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Why do people lose (so much) weight after surgery?

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  • Why do people lose (so much) weight after surgery?

    We live in a country where at least 1/3 of adults are overweight or obese. Food beckons everywhere and many succumb to its lure eating for taste instead of appetite,

    How come, then, I hear all the time both here and in the medical lit that weight loss is a serious problem after this surgery? It can only make me think it's such a hellacious experience, it just strips the flesh off your bones - or something.

    I don't expect anyone to tell me it's a miracle cure for weight loss, so what really IS the scoop on why it happens? We're not unconscious for that long , and even what I've been thinking of as the average "hell" period (one-two months) isn't THAT long.

    Nor can we engage in vigorous exercise during that time (in fact, I'm very concerned about becoming debilitated and losing all my good and hard won muscle tone. After all, how can I do crunches or the other floor exercises I've been relying on? But that's another thread...)

    It's just so hard to imagine everyone dropping that much weight unless something strange and awful is going on. I almost always have a good appetite. In fact, it's a problem to eat healthy and moderately. What lies ahead??

    Meds? Agonizing pain? Sleeplessness?
    Not all diagnosed (still having tests and consults) but so far:
    Ehler-Danlos (hyper-mobility) syndrome, 69 - somehow,
    main curve L Cobb 60, compensating T curve ~ 30
    Flat back, marked lumbar kyphosis (grade?) Spondilolisthesis - everyone gives this a different grade too. Cervical stenosis op'd 3-07, minimally invasive

  • #2
    I had one surgeon tell me I'd lose 25 pounds and need a whole new wardrobe. Didn't use that one. I actually gained 20 pounds due to swelling withing a week and a half. I was in rehab and it is one of my main memories. I would have been WAY more upset if I had all my faculties about me. Eventually over a couple months I lost that and about 15 more. Lowest I've been in years and thought I'll never gain this back. Unfortunately I did and more and it's back to Weight Watchers. I think it was the stress of the surgery and meds. For once in my entire life I didn't have much appetite. When it came back it made up for it big time. It's ridiculous. I've always fought it but it's like my body is now making up for anything I didn't eat those few months. GRRRR... Janet
    Janet

    61 years old--57 for surgery

    Diagnosed in 1965 at age of 13--no brace
    Thoracic Curve: 96 degrees to 35 degrees
    Lumbar Curve: 63 degrees to 5 degrees
    Surgery with Dr. Lenke in St. Louis--March 30, 2009
    T-2 to Pelvis, and hopefully all posterior procedure.

    All was posterior along with 2 cages and 6 osteotomies.

    Comment


    • #3
      As a diabetic, is this going to be a problem for me ? Am I going to have to force myself to eat even when I really do not feel like at all?

      Melissa

      Comment


      • #4
        Hi Amanda
        i have lost alot of weight now, before surgery, due to using strong pain meds...they kill my appetite...completely wipe it out!
        i am told that, after surgery, heavy pain meds are given, at times morphine, or other heavy duty ones... by IV and then by mouth...such drugs usually wipe out the appetite of anyone, especially someone who is in pain and who's body has just been through such trauma!

        i need to gain weight for the surgery to happen..
        at 94.5 lbs, the surgeon is worried about my nutritional profile...and would also like me to gain some weight in preparation for me losing weight after surgery...

        i know that many patients have swelling and/or bloating after surgery...fluid retention...but that can be temporary weight gain...fluid weight is often the fastest to lose...of course, if any of it is from steroid use, (sometimes needed to take inflammation down) or other reasons they use steroids, that is a whole other kinda weight!

        blame the medications when it comes to weight loss connected to surgery....


        jess

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        • #5
          Thanks jess, but I can tell you if it were the meds, I would already have been emaciated (struggling to lose weight). After all, having lost four inches, as Woody Allen once quipped, "I'm not overweight; I'm under-tall!"

          That's my story now. Sucks.

          I detoxed myself in June from FIVE times a high average dose of hydrocode plus oxycodone. No fun! But no weight loss before or afterwards, either. In fact, when I couldn't sleep during detox (the worst symptom for me), I ate constantly with no appetite - just out of fidgetiness!

          I have a latent eating disorder. This is going to be awful for me!

