I do not understand 'no restriction left"

[sharonintx 1,275]

Help me understand. I am 5 yrs out from sleeve surgery. There has never been a time I was able to overeat to a large extent, I feel very near the same restriction as about 6 months after surgery. I can eat more sweets than real food but even so there is a limit I cannot cross.

I see people taking about feeling no restriction and saying their sleeve has stretched and they have gained a lot of weight - a lot being more than 20-30 lbs.

On occasion I have gained a few pounds. Most notably gaining 12 lbs this past summer due to my consumption of coffee milk shakes from Whataburger. The scales hit 12 lbs over what I was comfortable with, I said to myself ' stop this s#@t before it goes any further". I quit the shakes and switched to strawberry Protein smoothies from Starbucks and the pounds went away.

I do not understand 'my sleeve stretched'. Am I wrong in thinking that the only way this could happen is if someone stuffed it past capacity repeatedly? Over and over? And if that were the case then wouldn't the problem be that one has yet to conquer the mental demons that make us overeat in the first place?

Am I missing something?

[shedo82773 1,236]

I'm really not sure about the "stretching the pouch" I have heard so many tales of it. I have heard from a DR online, (wish I could remember his name) he said stretching your pouch etc is a myth. Also he said it wouldn'tbe your pouch any how...it is the opening from your pouch not the pouch itself. I have eat to much and it hurts like heck. I still have plenty of restriction. But I can eat more than before. I weigh between 125 to 130. Pretty good. I am very happy with my WL. You are defintly right about the over doing part. Have a great rest of your weekend.

[Healthy_life2 8,330]

2 hours ago, sharonintx said:

Help me understand. I am 5 yrs out from sleeve surgery. There has never been a time I was able to overeat to a large extent, I feel very near the same restriction as about 6 months after surgery. I can eat more sweets than real food but even so there is a limit I cannot cross.

I see people taking about feeling no restriction and saying their sleeve has stretched and they have gained a lot of weight - a lot being more than 20-30 lbs.

On occasion I have gained a few pounds. Most notably gaining 12 lbs this past summer due to my consumption of coffee milk shakes from Whataburger. The scales hit 12 lbs over what I was comfortable with, I said to myself ' stop this s#@t before it goes any further". I quit the shakes and switched to strawberry Protein smoothies from Starbucks and the pounds went away.

I do not understand 'my sleeve stretched'. Am I wrong in thinking that the only way this could happen is if someone stuffed it past capacity repeatedly? Over and over? And if that were the case then wouldn't the problem be that one has yet to conquer the mental demons that make us overeat in the first place?

Am I missing something?

My restriction is still there and working after 4 years. Statistics I've seen say revisions are rare.

I have compassion for anyone who has had a large weight gain or complications.

The sleeve stretching scenario leaves me baffled. Are the mental health evaluations identifying eating disorders pre surgery? Are surgeons offices/medical community intervening if someone is binge eating past capacity repeatedly?(stretching their sleeve)

Do people confuse stretching their sleeve with grazing? It's not that the sleeve has stretched. Grazing is not eating past the feeling of restriction.

Grazing: Consuming poor food choices and/or excessive calories in many meals over, over and over throughout the day. The amount of calories would be as if you never had surgery. The weight would come right back.

any thoughts?

[sharonintx 1,275]

Jenn1 maybe grazing and restriction do get confused. I think you are right about that

[Healthy_life2 8,330]

1 hour ago, sharonintx said:

Jenn1 maybe grazing and restriction do get confused. I think you are right about that

Not that I'm trying to put this person in a bad light...I just don't understand....

https://www.bariatricpal.com/topic/411819-panicking/

[jess9395 5,450]

I'm really not sure about the "stretching the pouch" I have heard so many tales of it. I have heard from a DR online, (wish I could remember his name) he said stretching your pouch etc is a myth. Also he said it wouldn'tbe your pouch any how...it is the opening from your pouch not the pouch itself. I have eat to much and it hurts like heck. I still have plenty of restriction. But I can eat more than before. I weigh between 125 to 130. Pretty good. I am very happy with my WL. You are defintly right about the over doing part. Have a great rest of your weekend.

You are talking about a gastric bypass, they can stretch their anastomoses (sp?) which is the opening to the pouch. Sleeve surgery doesn’t use a pouch and f it’s formed correctly cannot stretch. The fundus is the stretchy part and that is usually removed. Even overeating can’t really stretch it from what I’ve read. So perhaps the people for whom it stretches have not had the fundus properly removed?

[sharonintx 1,275]

6 hours ago, jess9395 said:

You are talking about a gastric bypass, they can stretch their anastomoses (sp?) which is the opening to the pouch. Sleeve surgery doesn’t use a pouch and f it’s formed correctly cannot stretch. The fundus is the stretchy part and that is usually removed. Even overeating can’t really stretch it from what I’ve read. So perhaps the people for whom it stretches have not had the fundus properly removed?

You are right. That's why i cannot grasp the comments I see from sleeve patients saying that their sleeve has stretched and they have no restriction. For me personally, not only does the sleeve not stretch but the opening to it does not give an inch either. I think the comment about grazing would be more accurate. It's simple - you gain weight because you eat too much. Period.

