Weight loss surgery patients and those considering weight loss surgery – particularly gastric bypass surgery – are often concerned that they might “stretch” their pouch again after undergoing the procedure. Bariatric patients who are several years out from their surgery also wonder whether they may have stretched their stomach pouch, since they no longer have the same feeling of fullness as they did in the first 18 months after having weight loss surgery. Is it possible to stretch the stomach pouch created by a gastric bypass or gastric sleeve procedure? If so, what can be done to reverse the effects?
Managing Your Pouch
Your pouch will naturally stretch a little over time; however, it is generally unlikely that it will stretch all the way back to its original size. Although you may feel both physical symptoms as well as emotional remorse after an especially large meal, it is highly unlikely that you caused any permanent damage. That said, you are in control of your body and how you treat it. Here are some tips for managing your pouch to ensure you maintain a healthy weight for years to come:
- Avoid Overeating – Before weight loss surgery, many patients wouldn’t think twice about taking seconds, thirds…even fourths during a meal. After weight loss surgery, you may only eat a few bites because the pouch makes you feel full with less food. In the first months after your procedure, note exactly how much you are eating to achieve that “full” feeling. Avoid helping yourself to seconds when your stomach is already at maximum capacity. Also, eat slowly to let that “full” feeling sink in. By measuring your food, taking your time during a meal, and being mindful of when you are full, you can avoid stretching your pouch.
- Don’t Skip Meals – Skipping a meal will leave you hungry, and often you will find yourself grabbing the first snack available. Rarely are snacks grabbed on the go nutritious. Most people will reach for a chocolate bar instead of a banana at their local convenience store or supermarket checkout. Likewise, grazing on junk food, such as popcorn, biscuits/cookies and crisps/chips, is a sure-fire way to pack on a lot of calories without feeling full. You can avoid temptation by planning your meals, packing nutritious snacks when you’re on the go, and making sure you stay on schedule with your eating.
- Watch Out for Emotional Eating – Many people who struggle with obesity have a habit of emotional eating. They eat when they are bored, lonely, angry, happy, or stressed. In other words, they eat to manage their feelings. Although weight loss surgery can curb physical hunger, it can’t do anything about your “head hunger” or appetite. Joining a support group and learning to recognize triggers and patterns can help you avoid emotional eating to ensure that you eat only when you are hungry, and that you limit the food on your plate to the calories your body needs (not what your eyes crave).
- Protect Your Stoma – The stoma is the opening that gastric bypass patients have between the upper pouch and the intestine, which helps to regulate their food intake. If you don’t chew your food thoroughly or you wash large bits of food through the stoma with liquids, you can actually stretch this opening. If the stoma becomes enlarged, food will not stay in the pouch as long, and you will end up eating more because you never really feel full.
- Avoid Bubbly Carbonated Beverages – Regular sodas and fizzy drinks are packed with sugar and high in calories, which can cause you to regain weight quickly, and also cause dumping syndrome if you had a gastric bypass. Diet sodas have zero calories, but ironically, they still can cause you to regain weight. Numerous studies show that diet sodas trigger certain hormonal reactions that cause the body to store more fat. In addition, if you drink a carbonated beverage – even fizzy/seltzer water – while eating, it forces food through the stomach pouch faster. That means food does not stay in your pouch as long and you lose the feeling of satiety and increase the chances that you will eat more. Finally, the gas released from the carbonated beverage may cause the food forced through the pouch to enlarge your stoma, which again would allow you to eat more at one sitting – defeating the purpose of the weight loss surgery. Stick with water, caffeine-free teas and coffee (in moderation), and other non-carbonated beverages for best results.
Remember that having weight loss surgery is not a get-out-of-jail free card, as far as your eating habits go. Long-term success requires long-term discipline. Although your body might let you get away with a small cheat now and then, eating sweets, high-calorie foods, and carbonated beverages will have a detrimental effect on your weight and your waistline. Eventually, those bad decisions will catch up with you again. Your best bet is to plan your meals in advance, avoid temptations, and connect with a weight loss surgery support group that can help you keep up all of your new healthy habits. If you find that you are eating larger and larger meals and that you are gaining significant weight over time, you may need to speak with your doctor about revision surgery.