          I know you're thin and I sympathize abstractly - must be just as bad as being overweight, especially when you need the weight to be at a thresh-hold to get the surgery you need so much. In fact, one thing prompting this thread is reading one surgeon's' presentation (all were at the top scoli docs' convention from last Sept. San Antonio).

          He was discussing prognostic indicators for successful recovery, and one was a good weight. Apparently, some patients post-op require "hyper-alimentation". This can mean either nasty fattening milkshakes or even tube feeding. If the day comes when I need a naso-gastric tube, I'll know I'm ready to cash in!

          Not crazy about the idea of cortisone either, having seen (as a psychologist) what it can do a person's sanity/stability. Depression, psychosis. Maybe I seem to be looking for trouble, but I'm one of those people who likes to look right into the abyss before going across the rope bridge!
          Not all diagnosed (still having tests and consults) but so far:
          Ehler-Danlos (hyper-mobility) syndrome, 69 - somehow,
          main curve L Cobb 60, compensating T curve ~ 30
          Flat back, marked lumbar kyphosis (grade?) Spondilolisthesis - everyone gives this a different grade too. Cervical stenosis op'd 3-07, minimally invasive

          Comment


          • #6
            i struggled with weight when i was younger...i swear, had i known that pain and pain meds did this, i would probably have gone looking for it! after all, i come from the city where the expression of many women is "no one can be too thin or too rich"!!

            jess

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            • #7
              I was one of the few who gained weight-- I gained in the hospital and it never came off. That was even with having an ileus for 5 days (so no food or drink during that time). I think it depends at least a little on the type of metabolism you have. I have always gained easily and struggled so hard to lose any. I did not over-eat-- my body just clamps down and says it's in starvation mode or something, and doesn't burn the calories like it should.

              Just wanted you to know that not everybody loses weight. I had hoped it would happen with me, but didn't.
              71 and plugging along... but having some problems
              2007 52° w/ severe lumbar stenosis & L2L3 lateral listhesis (side shift)
              5/4/07 posterior fusion T2-L4 w/ laminectomies and osteotomies @L2L3, L3L4
              Dr. Kim Hammerberg, Rush Univ. Medical Center in Chicago

              Corrected to 15°
              CMT (type 2) DX in 2014, progressing
              10/2018 x-rays - spondylolisthesis at L4/L5 - Dr. DeWald is monitoring

              Click to view my pics: pics of scoli x-rays digital x-rays, and pics of me

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              • #8
                Susie*Bee,

                Cant believe hearing that would cheer me up so, but indeed it did!

                So. I'll proceed as usual. Meaning once I'm out of rehab, I'll go back to fish, protein shakes, burgers and lots of produce with the nightly glass of wine or champagne to look forward to - if they let me. (Aw shucks, guess the booze will be out for a while thanks to all the opiates. *shudder*).

                As long as my S-I-L doesn't try to overfeed me to show her good will! (Hate over-eating to be polite).
                Not all diagnosed (still having tests and consults) but so far:
                Ehler-Danlos (hyper-mobility) syndrome, 69 - somehow,
                main curve L Cobb 60, compensating T curve ~ 30
                Flat back, marked lumbar kyphosis (grade?) Spondilolisthesis - everyone gives this a different grade too. Cervical stenosis op'd 3-07, minimally invasive

                Comment


                • #9
                  Originally posted by mbeckoff View Post
                  As a diabetic, is this going to be a problem for me ? Am I going to have to force myself to eat even when I really do not feel like at all?

                  Melissa


                  Melissa,

                  Make sure the doctor who normally monitors your diabetes is aware of your surgery. He/she can suggest things to help control your sugar levels. If you take oral meds or insulin, it might need to be adjsted for awhile. Make sure you or a family member reminds the hospital staff that you are diabetic.

                  I would suggest trying fruit smoothies or milkshakes if you aren't hungry. At least with the smoothies, you are getting a little bit of fruit and the milkshakes have milk.

                  Mary Lou
                  Mom to Jamie age 21-diagnosed at age 12-spinal fusion 12/7/2004-fused from T3-L2; and Tracy age 19, mild Scoliosis-diagnosed at age 18.

