Mckennajaims

I have been going through a rough time mentally and have lost too much weight from my sleeve and started restricting my diet so I don't stretch my stomach. Starting to get help to overcome this. My boyfriend has been a saint and helps me because I have been at my lowest. He has issues too. He is only 24, I am 29. And has already had his 2nd open heart surgery. SO he is dealing with a lot too. I am trying to recenter myself and find a happy balance, but I just can't switch to happy overnight and be like yup all fixed! He told me today it feels like he has lost me and that I don't want him around. Which is not true. Just I am someone who needs me time too especially through this emotional rollercoaster. I try to practice mindful eating because my hunger and fullness signals are VERY similar and I am trying to decipher which is which and after dinner he comes up and grabs me around the waste and like throws my stomach around. Or at night time he wants to lay ontop of me. Which was ok before for a little bit, but I now weigh 114lbs and he is 285lbs. I feel crushed and it hurts and he gets mad saying I feel like I am going to hurt you and you don't want me touching you. It isn't that at all! I am just fragile right now and trying to get better and I do not want to lose him. We live together and talk about kids and marriage and I feel like I am ruining everything I have ever dreamed of. A little backstory, I used to weigh my food the 1st year and a half outta surgery on a food scale at 4oz. I was happy and enjoyed a lot of foods. Then My providers said NO not 4oz of weight WE MEAN VOLUME! What I can fit into a measuring cup. I had an endoscopy to make sure I didn't stretch my stomach and they said I was good. But if I kept doing what I was doing it would eventually stretch. I got SCARED and restricted my self to 1/3cup volume to ensure I never would overeat. Well then I started mourning food and felt deprived. It is so hard to find food to mush into a measuring cup! Eventually I got full off my 1/3c or what I think fullness is?? And eventually couldn't even finish that. meat no longer sits well with me and neither does eggs or dairy. I had Laparoscopic Sleeve Gastrectomy August 6th 2019. My HW was 352lbs and now I am 114lbs. Now my providers say don't weigh or measure anything at all just go by how I am "Feeling" and that is hard for me! I eat 3 meals a day with a protien shake in between. I am so messed up about eating and where I will be in 3 - 10 years because medical journals say that ultimately the sleeve is a failed procedure in the long run and that terrifies me. Multiple published medical journals, sites my surgeon belongs to, say most gain their weight and stretch their stomach back 3-10 and gain anywhere to 20 - 80 - too ALL OF THEIR WEIGHT BACK. SO here I am freaking out and could possibly lose the love of my life, but everyone just expects me to turn around and be happy and not worry and say so ya gain a few pounds, go ahead you can overeat this one time..it wont hurt you! No, but those habits will!

Tat is my long rant.. I am so sorry...

Thank you all for the advice. I greatly appreciate your input on what to do. My bariatric support team is broken and I am stressing my family out so much. My providers said if i went back to weighing on a scale and not by volume that I would stretch my sleeve. I feel like my body is accustomed to this 1/3c now because now I can barely swallow only a few bites of solid food without it hurting my chest and I am losing more weight. I always wanted to be "pretty and skinny" 🤦‍♀️🤷‍♀️ and now I can count all of my bones and look like a Halloween skeleton. I poked myself the other day and was like ow what'd I hit?! ...JUST A SHOULDER BONE!😭😭😭
I missed bread so I found these mini Bob Evans bread and sausages, they're tiny about the size of my 1/3c. Mentally I thought I'd start slow because I don't remember the last time I ate bread and that went down just fine but made my abdomen feel full of air and the sausage was good. I couldn't finish it though even though I was still hungry because the way my stomach felt. I was excited to eat more and I couldn't even finish it. I couldnt even finish cottage cheese because I felt full and the dairy didn't set well

1 hour ago, RickM said:

Here is a good reference that I like to use -

You don't need to follow his dietary guidelines, but I do find that his progression on meal volume over time is consistent with my experience. In short, some increase in volume capacity is to be expected and is normal. Call it stretching, adaptive growth (the body will adapt to the changes that surgery has imposed upon it, like it or not) or a more varied diet that includes more slippery foods that move through rather than stay in the stomach, or more likely, a combination of all three.

On the volume vs. weight issue - a basic physics lesson to start with. When measuring Water, an ounce of volume weighs an ounce - that is a definition and is the basis of our measurement system (similarly, a ml or cc of Water weighs a gram in the metric/SI system. Most of our food is mostly water (as indeed, we are,) so on average, an ounce of food by volume will weigh about an ounce, give or take maybe 20%, and over the different components of a meal meat, fruit, veg, starch, etc. - should about average out to about one for one.

Another consideration is that the important thing to your stomach is what the volume is when it hits your stomach, not when you put it into your mouth before you chew it and soak it in saliva. Once that is done, you have a blob (bolus) hitting your stomach that will be about, wait for it..... and ounce of volume that weighs about an ounce. This really saves you from agonizing over how to measure a cup of spinach - how big a leaf, chopped or whole leaf, how finely chopped, how densely packed into the cup...?

Dr Weiner in the video above notes that we ultimately, on average, will be able to consume in a meal about half of what we could before surgery which is consistent with my experience ten years out, and in looking at others whom we dine with in our support group (pre Covid) who are all in the 10-20 year out range, and most every one is taking something home or leaving it on their plate, so some increased volume is normal. The tricky part is keeping your caloric intake steady as this volume increases over time - you still need to keep it at 1200,1500, 2000 calories - whatever level keeps your weight stable.

