Tirzepatide and Bariatric Surgery

fyrepep

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Have any of y'all had bariatric surgery, had regain, and followed it up with some tirzepatide?

Typically, post bariatric patients are excluded from the studies, but it sounds like there has been success with tirzepatide usage post-bariatric. But the data is so limited...
 
🙋‍♀️ I had a VSG in 2013. Lost 154 lbs. Regained about 40 lbs over the last few years. About to take my 4th dose of Tirz and it’s working well for me so far. I have about 40 lbs to lose to get down to my absolute most amazing GW.
 
I had VSG in 2010 and kept almost all the weight off for 9 years. I slowly gained 40 pounds the last 5 years and it dropped off very quickly with T. I am now only 4 pounds heavier than my lowest following surgery. I will say that T has completely "reset" my stomach. It feels like the early days post-surgery with food restriction. My only advice for you is to work really hard with caloric intact the first 4 months because, at least for me, the efficacy of T in decreasing appetite decreased substantially after 5 months regardless of how I titrated up on the dose.
 
I had VSG in 2010 and kept almost all the weight off for 9 years. I slowly gained 40 pounds the last 5 years and it dropped off very quickly with T. I am now only 4 pounds heavier than my lowest following surgery. I will say that T has completely "reset" my stomach. It feels like the early days post-surgery with food restriction. My only advice for you is to work really hard with caloric intact the first 4 months because, at least for me, the efficacy of T in decreasing appetite decreased substantially after 5 months regardless of how I titrated up on the dose.
Thanks! I see some switching glps because of no longer being effective after months on tirz
 
I had an RNY May 2000. Lost 140 lbs and stayed within the same 10lbs for about 8 years and then slowly started regaining. Eventually got back to, and surpassed starting weight by 30 lbs. I started tirz Dec 2023 and am now just over halfway to my 160 lb goal again. Total lost since starting is 67 lbs. I'm at 12.5mg split dose per week, and have been for 10 weeks. Just this past week I added 0.3mg cagrilintide.
 
I have not had any bariatric surgery but I know a lot of people using glp1s who have and are doing well, if not better since starting them. If you go off the meds you can probably expect to regain but many people back down to lower doses once they reach their maintenance zone.
 
Up front I'll tell you, I know now that my main obesity and diabetes problem is food noise. Tirz revealed that to me when I woke up on Nov 7 2023, after having taken the first shot the night before, and my food noise was gone. I had gotten control of my life back.

I had gastric bypass in 2017. At almost 300 lbs (M, 5' 6"), my surgeon made me go on ultra low carb diet to lose as much as possible before the surgery. It was 8 months of Hell thanks to the food noise. Absolutely brutal and I know there was some clinical depression in there (maybe PTSD lol???) along the way due to it. Got down to 220 and had the surgery, which got me to about 180. Then I started slowly gaining over the years. Last year was back to 240 when I started Mounjaro after I got a new diabetes Dr and he put me on it.

On Nov 8 2023 I completely changed my eating habits for the better, and have had a fairly consistent 2lb/week loss. I'm at maintenance now, bouncing around 150-153.

There have been a few dosage modifications along the way. I'm currently on 5mg every 4 days.

Tirz gave me my life back and got me where I wanted to be with my weight. Surgery couldn't do that because surgery can't touch the food noise.

I plan to be on tirz or something like it for life.
 
For those who had the surgery, what do you think of the effects of surgery vs the shots with your appetite? Which do you feel was better for you?
Surgery doesn't really do anything for appetite, which is why most people "eat their way around a sleeve" and gain weight eventually. You are physically restricted from eating a lot of food. They say your stomach produces less Ghrelin so you're not as hungry, but I'm not sure if that's real or voodoo science.

