[nygal]

Hello,

I need info please.

I have a friend here in upstate NY. Bariatrics support is sooooo limited!
She has hit a wall (like of us do/have).

She is less then a year out. She had RNY.

She still eats and follows her diet, but she is taking Phentermine or Phendimetrazine or something like that too. I told her NOT to take them, ride it out like i did, and talk to her doc, but she is not listening to me!!

I worry about the damage it will do to her pouch and metabolism etc. She broke through the wall of course, dropped 10 lbs in just 4 days!!

But at what risk-- and won't she gain it back-- like we all did before our surgery?? Is she stopping future progress?

I looked up info online but can't find anything about a post op taking non-aspirin diet pills.... HELP!

Thanks.

[Christy0283]

Interesting post. Doc, will the diet pills damage her pouch?

[LadyLisa]

Not only is there a problem with the possible effects on her pouch but I think it also reinforces old habits. And thinking that magic pills really work. I know I was stalled for five months and have just recently lost five pounds and hope that is the start again, but I did have times when I felt like not eating to lose weight but I had a nice long talk with myself. Ask her to ask herself why did she have the surgery and did the pills and drinks ect help her keep it off before and does she think its a really good thing for her to be doing and ask her to be honest with herself because she is the one that has to live with the outcome of her actions

[nygal]

Thanks for all the input...

I know when i have had long stalls (not the typical week or three) but the LONG ones, like MONTHS long, and some bouncing/gaining too-- i would eat MORE and then VIOLA! the scale moved again

For me, now- i think i am pretty much done losing. I think i have stabalized. Truly i cant see that i have more left to lose really! lol-- im a size 1-2 from a 28.

At 15 months out, will i still lose??

i really am very happy where i am.

Anyway, she wont hear me when i tell her to hang in there, and switch it up a bit. she thinks because i passed my goal that i am just giving her "lip service". i treat my TOOL like gold 98% of the time- she calls me the poster child for RNY! lol. i sooo am not. but i respect my tool.

I, like most everyone here, has or is going through this. i am no different then she is, just further in a similar journey.

i know i cant stop her-- i haven't obviously, but i do wonder at what the effects to her will be in taking these pills.

not just the mental-- but what will it do to her metabolism and pouch?

[DocSanae]

NOOOOOO!!! No diet pills.

That said, I do not think there are any data actually on what the effects of those pills are to a bypass/weight loss surgery post op, physically/medically speaking.
I imagine there are no such studies because surgery is supposed to be the final resort, and the surgeons don't expect their patients to go on such pills, nor do they want them to.

But, even without data, there are some educated guess that one can make from the known changes for other meds/chems.
The following will most likely apply.

1) If the medication is the type that is absorbed in the stomach helped by the enzymes in the stomach, then it may not be absorbed properly or in the amount needed. This is the case of VB12 and iron.
2) If the medication is the type that is absorbed through the intestines, then it will hit the blood stream much faster and in higher concentration than expected from the dosage because the stomach will not serve as a stocking/diluting place to slow down the passage of the medication and lower the concentration. This will increase the effectivity of the meds/chems, but at the same time, it will also increase their toxicity. This is the case of alcohol, and most meds/chems as well.
3) When the meds/chems hit the blood stream faster and in a higher concentration than intended, they may very well cause damage of the liver or kidney or both because these are the two main organs where the meds/chems are proccessed and excreted, due to the increased toxicity.

The reason she dropped 10lbs in 4 days is most likely due to the increase in effectivity, but this means that she is being exposed to the increased toxicity as well. Very very bad. Besides, even with WLS, you don't lose that much in that few days, if you lose 10lbs in one week, that's an exceptionally good loss. That kind of loss in itself is very very damaging to the body. She may not immediately regain the weight she lost because of the way she is eating post op, but somewhere along the line, she may very well pay for this caper.

With weight loss surgery, you are in a way forcing your body to starve and to retain your life by using the stores of the excess fat that you have. You need to let the body lose at the rate that is still safe for the body and for maintainig life, which means that every once in a while, it will go into maintenance mode and adjust, which will show up as the stall in the scale. During that time, your body will be realigning things by useing up the body fat and building up your muscles, so you will lose in inches rather than in scale numbers. You NEED to let your body rest from losing weight to keep on losing effectively and healthily.
The reason you lose weight when you increase your intake just a little, it's because your body knows that it will ge the nutrients it needs, and do not have to hang on to every thing, so, it let goes of what isn't needed.

Even more damaging than the meds themselves is the "quick fix" mentality. You didn't put on weight in a few days, so it isn't going to go away in a few days. You need to look at it year by year. Patience is the key. Also very very important is changing your outlook on food, on life style, on how you understand and cope with stress.
The more the numbers of the recepients of this surgery increases, the more I am afraid that many who need the surgery, will go into it without truly understanding the impact it will make on every aspect of one's life. That you MUST get yourself out of the "quick fix" "instant success" "instant comfort" mentality. That you MUST change your eating pattern, your life style and make it stick. You MUST change your whole outlook on life. In truth, life is a lot of ups and downs, a lot of stress as well as a lot of joys. A whole heck of a lot of emotions that have to be dealt with. These will be there whether you are thick or thin, many things actually don't change at all with the change in your weight, some issues will go away, sure, but other will pop up unexpectedly, and those that were there but were being ignored may start clamoring for recognition and force you to deal with them rather than look the other way. Learning to deal with those issues head on is probably the hardest aspect of this journey. How to eat and losing weight is actually only the beginning of this journey, what you do, how you maintain, how you deal with life beyond the immediate weight loss is what this journey is actually about.

It's tough, but you can do it.
It's sad about your friend, but unless she comes to her senses, she may very well fail at the whole attempt, and damage her health as well.

[Kenyar]

i love the way you explained that doc. very informative.

[nygal]

I printed this out and will show this to her when i see her this weekend. I told her similar stuff but in no way cound i have put it like you have! you are such a blessing to soooo many of us

**this should be a sticky or something (if it is i missed it). i know this topic comes up now and then.

[LadyLisa]

Yes Doc teaches us new things all the time. Just when we think we know all about WLS she shows us we don't. It did not dawn on me the way you would digest the diet pills and how they can effect your organs. I know we dont digest things the same and shouldnt take time released stuff but never went into such detail about it.. Thanks Doc for taking the time to type that up for us. And I hope printing that out and giving it to your friend will help. Sometimes friends are like kids and wont listen to those around them and need outside internention. Good luck and let us know what she says.

[clancythecamper]

Thanks these are the questions that sneak back into our minds from time to time. I'm curious who gave them to her or maybe she just had some leftovers? Good luck talking to her.

[Nurse2B]

Doc was right on the money, as usual.