duodenum of the small intestine. And ghrelin is good for our health. If there were a way to lose all the weight and have very high ghrelin, that would make us the healthiest. But, in the absence of that ideal option, it may be that we have to accept unnaturally low ghrelin in order to lose the weight.
(2) RNY surgery causes long-term weight loss due a combination of (i) restriction and (ii) malabsorption of calories.
- Wrong on both counts! Based on the best research, RNY causes long-term weight loss because of (i) decrease in appetite not due to restriction and (ii) drastic increase in resting energy expenditure (aka metabolism). The malabsorption component is irrelevant to proximal RNY weight loss, and this has been confirmed across multiple studies.
(3) People regain weight because their pouches stretch.
- If this were trure, the lap-band would produce major long-term weight loss, but it doesn't. By contrast, without any restriction at all, a simple sleeve inserted into the duodenum of the small intestine to move absorption further downstream produces drastic weight loss (almost on par with RNY) without malabsorption of calories -- and it cures diabetes, high blood pressure, high cholesterol, etc (but they won't let you leave it in permanently as of yet). The point is that long term, major weight loss has everything to do with altering the body's fundamental homeostasis (balance point) for weight -- and not much at all to do with motivation, will power, stomach size, ability to 'push away from the table', or 'portion control', or exercise. This is why over 95% of people with morbid obesity fail at diets and exercise (let's just round off and call it 100%). It is like asking someone to breathe 25% less per day, and then to exercise more to help the process -- impossible! Same re food if you have the disorder of morbid obesity -- exercising more will just make you eat that much more and then some. The VSG and RNY surgeries address the homeostasis issue, and that is why they work long-term, not because of restriction (which may help at first, but not long term). If people regain the weight from VSG or RNY, it is because the homeostasis solution failed to work, and there is research on why this might happen for some but not others. Don't blame yourself for becoming fat is the message -- it is an physiological disorder.
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