Eventual Capacity.....Why it matters

This surgery and follow through has several components to it.

First and foremost you must develop good habits that will be sustainable for the long haul.

Eating right in the proper portions along with moving your body in some form or another are the basics.

The surgery itself has two major components to it "generally speaking" Capacity/restriction and reduction of the hunger hormone Grehlin.

Most modern day VSG's can provide enough power to aid in WL even though there are a wide range of approaches to this non standardized procedure.

Developing good new habits during WL is absolutely key in long term success (which I myself am trying for.... not there yet, still learning)

In the big picture, WL is the shorter easier part when we look at "for the rest of our lives".

For the rest of our lives, hopefully is a long long time!

This is where eventual capacity comes into play as a major component along with those good habits for us VSG patients.

Eventual capacity from VSG ranges greatly..... 3oz. to as high as 16oz. from what I have seen here and IRL.

There are two main factors to eventual capacity. 

- How your sleeve was made

- How you treat your sleeve

 

If your pre-op take the time to really study all the procedures even down to the variables within each procedure and see what's best for you. Study surgeons and programs and try match their goals and intentions with your own.

Read up on the revision board and see where the issues have been.

If your early post op, really get a grip on developing those good habits and "Under eat your capacity" as it is the only real true way to preserve your restriction/capacity.

There are 3 basic ways to control caloric intake:

- Quantity

- Content

- Frequency

For long term I choose to eat smaller with a wider range of foods to fit my lifestyle the best. In maintenance there is nothing that I don't eat. Lot's of things are very few and far between, but nothing is off limits.

That is "my" choice, you may want to eat more leaner foods to get to the same end, or eat more times per day to get the same.

But what you probably can't do (a few can) is eat more richer foods and still maintain.(I can't)

Long term is where eventual capacity comes into play when you consider that 100 calories per day over your balance point is about a 10lbs. gain in a year.

If you really think about it, WLS is really more about keeping the weight off that you lost.

When you read about someone who is two months out and they think they know what's up with capacity, they probably do for two months out.

Or when a capacity question comes up and the comment is.... don't know and don't care, well again probably true cause weight comes off pretty easy early out.

The bottom line here is...... I'm NOT asking you to believe me. I raise questions and awareness for you to get the answers for yourself.

Nobody is doomed, if your short in one area, you must make it up in another. YOU control your own out come.

Learn as much as you can to have the tools in the toolbox to fix as you go.

This is a great opportunity for all of us..... make the best of it !!!!

frisco

Very interesting and helpful and thought provoking.

I'd add that the length of your stomach also effects capacity (something that's out of our control). 

Below is some fuzzy match - tell me where my error is??? 

a 32F is about .4" in diameter and if your stomach is 6" long your volume is .0123 liters

a 40f is about .5" in diameter and if your stomach is 6" long your volume is .0193 liters

a 32F if your stomach is longer, say 8", your stomach volume is .0164

.0123 liters is appz .42 oz and .0193 is appx .65 oz

How can our sleeves be so small? where does our food go? That math can't be right, but I can't find my error and it's driving me crazy!

Link to bougie size  http://www.obesityhelp.com/member/carmelita/blog/2011/03/31/-2/

Link to volume calculator  http://www.handymath.com/cgi-bin/cylinder.cgi?submit=Entry

Link to liters to ounces  https://www.google.com/webhp?sourceid=chrome-instant&ion=1&espv=2&ie=UTF-8#q=liter%20to%20oz

I agree with what Frisco said about what you eat, how many calories you eat mattering. I suppose it's easier with a smaller sleeve, that's why we all had surgery :)  It's about knowing ourselves, our triggers, our emotional eating habits, our grazing, our unplanned eating, etc... and using the tool to help us manage. If we keep filling up our sleeves with high calorie foods, oils, potato chips, cheeses, bacon, ice cream, etc... the math doesn't work. For those that can moderate food, moderation is golden, for those trigger foods or food groups that (for dramatic purposes) are toxic to us, it's much harder. (carbs, refined sugar, alcohol, etc...)

What I hope works for me down the road is 6oz chicken breast (280 cal) in tbl olive oil (119 cal), topped in 2oz avocado (47 cal) and 3 oz steamed broccoli (30 cal) with a tbl of butter (102 cal) for a total meal of 578 calories and appx 11-12 ounces of food. 

