Is my gastric sleeved stretched out?Would I need a revision?

Question

I am about 1yr & 7mos out since I had my surgery.I've noticed that my stomach can hold more than it use to.I'd lost about 50lbs,then I fell off 6mos ago.I gained back 12lbs.Before I would eat 3-4 bites & I was full.Now I am eating about double that until I feel full(no pain).I'm just so worried that I did stretch my sleeve, I feel like all my dedication/surgery that I did was a waste if I did stretched it.If I get back on track with it go back to the way it was or is it too late?Revision?Help!

Ali Solmaz, MD · Answer

It’s completely normal for your stomach capacity to increase slightly over time after gastric sleeve surgery. Right after surgery, your stomach is swollen, and you feel full with very small amounts of food. As healing progresses, the swelling goes down, and your stomach adapts, allowing you to eat a bit more. However, eating twice as much as before doesn’t necessarily mean your sleeve is stretched beyond repair.
A true sleeve dilation is rare and usually happens due to consistently overeating over time. If you don’t feel pain or extreme hunger after meals, your stomach likely hasn’t stretched significantly. Instead, your hunger cues and portion sizes might have gradually increased, making it easier to eat more.
The good news is that you can get back on track without needing a revision. Many people regain some weight after 12-18 months, but you can reset your habits and see results again. Here’s what can help:
Try the "Pouch Reset" or a Modified Liquid Diet – Going back to protein shakes and soft foods for a few days can help shrink your stomach’s tolerance for food and reset your hunger signals.
Prioritize Protein & Dense Foods – Eat protein first, as it keeps you full longer. Avoid slider foods (soft carbs, chips, crackers, ice cream) that don’t fill you up.
Measure Portions – Use small plates and aim for 3-4 oz of food per meal.
Check for Mindless Eating & Emotional Triggers – If you’re snacking more or eating past fullness, try logging food for awareness.
Increase Water & Cut Out Sugary Drinks – Dehydration can sometimes be mistaken for hunger.
A revision is not the first solution for a small regain like this. If you regain 50+ lbs or truly feel out of control with eating, you could look into an endoscopic sleeve revision (ESG) or converting to bypass, but you’re far from that point now.
You’ve already lost 50 lbs, and a 12-lb regain is fixable. Get back on track, be consistent, and give it a few weeks. You’ll likely notice that your hunger and capacity decrease again.

Ariel Ortiz, MD, FACS · Answer

If your sleeve has stretched and are having trouble getting to or maintaining a healthy weight, you can have a sleeve rescue surgery, meaning, your sleeve can be made smaller.  For some its a matter of the sleeve stretching, but sometimes the sleeve wasn't done effectively the first time, and you may have falled into some bad habits (too many carbs).  By fixing your sleeve, you can get back on track, reduce your pouch size, and work with a nutritionist to make sure you are making healthy choices.

Salvador Ramirez, MD · Answer

Hi there.It does sound like you are having some trouble, I think a direct assessment with a bariatric surgeon would be your best bet, to know what to offer you, because not everyone is the same.
Although easy advice could be resetting your diet, using the liquid diet, that was given to you during the immediate Post Op period, do this for around 4 weeks, to get used to smaller portions once again.Like the previous Doctors that answered below, there is the possibility that your sleeve stretched out to a point where the restriction is not being enough to maintain a healthy weight. 
During a bariatric assessment, the desition could be made to offer you a revision surgery to continue with the weight loss until you reach your final weight goal
Best, Dr. Salvador Ramirez Guzman

Alejandro Lopez, MD, FACS · Answer

Hello arozas.
It is possible that your sleeve stretched to a point where the restriction is not being the optimal. In my experience with revision sugeries it also lies on enlarged Gastric Fundus, some surgeons leave bigger sleeves than others.I would recommend a bariatric assesment to determine a revision surgery which could recalibrate your current sleeve or do a revision from a gastric sleeve to a gastric bypass to continue with the weightloss until you reach your final weight goal.

Pablo Garcia, MD - Account Suspended · Answer

Hello,Thank you for your question, I would definitely consider the case for an evaluation.  The gastric Revision is surgical procedure that is performed on patients who have already undergone a form of bariatric surgery, and have either had complications from such surgery or have not successfully achieved a significant weight loss results from the initial surgery.
The first thing is that you must evaluate yourself with a certified bariatric surgeon who can perform the gastric revision and, also review your case then proceed to take the best decision with you. And why you are regaining weight.
To maintain a positive mind: 1. Remember your goal, what is your objective. 2. Never look back, fresh start when needed it 3. Small Goals. Just live day by day. TODAY I'LL DO MY TRAIN ROUTINE. TODAY I'LL EAT HEALTHY. 4. Look for support groups. Its known that you'll have better results.Here are a few quick tips: 
1.Try to avoid artificial sweeteners. Artificial sweeteners can be 300x (if not more) sweeteners than real sugar.
2.Rest. When the body is tired it looks for energy (it is trying to do us a favor) and it knows the the quickest way for energy to get into the body is via sugar. Ever notice that when you are tired you crave processed carbs and/or sweets? This is why. The next time you feel like you need to rest, do yourself a favor and rest.
3. Add more natural sweet food. This one is especially true for my dieters and low carb peeps. When we have a diet very low in carbohydrates and sugar we tend to want sweets. By simply adding some nutritious sweet foods to your day you can cut that craving way back. Some great examples are sweet potatoes, squash, brown rice, oats, and carrots. An idea of a yummy snack might be carob chips and coconut with nuts mix.
4. Protein. If you find yourself craving sugar, just take note of how much protein you have been eating. If it seems high, try cutting back. If it seems low, experiment with adding some more in. I’m telling you, being interested in ourselves is one of the best ways to figure out what our bodies need.
5. Add non-food sweetness. It can be a simple as a phone call with a dear friend, a walk, a girls night out, a great book, etc. The options are endless, but the key component is that you remember to keep yourself on the top of your own list.
I recommend that you go to your certified doctor or nutritionist so you can find guidance and answers to what diet is best for you., it depends in your metabolisms and how your body reacts to different types of diet plans, talk to your doctor to find the best solution for you. 
I hope these tips help you! :)
Best Regards
Do not get discouraged in the search of options to improve your health.
My Best Regards

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