I was always able to use the surgery as a great tool and I just didn't keep garbage food in the house. When I started T, I was still only a 31.5 bmi, so I have done well in the last 14 years since surgery. But VSG and Tirz are a one-two punch. You are physically restricted, and you're not hungry anymore. If these meds had been around I would not have had the surgery. So much of life revolves around food. I find myself coming up with excuses to decline lunch and dinner invites because it creates a lot of anxiety and embarrassment for me hoping to not have to explain to people why I cannot hardly eat any food. I would love to be able to really enjoy a nice persian or Italian restaurant again--my favorites.

If anyone is interested, I highly recommend the surgeon in Mexico, Dr Alvarez. It was $7500 back then.
 
This may only be partially helpful as I haven’t had regain. My VSG surgery was 8 months ago. At 6 months, I had lost 65 lbs and had been stalled for a month and a half. I was starting to fall back into bad habits and the food noise was out of control. I was scared, and wanted a way to reel it back in before I did start to regain. 2 months ago I started compound tirz and that has been a huge game changer. I’ve lost 20 additional lbs and I feel back in control of my weight loss journey. I have about 40 more lbs to lose and am confident I will reach that and maintain with GLP-1s

Once I got to 5 mg tirz, the fullness and restriction I felt the first few months of surgery is back. I find it much easier to think of food as fuel and not an emotional crutch. It’s an awesome tool to help me continue to where I need to be!
 
🙋‍♀️ I had a VSG in 2013. Lost 154 lbs. Regained about 40 lbs over the last few years. About to take my 4th dose of Tirz and it’s working well for me so far. I have about 40 lbs to lose to get down to my absolute most amazing GW.
154 lb is fantastic! What dosage are you taking right now? I'm about 35 lbs above my goal weight, and going through an extremely extremely stressful time, so I'm afraid I'm just going to keep packing the weight on!
 
I had VSG in 2010 and kept almost all the weight off for 9 years. I slowly gained 40 pounds the last 5 years and it dropped off very quickly with T. I am now only 4 pounds heavier than my lowest following surgery. I will say that T has completely "reset" my stomach. It feels like the early days post-surgery with food restriction. My only advice for you is to work really hard with caloric intact the first 4 months because, at least for me, the efficacy of T in decreasing appetite decreased substantially after 5 months regardless of how I titrated up on the dose.
Very good to know about the four month thing! I feel like that's the same kind of advice they give you when you have bariatric surgery is to basically work super hard to lose the weight while you still have the extreme restriction.

It seems like 40 lb it seems to be the magic number of regain for my very small sample group! I'm very interested to see what kind of drop I get in what time period when I couple it with a duodenal I had done in 2016.
 
I had an RNY May 2000. Lost 140 lbs and stayed within the same 10lbs for about 8 years and then slowly started regaining. Eventually got back to, and surpassed starting weight by 30 lbs. I started tirz Dec 2023 and am now just over halfway to my 160 lb goal again. Total lost since starting is 67 lbs. I'm at 12.5mg split dose per week, and have been for 10 weeks. Just this past week I added 0.3mg cagrilintide.
It sounds like you've had a heck of a ride with weight loss and trying to keep it off! I'm only at about a 35 lb regain, but it's been steadily increasing. The last thing I want is to have to take off all of my original weight and then some, so my heart goes out to you. I'm really glad that you're having such good success on tirz though. It gives me a lot of hope for myself.
 
Up front I'll tell you, I know now that my main obesity and diabetes problem is food noise. Tirz revealed that to me when I woke up on Nov 7 2023, after having taken the first shot the night before, and my food noise was gone. I had gotten control of my life back.

I had gastric bypass in 2017. At almost 300 lbs (M, 5' 6"), my surgeon made me go on ultra low carb diet to lose as much as possible before the surgery. It was 8 months of Hell thanks to the food noise. Absolutely brutal and I know there was some clinical depression in there (maybe PTSD lol???) along the way due to it. Got down to 220 and had the surgery, which got me to about 180. Then I started slowly gaining over the years. Last year was back to 240 when I started Mounjaro after I got a new diabetes Dr and he put me on it.

