Hello i have had an illiostomy for 20 years now and over tge years i have gained atleast 60 pounds. I have never been a small person. But not this big either. Im asking her suggestions to help with my weight loss. So many things dont work because i have no colon.
Help signed Desperate
Desperate,
I've had an colostomy for 41 years and have maintained a healthy weight.
Losing weight is generally about good balanced diet, portion control and modest exercise.
I've found a good place to start is a diabetic diet where you manage your carbohydrate intake, which is a balanced diet with an emphasis on portion control.
Better yet, as you lose weight you'll likely find you have to change your appliance less often.
Talk to your doc.
Mike Q
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Hi Desperate
I have the same problem. I went on to Weight Watchers and lost 20 pounds. Still have a bit more to go, but it is the most sensible "diet" out there.
Good luck
Sandi
Hi, Desperate,
From what I've read of comments in several forums, weight gain after a colectomy actually seems to be a "thing" for a significant percentage of colectomy patients. It is not (yet) recognized as a discrete medical issue by the GI profession, as far as my research indicates, although aspects of it are discussed here and there in scattered medical literature.
Here are a couple of things I've gleaned regarding colectomy and weight gain:
Mood:
The colon produces most of the serotonin in the body. When it is gone, serotonin levels plummet. This can lead to an ongoing low level of depression (or high level, if one has been struggling with depression pre-colectomy). And when people are depressed, they often eat more, hence contributing to weight gain.
Feeling full - or not:
Leptin is the hormone that tells you when you feel full. Eat to satiety, get a surge of leptin, feel satisfied, stop eating. That's the normal cycle. In persons with a total colectomy, leptin is overproduced in the mesentery and bowel wall. This means you probably have higher levels of leptin in your system than normal. The result is like insulin resistance, only in this case, leptin resistance: your body doesn't recognize that post-meal leptin surge as anything significant, and you are less likely than a normal person to feel full after eating, more likely to snack frequently or late at night, and so on.
I'm still researching this, but it is like putting together a jigsaw puzzle. More pieces of the picture are out there but I have yet to find them. In any case, these two facts alone (mood and not feeling full after eating) can be huge contributors to why one puts on weight.
I also am dealing with significant weight gain post-colectomy (I also have an ileostomy), and one thing I've noticed that helps is if I take care to eat food combinations that make me feel full. For instance, beans and rice together form a complex carbohydrate that is more filling than either item alone, takes longer to digest, and includes fiber (from the beans) that further gives the body a lot to chew on (so to speak). This helps address the misread leptin issue, I think, because I end up feeling more full (like clubbing my leptin-meter over the head with a stick to get its attention) - and hence it is easier to do portion control and eat less.
Aside from this, I have no other advice to offer at the moment except that old tried and true "eat less, move more." But I think it is interesting (and bothersome) that a total colectomy can complicate this picture because of the many ways the absence of a colon throws our systems out of whack.
Good luck with managing your weight! It shouldn't be this hard, but maybe the medical things I've discovered (above) can help you (and others) also get a better handle on this problem.
-Teramis
