Can someone please explain this magical weight loss window thing to me?

[Marquis Mark]

I am not sure what you are struggling with, Mark (I don't mean that to sound snotty by the way). Two years (1224 months) is generally in the industry thought of as the period when one loses their weight...it takes time to get it off, some shed their weight in 12 months, others take more like 2 full years or more....It is also the time it seems to take (generalizing) for the villi in our absorbing small intestine to grow back (hypertrophy) to the point where it settles into equilibrium where it will for the most part be the rest of our lives (nowhere near the absorption we had pre ds but a bit more than the first 2 years).

So I think two things happen. Our bodes shed the excess weight, and then our bodies maintain that weightloss with our new "settled in" guts for the rest of our lives. At this point we are more like normies in that we have to watch what we eat or we will gain some more weight than we want, and the vets seem to find that comes from excessive carbs. Carbs do not cause any weight gain for me now, but do make my gut ache if I over do it and it can cause rough gas and the shits....but for most of the longer term vets they find that if they overdo the carbs they gain weight (not a bunch but 10-25 pounds) and to get it back where they want the weight to be they have to eat more protein, exercise and eat less carbs...but it does come back into the range they want to be in.

I think in general it is pretty safe to say that if we eat decently we are going to stay in a pretty darn healthy state at our desired weight, but even if we eat poorly we aren't going to reach fatassville where we used to reside.

I guess what I'm getting is that the body will readjust to its new thermostat at two years. And, just like before, you will have a hard time changing it. So the idea is to lower the thermostat as much as possible before homeostasis sets in...

 

[robs477]

God I love this place! So predictable!...in a good way of course...LOL….NOT to be dis-respectful or a jerk or anything…..BUT, I didn’t respond to this on purpose for a day or so because I too wanted to see if anyone would answer your question and just as I thought, they COULDN’T!!!! I TOTALLY UNDERSTAND THE INFO YOU ARE SEEKING, because I have been asking THE SAME question for well over a year now. I WANT (and you) want to know the SCIENTIFIC MECHANISMs that changes in the Gut, intestines, hormonal, eating more etc, or a combination of the 3 or 4 that actually SLOW DOWN the malabsorption after 1-2 yrs. I believe Dr.K wrote an article about microvilli density etc that actually grow denser and more populated in the intestinal epithelial lining after that 1st yr or two. Diana touched on it in the past also. THAT is the “Technical info” I think you are seeking??? Please correct me if I’m wrong because I AM seeking the same knowledge because of my excessive malabsorption issues and am waiting for that “mechanism” to kick in.

Truth is though, IMHO, no one really knows all the mechanisms. There are over 80 different hormonal chains that Science knows are there but have only officially categorized 5-10 or so and really have no clue either. I think the "Metobolic" changes play a MAJOR factor. I could feel that mine had reved up to full throttle the very day after my surgery and have been in overdrive ever since. IMHO...this is also the SAME exact "Mechanism" that factors in regarding how the DS will cure Type II diabetes immediately as well as a host of other ailments such as Psoriasis etc. My cells are now communicating with each other, i.e., absorbing the insulin, (Not insulin resistive) as in Type II diabetes etc and all those other hormonal triggers, signals and metabolic mechanisms we do NOT yet know about....SO...AGAIN...NO ONE REALLY KNOWS exactly how it works!

 

[Marquis Mark]

God I love this place! So predictable!...in a good way of course...LOL….NOT to be dis-respectful or a jerk or anything…..BUT, I didn’t respond to this on purpose for a day or so because I too wanted to see if anyone would answer your question and just as I thought, they COULDN’T!!!! I TOTALLY UNDERSTAND THE INFO YOU ARE SEEKING, because I have been asking THE SAME question for well over a year now. I WANT (and you) want to know the SCIENTIFIC MECHANISMs that changes in the Gut, intestines, hormonal, eating more etc, or a combination of the 3 or 4 that actually SLOW DOWN the malabsorption after 1-2 yrs. I believe Dr.K wrote an article about microvilli density etc that actually grow denser and more populated in the intestinal epithelial lining after that 1st yr or two. Diana touched on it in the past also. THAT is the “Technical info” I think you are seeking??? Please correct me if I’m wrong because I AM seeking the same knowledge because of my excessive malabsorption issues and am waiting for that “mechanism” to kick in.

