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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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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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