On Nov 8 2023 I completely changed my eating habits for the better, and have had a fairly consistent 2lb/week loss. I'm at maintenance now, bouncing around 150-153.

There have been a few dosage modifications along the way. I'm currently on 5mg every 4 days.

Tirz gave me my life back and got me where I wanted to be with my weight. Surgery couldn't do that because surgery can't touch the food noise.

I plan to be on tirz or something like it for life.
Wow! Your story is incredible, and I think it does a very good job of outlining what it's like to be a food addict. I tell people I am obsessed with food, and they giggle, but I don't think they understand what it means. I am very excited about the possibility of getting rid of the food noise. Bariatric surgery got me from 255 to 140ish but not without a lot of misery and finding ways to game the surgery and eat around the restriction and malabsorption. Which is why I am back up to 175 and climbing. Thank you for sharing, and I am excited to start Tirz tomorrow. I hope I have similar results as you.
 
This may only be partially helpful as I haven’t had regain. My VSG surgery was 8 months ago. At 6 months, I had lost 65 lbs and had been stalled for a month and a half. I was starting to fall back into bad habits and the food noise was out of control. I was scared, and wanted a way to reel it back in before I did start to regain. 2 months ago I started compound tirz and that has been a huge game changer. I’ve lost 20 additional lbs and I feel back in control of my weight loss journey. I have about 40 more lbs to lose and am confident I will reach that and maintain with GLP-1s

Once I got to 5 mg tirz, the fullness and restriction I felt the first few months of surgery is back. I find it much easier to think of food as fuel and not an emotional crutch. It’s an awesome tool to help me continue to where I need to be!
I think that that is helpful information, for anybody that is reading this and may be in a similar situation. I know for myself that I would have liked to have taken action before I regained 35 lb. And if I had been listening to what was going on and done some research, I could have saved myself from this regain, the embarrassment, and now having to take it back off. It sounds like you are going to be very successful between the two choices, and I wish you the very best of luck!
 
Have any of y'all had bariatric surgery, had regain, and followed it up with some tirzepatide?

Typically, post bariatric patients are excluded from the studies, but it sounds like there has been success with tirzepatide usage post-bariatric. But the data is so limited...
Bypass in 2021. Went from 303 to 193.

Regained to 240. Became alcohol dependent.

Started tirz July 2024, back down to 210. Still want alcohol. Hoping as dose goes up that might subside.

30 pounds to go, adding intro dose of cagri this week to combat tirz hunger on day 5-7
 
154 lb is fantastic! What dosage are you taking right now? I'm about 35 lbs above my goal weight, and going through an extremely extremely stressful time, so I'm afraid I'm just going to keep packing the weight on!
I will take my 4th dose at 2.5 mg on Friday (bought compound before I went grey). I have definitely found this to be a superior tool so far because it helps address the mind part of food addiction. I hope you feel this too ❤️. It’s a serious game changer.
 
Up front I'll tell you, I know now that my main obesity and diabetes problem is food noise. Tirz revealed that to me when I woke up on Nov 7 2023, after having taken the first shot the night before, and my food noise was gone. I had gotten control of my life back.

I had gastric bypass in 2017. At almost 300 lbs (M, 5' 6"), my surgeon made me go on ultra low carb diet to lose as much as possible before the surgery. It was 8 months of Hell thanks to the food noise. Absolutely brutal and I know there was some clinical depression in there (maybe PTSD lol???) along the way due to it. Got down to 220 and had the surgery, which got me to about 180. Then I started slowly gaining over the years. Last year was back to 240 when I started Mounjaro after I got a new diabetes Dr and he put me on it.

On Nov 8 2023 I completely changed my eating habits for the better, and have had a fairly consistent 2lb/week loss. I'm at maintenance now, bouncing around 150-153.

There have been a few dosage modifications along the way. I'm currently on 5mg every 4 days.

Tirz gave me my life back and got me where I wanted to be with my weight. Surgery couldn't do that because surgery can't touch the food noise.