[jess9395 5,450]

You are right. That's why i cannot grasp the comments I see from sleeve patients saying that their sleeve has stretched and they have no restriction. For me personally, not only does the sleeve not stretch but the opening to it does not give an inch either. I think the comment about grazing would be more accurate. It's simple - you gain weight because you eat too much. Period.

Grazing, “slider foods” (I could eat a whole box of cheezits because they crush to a powder), liquid calories (I gained a few Starbucks pounds, just on flat whites so I can’t imagine if you drank Frappuccino’s)....

[PdxMan 4,292]

I've written a lot about this over the years. I believe the "stretch" is more a function of a person's ability to "eat around" the sleeve. When eating by the guidelines given us at the beginning, my restriction is the same as it was a year out. But if I am eating slider foods, sure, I can eat a larger quantity. If I am sipping Water with my meal, sure, I can eat a larger quantity. If I graze throughout the day, sure, I can eat a larger quantity.

Rather than blame myself and my need to fill my soul with food, I can just blame it on the sleeve "stretching". Now, I'm sure this does not cover 100% of the folks out there. I am sure there were surgeons who left too much fundus and their stomachs are able to distend larger than the "average" sleever, but I am guessing they are in the minority. But one this I am confident about is if they go back to the original guidelines, they will lose anything they have gained.

I am confident about this as it has been true for me.

I have slipped into old habits of using food as a crutch and ate around my sleeve. I gained 20 pounds over a couple years. I'm not not cured of my food issues. But I simply returned to the old guidelines and 6 months later, I had dropped that 20 pounds.

This only works if you work it. We cannot forget nor ignore this, lest we suffer the consequences.

[Travelher 915]

On 3/4/2018 at 3:53 PM, sharonintx said:

Help me understand. I am 5 yrs out from sleeve surgery. There has never been a time I was able to overeat to a large extent, I feel very near the same restriction as about 6 months after surgery. I can eat more sweets than real food but even so there is a limit I cannot cross.

I see people taking about feeling no restriction and saying their sleeve has stretched and they have gained a lot of weight - a lot being more than 20-30 lbs.

On occasion I have gained a few pounds. Most notably gaining 12 lbs this past summer due to my consumption of coffee milk shakes from Whataburger. The scales hit 12 lbs over what I was comfortable with, I said to myself ' stop this s#@t before it goes any further". I quit the shakes and switched to strawberry Protein smoothies from Starbucks and the pounds went away.

I do not understand 'my sleeve stretched'. Am I wrong in thinking that the only way this could happen is if someone stuffed it past capacity repeatedly? Over and over? And if that were the case then wouldn't the problem be that one has yet to conquer the mental demons that make us overeat in the first place?

Am I missing something?

Dr. Weiner has a good Youtube video on this. he says it isn't the pouch or sleeve stretching. it has to do with the stretch receptors in the intestines....and sets the expectation that over time people can eat more...not because the stomach stretches but because food isn't in the stomach more than a minute or two anyway and it is the stretch receptors in the intestines that don't register the same way...sometime to that effect.

according to him when they have looked at the stomachs of people with those complaints, they look the same as the rest...

Edited March 9, 2018 by Travelher

[Healthy_life2 8,330]

4 hours ago, Travelher said:

Dr. Weiner has a good Youtube video on this. he says it isn't the pouch or sleeve stretching. it has to do with the stretch receptors in the intestines....and sets the expectation that over time people can eat more...not because the stomach stretches but because food isn't in the stomach more than a minute or two anyway and it is the stretch receptors in the intestines that don't register the same way...sometime to that effect.

according to him when they have looked at the stomachs of people with those complaints, they look the same as the rest...

I liked his video, The title is deceptive *laughing*

He says exactly what we have been talking about. Patients are misusing the term "stretched sleeve" to describe the normal progression of the ability to eat more food as the years pass. 5 to 10 years a full plate of food.

It's the same bariatric basics we have been told over and over. You have to eat healthy and exercise long term. Maintaining is just as much work as weight loss.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1365716/?page=6

The study above is on gastric stretch receptors and the satiation of hunger and thirst.

[Tracie76 13]

I’m here to tell ya, stretching your sleeve is not a thing. I gained and ate like a crazy women when I was pregnant. The Dr did an upper GI on me last week. You guessed it! The sleeve is the same size it was 3 months after surgery....however, I did manager to develop a nice size hiatal hernia from eating so poorly.
I’m getting my life together now, nutritionists is a big help. I’m 4.5 years out.

[playlikeworldchamps 595]

maybe it depends up how large a sleeve it was. i can fit a lot more than i could 1 year out. (i am 5 years out). i need to use Portion Control more than i did at that time. however i cannot binge like pre surgery so obviously there is restriction. i also cannot eat 3 course meals. i am still a cheap date. only entree for me. no appetizer and no dessert. so yes it is bigger but not back to presurgery capacity!

[Stella S 613]

Agreed. I can eat more and have to always stay on top of it. Which is very boring I get tired of staying on top of it. I have just learned a lot as I too never understood losing the restriction. I
I noticed I do not have the same support in my community as I did 3+ years ago as though I have received an exorcism of sorts.

[Tracie76 13]

I can eat more too. My Dr said it was because my sleeve was healed and I have become less sensitive to the restriction. For the first 18 months I could not eat more then 1 oz of steak now I can eat 4 ozs.