Stomach shrinkage

[Luciana]

I have many questions about it, as the whole thing is very confusing to me.

From what I understand, stomach walls stretch or shrink depending on the amount of food you're used to having. So if you overeat for a week, or even less, your stomach will be larger and you'll need more food to feel satiated. Similarly, undereating for a few days will make your stomach shrink, so that from now on you'll be satisfied with a small portion.

I know this is how I start a diet - eat very little for three days. The hunger is bad, but soon enough it's less of an effort to eat very little and the diet feels smoother from day one.

Do liquids influence in this stretching/shrinking thing? That is, once you drink more than what you need, will the "extra" water contribute to expand your stomach?

Many times I see dieticians suggesting that if you're feeling hungry, a glass of water would help. And I can't help but wonder if that's not counterproductive. Not to mention the dreaded "water is good for you" so you should drink it as much as possible. Aside from making my kidneys overwork, I don't see the benefit. And if it keeps your stomach large... come on.

The other question pertains to how fast a stomach can shrink/expand. I'd say two or three days, but I'm not sure.

This thread was prompted by the "detox" diet one, which I did not mean to derail. The general idea is that two days of feeling hungry, be it with juice-only routine or any other way, is not entirely bad because if you start a diet soon after you will have paved the way for consuming smaller portions and being happy with that.

[El Greco]

I don't know details about stomach shrinkage, but I know that the major regulator of hunger is, unfortunately, the number of calories you eat. Other factors do play role, but unfortunately less important. Eg: exercise; macronutrient ratios; amount of fiber; sleep; stress; food variety; food texture; etc. If feeling bloated was that important, then we could keep ourselves bloated with water all the time and not be hungry.

[bjb]

I don't have any good evidence for you, but I do have an anecdote. Two years ago, my wife went on the South Beach diet and while it's been working well, it has become a bit tiresome. A few weeks ago, we started using a Weight Watchers trick of eating cabbage soup before each meal. The soup itself doesn't contain very many calories but it tastes good and is very filling on its own. Dinner itself wil be just a few small pieces of chicken or maybe even a single meatball (turkey). I've come up with variations on the basic cabbage soup and I've even made some other non-cabbage based vegetable soups. They all turn out well and help make the South Beach diet more tolerable.

This soup diet works and I have lost about 8 pounds even though I'm not actually on the diet. An interesting side effect is that my wife eats less at each meal than she used to. I honestly don't understand because the actual *volume* of the meal (soup + dinner) seems larger than before. But now when she gets her regular lunch an El Pollo Loco, she's is physically unable to finish it whereas she was able to finish it before the soup diet.

The advantage of this diet is that you never feel hungry. Don't forget that starving yourself causes your metabolism to slow down which diminishes the effect any diet. Weight Watchers allows you to eat as much of the vegetable soup as you like. The vegetables can be pretty much anything. Fresh vegetables are best but we've made decent soup using a big can of chicken broth and a bag of frozen vegetables. I like to use the frozen stir-fry veggies since they don't contain peas or potatoes. Those are starchy vegetables and the South Beach diet discourages them.

[Deetee]

Originally Posted by Luciana Nery

Do liquids influence in this stretching/shrinking thing? That is, once you drink more than what you need, will the "extra" water contribute to expand your stomach?

You mean all those litres of extra diet coke, surely......

I do not think this stretching/shrinking theory holds any water. However if you do drink and fill your stomach with water, there will be less stimulus to eat as you will feel fuller (but only for a while).

[Dr. Imago]

Originally Posted by Luciana Nery

From what I understand, stomach walls stretch or shrink depending on the amount of food you're used to having.

I think this is probably, like Deetee says, more of an "old wive's tale" than it is the truth.

The fact that your stomach gets "used to" a large volume of food probably has to do more with the interplay of hormones (like CCK, gastrin, etc.) when you regularly overdistend the stomach, as opposed to the actual size of the stomach increasing. The body responds and adapts to repeated stimulation, in whichever form that takes, often by "upregulating" hormones and other transmitters to accomodate the new "set point" that it's gotten accustomed to. When you suddenly take away the stimulus, in this case lower the amount of food intake, you end-up in a short term oversupply of now-unnecessary hormone. We know that these hormones also have powerful effects on our appetite centers. We are trying to better undestand the different effects on satiety centers, and whether or not there are other factors at play.

In other words, when you don't trigger the release these stored hormones by giving the body the amount of food it's come to expect, they have a secondary action of putting your hunger into overdrive in an attempt to compel you to eat. Same thing with the "stretch" and satiety (or feeling of fullness), although this is less well-understood when compared to the previous. It has less to do with the actual adaption in size, or hypertrophy, of the stomach. I've seen plenty of gastric bypass procedures, and there has never been a huge-sized stomach sitting in there waiting to be stapled.

