Any signs that malabsorption has ended?
I agree there is ample evidence that intestinal adaptation occurs in response to gastric resection. However, I wasn't able to find anything that establishes the trigger of that adaptation as the presence of lesser-digested food. It's certainly a possibility. It's also a possibility the adaptation is due to some other feedback system that doesn't kick in for gastric bypass patients. For example, blood flow or the autonomic nervous system.
Can you provide a citation?
Several. (Yes, there may be many other things that also signal the body that adaptation is needed, but undigested food is a known one.)
Luminal Nutrients and Intestinal Adaptation Weser, Elliot Journal of Pediatric Gastroenterology & Nutrition (April 1985) 165-166
Intestinal Adaptation — Mechanisms of Control Robin C. N. Williamson, M.B., M.Chir., F.R.C.S. New England Journal of Medicine (June 28, 1978) 1444-1450
Intestinal adaptation after massive intestinal resection A R Weale, A G Edwards, M Bailey, P A Lear
Luminal Nutrients and Microbes in Gut Mucosal Growth In Regulation of Gastrointestinal Mucosal Growth. Rao JN, Wang JY. San Rafael (CA): Morgan & Claypool Life Sciences; 2010.
Role of Oral Intake on Intestinal Adaptation after Small Bowel Resection in Growing Rats Claude L Morin, Victor Ling and Micheline Van Caillie Pediatric Research (1978) 12, 268–271
Lora
14 years out; 190 pounds lost, 165 pound loss maintained
You don't drown by falling in the water. You drown by staying there.
So if you don't think the body adjusts and starts to absorb more do you think everyone just starts eating off the charts and gaining weight like gang busters? Because I can assure you when my body adjusted and I started to be able to eat the same and gain came at 4 years out I was shocked, dismayed and mad at my body, then I realized what an awesome gift I was given, and started cutting calories, listen to my bodies desire for food, when and where and have kept myself at goal ever since. Is it fun? Nope, saying no gets old sometimes, but every single morsel of food I put in my mouth is debated and weighed in my head, do I really want this? Is it worth it? Is there a health benefit or does it just serve some physical desire? If I am gonna get sick is this thing that good I am willing to get sick over? Yup every single thing I stick in my mouth, every day, all day, this is how I determine what I eat and what I don't. Perfect, never, but on point, always.
Thanks! I've had a great deal of success with my RNY also, losing 214 lbs and 100% of my excess weight. I have not experienced regain (at least not yet - 2.5 years out).
My own informal anecdotal research indicates that about 1/3 of patients experience significant regain. Right now I'm looking for someone who has studied this phenomenon in post-RNY patients and published articles about their research in peer-reviewed medical journals.
There is much conflicting information floating around...
I don't think you will find any. It is pretty difficult to get human test subjects for that kind of a study. That is why so many of the studies are done on rats.
Although there may be additional things that happen with NY, that does not mean that what happens in people with removed intestines is invalid and does NOT happen.
Lora
14 years out; 190 pounds lost, 165 pound loss maintained
You don't drown by falling in the water. You drown by staying there.
Maybe not, but there might be other interactions with RNY that change or negate the effects seen with major resections. We will never know without empirical studies that pass review, which can be repeated by multiple researchers.
Studies of post-RNY human subjects could be engineered that empirically measure how much food is metabolized vs. how much is consumed. As far as I know, no one has done one yet. I am sure someone will at some point, then we can say we know what is happening.
For me, I did have to drastically cut back on my calories. At the 2 year mark, I was eating 2700-3000 calories a day so I would not lose any more weight. About this time I gained 10 pounds practically overnight. I had to cut back to my current 1700-2000 calories a day.
Laura in Texas
53 years old; 5'7" tall; HW: 339 (BMI=53); GW: 140 CW: 170 (BMI=27)
RNY: 09-17-08 Dr. Garth Davis
brachioplasty: 12-18-09 Dr. Wainwright; lbl/bl: 06-28-11 Dr. LoMonaco
"May your choices reflect your hopes and not your fears."