Seattle Area Duodenal Switch Message Board › Weight Regain (a.k.a OMG! My scale hates me!)

Weight Regain (a.k.a OMG! My scale hates me!)

Sammamish, WA
Post #: 15
Regain is not something we hear talked about in most DS circles. I've never truly understood if it was because people believe it doesn't happen or if people like to keep it a secret. Either way, it does happen and CAN be corrected.

One thing Dr. Rabkin has said to the group is that when we regain weight, we're very lucky that we have the DS because it is so receptive to dieting. I know, dieting is such a four-letter word but it is a tool we have at our disposal.

As we get further out our bodies because more efficient and start to absorb more nutrients from our food. Darn those vilii! It's one reason why many DS Dr's will recommend a lower fat diet for their patients, it's not because they don't know what our bodies does but they do know what it does later on. If you become accustomed to eating certain way then it's harder to break those habits to lose weight weight (if you regain). It's often why we all ended up having the surgery in the first place.

But it is fixable.

The first thing we want to do take a look at what we doing and not doing.

1) When was the lab time you had your times labs drawn? How were they?
2) Are you compliant on your supplements? What are you taking daily?
3) How much protein are you getting daily? In what forms?
4) Is your daily eating carb-centric? If so, what foods are you eating most often?
5) How much do you eat at one sitting? Are you are "normal" pre-op amounts or do you still eat small amounts?
6) How frequently do you eat each day? Are you a 3x/day eater or a "every two hours" eater?

Once you take a look at these basics you can start to formulate a plan to get the extra weight off.

Some of us had smaller stomachs made with longer common channels (for DS'ers) and some of us had short common channels with larger stomachs. The stomach itself is made up of two distinct areas/textures and the area left behind for us is less stretchy that the outer section of the stomach (where RNY pouches are formed). Because it is less stretchy it takes longer to stretch out, but it still happens.

If you aren't sure how much capacity you have right now, you can take the cottage cheese test. It can be an eye-opening experiment to see just how much food you are able to eat at once. The further out we get the easier it is to forget what it was like in the beginning when an ounce or two was tough.

Here's the "Cottage Cheese Test" if you are interested:

1) Purchase a container of small-curd cottage cheese.
2) On a completely empty stomach, usually first meal of the day, begin eating the cottage cheese at a quick pace until you feel full. It should take less than five minutes (in average). The small curds don't require a lot of chewing and you want to get your stomach (or pouch) full before it begins to move out.
4) After eating your fill of the cottage cheese you can place water on top of it in the container until it reaches the top. The amount of water used indicates the volume of your stomach.

Example: if you buy an 8oz container of cottage cheese, eaten until full, and then pour in water measuring 6oz then your stomach volume is currently 6oz.

By the way, RNY research has indicated that stomachs up to 9oz should have no difficulties in continuing to lose and/or maintain their weight. We don't have studies like this for DS patients that I'm aware of or do not have access to.

Now, let's get to the nuts & bolts ..

The first thing I recommend EVERYBODY do, whether they are 10 years or 10 days out:

30 grams of protein (minimum) within 30 (up to 60 minutes) of waking up.

If you build that solid foundation the rest of your day should go smoother. I also recommend that the protein be in shake formula because it's already in an easy to access format for our bodies and we get as much of it as we can. I know quiet a few people who are proud that they've never drank a shake in their entire surgery but I don't consider that an accomplishment since I know what they've done for me that eating protein from regular food hasn't.

I'm one of those with the smaller stomach and longer common channel. I just can't/don't/won't eat enough "real" food to get my protein in on a daily basis. I also like to eat 3x/day when most people are on the every two hour track. I find that if I eat 3x/day then I eat less food overall (I know, sort of a 'duh' comment but …) and I feel better. If I eat every two hours not only do I eat more food but I start craving food that isn't good for me.

If I start with a protein shake, which I generally make with two scoops of protein (48 grams total) plus 1/2 cup heavy cream that gets me going and keeps me going until my normal lunchtime. I have reached the point where I wake up craving my protein shake. My body likes it and so do I.

Now what?

Now you look at the list above and you take an honest look at where you are in your post-op life. A ship must make a thousand corrections while traversing the ocean just to keep a straight course. We're not any different than that ship. It takes a lot of work to keep going on our path.
Kari L.
user 8319723
Lake Stevens, WA
Post #: 1
I so needed to read this. There are so many things I'm not doing. I'm behind in having my yearly follow up with Dr. Rabkins office. I take a multivitamin but am low in so many if not all areas concerning labs. I need to get my act together before I become a statistic. I will be at the meeting in Feb. I know I can do this. I believe in wls and have always felt I made the right choice. Time for me to put on my big panties and do what I need to do. I just bought Gold Standard 100% whey isolates to supplement. Can tell my body is appreciating it. Thank you!
user 54835832
Seattle, WA
Post #: 1
Thanks Tracey, That's a good subject.
Like you, I have the smaller sleeve with the longer common channel so I'll most likely have to supplement with protein for the rest of my life in order to get my required protein in.
It seems the DS'ers who have succumbed to the carb monster have the most regain. Carbs are not DS friendly! Make sure you have had your protein before indulging.
Sammamish, WA
Post #: 16
The theory behind the use of the longer common channel is for more absorption because things are in the system longer. Which means, theoretically, when you have a longer common channel you would need LESS than someone with a shorter common channel because you are able to absorb it.

That said, we're all so different. I know people who have better labs than I do that don't take many supplements, don't take protein shakes and have a common channel length of 75. Correlation is not causation. While I don't mind having a longer common channel and think the idea is sound, I also know that we're all too individual for it to be conclusive.

You have to be diligent about your labs and paying attention to YOUR body because when it comes down to it, that's all that matters.
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