Confession Time

Time to confess. I've gone back to a really bad pre-Bariatric surgery habit. In order to get in all or at least 75% of the protein and fluid that I need daily, I've been eating and drinking at the same time. I haven't been doing it exactly like I did preop where I used to take a bite of food, swallow it, and then take a sip of liquid. What I've been recently doing is taking a bite of food and putting water in my mouth and then I chew it until it all becomes mushy and then swallow that. Then I'm not restrained by the waiting 30 minutes before and after eating. Sometimes I'll even eat while drinking a protein shake but in the same way of making it like a mushy. I found it was a huge time saver. It's like still being in mushy phase. I know that I should break these habits. It's too early for me to have these bad habits, but otherwise I'll have to watch the clock all day long. I don't know how everyone does it. I was getting very weak before doing that. If I don't do it this way, I'll never get everything in, never get rid of my dependence on protein shakes, and never be able to finish 2 ounces of protein in 30 minutes. I'm eating Greek yogurt as suggested here but learned that I cannot count it in my fluid totals. I'm not giving up. I was desperate, but now that I'm stronger, I'm going to try to do things properly from now on and hope that I haven't already stretched my sleeve.

This may be a controversial post, but I don't think you've done anything terrible, and nothing you've done will stretch out your pouch.

I've heard two reasons for not drinking while you eat. My dietician says her main concern is that a patient will be full of liquid, and thus not be able to eat enough. She says that if I get thirsty while eating, it's OK to have a sip of water. According to your post, taking in fluids while you eat is actually helping you to get the protein you need. I don't know if that's the best way for you to accomplish this, and I recommend you discuss it with your dietician. Mine is not very strict about the drinking while eating rule.

The other reason I've heard is that because fluids empty quickly from your stomach, they may carry the solid food down with them. This might cause you to feel less full, and thus eat more. (Personally, I'm a little sceptical of this, because soup is allowed, and soup is basically solid food plus water. I can consume perhaps a full cup of soup, but only a half a cup of solid food, but I'm getting about the same amount of calories either way.)

Neither of those reasons suggest to me that you're in danger of stretching your sleeve. That said, there are probably better ways for you to meet your protein and fluid requirements. Have you discussed your problems with your dietician?

I'm nearly three months out of surgery, and I still have trouble with food that's dry. Perhaps you'd have an easier time eating things with more moisture.

Soup is acceptable for post-op eating, but once you are on solid foods, it is not advisable as a regular menu item for the very reason you stated. You can eat twice as much volume of soup BECAUSE of the water in it, which means it processes through your stomach faster.

I am puzzled as to why so many VSG's state that they "might stretch their pouch". My surgeon has stated to me that a pouch cannot be stretched to be bigger. I have read several scientific articles as well that this is one myth that many people who have had WLS believe. So I asked my WLS support therapist if it is a myth or is it true that we can stretch our new pouch by overeating??? Frankly, if I overeat or don't chew my food up completely or eat too fast or too much, I always will have trouble keeping the food down. In other words, I have thrown it up but just a few times when I ate too fast. I weigh all food that I eat and I have learned that I cannot eat more than 5 ounces at one time. Interesting enough, I read the article that was posted in this month's OH newsletter that talks about grazing when you eat small snacks all day long that that can lead to weight gain and defeats the purpose of staying on a plan of eating 3 protein dense meals per day with 1-3 protein rich snacks per day on a planned time schedule. Some days I may drink prior to 30 minutes after completing my meal; however, when I do i usually suffer from the pain or tightness in my chest between my breast which is probably where the liquid goes into my pouch because the protein in still in my stomach and I am already full. I am fortunate and grateful to be in a support group with a certified WLS therapist and a RD that I can call on at any time to answer my questions and set me straight when I come to them with some of the myths about being a WLS patient. I have learned that there is a very good reason for every recommendation and guideline for what to eat and drink and when to do it after having this surgery. For me, I have learned that my greatest success happens when I follow the guidelines set out by my surgeon and the support clinicians that the Bariatric Center have given me to follow.

