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gastric dilatation does not necessarily lead to weight regain



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Does gastric dilatation limit the success of sleeve gastrectomy as a sole operation for morbid obesity?

http://www.ncbi.nlm.nih.gov/pubmed/16469218 Research Study

http://www.weightlosstriumph.com/does-gastric-dilation-limit-the-success-of-sleeve-gastrectomy.html further discussion of research results

Great news! This research indicates that dilataion (stomach streching) does not necessarily lead to weight gain. In fact, most of the research that I've done (scientifically based) parallels the results of this study.

The reason I've researched this topic is because my capacity has increased after one year post op and sometimes wonder if my stomach is dilated. I don't think my eating behaviors caused dilatation because I can only remember 3-4 times that I ate to the point of discomfort in the past year.

Even if my stomach is dilated, I can still keep the weight off. The surgery did its job by helping me lose over 150 pounds and now I have to put my effort into overdrive during the maintenance phase. For me, this maintenance phase is actually harder than the weight loss phase because it is less structured and I really have to watch my portions because my stomach can hold so much more than before.

The article recommends revision surgery through bypass or duodenal switch if the stomach becomes dilated. However, according to Dr. Weiner (well known bariatric surgeon, search on youtube for his videos), most patients that undergo this revision only lose an average of 15-25 pounds afterward. He often notices (during the revision surgery) that many patients DO NOT even have a dilated stomach.

FYI:

Dilation (stretching) does happen, but mostly to larger sleeves. You are going to have many people tell you that it just can't happen, they are wrong. This seems to have a great deal to do with how much of the fundus is cut out. The remaining fundus can stretch up to four times it's original size. Research shows that about 50% of the ghrelin is still produced in our bodies. I can also attest to the fact that my hunger and cravings are about at 40% compared to before surgery. I've read that most sleeves hold about 2 ounces after surgery but will eventually hold 4-6 ounces. This means that it is normal for the sleeve to enlarge 2-3 times its original size over time, despite not overeating.

Really, what counts is NOT the size of our stomach, but what we put in it. I've seen patients regain weight no matter what their sleeve size. It's interesting to note that I've lost much more weight than those that boast at meetings that they are full after a few tablespoons. Even if your capacity has increased, the key is to stay positive! You can and will be successful!

Further info: http://myaceinhand.blogspot.com/2012/01/bougie-size.html

Edited by WL WARRIOR

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I would have to agree with the above topic. I have had my sleeve balloon dilated 3 times between Dec 2012 and August 2013 as a last ditch effort (well in addition to two hiatal hernia repairs and a lychees of adhesions procedure) prior to revising to the gastric bypass. I had lost all of my weight 100+ pounds and still then some and have never had one single actual hunger pain. My stomach as my doctor refers to it now is the size of a shrunken walnut and I am on TPN for malnutrition. The balloon dilations however were very welcome procedures as at the time I was unable to keep anything down due to the strictures of the esophagus.

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The first study you reference is from Feb of 2006, almost 10 years old. Its sample size is so small, 23, as to be almost meaningless. I would almost discount this one completely due to the age of the study and the limited sample size.

Not saying your basic premise is wrong, but I see no smoking gun here.

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Does gastric dilatation limit the success of sleeve gastrectomy as a sole operation for morbid obesity?

http://www.ncbi.nlm.nih.gov/pubmed/16469218 Research Study

http://www.weightlosstriumph.com/does-gastric-dilation-limit-the-success-of-sleeve-gastrectomy.html further discussion of research results

Great news! This research indicates that dilataion (stomach streching) does not necessarily lead to weight gain. In fact, most of the research that I've done (scientifically based) parallels the results of this study.

The reason I've researched this topic is because my capacity has increased after one year post op and sometimes wonder if my stomach is dilated. I don't think my eating behaviors caused dilatation because I can only remember 3-4 times that I ate to the point of discomfort in the past year.

Even if my stomach is dilated, I can still keep the weight off. The surgery did its job by helping me lose over 150 pounds and now I have to put my effort into overdrive during the maintenance phase. For me, this maintenance phase is actually harder than the weight loss phase because it is less structured and I really have to watch my portions because my stomach can hold so much more than before.

The article recommends revision surgery through bypass or duodenal switch if the stomach becomes dilated. However, according to Dr. Weiner (well known bariatric surgeon, search on youtube for his videos), most patients that undergo this revision only lose an average of 15-25 pounds afterward. He often notices (during the revision surgery) that many patients DO NOT even have a dilated stomach.

FYI:

Dilation (stretching) does happen, but mostly to larger sleeves. You are going to have many people tell you that it just can't happen, they are wrong. This seems to have a great deal to do with how much of the fundus is cut out. The remaining fundus can stretch up to four times it's original size. Research shows that about 50% of the ghrelin is still produced in our bodies. I can also attest to the fact that my hunger and cravings are about at 40% compared to before surgery. I've read that most sleeves hold about 2 ounces after surgery but will eventually hold 4-6 ounces. This means that it is normal for the sleeve to enlarge 2-3 times its original size over time, despite not overeating.

Really, what counts is NOT the size of our stomach, but what we put in it. I've seen patients regain weight no matter what their sleeve size. It's interesting to note that I've lost much more weight than those that boast at meetings that they are full after a few tablespoons. Even if your capacity has increased, the key is to stay positive! You can and will be successful!

Further info: http://myaceinhand.blogspot.com/2012/01/bougie-size.html

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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.
      · 0 replies
      1. This update has no replies.
    • 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.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
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    • KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
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