Hi all,

I am about 1 year and 1 month post-op and I'm wondering if what I'm experiencing is normal or if there is reason to be concerned. So far, I've lost about 90 lbs in the year that I've been post-op and I'm happy about that. However, I'm concerned that I'm able to eat more than I should in one sitting. For example, I was able to eat four slices of pizza (minus the crust) and it was shocking that I was able to do that. Granted, the slices were pretty thin, but I still feel like I shouldn't be able to do that. Another example: I was able to eat two boneless skinless chicken thighs and about two cups of spring mix no problem and that also somewhat concerned me. My weight has remained relatively stable and I'm okay with that. With how much I've been able to eat, should I contact my physician about it? My physician said before I got my surgery that my stomach wouldn't "stretch" back to a larger size, but sometimes it does feel that way. What's the typical action to take at this point?

How does what you eat compare to what your plan indicates. My plan didn't really indicate how much in pizza toppings I was supposed to eat, though depending on volume and specific toppings it might fit into my plan. A couple chicken thighs, again depending on size, could easily fit my plan, so again not an instant red flag. Not saying I could always manage the quantities you describe, but I can't always manage my plan quantities either.

The bottom line is: Are you eating to plan? I eat to plan, or what I am able, whichever I acheive first. If you are doing likewise you are golden. If you are doing otherwise, it's your call.

Good luck,

Tek

To be honest, I don't have a plan. I allow myself to eat until I'm satiated and lately, I've allowed myself to eat mostly whatever I want since I'm fine with maintaining the weight that I'm at now. My concern is that I have the ability to eat four slices in one sitting, not so much the nutrition (however many calories, carbs, etc.). When I first started eating pizza again, I could manage to eat only the toppings off of two slices of pizza and now I'm able to eat four full slices. Because of this, I'm worried I might gain weight in the future because I'm able to eat so much more now

I have not had surgery yet, but from what I am learning, the focus for long term success should be protein first. If eating four slices of pizza was something you did once it’s probably isn’t the end of the world, but it is also not going to provide you with the nutrients you need. Is it a slippery slope for you? If you pull the meat off two chicken thighs, it doesn’t seem like it would be to much. That may be a better option.

What plan did your surgeon give you?

If the surgery is a tool, the work lies in sticking to the plan. Eating whatever I want has ultimately got me thinking about having surgery. if you are eating what you want, are you tracking calories? What do you need to be eating to maintain?

We all are able to eat more as we progress. It’s how we get reach the calories & nutrients we need to maintain our weight & for our body to function effectively. Though all because you can eat more doesn’t mean you should. How much you should/need to eat is an question best answered by your dietician.

Some need more defined guidelines about eating & food choices. Check with your dietician as to what portion size, caloric goals, etc. are best for you & your needs (age, gender, losing or maintaining weight, activity level, etc.) & to ensure you are on the right track. Do you track your food. If not, it may be an idea to do so for a couple of weeks so you can review it with your dietician.

PS Congrats on your weight loss.

I feel like you may have a misunderstanding here? (Unfortunately a very common one!)

From the sound of it, you're expecting restriction to be the thing that keeps you from gaining weight, but that's rarely true for most post-surgical patients. A cursory glance at these forums should be proof enough of that. Look at all the posts from people asking for help because they gained a bunch of weight back and don't know what to do now.

Some recommendations:

1. Consider finding a therapist that specializes in eating disorders and work with them to reset your relationship with food. As long as you have a desire to be "full" and keep pushing the envelope, regain is going to be a real possibility.
2. Talk to a nutritionist to get a handle on proper amounts and types of food that will work for you to maintain your weight.
3. Track your calories and macros. If you don't know how much you're really eating, it's hard to know how much is enough, and how much is too much.
4. Find a way to have your Resting or Basal Metabolic Rate tested (Google it). This will tell you how many calories you're actually burning per day. Use this, along with your food log to make sure you're not eating more than your burning.

Perhaps I didn't phrase my initial post in a great way? I suppose what I want to know is if the capacity of food we're able to consume in one sitting in sitting increases over time. Like, several months post-op I would feel full after just eating the toppings off of two slices of pizza. Now, I have the stomach capacity to eat four full slices of a thin-crust pizza in one sitting and that concerns me that my stomach is able to hold that much food. Arabesque said that we are all able to eat more as we progress, so I suppose that my situation isn't an anomaly? Nevertheless, is the fact that I have the ability to eat this much food in one sitting a cause of concern that I should talk to my surgeon about?

Some foods are easier to eat in a bigger quantity than others. Pizza may something you're able to eat more of. For me, I can now eat three Vietnamese rice paper rolls in one sitting. I'm very full after, but I can eat all three. But if I try to eat a sandwich or other bread-based meal, I can manage a couple of bites before I have to tap out. Thin crust pizza sounds like something that could be a slider food for you, perhaps.

So I don't think it's unusual so far out from surgery, it just depends on the food and why calorie counting remains so important. Ask your surgeon anyway, just because you should get the thoughts of your team on anything you're concerned about.

