The Big Stretch Fear: Truths About Stretching Your Sleeve After VSG

The short answer is yes, you can. The longer answer is that it’s not very common, especially if your vertical sleeve gastrectomy was done well. Fear of stretching the sleeve isn’t unusual among VSG patients, but there’s very little for Endobariatric patients to worry about.

Why you probably haven’t stretched it
“I can eat so much more now than I could after I was first sleeved!” It’s something I hear all the time, and it clearly makes patients nervous that they’ve stretched their sleeve and/or the sleeve isn’t working for them. I try not to downplay patients’ fears about anything; at the same time, an expertly crafted sleeve and a step-by-step guide to post-sleeve life—both of which you receive at Endobariatric—is a recipe for success. Even when patients ask me to re-sleeve another surgeon’s work, I don’t automatically assume a stretched sleeve is the reason they’ve regained weight. Much of the time, it’s a simple case of getting lax with gastric sleeve diet and exercise.

The “stretch” question tends to arise when patients realize that their stomach seems to hold much more than it did when their sleeve was fresh. Well, yeah it does! When you’re at maximum restriction right after being sleeved, you’re dealing not only with the natural restriction of a smaller stomach, but also things like swollen post-op tissues, which temporarily increase restriction even more. As you heal in the weeks and months that follow, you’ll be eating several times what you could in the beginning, and that’s a good thing. Your body needs more calories than it can physically handle in the immediate aftermath of VSG. You shouldn’t be able to eat anywhere near what you could before the procedure, of course, but if you’re comparing your stomach capacity to what it was three days after surgery, that’s not a good comparison.

Some patients have questions about stretching as it relates to specific food or drink, with carbonated beverages being the main culprit. If you haven’t had one in a while and then indulge, it can feel very weird. And, yes, the sensation might even feel like stretching. While I don’t recommend carbonated beverages, they won’t stretch your sleeve.

What CAN cause stomach stretching
It certainly isn’t impossible to stretch your reformed stomach after vertical sleeve gastrectomy. And, unfortunately, the behaviors that cause it are some of the things that likely led to your weight problems in the first place—chronically overeating, binge eating, and eating when you’re not hungry. You’re not going to have stretching problems if you engage in these behaviors once in a blue moon, similar to how overeating once in a great while won’t lead to significant weight gain. But if you find yourself unable to stop binging or frequently eating until your stomach hurts, you could be in danger of stretching your new sleeve eventually. For both your mental and physical health, please make an appointment with a therapist who specializes in addiction to address these urges. Other steps you can take to keep your sleeve (and waistline) in good shape:

  • Snack smart. I’m not a big fan of snacking, but if you can’t make it between meals without a little something, make sure it’s the right something (ie: protein and veggies). It’s also crucial that you’re actually hungry when you reach for a snack. I like to use the “carrot stick test.” True hunger means you’ll eat just about anything, so you’ll be as happy to munch on carrots as you would potato chips. If you’re only hungry for one kind if snack, you’re experiencing a craving—not true hunger.
  • Rethink your dinnerware. If you’re looking for permission to replace the plates you’ve had for 30 years, you have it! Rather than dinner-sized plates, eat your meals on salad-sized plates so that your portions look bigger.
  • Enjoy every bite. So many people wolf down their food, which doesn’t give the brain time to register that the stomach is full and almost always leads to eating more than is necessary for satiety. Take small bites, chew very thoroughly, and pause frequently to let your brain catch up to your stomach.

The bottom line is that you can stretch your sleeve a bit, but you’ll never stretch a well-crafted sleeve to the size of your old stomach. If you’re having trouble losing or maintaining a weight loss, take a look at your VSG habits rather than the sleeve itself.

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 “Changing lives…one sleeve at a time”.