Originally Posted by Lia /img/forum/go_quote.gif Like that, a person can eat sliced bread with butter dissolved on the milk, cake, melted chocolate, condensed milk , mashed potatoes, all those kinds of liquid/semi solid fattening food while on bypass surgery. Eating all day small quantities of it does the same damage as eating a full meal at once. I know you are a doctor (if I recall correctly?) but the above is actually false.
Are there some patients who can eat as you described? Of course. There's an exception to every rule. We foodies call it "eating around your pouch".
However, the very nature of gastric bypass creates a totally new physiological profile and something called "dumping syndrome", which I am sure you are familiar with.
Dumping syndrome is a result of bypassing the intestine (contrary to many peoples' belief, no portion of the intestine is removed- hence the name "bypass"). It seems that the more distal a bypass is, the more dumping a person seems to have. I had 150 cm. bypassed which is a fair amount-- not too distal. Dumping syndrome is actually an insulin reaction as the food isn't digested as it normally is in the stomach. The food hits that portion of the intestine and, insulin is released. Depending on what one eats depends on what amount of insulin is released. Overweight individuals have already made their pancreas hyper-sensitive in releasing insulin. Any small amount of sugar consumed prior to surgery makes the pancreas dump copious amounts of insulin. Insulin flows into the system causing a hypoglycemic reaction (low blood sugars, sweats, shaking, etc. etc) Also contrary to many peoples' belief, hypoglycemia IS NOT the opposite of hyPERglycemia (diabetes). It is actually a precursor to diabetes.
Since the overweight person's body is so adept at pouring insulin into the system, that is exacerbated further with the surgery and eating even small amounts of sugars, refined sugars, simple carbohydrates and many times milk can cause the pancreas to release even MORE insulin than before the surgery. What results is called "dumping syndrome" and is the worst side effect of the surgery. You shake, you vomit, your blood sugars drop, you can get diarrhea, lightheaded, pass out, etc. That's the whole point, however-- forced behavior modification. The idea is that with enough negative side effects from a certain food or group of foods, one will stop consuming them altogether or will cut them drastically. (You know, if a baby touches something hot, they'll soon discover what "hot" is and they don't want a part of that negative outcome so they'll refrain from touching hot things again.)
That's not the only principle of gastric bypass-- with the intestine bypassed, it creates a significant amount of malabsorption- of good stuff and bad stuff. The malabsorption is great for the bad stuff as one doesn't absorb so many calories, fats, etc. It's bad as far as vitamins go because you don't absorb as many vitamins and nutrients from what you consume and many times vitamin supplementation is necessary for the rest of your life.
I am editing because I forgot to add one of the most important facets of the surgery: restriction. In gastric bypass, the stomach is resected and made smaller. Many people think they remove part of your stomach-- nothing is removed in a bypass. The stomach is cut into two parts-- one small "pouch" and the other side is completely separated and attached to a different part of the intestine. It's not stomach stapling although staples are used along with stitches merely for holding the stomach together. No the staples don't dissolve. Yes, sometimes they can cause a minor problem. Another thing-- a person CAN stretch their pouch out although, once again contrary to popular belief, one cannot stretch it back out to the same size as before as the stomach has been completely physically altered and cut down and there's not enough tissue/muscle there to stretch back out.
As with any "addiction", one can easily switch their DOC (drug of choice). Many times a pill popper will become an alcoholic. Yes, they no longer pop pills but now they consume alcohol to excess. The same is with obesity-- "solve" the symptom of the obesity and many times one substitutes their DOC for something else-- many times, alcohol. So yes, one must be vigilant when having gastric bypass and understand that it is MERELY A TOOL to meet one's goals-- it is NOT the answer to everything. And, as with any tool, if it's not used properly, it will become old and rusty and will soon no longer work.
Warmly,
Brandi