Thank you for all of this information. I can't wait to go home tonight and watch this. My head hunger is bad and I miss eating a snack every now and then. I was perfect my first year and a half until they said, no we mean volume, not weight. Now I have a horrible fear of stretching my stomach that I am making myself sick and I miss eating and don't know how to stop this.

4 hours ago, GreenTealael said:

IMHO ...

For someone who has been successful this seems like a lot of extra grief to switch over the way you measure your food.

If it were me, I would talk to my team again and tell them I need help with this specific issues because it’s confusing.

Good Luck ❤️

Thank you for your kind response. I am trying everything I can🥰

1 hour ago, Jaelzion said:

This right here

I have lost all of my muscle and cannot lift a ream of paper into the copier at work and barely go up stairs no matter how much I exercise my strength is gone. I miss food from overly restricting, but my fear is so great. I faint, pass out and can count all of the bones in my body. My arms and legs get numb and tingly and my hands and feet turn red and purple and I freeze! I eat 1/3cup 3 times a day and don't eat anything in between. I know something is wrong I am just afraid to fix it.

Thank you, they told me I was a patient for life when I started this journey. Now I am facing financial difficulties and they say I am beyond their help anymore if I cannot pay and because my fear of stomach stretching is repetitive. My nutritionist told me I could reach out to her whenever through mychart, but now this one nurse intercepts my messages and doesn't let me speak to her...

Hello, I am new here and don't know where or how to post things to ask the Dietician - but here is my story and I need help please.

I had Laparoscopic Sleeve Gastrectomy August 6th, 2019. My surgeon and nutritionist said being almost 2 years out of surgery, my stomach should be able to hold 8 ounces in volume or 1 cup of food at a time (but obviously if I get full, don’t eat the whole thing) When I first started this journey, I had the Laparoscopic Sleeve Gastrectomy on August 6th, 2019, they said only eat 4 ounces of food for a meal three times a day. I did that and weighed my food at 4 ounces on my kitchen scale. Then a year and a half out they tell me no, I need to go by VOLUME and not by weight or else I will stretch my stomach! I feel like I am limited in what I can eat now because how do I make a sandwich fit in a measuring cup or a piece of pizza (which I no isn’t nutritious..) but just using those as an example for size. In addition to the whole volume thing, what about foods that expand like breads and crackers and Pasta? How do I measure their volume? If I figure out the volume of something like that should I take away some of the food item that will expand, so I do not go over the volume? For example: If I make a sandwich that is a perfect half cup in volume, should I remove some of the bread because if it expands it will be more that that half of cup? I hope that makes sense. I have lost 230lbs since August 2019. Now I have to learn how to reeat again, because I don’t know how to measure volume without putting it into a measuring cup. I find conversion calculators online, but they give me different answers. I thought, well if my kitchen scale says 4oz in weight am I able to find the fl oz of that without smushing it? I don’t know what is accurate? Weighing was so much easier, but now I am told volume and that it has to fit into a measuring cup, but how do you put a meal in a measuring cup? Right now, I eat 3 meals a day at 1/3 cup volume measuring cup per meal and with 1 – 2 Protein Shakes for the day in between my meals. I eat a meal at around 6am, 12 – 1pm, and around 6 – 6:30pm. I get full on only a few bites of my 1/3 cup food or what I think fullness is so I don’t always finish even that.
My hunger signals and fullness signals are all screwed up. And I don't know if it is all in my head?

Thank you so much for your time. I truly appreciate it. I try asking my nutritionist and surgeon these things and they say they don’t know how to answer them – just make sure you don’t stretch your sleeve and go over the volume! I try to stay at 1/3cup volume per meal, because I am afraid of stretching my stomach out now. Maybe one day I can go up to 8 ounces in volume I hope because my meal choices have become really restricted because I can’t mush them into a measuring cup and what I can doesn’t seem worth it because If I wanted to enjoy a little something sweet, it barely fits in the 1/3cup – so why bother. Then that makes me sad. I originally weighed 352lbs and now I am 119lbs.

I also spoke to someone who said that after I lose all of my weight that it doesn’t matter if I overeat and stretch my stomach back out any more just as long as I stay within 1,200 calories, 120 carbs, and 90g of Protein? Is that true? My hunger and fullness signals are really difficult for me to tell apart and I have a severe anxiety over stretching my stomach (that I am trying to seek help for). But if the whole “It doesn’t matter if your stomach stretches back to normal” is fine and I watch my nutrition, is that ok? I feel like that would be giving up and taking the easy way out because I “like food more than blah, blah, blah, and just want to eat..” I am afraid of going back to old habits because I love bread and sweets. It scares me to gain any of my weight back because I don’t want to be one of those where people say, look at her – you can’t even tell she had weight loss surgery because she gained it all back! I made this big decision, this massive life change and accomplished a great weight loss, but now am I giving it all up? All because I miss food and want to eat in between meals. Right now I am so hungry or head hungry, but not physically hungry, but head hungry enough I think I want to eat something.

I need help tp get on track and figure some things out please? I don’t know what else to do and I am so utterly lost. My surgeon tells me to ask my dietician these questions because he doesn’t know how to answer them – he just preforms the surgery. My dietician told me to go by weight, then volume and now she’s telling me not to weigh or measure at all just to go by how I am feeling? Well sometimes I feel I can eat a lot. I am not getting the support from them I need and I just need someone to have patience and understanding and who is kind to work with me please. I am sorry if this is a lot of information to take in. I don’t mean to go on a rant. I am just so confused. I am going to see a therapist, but the whole stretching my stomach thing is a real fear. I also had complications after surgery with bleeding that I am told may have given me PTDS..