Tirzepatide and Bariatric Surgery

[nurseratchit]

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.

 

[dogmom]

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.

 

[touringsedan]

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.

 

[clayd]

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

 

[fyrepep]

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.

 

[fyrepep]

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.

 

[fyrepep]

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!

 

[touringsedan]

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.

 

[fyrepep]

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!

 

[mduckett99]

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.

 

[clayd]

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.

on several forums around the internet, i am shocked at how many people started around the july timeframe. many with a compounded pharmacy, now some of those switching to powder. i'm on exactly the same path.

i remember that it hit the news around that time that hims/hers would start offering compounded weight loss and their stock popped, that's when i started researching my options. i wonder if there was something else in june/july that made a bunch of people get on the bandwagon

 

[clevesand]

on several forums around the internet, i am shocked at how many people started around the july timeframe. many with a compounded pharmacy, now some of those switching to powder. i'm on exactly the same path.

i remember that it hit the news around that time that hims/hers would start offering compounded weight loss and their stock popped, that's when i started researching my options. i wonder if there was something else in june/july that made a bunch of people get on the bandwagon

June/July is when the early adopters of compounding first started to show a lot of weight loss and posted all about it on social media and it was a snowball effect.

 

[clayd]

June/July is when the early adopters of compounding first started to show a lot of weight loss and posted all about it on social media and it was a snowball effect.

i'm assuming mostly on tiktok? (i don't have it)

 

[fyrepep]

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.

I hate it for all of us when we have regain. It's so frustrating and discouraging, but I am really enjoying reading about the success everyone has had on tirz. I am grateful and thankful we have an opportunity to utilize it. Congratulations on the loss so far!

I totally understand what you mean about not learning to eat like a normal person, although, I will never experience that due to malabsorption. But it was eating almost nothing to eating everything in sight with me only stopping because if I didn't, I'd vomit. I want to be able to stop when I am no longer hungry and feel "normal".

 

[mduckett99]

on several forums around the internet, i am shocked at how many people started around the july timeframe. many with a compounded pharmacy, now some of those switching to powder. i'm on exactly the same path.

i remember that it hit the news around that time that hims/hers would start offering compounded weight loss and their stock popped, that's when i started researching my options. i wonder if there was something else in june/july that made a bunch of people get on the bandwagon

I didn’t even know that compounding was a thing for this medication until my PCP mentioned it. I have an awesome PCP who said he had other patients doing really well on it. He sent a script directly to Empower Pharmacy in Texas. Less than a week later, I had my meds and started.

 

[lrossetto0722]

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.

that was my surgeon too! I did great at first when I got my sleeve but I eventually put about 40-60 lbs back on. I feel like since starting Tirz my pouch is back to a pouch ... its kinda weird ... I used to be able to eat a whole sandwhich or a whole slice of pizza and now I can't. also at my lowest with the sleeve I was 123 and now with the tirz I made it to 119.

 

[anniesolion]

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...

VSG club member here. I lost 90 pounds with VSG, stopped losing 40-50 pounds away from where I hoped to get. I had two goal weights, the statistically realistic goal (which I reached) and my dream goal, which I am now aiming for with the help of Tirz.

I was very happy with my VSG results which were average for % of excess weight loss with VSG. I maintained for awhile…then gained 20+ pounds back, getting back to a high of 201

I had been thinking about trying a GLP1 and that was the push I needed. Started taking Tirz 4 months ago and have lost all but a couple pounds of my regain and am feeling hopeful about reaching my dream goal weight. Being on Tirz feels a lot like the first 12-18 months post VSG did, but even more predictable in terms of restriction. My restriction never went away completely, but did lessen and become unpredictable overtime. I had days where I could (and did) EAT and eating “around” my restriction was certainly possible. The VSG helped, but I had a tougher time with “food noise” and cravings still, compared to being on Tirz. On Tirz, my food noise is really low again my restriction is combined with prolong satiety (from slower gastric emptying I’m guessing) that I didn’t fully experience once I healed from VSG surgery and was eating a normal diet.

Overall, for me, I feel like VSG and Tirz are a winning combo. I could see a future where these treatments are offered in combination for some.