New data on weight gain

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New Data on Weight Gain Following Bariatric Surgery

Gastric bypass surgery has long been considered the gold standard for weight loss. However, recent studies have revealed that this particular operation can lead to potential weight gain years later. Lenox Hill Hospital’s Chief of Bariatric Surgery, Mitchell Roslin, MD, was the principal investigator of the Restore Trial – a national ten center study investigating whether an endoscopic suturing procedure to reduce the size of the opening between the gastric pouch of the bypass and the intestine could be used to control weight gain in patients following gastric bypass surgery. The concept for the trial originated when Dr. Roslin noticed a pattern of weight gain with a significant number of his patients, years following gastric bypass surgery. While many patients could still eat less than before the surgery and become full faster, they would rapidly become hungry and feel light headed, especially after consuming simple carbohydrates, which stimulate insulin production.
The results of the Restore Trial, which were published in January 2011, did not confirm the original hypothesis – there was no statistical advantage for those treated with suturing. However, they revealed something even more important. The data gathered during the trial and the subsequent glucose tolerance testing verified that patients who underwent gastric bypass surgery and regained weight were highly likely to have reactive hypoglycemia, a condition in which blood glucose drops below the normal level, one to two hours after ingesting a meal high in carbs. Dr. Roslin and his colleagues theorized that the rapid rise in blood sugar – followed by a swift exaggerated plunge – was caused by the absence of the pyloric valve, a heavy ring of muscle that regulates the rate at which food is released from the stomach into the small intestine. The removal of the pyloric valve during gastric bypass surgery causes changes in glucose regulation that lead to inter-meal hunger, impulse-snacking, and consequent weight regain.
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.
“Based on these results, I believe that bariatric procedures that preserve the pyloric valve lead to better physiologic glucose regulation and ultimately more successful long-term maintenance of weight-loss,” said Dr. Roslin.







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Wow. My question on another thread has been answered. Thank you for this.

Sorry about all the crap at the top, im still learning to use the computer!!!
Kim

It's fine Kim, the data was very useful!

Interesting study - thanks x

good to read! thanks

wow! good advert for the sleeve and d/s xxx

Great post ty x

Thanks for the article. Knowledge is power so they say. I hope so as I'm terrified of weight gain down the line!

I had a sleeve so I'm happy!

luckyla said:

I had a sleeve so I'm happy!

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yeah its got me thinking lol

Me too, its always been a concern, ide be heartbroken if it all went back on again. Just stumbled across this last night and i had to share.
Kim

I had ruled the sleeve out until i read that, trouble is it may delay my op if i change my mind now

flowerofshona said:

I had ruled the sleeve out until i read that, trouble is it may delay my op if i change my mind now

Click to expand...

Nothing lost by asking on tues hun

flowerofshona said:

I had ruled the sleeve out until i read that, trouble is it may delay my op if i change my mind now

Click to expand...

Why had you ruled out the sleeve?

Hi all. I had the sleeve op on 1st Nov 2011 and since then in the 12 weeks including pre op diet I have lost 7 stone. My diabetes has completely gone and I feel loads better. Solid food is going to be a long journey. I'm glad I had the sleeve as I will never be able to eat lots ever again but I will have the choice of most foods in small quantities

witchingmoon said:

You need to look in to the full study and how many people took part. Also diets in America are normally higher in sugar than the UK.
I was advised it is a marketing ploy to make people go for the DS as it cost more. I think yes it is good to know but if your worried talk to your team. I know quite a few long term Bypassers who have no weight gain or problems of this sort.

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All these reports just adds to the anxiety of us newly bypassers, I wanted the sleeve, but was advised by a very good surgeon that the bypass was best for me and my circumstances, as I was going private, the cost was the same, he had no reason to point me in the wrong direction ( i hope ).

I decided that my eating habits lent me to the bypass so i could not cheat, the sleeve does not stop me eating sweet stuff so for me the chance of dumping (i don't do vomiting, rather pass out!! ) ment that there is no way i would risk it.
I guess its down to how we change our life style post op as it wether or not we re-gain ??

flowerofshona said:

I decided that my eating habits lent me to the bypass so i could not cheat, the sleeve does not stop me eating sweet stuff so for me the chance of dumping (i don't do vomiting, rather pass out!! ) ment that there is no way i would risk it.
I guess its down to how we change our life style post op as it wether or not we re-gain ??

Click to expand...

This is it exactly - it is in the end, just a tool - its down to us what we put in it - if we go back to our old eating habits, then yes we will put on weight, if we eat good healthy food in the right quantities, we shouldn't stretch it to breaking point, and we shouldn't gain weight - in the end it is as its always been down to us - it will help us - but it will not make us thin - that is what we need to do - use it to its best ability and not chuck rubbish down it ( so much easier said than done) but really it is up to us