Can You Stretch Your Pouch After Weight Loss Surgery?

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Stretching the pouch after weight loss surgery is a concern for many pre- and post-operative patients. Gastric bypass patients, in particular, run the risk of regaining the weight they initially lost if they stretch the pouch that was created during bariatric surgery, or the stoma that connects the upper pouch to the intestine.
So, just how likely is it that someone will stretch their gastric pouch after weight loss surgery, and how can patients avoid weight regain?
The Risk of Regain
After gastric bypass or gastric sleeve surgery, the stomach pouch will naturally stretch a little over time. The feeling of satiety – or fullness – that is caused by the changes to the stomach and the resulting hormonal changes after weight loss surgery enable most patients to limit the amount of food they eat, which maintains the size of the pouch. But the failure to adhere to a doctor’s guidelines and maintain healthy eating habits can result in the pouch or stoma becoming stretched again, leading patients to regain weight even several years after their original procedure.
“For gastric bypass patients, the pouch ...
... will gradually stretch for the first two years after surgery, but it’s unlikely that the pouch will stretch beyond 8 or 9 ounces,” says Dr. David Provost, a bariatric surgeon in Denton, Texas. “Of course, if someone regularly overeats, they will eventually stretch their pouch and also regain the weight they lost after surgery.”
Dr. Provost offers several tips to avoid stretching the pouch and maintain a healthy body mass index after weight loss surgery:
• Manage Portion Sizes – After weight loss surgery, patients generally are advised to eat several smaller, nutritious meals throughout the day. Many people who struggled with obesity need to discover what “full” feels like with their new, smaller stomach pouch. Eating only a few bites at each sitting can feel foreign to them, but keeping portion sizes small is the key to maintaining a healthy weight.

• Skip the Snacks –Junk food is not only high in calories, but foods like chips or popcorn don’t provide a feeling of fullness and can increase the chance of overeating. Salty and sweet snacks also can be addicting, and since they are available at every supermarket and convenience store, temptation is all around. Planning meals in advance and packing healthy snacks, like almonds and apple slices, can help weight loss surgery patients stave off hunger and keep their caloric intake low.

• Avoid Emotional Eating – People who struggle with their weight often have the habit of eating to manage uncomfortable emotions, like boredom, anger, loneliness and stress. Weight loss surgery can minimize physical hunger, but it will have no effect on a person’s appetite. Participating in a support group can help patients recognize and manage triggers so they eat only when they are hungry, not because of an emotional craving.

• Cut Out Carbonation – Drinking carbonated beverages, like sodas, champagne and seltzer water, while eating can enlarge the stoma and force food through the stomach pouch faster. The result? Patients don’t experience the feeling of satiety that tells them they have eaten enough, and they continue to eat more calories than their body needs.
Weight loss surgery is a one-time procedure, but it’s a lifetime commitment, says Dr. Provost. To avoid the risk of stretching their gastric pouch, patients have to practice discipline in their eating habits years after their surgery. Planning meals ahead of time, avoiding sweet and salty snacks, and participating with a support group can help patients keep up their good eating habits and manage their pouch to maintain a healthy weight for the rest of their life.
Dr. David Provost has helped thousands of patients during his 20-year career as a bariatric surgeon. He provides weight loss surgery patients with nutritional guidelines to help them manage their surgically altered stomach pouch and holds regular support group meetings to guide them with the long-term lifestyle changes needed to stay healthy after bariatric surgery.