Back to Patient Portal
Weight gain following bariatric surgery, whether it be gastric sleeve or gastric bypass, can occur in patients for a variety or combination of different reasons. Gastric sleeve surgery restricts the volume of the stomach to 15 – 20% of its original size, but the sleeve itself does not make you lose weight. It is a tool to help restrict the amount of food a person eats by having a direct effect on hunger and the rate at which food is consumed. Put simply, patients have a feeling of satisfaction and a feeling of ‘fullness’ after eating a much smaller quantity of food than they usually would. But this can change over time.
Why does the stomach stretch?
The gastric folds in your stomach provide elasticity and are designed to expand when you eat, cleverly increasing the surface area for nutrient consumption during digestion. It’s also this expansion of the stomach that signals to your brain that your stomach is full.
It will take more than one or two large meals to stretch your stomach, but regular overeating may cause the stomach to gradually and permanently increase in size and capacity, although we have no direct evidence that this is the case.
When we do special stomach volumetry tests on people many years after surgery, we often see that post-sleeve stomach size is the same for people who haven’t gained weight as for those who have. It seems however that the tendency some people have to eat until they are “bursting” can interfere with the normal hunger signalling process; the stomach may begin to only signal the feeling of satiety (fullness) when it is severely stretched, which can lead to further weight gain.
Weight regain is often associated with disorders such as binge eating, addiction, emotional eating, night eating and other behavioural problems that are not related to the “size of the stomach”.
Can the stomach stretch after gastric sleeve surgery?
Following gastric sleeve surgery, your stomach will never grow back to its original size. The remaining part of your stomach will stretch or expand, as it does in everyone who has the surgery, however, it will always be tiny when compared to your pre-surgery stomach.
Mild stomach stretching is normal, but on occasions, we certainly find individuals where stomach stretching has likely contributed to weight regain and these people may benefit from re-do surgery. If we operate on someone who has a behavioural driver of weight regain, the weight loss results will be disappointing because surgery won’t make people who are doing the wrong thing do the right thing. If someone is regaining weight after surgery we encourage them to return for follow-up so we can assess their stomach size and their eating and exercise behaviour, and offer help to get them back on track.
Gastric sleeve surgery is a tool
The gastric sleeve itself does not make a patient lose weight following surgery. It helps to restrict the amount of food you eat (stomach capacity and hunger signals). Removing part of the stomach alters the hormones released after eating, prolonging appetite suppression between meals.
If a patient follows the advice of their dietitian and specialists following gastric sleeve surgery – eating healthy meals (i.e. low-energy) three times a day, avoiding snacking and increasing activity levels, they will use more energy than they consume and will lose weight. This is a lifestyle change that has to be adhered to for long-term weight loss and weight management.
3 Ways to avoid weight regain after gastric sleeve
1. Avoid Overeating – it’s easy to fall back into bad eating habits. Using tools such as portion size plates to manage the size of meals (or a smaller plate), planning meals ahead of time to ensure you’re getting plenty of protein, and employing other tactics such as mindful eating.
2. Don’t Snack – snacking is just wasted calories, and if you are eating a fully balanced diet and getting everything you need from your main meals you shouldn’t need to snack. If you do feel the need to snack, make sure they are healthy choices like boiled eggs, vegetables or fruits. Snacking is the single most common reason for weight regain after surgery, and usually takes the form of milky coffees, alcohol, and other sweet liquids, biscuits and many other “snacks” that people consume out of habit, boredom and routine rather than hunger.
3. Limit Liquids – limit your fluid intake before and after meals, so you can enjoy the right amount of food without overfilling your stomach. Drinking with your meals can help to push the food through your sleeve faster, leaving you feeling hungrier quicker. Fizzy drinks can increase pressure in the stomach and cause discomfort, particularly if you have a gastric sleeve, so are wise to avoid.
Studies have shown that after 2 years people with a gastric sleeve experience 25 – 30% total body weight loss. It’s impossible to predict how much weight an individual will or can lose, with a variety of considerations such as starting weight, age, medical conditions, ability to exercise and resilience.
If you are interested in learning more about gastric sleeve surgery visit our website for more information, or you can make an appointment to discuss your weight loss options with one of our specialists by calling (02) 9553 1120.
0 Comments