Truth is though, IMHO, no one really knows all the mechanisms. There are over 80 different hormonal chains that Science knows are there but have only officially categorized 5-10 or so and really have no clue either. I think the "Metobolic" changes play a MAJOR factor. I could feel that mine had reved up to full throttle the very day after my surgery and have been in overdrive ever since. IMHO...this is also the SAME exact "Mechanism" that factors in regarding how the DS will cure Type II diabetes immediately as well as a host of other ailments such as Psoriasis etc. My cells are now communicating with each other, i.e., absorbing the insulin, (Not insulin resistive) as in Type II diabetes etc and all those other hormonal triggers, signals and metabolic mechanisms we do NOT yet know about....SO...AGAIN...NO ONE REALLY KNOWS exactly how it works!

Thank you for that. I was the kid asking questions like "Why is there air?" until my mother wanted to sell me for medical experiments. I have a hard time just trusting answers unless I can actually understand WHY. But I think I'm also having trouble articulating my question. I just don't get why the body "locks in" your weight at two years (which is what many people seem to indicate) if you still have malabsorption (albeit not as much). I mean, if you were eating chocolate cake for the first two years and only lost 50, but then you suddenly decided to eat right, would the outcome be any different than the reverse? Wouldn't your body eventually find the same weight? Even now I don't feel I'm articulating this question correctly. But If anybody wants to take a stab, feel free!

 

[duh_Mom]

I totally get it - I always want to understand the physiology behind the process. but my smart asses answer is just that it is magic and you can't question magic. . . see SA

 

[Munchkin]

My surgeon explained it this way, "Your body fights to get back to normal over the years. Given what's been done, it's not possible but it will still try and make whatever changes it can to do so."

Certainly things aren't the same for me as they were that first 18 mos. My body has adjusted and I have had to do the same. However, it never will be as it was preop.

Exactly!

 

[aaa]

My surgeon also discussed the "microvilli density etc.," that Dr. K. mentions.

 

[DSRIGGS]

My surgeon also discussed the "microvilli density etc.," that Dr. K. mentions.

I think I posted a blog from Dr K on the atrophy of the BPL and the Hypertrophy of the CC & AL that are absorbing. He had a sample of tissue at the BPL, CC & AL junction and the slides were very cool. Those section who got a work out were much more dense and "muscular" than the non absorbing portion. As far as timing and percentage of regrowth I am not sure there is any hard data and it varies by patient, but as Dr K more or less told me, we know the villi grow back and we suspect somewher in the 24-32 month time frame is when the growth ends or slows greatly.

I am kind of in that period right now with the portion of BPL that was converted to CC and AL channels. As that hypertrophies my absorption improves and I get healthier. I am not where I need to be but I know it is getting better because of the villi growth and tissue strength we are discussing.

I predict that Rob is going to bottom out before too long an start his bounce back.

 

[DianaCox]

"this magic window thing which seems to imply that the weight you lose in the first two years is permanently yours."

Your basic mistake is right there. This is utterly false.

The weight you lose in the first two years is the EASIEST weight to lose, that's all. After about 2 years, your body starts to adapt to the short gut by growing more villi and even more intestine; your metabolism has adapted to being starved by becoming as efficient as it can be; your stomach has stretched out a fair amount (though most likely not nearly as big as it used to be). Plus, you're older.

Although it doesn't require the kind of vigilance and deprivation that other surgeries require, for most people there is 10-30 lbs of bounceback after hitting bottom - some people can have quite a bit more, if they don't watch their carbs. I have no idea where you got the idea that ANYTHING about DS weight loss at ANY time is "permanent."

 

[Marquis Mark]

"this magic window thing which seems to imply that the weight you lose in the first two years is permanently yours."

Your basic mistake is right there. This is utterly false.

The weight you lose in the first two years is the EASIEST weight to lose, that's all. After about 2 years, your body starts to adapt to the short gut by growing more villi and even more intestine; your metabolism has adapted to being starved by becoming as efficient as it can be; your stomach has stretched out a fair amount (though most likely not nearly as big as it used to be). Plus, you're older.

