24hour ph test showing no acid reflux? Resleeve but he uses a size 40boogie

Ha.  

To be fair, there is one study (sadly I don't have the link) with a 5% difference in weight loss at most between bougie sizes, which is the difference of like 1-4 pounds on average. 

Yeah, it's that "bougie envy" thing that some are infatuated with. My wife has a huge stomach relative to ours (typical DS bougie at the time would have been a 56-60) which is consistent with her nominal stomach size of about 4 oz at time of surgery, vs mine that was 2.5 oz and probably a typical VSG 34 or 36 bougie (if he even used one - I never asked and still don't care - it works and still does,) but her functional meal capacity isn't markedly greater than mine - maybe 25% at best and sometimes less. As they like to say with other size arguments, it's how you use it more than how big (or small) it is.

Yup, and 1 - 4 lb difference is NOT worth (IMO) literally demanding that a surgeon use the bougie size you request, or threatening to find a different doctor.

Calling him out on that one is what got me blocked ;)

Most particularly instructing a surgeon as to what tools he is to use. You are buying a package from him with expected results indicated by general results data for that procedure and data specific to that practice (and hopefully, relevant to patients similar to yourself.) While threatening to go to a different doctor in order to get your way with one is bad form, and not a good way to get good results, one should not be shy about getting second opinions and vetting several different practices. I fully agree with Frisco that a surgeon who tells you that you should expect about 60% EWL will probably deliver 60% EWL and you might want to look for one who is more optimistic - expectations can certainly drive results. If a doc routinely uses a 38 Fr (or worry about carb counts,) and averages 90% EWL, who is to argue that he is using the "wrong" tools?

I agree.

A surgeon can't really predict EWL based on physiology alone, is the thing.  Any surgeon who does boast it should, I agree, be able to follow up.  Almost all of it is based on individual psychology and support outside the surgeon's office. A surgeon is a great general, but as with all war, it's the troops that matter and the terrain.

Stomach length is a factor in capacity too, I'd imagine, as all our stomachs are different lengths within a range.  So even if you use a 30f, you may have more capacity than someone with a "shorter" stomach.  Also, how close they staple makes a big difference too.  You can't just go in like a maniac and staple too close with some sort of maniacal laughter.