bypass reversal

Question
I had a R-Y gastric bypass surgery about 5 years ago. I lost some weight but regained most of it back.

2 years ago I found recovery through Overeaters Anonymous and have lost 185 pounds eating a weighed and measured, low carb, low glycemic index diet given to me by a nutritionist. All my food for the last year and a half was organic, local, etc. My fats all come from organic nuts and wild-caught roasted salmon. I commit what I'm going to eat to my sponsor every day. I felt better than I have my entire life. I was exercising regularly and was up to 50 laps in the pool and up to an hour on the elliptical machine.

Note that I have never had even pre-diabetes, much less diabetes. I have never had high blood pressure nor high cholesterol. My resting heart rate is low 60's. I'm 5'10" and my current weight is 210. I continue to lose 3-8 lbs a month.

4 months ago I started feeling bad. Eventually my primary doctor prescribed a glucose monitor and I discovered that 15 min after I eat a meal, my blood sugar will hit 200-400 and that 30 min later it dropped as low as 48. My lowest was a 30 at the doctor's office. My insulin is a 22, my A1C1 is a 5. He also referred me to a endocrinologist.

I seem to be having reactive hyperglycemia PLUS reactive hypoglycemia. I have read that getting a reversal surgery may cure me of this.

What is your opinion of my symptoms and bypass reversals please?


- Shannon


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Answer
Shannon,
It is usually technically possible (though somewhat risky) to reverse the gastric bypass.  If this is done then I would expect your blood sugar gyrations to settle down, BUT I would also expect you to regain most or all of your original weight.  The prospect of weight regain is not a reflection on your habits or willpower; you sound like a highly intelligent and motivated individual.  I would expect significant weight regain because you suffer from the metabolic disease of obesity; the gastric bypass and your own efforts have brought this disease under control but history shows that individuals with this disease can not maintain weight control without the assistance of surgery.

You described your current food intake as "low carb, low glycemic index," yet the syndrome you describe is a classic response to sugar or carb intake in someone who has a gastric bypass.  I suggest that, instead of looking to reversal of your gastric bypass, you may benefit from visiting with a dietician who works with a bariatric surgeon.

Best of luck,
Dr JP

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