Why aren't you hungry after RNY?

Your surgeon is correct. Sleevers get hungry again, same as RNY. Ghrelin is produced in other parts of the body, not just the stomach. And Ghrelin is not the only thing that causes hunger.

Trying to pick a surgery based on hopes of lack of hunger in the future is like trying to pick a winning lottery number. Good luck with that. Most everyone will get hungry again, and be able to eat enough to gain weight. The real work will end up being in your head.

Based on your severe GERD, that would be the primary factor in your decision. For me, it would be the only one. I would never get VSG with reflux. Ever.

Thanks a bunch for your input! I'm definitely not hoping to never be hungry again, and I've made some considerable changes already that I hope will last and help me make this successful. I'm still just really curious how you don't wind up hungry all the time with a part of your stomach hanging out in your abdomen that never gets food...it's the actual mechanism I'm trying to figure out.

I'm not sure scientists understand, beyond the fact that there are lots of hormonal changes. Lack of hunger can be qualitative, and subjective, and very difficult to measure.

One hormonal change that is crystal clear is remission of diabetes. Many wake up after surgery with diabetes in remission, like some internal switch was flipped. Scientists don't fully understand that, either, but the results are indisputable. Lack of hunger is another hormonal change, and saying simply lack of ghrelin doesn't begin to scratch the surface. One day our children, or grandchildren, will figure out how to flip the hunger switch without surgery, but for now it's all we have.

Just within the last month or so, the FDA approved a device, a kind of pacemaker, that is implanted and attaches to the vagus nerve, and helps control hunger. Tests showed it helped enough to get it approved, but it only helped lose about 10 percent excess weight. Not much, in my opinion.

Another hormonal change that researchers have ignored is the cold factor. Some people wake up from WLS cold, all the time, where they had always been overly hot before. Most just shrug it off as "loss of insulation," and it's nothing harmful. But a hormonal change is the only way to explain the change happening that fast.

Even if you set aside the psychological component, hunger is a very complex physiological mechanism. They've barely begun to understand it. But what is very clear, is that the success of any WLS, besides the band, has little to do with simple concepts like restriction or limited and temporary malabsorption. It truly is METABOLIC surgery.

When people say things like, "Well, if you have to watch what you eat and exercise after surgery anyway, why don't you do it without surgery?", they clearly do not understand all the things surgery does.

Thank you for sharing all of your insight! You're absolutely right -- it's not just a matter of anatomical changes, but functional ones as well. And I'm sure it gets even more complicated than that, with the new diet playing a role in hormone production as well. Even pre-surgery, I notice myself no longer craving things I used to eat all the time, especially since I actually started eating vegetables. Thanks for helping me get revved up for the next step of this wild ride!  :)

I agree that there are a ton of hormonal changes that happen under the hood post surgery, but I never would have thought that feeling cold would be connected to hormones.  So interesting!

Jen

I read that twice!! Good knowledge transfer .thank you

gremlin production,for me,was not temporary. I am six years out and can count on one hand the number of times I have been hungry. 

 Everyone is different;  I very rarely have the hunger pangs like I did pre-op.  Now I'll get the jitters due to low blood sugar, or maybe a mild dull ache.  

I am 29 months post op and never have had hunger return like before. Now if I go too long between meals I will get weak feeling but not the stomach growling hunger of before. Everyone is different though!

My surgeon told me he would eliminate my hunger by also cutting my vagus nerve.  It is over seven years now and I have not been hungry since the RNY and cutting of vagus nerve.