Comment Response

I got an interesting comment from my post the other day "Musings". I'd like to answer this comment as my post for today as it has some excellent points (thanks to the anonymous poster!):

First, you say that when you have the surgery you will change your eating habits and increase your exercise. What's stopping you from doing that now? I get that once you hit a certain weight, it is extremely difficult to lose weight, I've been there myself. I'm just curious what is different about your level of exercise and diet now. Obviously, after surgery you can only eat a little, but would it not be to your advantage to eat a healthy diet now in preparation for surgery?

That's an excellent question. As I've just started this blog I haven't really gotten in all my thoughts on this surgery, etc (I suspect they will take a long time to all come out!). In response I'd say this: There is something that is 'stopping' me from exercising more than I already do - it's my weight! Ironically, walking around with 100 lbs on my frame for long periods of time (more than 10 minutes) makes my ankles throb and my knee scream painfully. My hip is messed up too and although it doesn't hurt when I walk, I sure hurts afterwards. I know I sound like I'm whining, but it's just the gory truth. I move as much as I can without unnecessary pain and look forward to being able to move much more once I lose 50lbs or so. I don't eat all that poorly now, but have really come to conclude that diet is not my biggest problem - it's what my body is doing with the food I put in. My husband is much smaller than me (regular size) and eats the same diet. Metabolism "is a bitch" (pardon my french). It's a difficult, frustrating and often pointless uphill battle to lose the weight (which I have done before), for it just comes back with friends. Down 20, up 25, down 40, up 50. It's stupid. I refuse to diet anymore until I have a long-term solution that will give me a fighting chance against my metabolic syndrome.

Second, you say that hunger rules your life. What about the surgery will change your level of hunger? From what I understand, the surgery changes the way you absorb calories and the size of your stomach to reduce the amount of food you can eat. Will this reduction really change your hunger level enough to make you satisfied with only a few bites at meal times? It seems to me, hunger is twenty percent physical and eighty percent mental. Will the surgery make your brain stop wanting food when your body can no longer handle it?

Another great question! Thank YOU! The RNY procedure I hope to have actually does GREATLY effect your hunger. Obviously, I'm talking about physical hunger (not head hunger), and if I could make that stop I'd give almost anything. Years ago I went through a great program Christian, biblical weight loss program called the "Weigh Down Workshop". It has since had it's theological problems and lost much of it's acceptability in the Christian world (too bad really). I lost 40 lbs through spiritual discipline, and learning to eat when I was hungry and stopping when I was satisfied (not even full).

Although I continued to eat that way, within 2 months of reaching 200 lbs, I gained back 57 lbs. To this day I continue to strive to be aware of my hunger and fullness and I have reduced my "head hunger" to almost 0%. I've replaced feeding my spirit with food, by feeding it with spiritual things! Worship, prayer and reading.

So now I'm just dealing with physical hunger. My husband is amazed though... we can eat the same thing, the same amount and at the same time and I'm really, really physically hungry at least an hour before he is. Considering how many calories I have stored away, this made no sense to me. I went to my Dr. and basically said "what the hell?" I'm mad, this isn't working right at all. I'm way too hungry, way too often and the only thing that makes the hunger stop is sugar. A 4 course meal with balanced and nutritious foods fills me up and I can feel my stomach is full, but the hunger signal is still going strong. What's wrong with me?

My doctor sent me for some tests. He called me and said "I know what's wrong. You have Metabolic Syndrome." I didn't know what that was (but have learned lots since), and he continued on to tell me my test results showed highly elevated insulin levels, but normal fasting blood sugar levels. Whereas a diabetic would have rock bottom insulin OR blood sugar levels depending on what type of diabetes was present, I had a strange imbalance. He said my body is not using the insulin properly and that is why I'm hungry so often. The greatly elevated insulin levels in my blood "latch on" to any sugar in the food I eat and immediately store it as fat (within minutes) so the blood sugar level drops down too soon and triggers hunger too soon after I've eaten. It is legitimate hunger and feels (so says the doctor) like it does if a normal person skips the first 2 or 3 hunger feelings. The 4th is almost unbearable. Unfortunately, that's what my 1st trigger feels like. So either I eat every 2 hours (which equals too much food total in a day), or I wait until a reasonable 4 hours and eat way too fast and way too much in desperation trying to get rid of the hunger signal. And hoping to avoid a migraine which is exactly what I get when I get too hungry - like skipping the first hunger signal (as bad as that one was the next one is 2x worse).

As you can imagine, this is frustrating and depressing for me at 257 lbs. I don't need the food, I don't need the hunger, I have all the energy I need for weeks packed away on this poor fat laden body. But years of eating poorly, genetic disposition and pre-programmed personality traits (high energy, high stress attractor) leave me where I am today. If I could get the hunger signal to turn off, I'd be thrilled. When I'm not physically hungry I can make much better food decisions, unfortunately at this point that still doesn't help as beating the signal to the punch has to happen too often and even small amounts of food too often add up to too many calories. Especially when you need sugar to ensure the signal doesn't come.

In several articles and from speaking with others who have had the RNY surgery, hunger is definately HUGELY diminished. You go from filling a stomach that can hold over 2 cups to a pouch that can only hold 2 oz. One article summarizes this well and is available here in full.

You will certainly eat differently. Patients experience significant lack of hunger after the gastric bypass. This is most significant immediately after the operation, but improves some with time. Patients also become very full (satiated) after eating small amounts of food. After a gastric bypass people generally are satisfied with the foods that they eat, they generally can eat regular food (with the exception of sweets) and many of their previous cravings are gone. In the first several months of the operation, patients have to adapt suddenly to their new eating style. There is a lot of trial and error in food selection. Within a few months, eating is much easier.

Ultimately, some who have this surgery "overcome" the reduction and stretch out their stomach and increase their caloric intake by eating high-calorie drinks (milk shakes, etc). All this surgery really does is buy you a finite window to make a radical and ongoing change to your lifestyle so that you don't fall back to where you were before. It is NOT a solution in-and-of-itself it is a TOOL only. You have the first 6 months to make the largest change, and 2 years total is usually when the lowest weight is achieved.

So... that was a very long answer! Of note (I'll have to find the medical journal article I read somewhere), 98% of people who get RNY surgery and have metabolic syndrome are "cured" of the syndrome by the surgery. HOORAY! I sure hope that works for me!