If you have had gastric sleeve or gastric bypass surgery and you've started noticing that you can eat more than you could in the early days after surgery, you may have wondered, "Has my sleeve or pouch stretched?".

It is common and it's understandable.

Immediately after bariatric surgery, your capacity is very small. You may have struggled to eat even a small amount and felt full very quickly.

Then, months later and years later, you notice you can eat more.

Portions that once felt enormous may now feel quite manageable.

Maybe you're hungry again sooner.

Maybe you're grazing between meals.

Or perhaps you're experiencing some weight regain.

It's very easy to combine these things together and conclude that your surgery has stopped working and that you have stretched your pouch.

But there's more to the story than that.

Being able to eat more doesn't automatically mean you've stretched your pouch or sleeve.

Eating capacity immediately after weight loss surgery isn't a useful benchmark for what you'll be able to eat forever. Your body is recovering from major surgery. The tissues are healing, your diet is progressing through different textures and your eating pattern is changing.

Over time, your capacity and eating pattern will also change.

So, the fact that you can eat more now than you could during those very early post-operative stages doesn't, on its own, tell us that your surgery has failed or that your pouch or sleeve has suddenly become much larger.

In fact, when people come to us worried that their surgery isn't working anymore, we often find there are changes in how they are eating that are worth looking at first.

FOOD TEXTURE MATTERS . . . A LOT

After bariatric surgery, the characteristics of the food you're eating can make a big difference to how much you're able to eat and how satisfied you feel.

Think about the difference between eating a piece of grilled chicken and eating a soft, sloppy, easy-to-eat food, like a chicken and vegetable casserole. They are both the same form of protein, but they are not necessarily going to behave the same way in your pouch or sleeve.

Softer foods, liquid foods, or dry and crunchy foods that are very easy to eat can move through more quickly, making it possible to eat more before you feel you've had enough.

Therefore, if a large proportion of your meals and snacks are made up of these foods that are easy to eat or quick to consume, you may find that your old sense of restriction isn't as obvious as it once was.

That doesn't necessarily mean your surgery has changed. It may mean the way you're working with your surgery has changed.

THE AMOUNT OF TIME YOU SPEND EATING

Imagine you sit down to eat lunch at 12:00pm.

You answer a few emails.

You take a phone call.

You have another mouthful.

You chat to someone.

You have another mouthful.

Before you know it, you've been eating for 45 minutes.

During that time, food hasn't simply been sitting in your sleeve or pouch waiting for you to finish. It's moving through, so by the time you have another mouthful, there may already be room for more food.

This is one of the reasons we talk about how you eat, not just what you eat. Meal duration can affect how much you're able to consume, which can make a very real difference to your sense of restriction and satisfaction after weight loss surgery.

WHAT ABOUT GRAZING?

Grazing can be particularly sneaky because it doesn't necessarily feel like you're eating a lot.

A bite while preparing dinner.

A few crackers while working.

Something sweet with your afternoon coffee.

A handful of nuts while watching television.

Then another little something later.

Each of these in isolation can feel insignificant, but when food is continually coming in across the day, you are no longer relying on the structure of a meal to create that sense of satisfaction.

EATING AND DRINKING TOGETHER

One of the guidelines we recommend at Nutrition for Weight Loss Surgery is to separate food and fluids:

• Stop drinking at least 30 minutes before a meal.

• Don't drink with your meal.

• Wait 30 minutes after eating before drinking again.

Why?

Because food and fluids together can allow food to move through your sleeve or pouch more quickly, which can affect satisfaction and how long you remain satisfied.

It's one of those bariatric guidelines that can seem strangely specific until you understand the reason behind it.

We've even created a visual demonstration using yoghurt and a funnel to show what we're talking about. You can check it out here.

SO . . . HAS YOUR POUCH OR SLEEVE STRETCHED?

In summary, you can't determine that simply by noticing that you can eat more.

We don't want you jumping straight from, "I can eat more," to "I've stretched my pouch."

There are many factors that can influence how much you are able to eat and how satisfied you feel.

Your food choices, food texture, Meal duration, grazing, eating and drinking together, changes in meal structure and the way you approach food over time can all play a role.

WHAT SHOULD YOU DO IF YOU ARE CONCERNED?

Start with curiosity rather than panic. For the next few days, start to take notice of the following:

• How long am I spending eating?

• How often am I grazing?

• How much of my food is soft or very easy to eat?

• Am I separating food and fluids?

• Has my meal structure changed?

• Am I feeling satisfied after meals?

You don't need to judge the answers, just gathering information, as once you understand what's happening, you have somewhere to start.

Rather than reaching for another restrictive ‘reset’, meal replacement or diet plan, take a closer look at what is happening, and this is something we can work on together.

Set aside an hour and join us for our FREE online workshop, Halt the Weight Regain Train.

In it, we walk you through the most common reasons we see people experience weight regain after gastric sleeve, gastric bypass, or other forms of weight loss surgery, and what to adjust first.

It is practical, realistic, and focused on long term weight loss, not just another quick fix.

Save your seat here.