Will my stomach stretch after sleeve gastrectomy?

A very common question I get asked is “Will my stomach stretch after sleeve gastrectomy?” and it’s a very important question! The sleeve works so well because it shrinks the size of your stomach and helps to control your appetite. So is it possible to undo the surgery and gain the weight back by stretching your stomach? The short answer is yes, but there is a lot more to it so read on.

Why does a stomach stretch after sleeve gastrectomy?

Our stomachs have the amazing ability to stretch and expand as a result of our food intake. The walls of our stomach expand and contract depending on how much food is in your stomach. Normally, when your stomach is full, it sends a signal to your brain saying you’ve had enough (see this post on how to recognise that signal and avoid overeating). However, when you are overweight, there can be a disconnect between the stomach and the brain. This disconnect can make it really difficult to hear your hunger and fullness signals, making it hard to know when to eat and when to stop, and really easy to overeat.

After your sleeve, it’s important to listen to your new stomach and try to avoid overeating on a regular basis. If you overeat every once, your stomach will stretch but it will contract again (you’ll just feel “Christmas Day full” for a while). However, if you keep overeating on a regular basis your stomach may stretch permanently and your hunger and fullness signals may be muddled. A stretched stomach and muddled appetite signals can then quite easily lead to continued overeating and ultimately weight regain.

How to prevent the stomach stretch after sleeve gastrectomy

The key here is to practice listening to your new stomach. Try the following tips to reduce the risk of overeating regularly and stretching your stomach again:

• Use small crockery – serve yourself only a cup of food (measure it until you have your eye in). You can always go back for more if you’re still hungry.
• Concentrate when you eat. Turn of any distractions like the TV or your phone and try not to eat in the car.
• Take 20-30 minutes to eat your meal. Time yourself if you need to, or use the Eat Slowly or Bariatric Timer app.
• Take 1/2-1 teaspoon-sized mouthfuls and chew well!
• Listen for the “sigh moment” (read this post to find out why I love this so much)
• Wait about 15 minutes after you drink before you eat, and about 30 minutes after you’ve eaten before you drink again.
• Concentrate on quality rather than quantity and savour your meals. When you can’t have much, have the best!!
• If you do have a bigger than normal meal, make your next meal small and try not to make larger meals a habit.
• Keep your hunger between a 3 and 7 out of 10. If you get too hungry (below a 3/10), you’ll be more likely to eat like a hungry bear (too fast and too much without enough chewing!). Instead, have a small snack between meals (~1/2 cup) to help control your appetite at your next main meal.
• Lastly, DO NOT get discouraged. If you fell off the wagon and binged one or two meals or even the entire previous week, don’t beat yourself up. AYour stomach to stretch right away. Do your best to accept what happened and to go back to the habits above as soon as possible. If you find you’re struggling with binging or aren’t sure about the portions of your meals, call your team and ask for help before it gets too far out of hand.
• Similarly, if you think your stomach may have already been stretched, call your surgeon. They can do a swallow to check and reassure you that it’s okay or work out a plan if it has stretched.

So can your stomach stretch after sleeve gastrectomy? It sure can. But is it preventable? It sure is – and you have the power to practice those habits that will minimise the risk of it happening to you.

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