Sleeve Gastrectomy - Metabolic Changes

There used to be a hard-core group of VSGers here who were defiant in there belief that their smaller sleeves (and thus the skill of their surgeon) was responsible for their success. And of course, anyone with a larger sleeve from some inept clod would doom those chumps to failure.

We have seen many with small sleeves do poorly, and many with larger sleeves do great. It is, obviously much more complicated.

But it is also the only time people will argue that "mine is smaller than yours."

The smaller sleeves are a big cause of GERD post op. I'm glad to have 40f...I can't imagine how much worse it'd be smaller.

Ah, yes, the microsleeve crowd. They were also the big proponents of rushing to goal to take advantage of their "six month honeymoon" which was largely a function of diet fatigue from their dieting to get as much loss in within their six month honeymoon....

My wife has a DS sleeve that was initially about 4 oz - probably a 56-60Fr, vs my VSG sleeve with an initial capacity of about 2.5 oz, which probably corresponds to a 36ish Fr sleeve (assuming that the Rabkins even use a bougie - I never asked and don't care, as I'm more interested in the outcome than the process and specific tools they use), yet our meal sizes are roughly the same, many years out. Reference also some of the Dr. Matthew Weiner vids where he outlines the approximate volumetric progression, irrespective RNY or VSG. It's not just nominal capacity of the stomach, but also the throughput, which is quite dependent upon the meal composition - how much simple and slippery stuff vs. tougher, fibrous material. More even than the basic carbs vs. fats vs. protein thing as I find an artichoke just as filling and enduring in satiety as a piece of steak or chicken - things in real life are never as simple as the models we create to try to get our heads around a problem.

I very much wonder how long the metabolic changes last with VSG.

There is a period of ~1 year or so where there are over-compensating benefits with most surgeries. Studies I read for the sleeve listed the blood serum stuff at about a year. Many people talk about the "honeymoon period," and it may be this science backs it up.

Of course, if one returns to old eating habits, it's possible to become obese and reverse the change again, even if you have a powerful DS, as they still absorb most if not all of very simple processed carbs.

Regardless of surgery, forming excellent habits post-op is the best way to lengthen the bonus effect.