Question:
Post ops, how do you know if you are experiencing this type of

behavior? I asked my surgeon several weeks ago if my pouch could be stretched because it seems like I can eat more now. I don't want to be able to eat more...this is one of the reasons I had this surgery, so that I could use it as a tool and be more disciplined. I couldn't bear the thought of ever being obese again, it's just too painful. Mentally and emotionally, I don't think I could much handle it very well. So, his response was "as long as you don't get into *maladaptive behavior*, then you don't have to worry about your pouch stretching. Okay, yes, I'm further along post op than I was before, and I suppose I could just look the word up in a medical dictionary, but I'd prefer hearing from the AMOS community...exactly what is maladaptive behavior in reference to pouch stretching? It sounds serious and I want to do the right things. Please help! Thank you.    — yourdivaness (posted on May 20, 2003)

May 19, 2003
I would assume that your doctor meant eating too much, forcing yourself to be overfull and grazing. I don't think that grazing would stretch the pouch since you would be eating small amounts frequently, instead of forcing in more food than the pouch should handle. But it can cause you to gain weight. Of course, as time goes by, our pouches do stretch - they are supposed to stretch a certain amount. I had an Upper GI done at 6 months post-op and the doctor said that my pouch was a perfect 4 ounces. I can now eat about a cup or a little more of cottage cheese (no, I didn't do the cottage cheese test) at a meal but that's all I eat. And cottage cheese is on the watery side so I can eat a lot more of it than I can of meats and fish. Also, remember that the rule of protein first, then vegetables, fruit and "other carbs" is a lifetime commitment.
   — Patty_Butler

May 20, 2003
Pretty music on your profile! As time goes by you will be able to eat more at meals. Patty is right, the pouch does stretch naturally over time and after a year or more post-op we end up with 6-10 oz average size pouches. But even though that is more that earlier post-op days, its still tons less than what we could eat pre-op. Think of it this way-pre op we could eat a supersize meal and still have room for dessert, post op, we can fit the burger and a few fries with no room for dessert. Maladaptive behavior would be behavior that would get you into trouble and stretch the pouch abnormally, like overstuffing yourself regularly or grazing on carbs/sugar round the clock. Remember its still a game of calories in equals calories out. You'd be amazed how we can eat lots of high calorie foods, just in tiny amounts at a time, but it can add up and we can REGAIN. I know what you mean about not being able to handle even the thought of being obese again - its all of our fears..but that is what is going to keep up honest and disciplined and determined to maintain our losses.
   — Cindy R.