This topic is about finding effective weight-loss strategies for someone who has lived with an ileostomy for 20 years and no longer has a colon. The person has gained about 60 pounds and is looking for advice on how to lose weight, as traditional methods don't seem to work well for them. Here are some helpful suggestions and insights:

1. Stick to the basics of weight loss: focus on a balanced diet, control your portion sizes, and include regular, moderate exercise in your routine.

2. Consider following a "diabetic diet," which involves structured control of carbohydrate intake. This can be a good starting point for balanced eating and being mindful of portions.

3. Some people have found success with commercial support programs like Weight Watchers. For instance, one person lost 20 pounds and found it to be a sensible and sustainable plan.

4. Understand that certain physiological factors unique to having no colon can make weight control challenging:
- The absence of the colon can significantly reduce serotonin production, which might lead to low-level depression and increased appetite.
- Total colectomy can cause the bowel wall to overproduce leptin, leading to leptin resistance and a reduced feeling of fullness.

5. To help with feeling full, focus on meals that naturally sustain satiety. For example, combine complex carbohydrates and fiber, like beans with rice, to slow digestion and enhance the feeling of fullness.

6. As you lose weight, you might find that you need to change your ostomy appliance less often, which can be an added practical benefit.

7. Always discuss any diet and exercise plans with your doctor or stoma nurse to ensure they are appropriate for your specific medical situation.