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okay here is a picture that shows differences in bougie size. Let's say the difference between the biggest and smallest is 1 tablespoon. And you decided to make up the difference with the highest calorie thing you could find which would be 1 tbsp of butter I'm guessing? So you know, extra 102 calories compared to your smaller bougie counterpart.

It would take you 35 days of eating 1 extra tbsp of butter for you to gain a real pound. I have a hard time believing bougie's impact weight loss that much.

Besides, 85% of a larger stomach is still larger than 85% of a smaller stomach so bougie size is not the only thing that impacts capacity. My husband and I were sleeved same day by the same surgeon, same bougie size. As soon as we were on solids, he could hold 4 oz, I could hold 2 oz.

It's much more about behavior than about bougie, IMHO

Did you read the study above?

You did not mention the bougie size used on you or your husband.

According to the research a 32f is gold standard to "long term" success. And it would seem that data is now coming in that anything other than a 32 "could" lead to regain.

I use the "could" because yes some people don't use what they have learnt to modify what they eat any more because of lack of restriction.

I respect your opinion that bougie size don't make any difference but I do not agree.

Another angle on this as I see it is, we are all different and the capacity for the stomach to stretch might be more so for some than others.

Xx

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I did read the study. Best practice guidelines, but not based on causation or correlation. So while I agree that one can say Ideally bougie size should be between 32-26, if they truly want us to believe that a larger than 36 size leads to weight re-gain then they should either perform correlations, or ideally a logistic regression that allows us to see what factors contribute to regain, and the role of bougie size in regain. At least in this version of the article, that was not provided.

This article speaks more to gaining consensus than using data to guide best practices. Small but important difference, IMHO.

I often write best practice documents for clients. But those documents list the ideal way to do things on one dimension at a time. if a client truly wants to know what combination of events leads to the best outcome, I have to create statistical models to quantify the role of each element in the outcome.

I am sure many things contribute to weight regain, including the ability of the fundus to grow back. I have read of cases where that has happened, and I think in many cases it was surgical error, not patient non-compliance. I also have no trouble agreeing that people may have different capacities for stomach stretching both before and after the surgery.

And of course, it's totally okay for us to have differing opinions on the bougie size issue as well :). I'm just saying, the article doesn't demonstrate causation, and the fact that the difference in capacity is 1 tablespoon or less, some other facts may be at play if indeed bougie sizes contribute to weight re-gain--which latter fact was not demonstrated.

Okay enough geekery on my part! :P

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IMHO, and I am a "40"... I defer to my surgeon. I want him to do it right, and of the two of us, he's the only one awake.

So, I don't KNOW if "40" is good or bad for me. But I can't get a "36" or "32" now, so I'll play with the cards I am delt!

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