bariatric

Question
QUESTION: hello my name is carla gorissen i hade bariatric surgery in 2010 may i am still having problems eating but when it comes to junk food like chocolate bars cake i can get them down no problem for about 5 months now ive stayed at the same weight i have gain 5 ponds but i take it off and it comes back im so afraid of gaining the weight back i have a problem with aspertaine i cannot have any kind of artificial sweetners what do u recommend and the loss skin i have a skirt my belly ive lost 85 pounds i know weigh 155 dont get me wrong i thought really for what i eat i would have lost alot more i just cant seem to control myself when it comes to junk food please any suggestions would be terribly needed thank you

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ANSWER: Hi Carla:

I'm not sure which type of bariatric surgery you had--but I'm going to assume it was a Lap-Band or VSG, as most people who have an RNY can't consume sweets very early on due to dumping.

For sweets, if you can't avoid them or use something like Splenda, then your best bet is to regulate the amount you eat.  If you limit yourself to one treat per day, and only eat it after you've eaten a healthful meal containing lots of lean protein, and non-starchy veggies and fruits, you should be fine.  You can also make having your treat conditional on having done a certain amount of exercise for the day... or getting in your protein...water...or whatever.  If these don't work (and I recommend this anyway), contact your surgeon to see if he has a support group which you can attend.  You'd be in a grads group--and one of the things that they often talk about is how to avoid regain.  You could also look at joining a group like Overeaters Anonymous.  One other option is to look into mindful eating, and try to truly savor and enjoy your treat.  Even one M&M can seem decadent and satisfying through an approach like that.  Thich Nicht Hahn I believe has a book on it--but there is lots out there.  Check your library.

As for the excess skin on your stomach, the only thing that will really solve it is plastic surgery.  In the meantime, you can try wearing Spanx or something similar to at least hold it in.  Document any rashes or issues you have with your pannus, as that might help with insurance coverage for your abdominoplasty.  

I hope this helps.  Good luck.  It's really smart of you to try and solve your junk food addiction now, before things get out of hand.

Karla

---------- FOLLOW-UP ----------

QUESTION: thank you for your response yes i had the rny and you know i never had problems with sweets thats what worries me i had surgery done in toronto and i am from windsor before i had surgery i never really ate sweets i now crave them i was a diebetic 4 shots a day and oral meds my doc says its because my surgar goes down know that is y i am craving sweets i just dont want to go back to the way i was and my cravings seem to be taking over me

Answer
Hi Carla:

I don't know what your weight is, but if you have gained, one thing you could look into is converting to a Duodenal Switch or just doing the "switch" part (intestinal) part if you don't need to lose.  They are now doing that solely for diabetes as it has such a high cure rate (98%).  I know OHIP has paid for the duodenal switch, but I'm not sure about their policies regarding revisions or as a pure thing for diabetes.  Dr. Michel Gagner, one of the most renowned bariatric surgeons in the World, moved back to Canada (Montreal) last year from the States.  You might want to contact him and see what he thinks.

Good luck,
Karla

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