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Afraid of stretching my sleeve...



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Hey guys... I am currently three months out from surgery and my stomach is finally healed. Finally. But because of that, I feel like I can take in a lot more than before... I try very hard to make sure I dont drink with meals and dont overeat (about 3ish oz a meal) but I'm so so so afraid that I'm stretching my sleeve... is it possible so early out? I'm so worried. Any advice would be great. Thank you!

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My understanding is that your sleeve will stretch to accommodate up to half a cup of food during your first year and that it is important to measure your food to keep from pushing the limits and stretching it to be bigger than that. It sounds like at 3oz you're doing fine. Make sure you're eating slowly.

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I asked my surgeon about that a couple of weeks ago and she said it would take quite a bit of overeating over a prolonged period of time to stretch it out

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I'm pretty sure by 6 months out (RNY) my pouch held like 6oz of cottage cheese by weight (about a cup by volume) of food.

At 12 months I could hold 9oz of cottage cheese by weight (about 1 1/4 cups by volume) of food.

Now at 14months-ish, I can hold about 1 1/2-2cups of food. But should I? No. I try to measure everything. Volume is KING! Then you weigh stuff into your cup. Ideally you should shoot at 6-12months for 1/2-1cup of food per meal max for life.

I can eat way more veggies and salad than I can in a combined meal.

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I was told my sleeve would eventually hold one cup and I should eat 3 meals with no Snacks.

Today for lunch I ate 6 medium shrimp and I was stuffed to the max.

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Inflammation subsides as you heal after surgery, so the restriction feels like it has relaxed a bit. Don't challenge your 'sleeve baby', what will happen is - ' oh damn that last bite hurts, I have to spit that up or lie down.' Then after a month that EXTRA bite just feels slightly uncomfort able - see where I going? Weigh or measure your serving, eat slowly, and leave two bites on your plate and get up and dump it in the trash. Don't challenge your sleeve.

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48 minutes ago, gabybab said:

I was told my sleeve would eventually hold one cup and I should eat 3 meals with no Snacks.

Today for lunch I ate 6 medium shrimp and I was stuffed to the max.

As you should have been. That is your sleeve working.

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Inflammation subsides as you heal after surgery, so the restriction feels like it has relaxed a bit. Don't challenge your 'sleeve baby', what will happen is - ' oh damn that last bite hurts, I have to spit that up or lie down.' Then after a month that EXTRA bite just feels slightly uncomfort able - see where I going? Weigh or measure your serving, eat slowly, and leave two bites on your plate and get up and dump it in the trash. Don't challenge your sleeve.
I seem to always get confused though.. when you measure do you tend to go by weight or volume? I've found that they're vastly different.

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Posted (edited)
10 hours ago, Tejee said:

I seem to always get confused though.. when you measure do you tend to go by weight or volume? I've found that they're vastly different.

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Yeah, this confused me constantly! When to weigh and when to measure and I wish someone had told me this from the beginning. So here it is in a nutshell. Ok?

Volume is KING. (like seriously)

Our RD and surgeon talk in terms of ounces in 2 ways=volume and scale weight of food. Sometimes they use it interchangeably. But strictly speaking the only "true" time that they are 1:1 is in Water (a pint is a pound the world around which means 16oz =1lb=16oz by weight).

So we all know that liquids are gonna be a measurement and for instance 4oz of volume = 1/2 cup volume because 1oz fills 1/8cup of space. That works for anything that is smooth, including purees and Soups. Right? So far things are easily understood. Right?

But, when you start talking about dense foods, most specifically protein=which is also KING (or maybe it's QUEEN=second most important), things start getting blurry. Most RDs believe 1oz of dense Protein by weight fits in 1oz of volume (or in 1/8cup measuring cup). But that's not strictly true. Some "wet" Proteins might equal that, but mostly here is what you need to know to put this together regarding the dense foods that are best measured on the scale:

1oz dense protein by weight = approx. 1/4cup volume = 6-7g of protein/oz wt. = 6-7g protein per 1oz./wt. and 1/4cup vol.

