Gastric sleeve surgery is an investment—from the monetary aspect to the time and energy you put into losing excess weight. It’s only natural to want to protect that investment. So it’s no surprise that patients frequently wonder whether they can stretch out their sleeve if they eat too much. The short answer is “no.” But read on for the full answer and one caveat to that “no.”
“It makes sense that my sleeve will stretch if I eat too much.”
I get it. Before surgery, it probably felt like your stomach was “stretched” because of the amount of food you ate. Plus, anyone who’s ever gained weight knows that your skin stretches to accommodate new mass. So I understand that patients worry about their sleeve stretching.
Rest assured that my sleeves don’t stretch. During the procedure, I use a 32 Fr bougie (or calibration tube) to guide the size of stomach I create for my patients. A 32 Fr bougie has been proven—objectively in studies and in thousands of my own patients—to deliver excellent weight loss without being so small that you’ll likely have issues with strictures or narrowing in your sleeve. With the 32 Fr bougie, your stomach will stretch only a minimal amount after you’ve healed from the procedure and will never revert to the size it was before surgery.
“But I’m eating more now than I was right after my sleeve surgery.”
I’d be worried if you weren’t! Right after gastric sleeve, as with any surgery, your body tissues are swollen. This is the maximum point of restriction; as the months go by, that swollen sleeve tissue deflates and you can eat more. It might feel like you’re stretching your sleeve, but it’s just your body adjusting to normal post-procedure healing. Please don’t compare what you can eat now to the first weeks after you were sleeved. Rather, focus on the quantity and quality of food you’re putting into your body.
Some people may want to blame “sleeve stretching” for the fact that they aren’t losing weight at the pace they were before—or are even putting a few pounds back on. Again, it’s not that your sleeve has failed you. In this case, my advice is to reevaluate what and how much you’re consuming. You probably enjoyed the ease with which the weight fell off in the first months after surgery (thanks to that max restriction), and now you might have to work a little harder to lose weight. Again, this is totally normal and easily recalibrated with proper eating and exercise.
“I didn’t get my sleeve done by you. Is the no-stretching thing the same for other surgeons?”
Not necessarily. One major factor in a successful gastric sleeve surgery is finding a surgeon who creates superb sleeves. Other bariatric surgeons commonly use bougies ranging from 28 to 60 Fr. As I mentioned above, I use a 32 Fr bougie because it’s proven to be exceptional for both weight loss and quality of life. If your surgeon used a larger size, for example, your stomach is likely able to hold more food than my patients’ can. The bigger the bougie, the more “stretchy” stomach is left in you. This results in more stomach capacity over time. To find out whether your sleeve has stretched, though, you would need an upper endoscopy or barium swallow to see the anatomy of your stomach or your current sleeve.
The bottom line is that a well-done gastric sleeve won’t stretch. You will, of course, be able to eat more as your swollen tissues shrink in the weeks and months after surgery (though not nearly as much as before surgery). And please know that if you need help getting back on track with healthy eating, the team at Endobariatric is always here to help you achieve your goals!