Can You Really Stretch Your Pouch?

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 folks will reach for a Snickers® instead of a banana at their local convenience store. Likewise, grazing on junk food, such as popcorn, cookies and 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 Beverages – Regular sodas 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 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 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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