Although it doesn't require the kind of vigilance and deprivation that other surgeries require, for most people there is 10-30 lbs of bounceback after hitting bottom - some people can have quite a bit more, if they don't watch their carbs. I have no idea where you got the idea that ANYTHING about DS weight loss at ANY time is "permanent."

I didn't get that idea. I said the magic window thing seems to imply that, which makes no sense to me, which is why I asked for clarification and insight.

 

[Marquis Mark]

I think I posted a blog from Dr K on the atrophy of the BPL and the Hypertrophy of the CC & AL that are absorbing. He had a sample of tissue at the BPL, CC & AL junction and the slides were very cool. Those section who got a work out were much more dense and "muscular" than the non absorbing portion. As far as timing and percentage of regrowth I am not sure there is any hard data and it varies by patient, but as Dr K more or less told me, we know the villi grow back and we suspect somewher in the 24-32 month time frame is when the growth ends or slows greatly.

I am kind of in that period right now with the portion of BPL that was converted to CC and AL channels. As that hypertrophies my absorption improves and I get healthier. I am not where I need to be but I know it is getting better because of the villi growth and tissue strength we are discussing.

I predict that Rob is going to bottom out before too long an start his bounce back.

This bit about atrophy is the BPL is interesting. If it atrophies enough how is a reversal possible?

 

[Spiky Bugger]

"this magic window thing which seems to imply that the weight you lose in the first two years is permanently yours."

Your basic mistake is right there. This is utterly false.

The weight you lose in the first two years is the EASIEST weight to lose, that's all. After about 2 years, your body starts to adapt to the short gut by growing more villi and even more intestine; your metabolism has adapted to being starved by becoming as efficient as it can be; your stomach has stretched out a fair amount (though most likely not nearly as big as it used to be). Plus, you're older.

Although it doesn't require the kind of vigilance and deprivation that other surgeries require, for most people there is 10-30 lbs of bounceback after hitting bottom - some people can have quite a bit more, if they don't watch their carbs. I have no idea where you got the idea that ANYTHING about DS weight loss at ANY time is "permanent."

Yeah. About 7-8 years out, I gained enough that I was about 25-30# above my lowest post-op weight. (Even that was tchnically "obese.")

So...I ate like a MAN who wanted to lose weight. (You know how it works...women live on lettuce and gain weight...guys give up bread for two weeks and look anorexic.). With the DS, that worked...I ate steak and eggs and pork chops and FEWER candy bars and rather easily went back to about 10# over my lowest post-op weight. Almost no effort.

 

[Marquis Mark]

Yeah. About 7-8 years out, I gained enough that I was about 25-30# above my lowest post-op weight. (Even that was tchnically "obese.")

So...I ate like a MAN who wanted to lose weight. (You know how it works...women live on lettuce and gain weight...guys give up bread for two weeks and look anorexic.). With the DS, that worked...I ate steak and eggs and pork chops and FEWER candy bars and rather easily went back to about 10# over my lowest post-op weight. Almost no effort.

Steak, eggs and some candy? I think I can do that!

 

[DSRIGGS]

This bit about atrophy is the BPL is interesting. If it atrophies enough how is a reversal possible?

Because it hasn't been exercised. The analogy is that if you have a cast on your left arm for 6 months your right arm becomes stronger and your left arm becomes weak, yet after the cast comes off and you start using the arm again the muscle comes back. It is the same for the BPL.

 

[Marquis Mark]

Because it hasn't been exercised. The analogy is that if you have a cast on your left arm for 6 months your right arm becomes stronger and your left arm becomes weak, yet after the cast comes off and you start using the arm again the muscle comes back. It is the same for the BPL.

So, theoretically, the DS could be reversed at any time? When I spoke with Dr. K he said the furthest out he had done a reversal was six years. Do you know of one being done further out?

 

[DSRIGGS]

So, theoretically, the DS could be reversed at any time? When I spoke with Dr. K he said the furthest out he had done a reversal was six years. Do you know of one being done further out?

Yes a DS can always be reversed. It is just a matter of flipping the plumbing back, but it doesn't happen often and something like Poodles had it is the more likely outcome.