Personally, I was hoping for a large sleeve. My long term dream 5 or 10 years out is to be able to eat 12-16 ounces of food over 3 meals a day. Protein first, 80+ grams a day. Use veggies to help fill me up as needed (I'm assuming I'll have some sensation of full). That's assuming I am lucky enough to have a metabolism (with exercise) that lets me consume at least 1800 calories a day. Divided 1800 by 3 meals and I can fit 600 calories of good tasting protein into those three meals. 

From everything I've read, if you eat protein first and don't drink after (aka use the tool) your restriction stays. It's very difficult to stretch your stomach and it will never be able to stretch it did like when you had your fundus. 

Best,
Todd

Todd, the meal you are describing makes me hurt to just think about it. There is no way I could consume so much at one meal. ☺️

I am not criticizing ~~ just realizing that I'll never be able to eat that much at once. I am lucky to get 2-3 ounces total at one time.

Sorry, I don't know anything about the math you presented but it seems that you have completed a lot of research. I am impressed. Good luck!

Your math may be right, but you're not considering the fact that the math you're doing is for a rigid container.  Your sleeve isn't rigid--it is distendable.  Mind you, not as distendable as it was when it was a full-sized stomach, but still.  Also, liquids and solids take up different amounts of space.

The last thing you want is a large sleeve.  Otherwise, what is the purpose of having the surgery done in the first place?  This procedure provides restriction, which is one of the main objectives here. 

The meal you describe seems much, much larger than most of us are able to consume at all.  Personally, chicken breast is one of the foods I eat that causes my sleeve to tighten up quite a bit and that gives me great restriction.  I can eat roughly 3-3.5 ounces of chicken breast before I have to call it quits.  I was told by my surgeon my eventual capacity would be about a cup of food, and he is right on with that estimation.   I am nearly a year out, and a cup is about all I can handle most days, but most days I don't eat nearly that much at one sitting.

And yes, you are right--eat your protein first, always.  I think you will find that when you do this, it becomes very difficult to pack anything else in. 

Here is something else to add to your math...... not only can the sleeve stretch in diameter, it can also elongate........

frisco

Todd, thanks for this math.

Anecdotally, at nearly a year out, I can eat about 4oz of chicken with no room for sides, or 3 oz with room for sides. There is no way I could eat the meal you indicated at this point. You might be able to get in 1800 calories per day if that is what your body needs to maintain, but if my experience so far is any indication, you'll probably need snacks.

My normie husband is used to eating about 1400 calories per day and the nut told him to up to 1800. He finds it hard to be able to consume that much healthy food. He acknowledges that if he wanted milkshakes or ice cream or chips it would be simple, but that much healthy, whole food is tough.

Laurie

Deleted to protect the guilty.  :)

Elina, you are a total success. You have a lot of great experiences to share however, I wonder if posting a medical conversation regarding your friend's surgery is ethical. In my ethics training and HIPPA training such a disclosure online would be a violation of confidentiality. Your friend may not care about your sharing the story but it does make me uncomfortable to read it.

I am sorry that you are uncomfortable, but I also know two things, one my friend would not mind and two, I never shared her name, her age, when this was done or any other identifying information.  I could understand your position better if this friend was easily identified in any way.  She is not in any of my photos, or anywhere else on on this site.  I too take HIPPA rules seriously, but I don't believe that they mean that we can't talk about anecdotes that can't be traced to specific individuals. 

After further consideration of your point, I still don't think that she can in any way be identified, but because the point that I am trying to make is not dependent on the anecdote, I will delete my response.  The main point that I am attempting to make, is that the boughie size is only one of many factors involved in making a tight sleeve.  There is so much more involved in it, the surgical technique (where the cuts are made), whether the surgeon sews over the line, and many other issues.  The philosophy of the surgeon when it comes to capacity is what is important.   For example, kairk's surgeon uses a larger boughie but makes a very tight sleeve.  I know, I have eaten with him. :)  Others use the 32F but make it quite loose and this completely defeats the purpose.  The anecdote was meant to illustrate this point.