I plan to be on tirz or something like it for life.
Your description of how the food noise used to control your life and now you’ve taken back control is perfect. Spot on!
 
Bypass in 2021. Went from 303 to 193.

Regained to 240. Became alcohol dependent.

Started tirz July 2024, back down to 210. Still want alcohol. Hoping as dose goes up that might subside.

30 pounds to go, adding intro dose of cagri this week to combat tirz hunger on day 5-7
I wish you the best of luck combating two addictions instead of just one. I don't think that transference addiction is discussed enough before people undergo bariatric surgery, unfortunately. One of my friends is on tirz, and it has curbed her drinking immensely. (I believe she's at 10mg), so hopefully, you'll get that same effect soon. I feel for you. Keep doing what you gotta do to get to where you wanna go!
 
For those who had the surgery, what do you think of the effects of surgery vs the shots with your appetite? Which do you feel was better for you?
Surgery did zilch for my food noise and appetite. Other than physically restricting the amount of food I could eat (literally only a couple of tablespoons in the beginning), the constant screaming in my brain for consuming more food never went away. Just needing to taste it even. It's been over 24 years since I had my surgery but I still remember when I physically could not eat the food due to the pain it would cause with the small pouch, but I would chew food just to feel like I was eating, and then spit out. Gross, I know, but that's what I did.

With tirz that voice in my head has been silenced. I get hungry, but it's normal hunger and I eat a normal amount of food, and then I'm done and don't think about it again until I'm actually hungry again. I have been battling my weight since I was 8 years old (doctor told my mom I needed to lose 20 lbs) and it has never stopped. Now here I am on the cusp of 46 in a couple of weeks and I am still not sure this is real. I have tried everything you can imagine over the last 38 years to lose weight, and none of it ever came even remotely close to what this medication has done for me.

Side note: my mom (age 74) has been morbidly obese my entire life. She was 410 lbs at here highest and has had two bariatric surgeries in her life. She lost weight with both, but not permanently. She started Mounjaro (diabetic) also in Dec 2023 at 292 lbs. She is has now lost 77 lbs and says the same thing about the food noise. It's just gone and she feels normal regarding hunger and satiety for the first time in her life.

These are life-changing meds and I'm so sad and also angry that many people who desperately need them cannot get them due to their high cost. I really do hope
 
Up front I'll tell you, I know now that my main obesity and diabetes problem is food noise. Tirz revealed that to me when I woke up on Nov 7 2023, after having taken the first shot the night before, and my food noise was gone. I had gotten control of my life back.

I had gastric bypass in 2017. At almost 300 lbs (M, 5' 6"), my surgeon made me go on ultra low carb diet to lose as much as possible before the surgery. It was 8 months of Hell thanks to the food noise. Absolutely brutal and I know there was some clinical depression in there (maybe PTSD lol???) along the way due to it. Got down to 220 and had the surgery, which got me to about 180. Then I started slowly gaining over the years. Last year was back to 240 when I started Mounjaro after I got a new diabetes Dr and he put me on it.

On Nov 8 2023 I completely changed my eating habits for the better, and have had a fairly consistent 2lb/week loss. I'm at maintenance now, bouncing around 150-153.

There have been a few dosage modifications along the way. I'm currently on 5mg every 4 days.

Tirz gave me my life back and got me where I wanted to be with my weight. Surgery couldn't do that because surgery can't touch the food noise.

I plan to be on tirz or something like it for life.
That really is a mind blowing experience isn't it. I remember reading about this before I tried it but one can't fully appreciate it until they experience it. I didn't even know I had it until it was gone which was within 24 hours of first injection.
 
I had VSG in 2011 at about 330lbs. lost about 150lbs by 2013 but never got to goal weight (155lbs). I did get to 175lbs . Slowly year by year after reaching 175lbs I gained weight , like 5lbs+ a year and after 8 to 9 years I had gained about 55lbs back.

