Anyone else just hear that NPR piece?

I went to a bariatric symposium several months ago.  It was put on by the hospital where I work now and where I had my surgery in 2013.  All 3 bariatric surgeons said they have gone in and done revisions, scopes, etc. on sleevers and reported that they have never seen an "enlarged" or "stretched out" sleeve.  They said what happens over time is that the sleeve becomes much more pliable ie. flexible.  And as always, the foods that this more pliable sleeve will rush to accommodate are the nice, starchy carbs that break down very quickly into mush - crackers, cookies, cake, ice cream, chips.  You get the picture.  

The sleeve doesn't need to be made smaller for people to be successful, although I'm sure they convince themselves of that.  People need to eat a protein forward diet with green veggies for carbs and stay away from sugar and starchy crap food and treats.  

Weight loss surgery doesn't fail people.  People fail their surgery.  

I think you're right.  I definitely feel my VSG is a tool and not a failsafe answer. We know the right things to do. I really think the support network is the biggest part of making this work.

That is what my surgeon told me.  It does not stretch out of shape but it does get more pliable.  Maybe somewhat semantics as the end result is that you can eat more food.  And I agree that eating the wrong foods will cause weight gain regardless.  My surgeon wants 3 meals a day with no snacking.   He feels that is best for long term success. 

I know it is going to be a daily battle with me to avoid the starchy foods.

At 4.5 years out, I will say that I can certainly eat more than I could early out.  My capacity is on the small side of normal, and definitely more restrictive on dense proteins.  I doubt if anyone who didn't know I had WLS would think twice about how much I eat these days (unlike early days when someone said I ate like a bird, LOL!).  And hunger does come back.  All that said, though, I've found that regain is a function of WHAT I eat, not how much.  (I tend to move up and down the scale about 7-10 lbs.)  In my pre-WLS life, I was both a volume eater and a carb addict - meaning I usually ate huge amounts of carbs.  Now the volume issue is mostly resolved (I say mostly because I could still eat every hour or two to get in more volume if I wanted), and the content of my meals is on me.

I think it is very prudent of you to point out that our  sleeves have less capacity, but does empty faster than a normie. The reduced capacity will not be as helpful if we eat three times as often in other words. My only long term concern is ghrelin returning. I had a period there where I had psuedo hunger pains (turned out to be a temporary acid issue) and my calories really spiked up. I do great if I make healthy choices, but crap food is everywhere. I think that is why it is so important to stay plugged into some sort of a support group. The normies as a whole have weight issues, and if your peer network is comprised of mostly overweight to obese folks it makes it soooo much easier to fall back into the old eating habits that got us in this mess to begin with. 

I think the woman they profiled was sort of a ridiculous example. She didn't fail at bariatric surgery. Her bariatric surgery didn't fail her. She lost 175 lbs. After a whopping 10 years, she regained 20. Essentially, she regained 10% of what she lost. That's a slip that she could have handled without another procedure--not evidence that any part of bariatric surgery doesn't work or may require revision a decade down the road. That's evidence that human beings are human, and our bodies are biologically driven to retain fat. 

If she had regained 100, or 70, or even 50...maybe. But I question the morality and ethics of essentially performing surgery on someone who needs to lose 20 lbs.

The procedure that article is referring to is for RNY patients only. It reduces the size of the stoma, and VSGers don't have a stoma.

Studies of postops with significant regain show there is very rarely an issue with the size of the stomach or stoma. The phrase "your eyes are bigger than your stomach" are most apt. After 2, or 5, or 10 years, people are often eating more, eating more often, and eating more calorie dense foods. This is just bad habits and bad choices.

I thought it was an interesting article and a good cautionary tale.  I'm glad NPR shared it!