Down then up and a question after seeing doctor

I saw my metabolic doctor yesterday and left there feeling kind of confused. He said I was doing great, which was nice to hear but then after discussing a goal weight, I was a bit disappointed. According to the computer model that he does, he thinks the goal I set for myself is too low. I may hit it, but he doesn't believe that I can sustain the weight I would like to be.

When I got home, I saw some posts about goals not being a number on the scale but about being healthy. I guess I forgot that the real reason I had this surgery was so that I would stay healthy for me and for my kids for years to come. So thank you all for those posts!

Now, this doctor (who is not a surgeon) said that the stomach is alive and it's function is to be a reservoir for food. If you start putting too much in, it will stretch. He also said that the build up of gas in carbonation will help this happen if you drink soda and such. After searching this, most people say it can't since the stretchy part is removed. I'm not planning on going back to soda (it was a bad addiction) or planning to overeat, I'm just wondering if other people have heard this from their doctor. Again, this was not my surgeon and I do plan on asking the surgeon again when I see him in a few weeks but I was just curious.

Maybe some of the scientists can weigh in but i find it very very difficult to believe that drinking soda is going to cause such a release of gas that it would even be possible to cause enough pressure to stretch a non-stretchy part of the stomach. That would be some serious pressure and I think that if it had that effect, there would be relatively few if any post op VSGers drinking soda or carbonated beverages but ive seen a number who do chose to consume it and report no harmful effects.

I dont even know what your doc means by the "build up of gas in carbonation" - it's not like its an explosive substance - we bottle and can it every day and it's not stretching those :-p


I havent had even a sip of soda since Ive had surgery - no desire really. I used to drink diet soda like it was water, but now, I'd happily take my Mio or powerade over a soda. Just my choice though - im sure at some point in my life, i'll drink one, but no plans on doing it anytime soon.

Dittoing Allison's thoughts... I don't drink soda but for rare occasion, but I do drink sparkling water since about 6mo out or so.. I burp just like a normal person and have never felt any discomfort. I do not chug it (or anything) but occasionally sipping it is something I have enjoyed. My restriction has been steady at about 2oz +/- .25oz dense protein from 6 mo onwards as well, and from what I understand.. yes, there will be some relaxation in the sleeve- but carbonation, no- unless you somehow cannot physically release gas with a burp, no problem. That is just me, others can and do decide to avoid it at their own wishes.. I am not advocating one or the other, only my own experiences. I never was hooked on sodas, diet or otherwise, but I do enjoy an occasional fizzy water or beer now that I am within a maintenance range.

On the weight thing.. for your height, if125 is the weight he's saying is too low.. I respectfully disagree.. That gets you to a BMI just over 25. Remember, this is his opinion, likely based on the statistical average of success, which for most of us, feels rather like pulling up short after making such a huge commitment.. 55-65%EWL?

BMI is not a great indicator, but for a woman it does generally fit a bit better than for men that can occasionally have a much heavier build of muscle mass. I wouldn't adjust anything goal-wise, and I would aim for your goal with the knowledge that nothing is written in stone and that you may like what you see and decide you feel great at a higher weight. I needed to keep my eye on a normal range, and realized when I got there that I still had excess fat to shed. I think if I had revised downwards, I may have lost some steam before I was done.. that's me. I went into this as my full on, give it my all shot. I wasn't settling before my body called it. BF% should be the overall indicator, and shooting for somewhere in the range that you are healthy and like the way you look should be the benchmark of calling goal or success, which is why I still have not said I've reached my personal goal.. working on more muscle mass and a lower BF% is my current focus. Those BF% tests can be done as you get closer to dial it in more.. 

I don't know, but I have been between 108-110 lbs for the past 16 months. A few times, I have gone a bit higher (2 lbs), but I have been able to reel things in and get the weight back down. I am also 4'11."

I would ask your surgeon, since he/she is the expert into how much the stomach stretches. At almost 2 years out, I can definitely eat more than I could during the first few months, but it really hasn't changed too much in the second year. I continue to measure my portions and start with protein first. I can definitely eat more of "slider" type foods, but I generally stay away from them

As far as carbonation, I just don't go there. I have tried some sparkling water and I just don't like the feeling or taste that it gives. I don't believe that carbonation can stretch one's sleeve. Most of the stretchy part was removed, so I don't think the sleeve can dilate that much, if the sleeve was made correctly in the first place.

Bottom line, ask your surgeon.

My surgeon's goal was higher for me, but my first goal for myself was 120 lbs, because I had been at that weight for about 3 months, before I started gaining again. My PCP is the one who suggested 110 lbs, when I was about 118 lbs. I didn't know, if I could get there, but I just kept doing what I was doing, and the weight came off.

I also started weight training during my 4th post-op month, and I really think that helped me to reach a lower weight.

Gail

Maybe set "his" goal as an interim goal.  See how you feel and look at that weight, and then decide.  If you have surgery to remove excess skin, that could also account for a few pounds.  The closer you get to goal, the slower the weight comes off, so you'd have plenty of time to figure it out!

I think the key is to not get discouraged or sidetracked by the "number". 

My surgeon's explanation - the stomach will not stretch but will grow a little bit.  The scar of the staple line will become unstiffen and become more flexible over time providing a little more wiggle room.  But it's not possible to stretch the stomach out unless you eat to the point of vomiting over and over and over and over....well, you get the idea.

On carbonation, the gas is either going to go down through your pyloric valve or up through your mouth.  It's not like your stomach is sealed!  My dietitian's explanation for no carbonated beverages was more connected to ulcers and increased appetite.  Don't know how valid this is, but surgery was as good an excuse as any to give up the diet soda habit.  That stuff just ain't good for you, surgery or not.

Thanks, all! Giving up the diet soda and drinking water was one of the best things I ever did so I have no plans on going back to it. His comments about the sleeve stretching just sounded a bit funky so that's why I put it out there.

As for my goal, 125 was my original goal and that's the one he thinks is good. I had changed my mind and was trying to shoot for 115 which is the one he said that might not work. Doesn't matter anymore. Being healthy and happy is what matters so I'm over worrying about a number on the scale. Just going to keep plugging along and doing my best without making myself too crazy.