So in October 2022 I heard about GLP meds and mounjaro specifically. I've been on various GLP meds since then, off and on, Tirz, sema, reta, and also had long periods of stalls, but was able to get to 155lbs just recently.

I'm still happy I had VSG. It helped me from gaining all my weight back. Kept me at a "normal fat" weight rather than super morbidly obese weight.

I also think because I stopped binging (haven't binged since fall 2022), my stomach has shrunk back to my 2011 VSG stomach size.
 
I had a RNY in 2007, lost 150 (420->270) and held that for 5 years and starting gaining and would bounce around 290-310 always dieting and at war with my body and losing.

Enter GLP-1 agonists. Food noise suppression alone is a game changer for me as I feel that my lifetime battle with obesity already trained me to be a master dieter, but now I can follow any diet and focus on other things not food and lose weight.

Lost 55 lbs since July and it's working great.

I don't have the delayed gastric emptying effects or the fullness as I don't use my normal stomach, so for me I do rely mostly on the food noise suppression to keep me on track.
 
I wish you the best of luck combating two addictions instead of just one. I don't think that transference addiction is discussed enough before people undergo bariatric surgery, unfortunately. One of my friends is on tirz, and it has curbed her drinking immensely. (I believe she's at 10mg), so hopefully, you'll get that same effect soon. I feel for you. Keep doing what you gotta do to get to where you wanna go!
It's not stressed enough that 15-20% of bypass patients will end up dependent on alcohol. That's a huge number. I'm always torn about whether I'm glad I did the surgery because I'm still down 90 pounds but I have this other struggle now. In some ways if these meds continue to evolve, hopefully these surgeries will become more of a last resort/ a thing of the past
 
Surgery did zilch for my food noise and appetite. Other than physically restricting the amount of food I could eat (literally only a couple of tablespoons in the beginning), the constant screaming in my brain for consuming more food never went away. Just needing to taste it even. It's been over 24 years since I had my surgery but I still remember when I physically could not eat the food due to the pain it would cause with the small pouch, but I would chew food just to feel like I was eating, and then spit out. Gross, I know, but that's what I did.

With tirz that voice in my head has been silenced. I get hungry, but it's normal hunger and I eat a normal amount of food, and then I'm done and don't think about it again until I'm actually hungry again. I have been battling my weight since I was 8 years old (doctor told my mom I needed to lose 20 lbs) and it has never stopped. Now here I am on the cusp of 46 in a couple of weeks and I am still not sure this is real. I have tried everything you can imagine over the last 38 years to lose weight, and none of it ever came even remotely close to what this medication has done for me.

Side note: my mom (age 74) has been morbidly obese my entire life. She was 410 lbs at here highest and has had two bariatric surgeries in her life. She lost weight with both, but not permanently. She started Mounjaro (diabetic) also in Dec 2023 at 292 lbs. She is has now lost 77 lbs and says the same thing about the food noise. It's just gone and she feels normal regarding hunger and satiety for the first time in her life.

These are life-changing meds and I'm so sad and also angry that many people who desperately need them cannot get them due to their high cost. I really do hope
I agree with you that it sucks bad that people who desperately need the medication don't have access to them. It seems extremely unfair. I have had to administer ridiculous amounts of Suboxone and methadone to addicts, but we don't provide the same level of care and access to food addicts. I am not sure why the topic of food addiction is not taken seriously or a dress like it is with other addictions.

I'm glad to hear that both you and your mother are doing so well, and I really look forward to the food noises disappearing.
 
I had a RNY in 2007, lost 150 (420->270) and held that for 5 years and starting gaining and would bounce around 290-310 always dieting and at war with my body and losing.

Enter GLP-1 agonists. Food noise suppression alone is a game changer for me as I feel that my lifetime battle with obesity already trained me to be a master dieter, but now I can follow any diet and focus on other things not food and lose weight.

Lost 55 lbs since July and it's working great.

