Inclusion Criteria:  patient in Nord-Trøndelag 2-4 years after Roux-en-y gastric bypass surgery visits Namsos outpatient clinic for follow-up. having at least 3 symptoms of hypoglycemia presented in the dumping severity scale (DSS). at least one of these symptoms must be a neuroglycopenic symptom all these symptoms have an intensity of 2 or 3 on DSS.  Exclusion Criteria:  severe surgery-related complication revisional surgery life threatening health conditions. diabetes mellitus or other metabolic diseases pregnancy or breast feeding