This topic is about the challenges of losing weight after having an ileostomy, especially when feeling constantly hungry. The person sharing their experience has gained weight since their surgery and is looking for advice on managing weight loss with an ileostomy. Here are some helpful tips and insights shared by others:

1. Portion size and meal pattern:
- Try eating several small, low-residue meals or snacks throughout the day instead of three large meals. This can help reduce hunger and manage output.
- Using a smaller plate can help control portion sizes.
- Consider having four small meals during the day and a light snack at night to minimize the need for nighttime bag emptying.

2. Diet composition:
- Focus on lean proteins like chicken, turkey, fish, Greek yogurt, and protein shakes, along with low-glycemic carbohydrates. Avoid fried foods, sweets, soft drinks, excessive bread, junk food, and high-fiber foods that might cause blockages.
- Some people find success with structured eating plans, such as having a protein shake for breakfast, skipping or having a shake at lunch, and a protein with a small starch for dinner.
- Stay hydrated with plain water, low-calorie sports drinks, or decaf coffee to help control appetite.

3. Tracking and awareness tools:
- Keep a detailed food diary, including snacks and drinks, to identify hidden calories and emotional eating.
- Be aware of medications that might contribute to weight gain, such as long-term corticosteroids.

4. Exercise options when time is limited or fatigue is an issue:
- Consider home-based activities like YouTube workouts, walking with children, using a stationary bike, under-desk pedal machines, skipping rope, or short sessions of body-weight or light resistance exercises.
- Regular movement can also help distract from snacking.

5. Medical checks and supplements:
- Check thyroid and pituitary function, as undiagnosed hypothyroidism can lead to rapid weight gain.
- If rapid transit is an issue, consider using medications like Loperamide/Imodium to slow output.
- For short-bowel or malabsorption issues, Gattex injections or TPN under specialist care might be beneficial.
- Daily multivitamins, electrolyte supplements, or potassium citrate can help replace losses and prevent kidney stones.

6. Appetite and metabolic aids:
- Some people find that Ultra Berberine with cinnamon or generic berberine helps lower blood sugar and reduce hunger, though scientific support is limited.
- Modern GLP-1 drugs like Ozempic have helped some, but they are not suitable for those with a history of pancreatitis.

7. Behavioral and lifestyle pointers:
- Prioritize self-care by scheduling "me-time," getting adequate sleep, and engaging in stress-relief hobbies. Managing evening intake or shifting the larger meal to midday may help with hunger hormones affected by interrupted sleep.
- Avoid an "all-or-nothing" mindset; gradual, sustainable changes are more effective than extreme restrictions.

8. Surgical or last-resort measures:
- Bariatric surgery, such as a gastric-sleeve procedure, can be effective for significant weight loss when medically appropriate and other methods have not worked. It requires careful consideration and screening.

9. General encouragement:
- Weight changes with an ileostomy can vary widely, so comparing yourself to others may not be helpful.
- Seek guidance from a dietitian experienced in ostomy care for a personalized and safe plan.