New Data on Weight Gain Following Bariatric Surgery

Thanks for having the courage to post this MM. 
(xpost)
Many of my pyloric valve PSAs, that I have been repeatedly burned at the stake over, have involved studies in which Dr. Roslin has been a part of.

The evidence has been becoming clearer and clearer that pylorus preserving WLS has many benefits over man made stoma*****hed into pretend stomachs. 

Yes, there is a chance that people with pyloric preserving surgeries can develop early/late dumping/RH but that number is significantly lower as compared to those with RNY and there is a myriad of other contributing factors as to why one with a pyloric valve might develop it , surgery or no surgery.

There are many people here *****fuse to believe that the Pyloric Valve has ANYTHING AT ALL to do with it and no study will convince them of the ever growing evidence.

Dr. Roslin and his team decided to investigate whether two other bariatric procedures that preserve the pyloric valve – sleeve gastrectomy and duodenal switch – would lead to better glucose regulation, thus suppressing weight regain. The preliminary data of this current study shows that all three operations initially reduce fasting insulin and glucose. However, when sugar and simple carbs are consumed, gastric bypass patients have a 20-fold increase in insulin production at six months, compared to a 4-fold increase in patients who have undergone either a sleeve gastrectomy or a duodenal switch procedure. The dramatic rise in insulin in gastric bypass patients causes a rapid drop in glucose, promoting hunger and leading to increased food consumption.

HOW MUCH MORE EVIDENCE DOES ONE NEED TO BE CONVINCED THAT KEEPING ONE'S PYLORUS IN TACT IS A GREAT ADVANTAGE OVER RNY?

 Courage?

It's truth.

I live with it.

 I've had a continuous glucose monitor shoved in my gut, and medication.  It happens.  :)

 

 

wow.........   

Girlygirl, I am glad to heat that my pyloric valve has not left the building! 

MM, we can HANDLE the truth, as we have to learn to live with it. 

Julie R., I am experiencing significant reactive hypoglycemia to certain fruits and some whole grains.  I need to be prepared for it to get worse and be aware that I need to avoid simple carbs like the God-blessed plague.  LOW blood sugars is an unexpected scenario for me and if I am not mindful, correcting it can lead to some bad habits (like cookies!).

So does this mean I'm doomed?  Does every RNY patient get reactive hypoglycemia?  I've been experiencing vertigo lately.   What symptoms do I look for? 
The prospect of regain is a total nightmare!!!!  This heightens my insecurities but it's a very important FYI.  Just another thing to be aware of long term because going back to being obese isn't an option for me.   Thanks for sharing.

I went through a period of orthostatic hypotension/vertigo from about 12 to 18 months out, then that dissipated.

i do not think that RH is a guarantee for RNYers... I haven't seen any stats on the commonality of it. I'd say (reaching for numbers out of thin air) that the stats on it is that it is as likely as dumping. 30%

And also MORE likely in those who DO dump. I have both, dumping and RH

One can exercise a LOT of control (or attempt to) ..... Monitoring levels of glucose, journaling extensive information about foods consumed, determining triggers, avoiding them, and then finally hoping that new triggers won't become apparant amongst the foods that you once deemed safe..

  Dr Roslin also wrote a great article in Bariatric Times about pyloric preservation in 2009

www.nxtbook.com/nxtbooks/matrix/bt_supp0609/index.php
iS IT TIME TO BYPASS THE BYPASS? 
SHOULD THE PYLORIC PRESERVATION
BECOME AN IMPORTANT PRINCIPLE
IN BARIATRIC SURGERY?