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 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
 

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