13 hours ago, itami o said:

To be honest, I don't have a plan. I allow myself to eat until I'm satiated and lately, I've allowed myself to eat mostly whatever I want since I'm fine with maintaining the weight that I'm at now.

Are you taking 30 minutes to consume your meals? Are you avoiding drinking 30 minutes before and 30 minutes after your meal? If you're questioning whether or not to be concerned, there's probably a reason you're feeling that way.

Food is fuel. It's taken me over 40 years to truly get a grasp on the concept. My understanding is that you can have whatever surgery you want to drop some weight, but if your habits don't change, you may end up right back where you started, or even heavier.

These procedures are tools - there's still a lot of work that needs to be done to maintain weight loss that resulted from one of them. WLS is not an easy way out - and it doesn't give you a free pass.

I agree with the suggestion to talk to a therapist about your relationship with food - I had to do that and it's been helping me a lot. I used to binge eat, skip meals, then scarf down dinner right before bed.

The greatest path to success on any program is loving yourself enough to sacrifice the 'wants' so that you can improve your quality of life.

Best of luck to you!

11 hours ago, itami o said:

Perhaps I didn't phrase my initial post in a great way? I suppose what I want to know is if the capacity of food we're able to consume in one sitting in sitting increases over time. Like, several months post-op I would feel full after just eating the toppings off of two slices of pizza. Now, I have the stomach capacity to eat four full slices of a thin-crust pizza in one sitting and that concerns me that my stomach is able to hold that much food. Arabesque said that we are all able to eat more as we progress, so I suppose that my situation isn't an anomaly? Nevertheless, is the fact that I have the ability to eat this much food in one sitting a cause of concern that I should talk to my surgeon about?

Over the first 6 or so months we tend to be able to eat more easier as time goes by becuase our stomachs are healing and normalizing over that period. It's not that the restriction reduces, it's that things are getting less and less sensitive because of healing.

After that, generally over time most folks are able to eat more. Some of it is you've learned the new mechanics of eating so you make fewer mistakes, so food goes down consistently easier.

The pouch/sleeve may also relax more and in some cases expand over the next few years. Hopefully by this time we've learned to NOT eat to satiation or fullness for most meals. The restriction is intended to be a secondary back-stop that you encounter when you make a mistake, overdo, or when your stomach is just being a brat. It's not intended to be the only mechanism you use to control your volume.

If you don't have a plan, then you need to find one that will work for you. It's just too easy to eat around the restriction over time.

The pizza thing seems to be bothering you, so let me say this: I could probably eat the toppings off of 4 slices of medium or even large pizza if I took long enough. If I had to guess, maybe 1.5 - 2.0 hours, not having done this personally. Also if I use fluids to move things along quicker it might even be less time. I can manage 2 slices as a normal meal in my normal way if the day is a perfect storm where my pouch is happy that day and I actually want to eat that much, which is rare unless it tasted super-duper ridiculously flavorful. On all this I'm including the cheese, because even bad cheese is good

It is a cause of concern to you as now know you can eat more than perhaps you should and you don't have a plan that might stop you from reaching the restriction. You should talk to your surgeon, but honestly there is nothing they can do short of another surgery. They might prescribe pills to curb your appetite if it's not something you can do without them.

What happens now is up to you.

Good luck,

Tek

Pizza is a slider food for me - wonder if it might be for you too OP? I can eat way more of that (volume wise) than just about anything else. To the degree that it's what I choose to eat when I'm concealing the fact I've had surgery or what I'm eating is under scrutiny by other people in a negative way. I can eat plenty pf pizza - certainly 3 slices, and then even more if I drink liquids at the same time to push it along even quicker, as Tek says. Not something I would advocate at all but I do use this technique when under pressure.

It sounds like you are out of the honeymoon stage, that is, less restriction and more hunger. It is common for many to be able to eat more after a year and get hunger again too. Your doctor is right, and it is generally true that our stomach will never go back to original size BUT some people learn to eat around their WLS and unfortunately gain their weight back. The honeymoon phase is the best time on learning to eat correctly to maintain long-term weightloss.

Portions increase with time up to a certain point - Dr. Weiner has an interesting video about increasing portions on YT after WLS with IMO the most important take away point being that it's normal.

So many people on here are freaking out about being able to eat more after some time. I wonder why surgeons don't seem to educate their patients about being able to eat more with time.

On 2/24/2023 at 1:54 PM, Spinoza said:

pizza is a slider food for me - wonder if it might be for you too OP? I can eat way more of that (volume wise) than just about anything else. To the degree that it's what I choose to eat when I'm concealing the fact I've had surgery or what I'm eating is under scrutiny by other people in a negative way. I can eat plenty pf pizza - certainly 3 slices, and then even more if I drink liquids at the same time to push it along even quicker, as Tek says. Not something I would advocate at all but I do use this technique when under pressure.

This is clever! So far my only slider food I have discovered is baby carrots. That won't get me very far in a restaurant setting. I guess as I get further along, I'll discover more.