I don't have the delayed gastric emptying effects or the fullness as I don't use my normal stomach, so for me I do rely mostly on the food noise suppression to keep me on track.
Wow! I'm glad to hear that you had such good results in such a short period of time! It's also interesting to hear about the different ways it works for different people. I do wonder how it's going to work for me, as I kept my duodenum, but I lost most of my stomach and a lot of my small intestines. Of course, it doesn't bother me to be full or not. I'll just eat anyway. The only exception that is when I took Phentermine, and I had to stop it because I couldn't even manage to drink a protein shake because the act of swallowing it made me want a vomit, and my life depends on my ability to consume vitamins and protein.

I feel like I am praying for a miracle with this stuff, and y'all are telling me it's possible. I think one of my biggest fears is I've had the granddaddy of all bariatric surgeries, and while I've maintained my goal weight for years, I have put back on over 30 lb. And it makes me feel like a failure and hopeless that even though I had the most restrictive bariatric surgery possible, I was still able to gain weight through it.
 
It's not stressed enough that 15-20% of bypass patients will end up dependent on alcohol. That's a huge number. I'm always torn about whether I'm glad I did the surgery because I'm still down 90 pounds but I have this other struggle now. In some ways if these meds continue to evolve, hopefully these surgeries will become more of a last resort/ a thing of the past
I hear you. I have the same debate with myself, because I have seriously complicated my future by having bariatric surgery. Like I don't have normal poops. And I am so reliant on protein and vitamins to make sure that I can keep myself alive. If we had an apocalypse, I would probably die because I wouldn't have access to calcium, magnesium, vitamin d, vitamin a, vitamin k, etc. But then also the surgery is what gave me my life back. So yes, it's definitely a double-edged sword. I was wondering the same thing if this stuff will put bariatric surgery on the back of burner. Obviously, it's a choice of last resort to begin with, and if there was any other choice when I had it, I would have made it. Here's to hoping!
 
Wow! I'm glad to hear that you had such good results in such a short period of time! It's also interesting to hear about the different ways it works for different people. I do wonder how it's going to work for me, as I kept my duodenum, but I lost most of my stomach and a lot of my small intestines. Of course, it doesn't bother me to be full or not. I'll just eat anyway. The only exception that is when I took Phentermine, and I had to stop it because I couldn't even manage to drink a protein shake because the act of swallowing it made me want a vomit, and my life depends on my ability to consume vitamins and protein.

I feel like I am praying for a miracle with this stuff, and y'all are telling me it's possible. I think one of my biggest fears is I've had the granddaddy of all bariatric surgeries, and while I've maintained my goal weight for years, I have put back on over 30 lb. And it makes me feel like a failure and hopeless that even though I had the most restrictive bariatric surgery possible, I was still able to gain weight through it.
You are in no way a failure. This is a chronic disease that turns our brain/body against us in ways non-suffers really cannot understand.
I hope you have the experience that I did when I was like why do I feel so calm and things just seem quiet.. It was the suppression of the food noise.
I have also had to find hobbies and things to keep me busy as I freed some much time being on this medication.
 
You are in no way a failure. This is a chronic disease that turns our brain/body against us in ways non-suffers really cannot understand.
I hope you have the experience that I did when I was like why do I feel so calm and things just seem quiet.. It was the suppression of the food noise.
I have also had to find hobbies and things to keep me busy as I freed some much time being on this medication.
Thank you for reminding me to be kind and patient with myself while I work my way through this process. I took my first injection this morning, and I am very excited about the possibilities!
 
I had VSG in June 2019 with a starting weight of 350 lbs. By March of 2020, I was down to 225lbs. Then Covid it. I gained back to the point of January this year I was back up to 341 lbs. I started a prescription diet pill in January and lost about 40 lbs by July. I have been on T since July (first with a compounded pharmacy) and then started Amopute in early October. As of this morning, I am down to 241.8 lbs. This medication has been a life changer for me. It has taught me to eat like a “normal person” much more effectively than the surgery ever did.
 

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