[DocSanae]

I received this Q in a PM. Instead of just replying to the PM, I thought it better to post here, as there may be others who have the same Q on their minds.

With any method of losing weight, whether it be with conventional diets and exercise, or by surgery, the reason is simple arithmetic. Reduce your intake of energy so that it is less than what you need to sustain your body at the present level, and you will lose weight as your body makes up for the lack of intake by using the stocked up fat in your body. As an example, say, you weigh 300 lb. You likely will need around 3500-4000kcal per day to sustain your present weight. If you get in 500-1000kcal less than that, in other words, if you take around 3000kcal per day, then you will lose weight because you use the fat that the body has stocked up for days when the intake is not enough, to provide the lacking 500-1000kcals.
Now, the weight lost by this will be at a relatively slow rate that may not be encouraging to some people. Too slow for them.

The reason you lose weight rapidly with weightloss surgery, be it bypass or lap band, is because you cannot eat as much as you used to before, especially in the early months, thus reducing the total calories you can eat, which will be far from enough to sustain your body at the weight you were immediately before your surgery. So, you are going to use the extra fat that your body has stocked up for famine days. As a matter of fact, your intake immediately post op will be reduced to a few hundred calories, and stay at below 1000 calories per day for a few months while your body is recovering from the surgery. Also, recovery from major surgery requires extra calories, which adds to the energy you need to sustain your body. These also are taken from your stored fat, along with the protein that you are required to get in because your body cannot provide the protein you need by itself.

Weightloss surgery is not another diet like Atkins, South Beach, Nutra Slim, and others. It physically prevents you from eating too much. At least in the beginning.


The normal stomach is about 10-11” long and 4-4.5” in diameter when stretched to maximum, and holds approximately just over a quart in volume. Pre-op, many of you must have stuffed it to the limit, then some more, more than once. Unfortunately, you can stuff a normal stomach some more. This is due to the (normal) movement called peristalsis where the stomach squirms and squeezes to push the food down. When you see your favorite food, and think “I want to eat that”, even if your stomach is full to the hilt, it will move faster and squeeze to push the food down, and make space for your favorite.

With the bypass surgery, the top portion of the stomach is stapled off to about the size of a golf ball from the rest of the stomach, and part of your intestine re-routed to decrease the area for absorption that the surface of the intestine provides. So, 1) your stomach cannot hold as much food at once as before and 2) the area that what food you are able to eat is absorbed is also reduced.

With lap band, a band is snapped around your stomach so the top portion will hold only a few oz at once, but the lower portion of the stomach and the intestines are intact, so the area for absorption is not changed.

With bypass surgery, as your new pouch recovers, its size will extend bit by bit, and become able to accommodate around 4-6, sometimes up to 8oz food from the original golf ball size. That is the most it will become able to stretch, though. Not the original one quart plus size. But, things can happen to sabotage this effect. One is that very rarely, the stoma--opening of the stomach to the bypassed small intestine-- stretches and gets larger than the inch or so size that it should be. If it gets larger, food will be able to slip out easily, making you feel hungry pretty fast, and have you eating more. On the other hand, you can sabotage the surgery by yourself by 1) grazing 2) taking liquids with your meals, which will allow the food to be pushed out of the pouch before you feel full, and 3) eating small volume high calorie foods like chocolate and sugar loaded stuff.

With many people, taste will change immediately post op, but eventually, normal taste comes back. So does your appetite. Only the amount you can actually eat, if you learn the Pouch Rules and abide by it, will be reduced to help you maintain and stay at your goal weight.

After the immediate physical effects of the surgery wears off, everything is going to be about making healthy choices, making healthy changes, and choosing to eat to live, instead of live to eat. No food will be off limits for you, unless you become intolerant to some things like lactose, sugar alcohols, or develop dumping with sugar, so it will be all about eating in moderation.

(((((((HUGS)))))))) May your journey go well.

[wannabethin]

Thanks for the good information, Doc. You always come through for us.

[ChuppyGirl]

Thank you Doc Sanea I like the thread very interesting information.

Keep posting your powerful knowledge I highly appreciate your support in the RR board.

Love ya
Hanadi

[ChoirSparkle]

Very cool stuff!

[SummerBreeze]

Doc, love how you explain things , simple and to the point so all can understand

[Mau177]

I have stalled in my weight loss. It has almost been 3 months (surgery on March 10th), I just recently started to get energy back. I'm surprised at myself that I wasn't exercising. Maybe some of it was emotional. I'm losing slowly the last month. A total of 40lbs since surgery. Today I made myself MAKE time for the elliptical and tomorrow I'm going to check out the local gym. I know I do not post very often, but I have to tell you that you are all angels and I love your posts. Thanks for the constant support.

[Ruby Tuesday]

So glad I read this.. you explained it very well. I had always thought that the no liquids with meals was cuz it would cause the food to 'swell' and could result in your pouch stretching.. but now I know it's something different.

[DocSanae]

Originally Posted by Ruby Tuesday

I had always thought that the no liquids with meals was cuz it would cause the food to 'swell' and could result in your pouch stretching.. but now I know it's something different.

Well, fluids do swell up some foods, especially if they haven't been chewed to mush. Sometimes, fluids can cause the swollen foods to get stuck in the pouch as well. If the food has been chewed to mush, it wil be all the more easier to flush it out of the pouch with fulids.

[dragonblade81]

Great information. I realize that for me I need to pick up on the exercise because while I run around with 3 kids all day that's not enough strength and cardio for me.