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Jill says
Why can’t I find any articles on people who WANT to stretch their gastric sleeve? I’ve left several comments on several websites, but they are never posted. They get deleted by the administrators of the website. Gastric sleeve surgery is the worst thing to ever happen to our FAMILY. Without going into great detail, my husband should never have had it, and he was not screened properly for psychological issues. This has been a nightmare. Please…how is the best way to stretch the gastric pouch to the fullest so that he can eat normally. He started at 5’11” and 250. I can’t believe that a surgeon even did this drastic surgery on him. He now looks like he’s been suffering from a terminal disease. We need help.
CAROL says
Hi Jill, I think the reason you don’t see much is because it is rare and most forums do not feel in any way qualified to advise on this, short of saying speak to your medical team. I am saying of course pretty much the same – you need to speak to your husband’s team and surgeon about the possibility of a dilation. Dilations aren’t very rare and many surgeons will have performed them if they feel there is a problem and the patient can benefit from it. I’m guessing you have been into websites and forums that talk generally about life after surgery (and there aren’t many open to laymen and women that discuss professional medical problems and their solutions – you usually have to be one yourself to access them) hence the lack of coverage of the problem. Your husband won’t be the only one who hasn’t had adequate screening either but thankfully this is an improving situation for others. I’m hoping that you still have to the team and surgeon and can get the kind of help you need. My experience is that teams and surgeons don’t abandon you and want to see success and good results as much as you do. Get in touch, pester and demand a meeting to try and resolve this. That said, I am so sorry that you as a family are experiencing this – it is just as upsetting as one who is coping with a chronically obese family member. I will however now see if I can get one of professional colleagues to write something for us so that we have something to refer to. C x
BT says
I am 5 years out since gastric bypass, I have a weird lump about the size of a golfball under my right rib cage, had it checked they said it could be gallbladder, I’m not sure about that since I don’t have problems with it, does anyone know if this could be from my surgery? Thanks
CAROL says
Hi Bonnie, very sorry to hear you’re having problems. None of us here at Bariatric Cookery are medics and therefore couldn’t comment on anything medically related. I personally haven’t heard of this symptom being anything wls-related either but I don’t know. I would request another opinion to try and sort out the issue with your GP/professional or surgery team since it is clearly worrying you. Hope things improve quickly. C x
Anna says
Is there any way to shrink the stoma if you’ve stretched it out by drinking soda and not chewing properly?
CAROL says
I am not aware of anything that you can do other than surgically to repair this Anna but I am no medic. I am told it is rare to stretch it so that it no longer works well but that may well be hearsay. Best to speak to your team or provider for the best advice. C x
Brian s Fugate says
I am 5 years out from sleeve..gaining my weight back…can I have it again or is there another procedure.
CAROL says
Hi Brian, there are revisional procedures but this is something to discuss with your wls team – they would want to assess what has gone wrong, why and many other criteria. It may well be that you simply need to get back on track rather than have further surgery. Maybe your habits have changed and reverted back to those from before surgery. On the other hand it may be something related to the original surgery itself – only a multi-disciplinary wls team can assess that and then make recommendations – contact them for some help and advice. Carol x
Tanya Walker says
Hi I’m only six months out and I’m not feeling as full as I did when I first had the gastric sleeve surgery, is it possible that I have stretched my stomach.?
CAROL says
Hi Tanya, it’s highly unlikely unless you have been way off track with things. It is quite understandable to be able to eat more as time progresses and for your appetite and toleration to foods to improve. I guess at 6 months out you are still in contact with your team. Check with them at your next appointment your intake level and see if they have suggestions to make. We all have these queries and worries so they won’t be surprised at your request. It’s rare to ‘stretch’ your pouch beyond certain levels – the key really is in getting your portion control right for weight loss and maintenance with a healthy ratio of all the macro nutrients (plus taking your essential vitamins and supplements). Carol x
Dellian says
I’m almost 18 months post OP and scared I’ve stretched my baby sometimes I don’t feel to eat and sometimes I cant have enough I had RNY December 2017 I can eat a bit more not one sitting but going back as bad habits I’m booked into food disorder clinic for September which I’m excited about.
CAROL says
Good luck with the clinic – the first step to sorting out any problems is to acknowledge them and I salute you for being brave and staking this step. I am excited too that you are wishing to address these issues. Do keep in touch and let us know how you’re getting on – your experience may well encourage another to seek help too. Carol x