Sleeve too small

[lgravois 20]

So I just had my gallbladder out and was told by my general surgeon that the sleeve was made too small and that I will have trouble and keep loosing weight until I stretch it out.... has anyone had this problem?? And what can I do to stretch it out.... I'm allready down 158 pounds in one year and still loosing....

[temkins 71]

How it could be too small? Isn’t it a standard technology based on anatomy. There are videos on YT with a full sleeve surgery filmed in details and with comments. So according to it sleeve just can’t be too small or large, it is just as your body dictates it to be. Not a specialist anyway, just my opinion.

[DropWt4Life 957]

It is no doubt your surgeon's fault if that is the case. What size boogie did he/she use? Also, are you having trouble eating now? How much can you eat per sitting at a year out? You aren't at goal yet. Maybe you should wait until you get to goal, and then be a bit more liberal with your maintenance phase instead of stretching out your sleeve. At least the restriction will still be there in case you decide that you need it.

You could possibly slow your weight loss simply by doing the following:

Eating more healthy carbs like vegetables, fruit and whole grains. If you eat every 3 hours, move to every 2 1/2 hours, and add a meal...A higher carb meal of possibly sweet potato and brown rice. This will increase your calorie load without affecting your sleeve size.

Exercising a bit less if you do exercise.

Maybe increasing your daily calorie count by adding a bit more healthy oils to your diet.

I am not going to advise you to add sugar, processed foods, or super fatty meats to your diet, because that can set you on a bad course leading back to where you started.

A surgeon advising you to stretch out your sleeve just doesn't sit right with me. Not only can overeating cause health issues, but that goes against everything that I have learned. Forget about Portion Control. Forget eating just until you are satiated, and not full. This surgeon is telling you to overeat so that you don't lose too much weight. That's one that I just haven't heard before.

Anyway, good luck in continuing your journey.

[lgravois 20]

I can only eat maybe 1/2 cup of food if that.... the doctor who did it in Louisiana no longer practices.... soo not sure what to do.... I am at goal and trying to maintain..... just not sure what to do....

[RickM 1,752]

A couple of questions/comments I have on this evaluation.

1. How did this surgeon come to the conclusion that your sleeve is too small? Did he specifically seek to measure that, or was this just an incidental observation while he was in there removing your gallbladder? Not trying to slam your surgeon, but if he is indeed a general surgeon rather than a bariaric surgeon doing that job, does he really know what to look for with a sleeved stomach? Sometimes we see posted on these forums a picture of some marking pens that represent the different bougies that are often used as a guide in making the sleeve, and there is very little difference between a "large" sleeve and a "small" one.

2. If he wasn't specifically looking to measure or evaluate your stomach, then it was likely empty as it usually would be when you go in for surgery. Even a normal non-WLS stomach is a deflated balloon in that state and hard to determine its actual size. If one is looking to evaluate the stomach, then something is put inside of it to see its actual shape and size - a contrast Fluid if they're doing a radiographic study, or it's inflated with air if their doing an endoscopic evaluation. I don't see how one can make an incidental judgement on such things, particularly if they aren't that familiar with all of the nuances of your particular surgery.

At a year out, a half cup, or 4 oz, is not that unusual - some will be higher and some may be somewhat lower still - particularly if you are largely sticking to firm meaty foods. To slow and arrest your loss you need to add calories within your capacity by adding meals and/or making your existine meals more slippery; basically going against all of the basic WLS rules for losing weight. More liquid calories or sliderish foods (I find many fruit and veg dishes, with some meat added to keep up the Protein as needed, to be fairly sliderish, so I can add calories to get where I need to go. Fats are good to add as they are very calorie dense. Clinically, high fat/low carb diets are used to minimize weight loss and regain unwanted lost weight in non-WLS gastrectomy patients. So, look for more calorie dense, but nutritious, foods to add to your menu. The tricky thing here is to avoid establishing too many habits based upon these techniques that could make it harder to control your weight in the future. Be flexible.

Good luck in this transition,

[mylighthouse 782]

This sounds so strange to me. I was told by my surgeon and nutritionist that the sleeve stretching out is a myth. Also have read that it will not stretch out.

I am almost a year out and can't eat more than 3 oz Protein and a couple bites of veggies in one sitting. Probably about 1/2 cup of food, like you. I agree with the points that RickM made.

[Berry78 4,261]

You've already gotten excellent advice. To stop losing weight you need more calories. Nuts pack the greatest calorie/density/nutrient punch. Drinking a nice smoothie with Peanut Butter and bananas sounds heavenly..

[Sullie06 1,013]

My surgeon told me that you cannot stretch the sleeve, that to stop the weight loss when I hit my goal to up my calories and carbs until I hit a place where I stop loosing but don't gain.

[Mytimenow17 99]

So I just had my gallbladder out and was told by my general surgeon that the sleeve was made too small and that I will have trouble and keep loosing weight until I stretch it out.... has anyone had this problem?? And what can I do to stretch it out.... I'm allready down 158 pounds in one year and still loosing....

Not sure how anyone would know their sleeve was too small unless like you they had to go in for another surgery and that surgeon could see the results of the sleeve. I've been told if you continuously eat things that you shouldn't be eating and overeat on a regular basis that that can stretch out your stomach. It does seem odd that he would even notice something like that. Congratulations on your weight loss!!

[Clementine Sky 708]

I also was told that sleeve stretching, at least to any meaningful extent, was a myth. A bariatric surgeon (not my own, but someone with videos I've found to be useful) explains it here beginning at the 1:10 mark:

If you're losing weight beyond your goal and what is healthy, then consuming healthy "slider" foods could help, like more caloric smoothies. I can't drink milk, but I know that full fat milk packs a lot of calories, a fair amount of Protein, and is fast to consume.

[OutsideMatchInside 10,166]

@lgravois

Unless you have a stricture, your sleeve is not too small. If you have a stricture that could be dilated. If you had a stricture, you would not not able to consume the amount of food that you can currently.

You are barely 1 one year out. Your capacity is likely to increase over the next year. Example at 1 year I could eat 4 ChickFila nuggets comfortably, now I can easily eat 8, and uncomfortably eat 12. I wouldn't modify your sleeve at all.

Also yes, you lost a lot of weight in one year but you had a lot to lose. I lost the bulk of my weight the first year and the rest slowly.

If you want to stop your weight loss, you can just increase your calories. Stopping your weight loss with the sleeve is really easy, you are completely in control

[Leo85 16]

On 10/10/2017 at 5:08 PM, Clementine Sky said:

I also was told that sleeve stretching, at least to any meaningful extent, was a myth. A bariatric surgeon (not my own, but someone with videos I've found to be useful) explains it here beginning at the 1:10 mark:

If you're losing weight beyond your goal and what is healthy, then consuming healthy "slider" foods could help, like more caloric smoothies. I can't drink milk, but I know that full fat milk packs a lot of calories, a fair amount of Protein, and is fast to consume.

loved this video! thank you for sharing

[Drzthickness85 46]

Amazing video! It make a lot of sense

[Clementine Sky 708]

On 10/27/2017 at 7:51 PM, Leo85 said:

loved this video! thank you for sharing

You're very welcome.

[teedsg 253]

Great video!

Sent from my SAMSUNG-SM-G900A using BariatricPal mobile app