Exactly right--the reason you get pain if you drink too soon after eating now, is that if you eat enough to fill your sleeve, and then drink too soon, you are overfilling your sleeve, causing the pain. Not drinking during meals allows you to fill your sleeve with solid proteins/foods, which take longer to break down and move through your system. Drink too soon, and enough hasn't left your stomach to allow for the additional volume...ergo, pain.

I disagree about sleeve stretching as a myth. Things that can stretch: wood, bone, steel. How am I to believe that things like wood, bone, and steel can stretch but it's impossible for human soft tissue to stretch?

I think it's unlikely that anyone would stretch their sleeve back to its preoperative size, but I think it's even more unlikely to believe that stretching soft tissue is actually impossible.

It absolutely, positively will be bigger at a year or two out than your surgeon made it. Likely twice as big. And th eres not thing you can do ab out it.

If you abuse yourself by cramming it full all the time, it's possible to make it even bigger. And if it becomes overly full, you can back food up right into your esophagus. It happens a lot.

Of course it will never get anywhere near as large as it was before surgery. But can you make it larger? Absolutely.

Drinking while eating causes the food in your stomach to pass through much quicker, thus keeping you from being satisfied longer. That is why you are instructed not to drink while eating and 30 minutes after. Your new stomach still has the pyloric valve, which regulates how fast food is emptied into your intestines. Solid food takes much longer to break down in order to get through the valve...liquid goes right through.

Therefore, drinking while eating is very important habit to break. If you continue, you can consume considerably more calories in a day because you will start feeling hungry much sooner. It is also why you are instructed to eat solid proteins first, and then anything else after. Solid proteins stay with you longer and keep you satisfied longer, thus keeping you from having to eat more often.

You will eventually be able to eat more than 2 ounces of solid protein, you're only about 8 weeks post op. Reliance on protein shakes is normal for the first several months, some never stop using them. There is nothing wrong with that. There is also nothing wrong with a tiny sip of water if what you're eating is too dry, like a dry piece of meat. But not enough to turn it into mush.

One more thing...if you continue making your food "mushy" it will take that much longer for your new stomach to adjust to solid proteins. You're doing yourself a great disservice by continuing to drink while you eat.

It is hard to stretch a sleeve, and it takes prolonged gross overeating to the point of pain to do that. At this point you're not even completely healed, the risks are more of rupturing the staple line from overeating than it is for stretching. And since you still can't feel how full you're getting, you could "mushy" your way into eating too much and doing damage.

Stop drinking while you're eating now. It is a habit you need to break and never start again for life. Use a stopwatch or an alarm if you have to set for 30-45 minutes after you finish eating. It's hard but we all have to learn to do it. You can do it!

Cathy has covered it well! I use a timer, I was setting my phone alarm for every 3 hrs. thereabout to eat a bit 6 times a day (my nutrition recommended that often) and if it is a dry meat I cook/heat in a liquid and then pull it out and cut it up and eat, I no longer need to set the alarm.

As for drinking 30-minutes AFTER eating, I do still set my timer on my phone no matter if I'm home or out I take that few seconds to hit the 30-minute timer! I do not drink with my meals or before those 30-minutes have passed.

I try real hard to follow what my VSG team has told me, I figure I trusted them to operate on my body and I need to trust them that this is not their first rodeo and they do know what they are talking about!

Someone mentioned soup being water based and it is, BUT you were using it on your fresh operated tummy to reintroduce more solids AND it helped to pass it through all that bruised parts, now you should be able to eat normal and let it pass through normally so you get all the nutrients from it.

You will not stretch your sleeve, however you are at risk of consuming more calories than you should be and this is definitely a bad habit to get into. Especially since you're displeased with your weight loss.

Are you seeing a therapist to help you combat this potential of self-sabotage?