Can we re-shrink our pouches?

I am almost 3 years post op and have maintained 170 pound weight loss. I know our stomachs are only skin and as we all know too well, we can stretch the skin out again without a lot of effort. I think I have been successful at maintaining because I work very hard at adopting a new lifestyle but I am so scared I might slip and go back to old habits because my body no longer tells me when to stop eating. There is nothing out there I can't eat. I have never dumped, nor do I ever feel full.......I really have to depend on my adopting better choices for myself these days. But it scares the H*** out of me. Does anyone know of anyway to really re-shrink our pouches.....I am just looking for a little insurance because we all suffer little slip ups from time to time and I really don't ever want to slide down that slippery slope again. Joann

That's a great question Joann! I get scared of the whole maintenance thing too b/c obviously I was never good at it in the past. I too have tried to focus on lifestyle changes b/c most research states that making those changes ie:exercise, good foods, etc is what really makes the difference between those that succeed in the long run and those that don't. I don't have the answer on re-shrinking the pouch, but I can say from past experience that after having the flu and not eating anything substantial for several days my capacity did go back down for awhile. Good LUck to you and I'll be checking back to see if anyone has the answer to your question!! Tracy B 328/150 5'9"

170 pound weight loss is amazing! Congratulations on maintaining it, too!!! The Pouch rules for Dummies [excerpt at http://www.nikkiinmd.com/pouch_rules.htm] indicates [based on published data] that it is a misconception that weight loss is relative to pouch size. Try following the 'rules' for a week and see if it makes a difference in your hunger. If it *doesn't* then maybe you want to take a look at the emotional side of eating for you. For me, following the rules of the pouch keeps me physically satisfied most of the time, and being in therapy along with actively seeking support of other WLSers has help immensely with the rest of it. Good luck! Awareness is the first step ... xosm

Thank you for this post. I am almost four years out and have gained 10 pounds. I am scared to death! I printed out the pouch rules and will start following these ASAP. I am going back to the support groups next week i hope I can get back on track! I like knowing you're here. Thanks again for your encouraging words! Susie

I know someone who has recently been just having liquids for breakfast and lunch (protein shakes), then a regular dinner (starting with salad for fiber). He said that his pouch feels like it did at three months post-op. Now - I can't say that I would want to eat like that every day for the rest of my life, but if you were trying to pull in the reins a bit and get control over some poor choices, that might be a good way to go. I think both of you nailed it exactly right - it's all about adopting good eating habits, a new exercise routine and working that tool on a daily basis. Hugs!! Kristi

Hi Joann - we miss you at the March 2004 Board! Please come back home! I have maintained my 216 lb. weight loss (I stay within the 140-145 range now) since my surgrey and the short of it is it is HARD WORK. I workout hard at least 4 times a week; if I lose my commitment to fitness, I will be sunk. So, first and foremost for me, my 1st commandment is MOVE THY BUTT! Otherwise, I try very hard to eat well but like you I can eat ANYTHING now and in any quantity. I recently spent a whirlwind weekend in NYC with my beautiful daughter and came home to discover I had gained 5 pounds - and YES, I ate way too much. But instead of throwing myself the usual pitty-party (which would give me the permission to keep eating), I shrugged it off and got right back to my program. In 4 days, the added weight was gone. 2nd commandment is MAKE HEALTHY FOOD CHOICES MOST OF THE TIME, and when you slip, get right back to your program. Finally, I try to live a vibrant life full of passion and truth - every day. When I concentrate on living well EMOTIONALLY, I just plain feel better about everything. And when I feel better, I take better care of myself - and those that I love. I hope this helps. Let go of the fear, it will just get in the way. Accept where you're at and simply take good care of yourself. And PLEASE go to the 3/04 Board and post - we'd all love to hear from you! Maureen

Not being a doctor, but, the stomach isn't "skin". It is composed of a different type of cell than our outer skin. It depends on what part of your original stomach the new pouch was created from. My surgeon uses the very bottom of the esophagus and just the very top of the stomach, which is less likely to "stretch". I don't know how much it will stretch over time, I think it is more likely that we just out eat the pouch through either grazing behavior, or drinking with/too soon after eating, so that the food is just washed out the stoma quickly. As others have said, simply continuing to follow the rules of protein, exercise, water, no drinking with meals, limited snacks, are what will keep us maintaining our weight loss. Debra M.

Thanks for all of your suggestions. It is all about a lifestyle change to be successful. But we are human and from time to time we are going to gain that five pounds. I know when we go on vacation, I always gain that 5 to 7 pounds. I try not to beat myself up over it. I tell myself I deserve to indulge once in a while. Then I get right back to basics...pushing the protein, getting in the water, step up the exercise and I am always able to get back down to my lowest weight. I mean, I don't want to ever feel deprived. As good as I feel about my weight loss success, I will never forget that with every diet I had done in the past, I always failed. I don't ever want to feel defeated again. I just wish I could have back that honeymoon period of the first 6 months when my body definitely told me to put down the fork. I guess it's a matter of having faith in ourselves. Meanwhile, the quality of my life these days definitely keeps me from sliding down that slope again. I am glad we have each other here. Joann

According to my surgeon he uses the portion of the stomach that will not stretch back out very much. What allows people to eat more and more is that they stretch the stoma which is the opening from the pouch. They stretch the stoma by continually or frequently eating more than the pouch should ever be able to hold thus stretching the exit hole which then allows the food to slide right out thus allowing you to hold more food. So, just make sure not to over eat and your stoma should stay in tact. Easier said than done sometimes, I know. But anyway, it sounds like you have everything under control and do the right things. Congratulations on your weight loss and good luck on your continuing journey. I think we all have that fear of going back where we came from. So, just visit here often for guidance and support and maybe we can all help each other and be successful and healthy for a really long time. A friend of mine just recently had some problems and they checked everything out real good. She is 8 years post op. They told her that her pouch was still really small just like it should be but that her stoma was a little stretched out but all in all looked pretty good for 8 years out. She ended up having scar tissue that was causing her pain. Once they removed that she was fine again. Melissa Lap Rny 1/15/04 277/136-140

Joann, my experience when going back to a 3 day liquid only diet including protein shakes is that when I introduce protien and vegetables back I can eat very little at a meal. It also has helped me reign in the real hunger vs. head hunger. I'd say that 80% of the time I have head hunger and not actual hunger. Dana