                  Comment


                  • #10
                    I've always been a normal weight -- on the slender side but not skinny. Once I started eating again in the hospital (around 4 days post-op), I actually had a pretty good appetite, in spite of all the drugs. Once I got home, I found that I wanted to eat 5 or 6 small meals a day instead of 3 big ones, which is better for you anyway, and I still tend to eat that way. I lost about 10 pounds and eventually put back 5 of them.
                    Chris
                    A/P fusion on June 19, 2007 at age 52; T10-L5
                    Pre-op thoracolumbar curve: 70 degrees
                    Post-op curve: 12 degrees
                    Dr. Boachie-adjei, HSS, New York

                    Comment


                    • #11
                      i cant eat with my pain meds...hydrocodone..had to quit the oxycontin...it made me too tired all day...and i went down to 87 pounds on it and got scared!! now i am at 95 pounds, and trying to get up above 100....when i think of how i struggled in my 30's and 40's...and then after menopause it was sooo hard to get rid of the weight i had put on from being on steroids....that darned moon face that wouldnt go away!

                      at this point, i just have zero appetite...i used to be a real sugar junky...now i dont even crave sugar...sometimes i'll eat it cause it is a pain killer and works on the same part of the brain as antidepressants! what a drug sugar can be!
                      years ago i read "Anatomy of a Food Addiction" and found out why i craved sugar so much!

                      i need to gain a litle weight for the surgery, and also get nutritionally fit, per Dr Lonner....

                      jess

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                      • #12
                        I did not lose weight but have gained some. I didn't eat much in the hospital the first few days but kind of forced myself to do fruits and veggies to get things moving. I had major swelling from transfusions/fluids and still have a little in my abdomen/hips. Have always had a healthy appetite and once I was out of the hospital, ate pretty much normally. Even though I'm walking both in and out of the pool and am pretty active, I am still at about 6-8 lbs. above my pre-op weight. Like everything else, it takes time, I guess.


                        Anne in PA
                        Age 58
                        Diagnosed at age 14, untreated, no problem until age 50
                        T4 to sacrum fusion
                        63 thoracic now 35, 92 lumbar now 53
                        Dr. Baron Lonner, 2/2/10
                        Am pain-free, balanced, happy & an inch taller !

                        Comment


                        • #13
                          You lose weight because you lose your appetite following surgery. I did not regain my appetite until about the 10th day when I was in rehab. Until then, just the sound of trays with food being distributed in the hospital and rehab made me want to puke. When I was transferred from the hospital to rehab, the first thing they did was take my weight. I had to sit in this weight chair, and I heard the woman say 156. And I thought what, how can that be? I went into surgery weighing 138 pounds; I had not eaten anything in six days so how could I have gained 18 pounds. All the while I kept thinking OMG I’ve just had 18 pounds of hardware implanted in me. My back did feel like I had a 100-pound weight strapped to it. I later learned that they used some other system for measuring weight and the woman miscalculated. I had actually lost 10 pounds. Phew!

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                          • #14
                            i don't lose weight or lose my appetite with surgery. Each time I have had surgery I have gained weight and never take it off. This time was no different. It doesn't matter that I don't eat the first couple of days because once home and with less activity (I guess) i gain weight. The only time I have ever lost my appetite was when I was 19 and had hepatitis and back then my doctor told me to eat hard candy, which I did and haven't stopped doing that for 40 years. That was it. I lost weight and thought it was the greatest thing. i just don't lose my appetite no matter what.
                            avis
                            1987 Lumbar Laminectomy (forget which levels)
                            2005 A/P fusion, L2 - L5, 2/2005
                            2009 2 Posterior fusions, T6 - Pelvis, 2/10 & 2/18,
                            Dr. Frank Rand, NEBH

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                            • #15
                              I didn't lose a gram from the surgery. I was eating on the second day (big mistake.)

                              But I lost 4 kilos in the first week I had the "withdrawals". I'm slowly regaining that.
                              Surgery March 3, 2009 at almost 58, now 63.
                              Dr. Askin, Brisbane, Australia
                              T4-Pelvis, Posterior only
                              Osteotomies and Laminectomies
                              Was 68 degrees, now 22 and pain free

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