As more and more people seek bariatric surgery to aid in major weight loss, a variety of techniques have been developed. One of the techniques that we don’t hear about in the news as frequently is sleeve gastrectomy, in which the size of the stomach is reduced to a narrow tube (essentially removing a large part of the stomach to produce a smaller stomach cavity and decrease hunger).
Unlike the lap band, which is intentionally reversible, a sleeve gastrectomy is intended to be permanent. One question about the surgery, though, is whether the stomach can increase in size after the surgery, especially if patients don’t carefully follow the limits on meal size that are required. Some studies have even suggested that within three years, patients might need to have another surgery in order to prevent weight gain.
Checking for Stomach Stretching
A team of surgeons at the University of Chile, led by Dr. Italo Braghetto, have conducted measurements of stomach capacity with patients who have undergone sleeve gastrectomies, checking their stomach capacity within three days of their surgery and again after two years.
This study, reported in the journal Obesity Surgery in January 2009, followed fifteen patients and found that the average stomach capacity did increase significantly over the two years after their surgeries. In fact, the average gastric capacity had more than doubled. These same patients had, for the most part, maintained their weight loss and had average Body Mass Index (BMI) of 25 (although an increase in BMI was seen in a few patients).
Although the patients had made and maintained significant weight loss, the study suggests that regaining of weight reported by earlier studies over the longer term following a sleeve gastrectomy might be due to the increase in stomach size.
Psychological Barriers
Dr. Braghetto and his team report that patients have a hard time limiting themselves to the very small meals necessary to maintain their new, smaller stomach size. Some gradually increase the size of their meals, while others keep meals small but make them more frequent. Because their stomachs empty quickly, they are more likely to feel hungry.
The Bottom Line
If you’re considering sleeve gastrectomy, this study suggests you need to be ready to commit to strictly following the limitations on meal size if you wish to avoid regaining weight or repeating surgery.