I'm kind off freaking out, my problem is that I'm a volume eater I like to eat till I feel full never been a grazer. So I think the sleeve is gonna do great for me. But I've spent a few days looking at the DS topics and it seems that they can eat a lot! How is that,  don't they have a sleeve also, will we all eventually be able to eat like we used to? I'm freaking out a bit, I'm pre op.

I don't think either DS or VSG patients can just go back eating like they used to. In fact I think that is impossible as there is restriction there, and the sleeve doesn't expand much at all, so I think the restriction is always there. I hear the DS is a little more forgiving as far as what we eat because of the malabsorbtion created by rerouting the small intestine. With the VSG we must be careful that we stick with heavy proteins first, avoid carbs, and be careful not to drink our calories. But if you are worried about losing the restriction, I think there is no need to worry.

As time goes by, your stomach capacity naturally increases. Will you always have restriction? Probably! But, it is important to keep in mind that you can eat larger volume the further out you get and if you are eating foods that are easily digested (oh you know, the ones that taste good! haha, like cake, cookies, etc.) then you eat quite a bit of it at a time. Not only that, but you can continue to eat it allllll day long. Which means, throughout the course of a day, you can eat a large volume and a lot of calories! I know I personally have been surprised by just how much I can pack away if I try!

I had looked into the DS for years before deciding on the sleeve. From what I know, DS patients lose their weight PRIMARILY through malabsorption. The restriction is just a small factor. The size of their "sleeve" does not matter in the least bit in comparison to how much the size matters for us. 

Make sure you ask your surgeon the size of your sleeve and then consult with the veterans on here. I honestly forget the size of my sleeve but I know it is on the small end of the scale. We will increase capacity somewhat in our stomachs (I know I can eat more now than I could 8 months ago) but it will NEVER stretch anywhere close to where we were before! You have to remember, our stomachs will go from roughly 64oz in size (someone correct me if I am wrong there but I believe that is the size of a normal stomach) to only about 2-4oz in size. Even if it somehow stretches to 10oz, that is not even close to the original stomach. This is a long term thing. Can you trick it? Perhaps... but for me, the restriction has been consistent no matter if I am eating or drinking. I cannot down a bunch of ice cream because its liquid. I can only handle small amounts of anything (even water sometimes which sucks) at any given time. Now if my stomach is completely empty, then a none-fizzy liquid like water will go down smoothly with no issue. However, if there is any thickness to it, I have found in my own personal experience, I always have a restriction. Now I am only a year out... so could it be different in another year? Maybe. Too soon to tell. However, I listen to my body, I don't over eat, and I tend to feel just fine!

Also... you will end up losing some of the hunger hormones because of the part of the stomach that is removed. So, you wont really WANT to eat as much. The only time I feel REALLY hungry is when I have been really active and have not eaten much of anything for awhile. Otherwise, I tend to eat mostly because I know I should. 

I hope this answers your question and relieves some of the stress! Life is so much better on the other side! Less to stress about. :) You got this!

Anecdotally, I find if I get carby, my sense of restriction disappears and I feel like I could drive a truck through my sleeve. If I eat the way I'm supposed to e.g. dense proteins first, the restriction is all still there. Lesson learned: follow plan now and forever. :)

Laurie

I too am a volume eater.  But my sleeve doesn't allow me to eat in anywhere near the quantities I could pre-op.  Your restriction is greatest the first few months.  After that, you'll find that your capacity increases but not by a whole lot.  I know that now I can definitely put down more food than I could 6 weeks post-op (when I was allowed to eat a full solids diet), but nothing approaching what I could eat pre-op.

Lesson here:  eat mostly dense proteins and your restriction will kick in and keep you satiated so that you don't HAVE to eat until you're full.  Eating until full isn't the point--eating until satisfied is.  Remember your sleeve is only a tool and that your behavior MUST change in order for it to be truly effective.  Without behavior modification, your tool will fail you.

There are a couple of major factors at play as to why the DS tend to eat more than sleevers.

One is that the DS is usually made with a larger version of the sleeve - a 60 bougie would be typical for a DS (for those docs who use them) while 32-40 is the normal size range for a stand alone sleeve these days. My wife's DS stomach was about 4 oz at time of surgery while my sleeve was about 2.5 oz. One can expect somewhat proportional growth in the stomach size with maturity (though the exponential growth suggested by some micro-sleeve advocates seems to be "stretching" things a bit - my wife's capacity at maturity is maybe 20-25% greater than mine.)

Another major factor is that a DSer, by way of their malabsorption, simply needs to consume more to maintain their weight than a comparable sleever. A sleeved person may need to limit themselves to, say, 1200 calories per day in maintenance (a not unusual number for an "average" woman post-op) while a comparable DS person may need 2400 calories, so their postings tend to reflect this greater emphasis on eating more. One can eat more with a typical sleeve if one is so inclined - you can eat around any WLS - and techniques such as using more sliders (generally the "good" kind like fruits and veg, as opposed to the "bad" kind such as chips and Twinkies,) and more fats in the diet allow us to tailor things for our individual metabolic requirements in the long term. I need around 2000 calories per day to be stable, so my eating style is somewhat different than one who needs to limit themselves to 1200 calories, and one who needs 3000 calories (either by way of the DS, or very high activity levels driving a high metabolism,) will be different yet.

So, short answer is that yes, eventually you may, at least partially, be able to eat like you used to, if that involves lots of sliders (particularly high calorie junk) and that is also a danger as it can lead to regain if you haven't adopted better eating habits than what got you into the WLS game in the first place. But the sleeve does allow some leeway in adopting new, healthier habits while you are losing (or preferably even before.)

The DS sleeve is USUALLY made quite a bit larger than a sleeve. They have to be able to eat more because of their malabsorption. It's in their best interests of course. Even DS'ers have to watch carbs and sugar.  Make sure your doctor is known for a nice, tight sleeve and has a good aftercare program. That will help you a lot at accomplishing what you need to. 

I was a MAJOR volume eater. I ate 3 meals a day and didn't snack much at all. Those meals, however, were huge. Large man portions. The sleeve has basically cured me of that issue. I still don't snack much at all. However, my meals are high quality protein mostly and a bit of complex carb. I NEVER eat meals of entirely carbs. Ever. If I did I can bet I'd have gained back quite a bit of weight. Yes it's true that carbs slide down faster and easier. Try to eat protein mostly and be sparing with carbs. Never eat carb only meals if you can help it. Focus on the proteins. And never forget where you came from. The sleeve is a true gift.