2oz dense protein by weight = approx. 1/2cup volume = 6-7g of protein/oz wt. = 12-14g protein per 2oz./wt. and 1/2cup vol

3oz dense protein by weight = approx. 3/4cup volume = 6-7g of protein/oz wt. = 18-21g protein per 3oz./wt. and 3/4cup vol

4oz dense protein by weight = approx. 1cup volume = 6-7g of protein/oz wt. = 24-28g protein per 3oz./wt. and 3/4cup vol.

1-1 1/2oz dense veggies raw by weight = approx 1/4-1/2cup by volume

1oz dense veggie cooked by weight = approx 1/8-1/4cup by volume

Depending where you are in recovery, your protein prescription for the day would be: 60-80g protein daily (by protein content).

And on meals you will be told to eat:

1-2oz protein (by weight or volume-remember they think it's 1:1). So they are saying you have a volume target of 1/8-1/4cup MAX per meal to accomplish your daily protein goal. So at first, you might literally be eating every 1-2 hours to reach your goal--and those meals mostly ONLY consist of protein heavy meals! But as you heal your meal volume target grows.

Phase 1: 1-2oz volume measurement (liquids), actual meal weight on scale will mostly equal volume measurement

Phase 2: 2-4oz volume measurement (liquids, purees), actual meal weight on scale will vary against the volume measurement

Phase 3: 3-4oz volume measurement (liquids, purees, soups/stew, mushy soft foods), actual meal weight on scale will vary greatly against the volume measurement (think 4oz by volume = 1/2cup of chicken pot pie filling weighs much more than 4oz by volume of a chicken broth by weight. Or 1/2cup of cottage cheese weighs much more than a 1/2cup of Greek Yogurt, which weighs even more than a 1/2cup of regular yogurt. You see where I'm going?).

Phase 4: 4-6oz liquid measurement (liquids, purees, soft mushy foods, dense proteins, dense vegetables), actual meal weight on scale will vary greatly against the volume measurement

Phase 5 (forever diet): MAX 8oz liquid measurement (all foods), actual meal weight on scale will vary greatly against the volume measurement

*******************

Ok, so what the hell does this mean? It means that you put a measuring cup on the scale at whatever your volume target is per meal (ie 1/4, 1/2, 3/4, 1 cup), and you actually "weigh" the food into it! You stop when you reach your meal volume target. That's all you get for that meal. At first, your cup will only be filled with dense proteins cuz that's what will fill you quickest, stay with you the longest and satiate, and will help meet your protein goals. But as your tool matures and there is more real estate inside, you will be able to get your protein goals in each meal with little problem, even when you eat to your maximum volume meal size target.

For instance, I can get all protein from food and no longer rely on getting it from Protein Drinks or bars/supps. But I will still have some of those when I "want" them. I just know now, with a mature pouch, the protein drinks and supplements will not fill me up like they did in the early days.

My meal volume for life = 1 cup per meal. Here's how I fill that.

1 cup volume/meal = 3oz protein (about 3/4cup filled up by dense protein) + 1 to 1 1/2oz dense veggie cooked (about 1/4cup filled up by dense veggie) + 1tsp healthy fat equivalent.

And here's what I can usually assume on protein for that meal. I can assume per meal that I'm getting:

3oz dense lean protein = 7g/oz by weight = 21g protein from meat

1oz dense veggie cooked = 1g/oz by weight = 1g protein from veggie

21g + 1g = 22g protein per meal for 1 cup of food that contains 3oz of protein by weight + 1oz veggie by weight.

My goal for protein is about 60-74g per day of very complete and varied protein sources.

**************************

I hope this helps and doesn't confuse you any more than you are. VOLUME is KING! But PROTEIN is QUEEN. You must satisfy the queen for the day, but you have to make sure you eat the correct volume per meal to do it = "KING's Orders"-- even if that means eating 6 times per day! Make sense?

Edited by FluffyChix

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I’m the same so afraid my sleeve will stretch but I use those tiny four oz tupperware and put my food also in baby bowls .. my problem is I feed a family of three and I want to eat what they eat but I can’t 😵

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