malabsorption

Question
I am 17 months out from bariatric gastic bypass surgey. I am stuck at a loss of 120 lbs. and am struggling to lose more (I DO NOT EXERCISE.) I asked the nutritionist who works for my surgeon and she said that after a yr or 18 months, the absorbing part of the intestines sees that the cut away intestines are no longer doing its work so the absorbing part takes over and absorbs all of it.  My two bariatric support counselors say that is not true and if it were true I would not have to take all the vitamins for the rest of my life.
Thank you for your time.

Answer
Hi Linda,

There is sort of some truth and non-truth in all of this.

At around 18-24 months post-op, the part of your small intestine that has not been bypassed will get better at absorbing carbohydrate.  This often seems to correlate with a decline in or loss of dumping syndrome and weight plateau or gain.

Vitamins and minerals are not absorbed that same way as carbohydrate.  They are often dependent on specific binding sites in the gut, which, if bypassed, will not reappear in another part of the gut.  Also, a big part of the problem with vitamins and minerals is intake, not malabsorption. (This is why band patients also get deficiencies).  It's just really hard to take in what you need after gastric bypass.  

So yes, you absorb better over time.  But this really only applies to carbohydrate and does not seem to impact vitamin and mineral nutrition.  It would be really cool if it was the other way around, but unfortunately it's not.

In Health,

Dr. Jacques

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