I have just finished my last nutrition class and am now waiting to be scheduled with the surgeon before insurance approval. Last evening I read a disheartening story on Obesityhelphelp.com about a guy who had lost over 100 pounds after his sleeve and has gained it all back and can eat a full hamburger fries meal etc. I knew there was the possibility of some weight gain especially if you let things get out of hand, but all of it? My question is it because of the size of the bougie. This is not my first concern about this. My Dr uses a 39 which I think is a larger size by today's standards. Most people are getting a 32 or 34 these days. I would like to hear from folks who either have the larger bougie or the weight gainers and their ideas as to why? I'm afraid to go through the risk of this process, suffer with another slooooow weight loss(I'm the world's slowest loser) only to gain it all back. :-(

Well nothing is guaranteed. My Dr used a 38 bougie. He assured the group that the stomach will never be the original size again because the stretchy part is cut out. Now with that said, I can totally eat more than what was predicted and I am only one month post op. ALSO, if you drink while eating, you can eat way more because you are pushing the food through the stomach faster. I think this is a valid concern that a lot of pre op’s (including me) have/had.

The sleeve is definitely a tool that you need to work with. Eating a hamburger meal is not going to make you gain 100 lbs but doing it every day might. Most of us are exercising and counting carbs (or calories) to ensure that our Sleeves help us and vice versa!

There is controversy within the VSG surgeon community as to how big to make the stomach - too big and there is increased risk of inadequate weight loss and regain while too small brings on the risk of chronic reflux. Since the VSG is still relatively new in the WLS field, everyone is waiting on more extended data, at least 5 year post op data, to refine things to find the sweet spot. The DS surgeons have gone thru much the same thing in working out an optimum common channel length, and as with them, I expect that experience will eventually guide the VSG guys into better matching stomach size with specific patient characteristics - an experienced surgeon will use a somewhat different stomach size for different patients. Discuss your concerns with your surgeon, and be honest about your past successes and failures. Try to get his perspective as to the advantages of the larger size and what problems might be anticipated from it, and how to prevent them. If possible, attend some support group meetings of other surgeons in your area to get a feel for how they operate - it doesn't hurt to check out the competition.

Good luck in your journey,

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My Dr. used a size 30 bougie and I was very happy with this. I'm just past 2 weeks out, but I can't imagine being able to even eat a whole hamburger. Like others have said, discuss your concerns with your Doc, it's your body!

I'm one of the overeaters/regainers. And yes, four years out from surgery I can eat a hamburger meal or half a pizza. My bougie was a 32 and my surgeon says I am just one of a small percentage for whom the VSG doesn't work. I lost 100lbs and have regained half of that. Now I am faced with revision to a gastric bypass or losing weight conventionally (which I failed at for many years, hence having the VSG!).

I wouldn't get too obsessed with the size of the bougie and weight regain. I know of people who had larger than me and have lost all their weight and kept it off. My surgeon says I may have an over-active stomach which empties faster than normal. But I also have made terrible food choices (lots of junk and sodas with meals) and have problems with binge eating and depression.

If you stay focused on the sleeve's needs and how to make it work, you'll be fine. It's so successful for most people. I just wasn't one of them.

The thing to remember is the sleeve is a TOOL - it is not the cure-all. You have to make the commitment to making the lifestyle changes that will ultimately allow you to maintain the weight loss. If you choose to eat poorly, not exercise, eat too much, etc. then yes, you will regain the weight - just like any other weight loss procedure or diet. If you make the commitment to making those lifestyle changes, the sleeve will help you be successful. By having the surgery, it forces you to immediately make changes otherwise you will be very sick. They say the first 6 months are critical - that is because that's when the tool is most effective in helping you modify your lifestyle. Use that 6 months to learn and permanently change your lifestyle. It's not easy, but it is worth it. After all, we have to UNlearn years of unhealthy and bad habits. That is never easy. Fortunately, the sleeve is a tool that can help us in that. The really hard part will be after that 6 month mark - when the tool isn't nearly as effective in helping to modify your lifestyle, because then it is all you. If you slip back into your bad habits, then yes, you will end up regaining the weight again. If you think there may be a really good chance that you would fall back into the bad habits that you had before surgery, then you really should talk to a psychologist about why that may happen and try to work that out if not before, then at least during the 6 month honeymoon period.