Did that make sense?

-Dr. Imago

[tkingdoll]

I usually only eat once a day, and I'm thin. I'm almost never hungry until about 8pm (we eat around 9pm).

However, if I eat breakfast, I am starving by lunchtime, and if I eat lunch, I'm hungry again by about 7pm. If I ate breakfast, I'd be a three-meal a day girl and , presumably, three times the size.

Eating more definitely makes me hungrier.

[CFLarsen]

Originally Posted by Luciana Nery

I know this is how I start a diet

Řeh.....why?

[CFLarsen]

Originally Posted by tkingdoll

I usually only eat once a day, and I'm thin. I'm almost never hungry until about 8pm (we eat around 9pm).

However, if I eat breakfast, I am starving by lunchtime, and if I eat lunch, I'm hungry again by about 7pm. If I ate breakfast, I'd be a three-meal a day girl and , presumably, three times the size.

Eating more definitely makes me hungrier.

There is some truth to this.

I have been to some gourmet dinners (with exquisite wine, the main reason), and it is always a very good idea to over-eat 1-2 days before, at regular meals, to get your stomach used to handling large quantities of food.

It is not something you should do every day, of course.... Once or twice a year will do nicely.

But you definitely need to eat at least twice a day anyhow. Eating once a day is notsa good.

[blutoski]

Originally Posted by Luciana Nery

Do liquids influence in this stretching/shrinking thing? That is, once you drink more than what you need, will the "extra" water contribute to expand your stomach?

The other question pertains to how fast a stomach can shrink/expand. I'd say two or three days, but I'm not sure.

I've been digging into this to support my exploration into a career as personal trainer. There's a lot of information out there, so confusion's justifiable.

The most scientifically based weight plan I've ever come across is 'volumetrics'. Contrary to El Greco's suggestion, volume seems to be an important factor to satiety. Soups are extremely effective in reducing caloric intake because they have low calorie density. They also take longer to eat, and satiety can kick in before you've overeaten.

Dr. Barbara Rolls has published a book on the subject, with impressive peer-reviewed support.

The stomach does not stretch or shrink over such short timespans as a few days. However, there are 'stretch' receptors which are intended to detect overeating and trigger appetite suppression via satiety hormones. If you challenge these receptors, they will establish higher thresholds for satiety, giving an effect that mimics a larger stomach. The opposite happens when you undereat for a few days.

The stomach *can* stretch over time, though. This is partly why 'stapling' surgeries are only a temporary solution: many patients re-enlarge their newly shrunken stomachs and end up right back where they started.

[El Greco]

Originally Posted by blutoski

The most scientifically based weight plan I've ever come across is 'volumetrics'. Contrary to El Greco's suggestion, volume seems to be an important factor to satiety. Soups are extremely effective in reducing caloric intake because they have low calorie density. They also take longer to eat, and satiety can kick in before you've overeaten.

I'm aware of such studies. I have even posted a couple here myself. However, I still have to see any long-term follow-up studies that show any worthy results in fat loss attributable solely in food volume. As I'm sure you know, there are lots of short-term intervention methods that seem promising and even have studies in favor of them. Eg, more and better sleep seems to reduce caloric intake in obese individuals, but has anyone permanently lost weight just by adjusting his sleep patterns ?

Anyway, I'm interested in this and if you have the time I'd like to see such studies. Are they cited in Barbara Rolls's book ?

[El Greco]

And here are a couple of relevant studies, with bold and underlining mine:

Quote:

Volume and variety: relative effects on food intake.

Norton GN, Anderson AS, Hetherington MM.

School of Psychology, University of Liverpool, Liverpool L69 7ZA, UK.

Volume has been shown to be an important direct control of food intake, since larger volumes of food consumed prior to a meal can inhibit subsequent intake. Variety of food is known to stimulate food intake. The present study was designed to examine the relative effects of manipulating the volume of a soup preload in the context of providing either a single or a variety of sandwich fillings. Thirty participants (15 females; 15 males) attended the laboratory on 4 occasions to receive a low (f=240 ml, 3.6 kJ/g; m=300 ml, 3.6 kJ/g) or high (f=480 ml, 1.8 kJ/g; m=600 ml, 1.8 kJ/g) volume tomato soup preload 30 min before a sandwich lunch with either single or a variety of fillings. Overall, subjects reported significant differences in hunger and fullness as a function of volume manipulations but the satiety quotient (SQ: change in ratings divided by weight of soup) calculated just before lunch indicated a smaller SQ for high than for the low volume soup. Therefore, although subjective ratings were influenced by volume this was not sufficient to affect intake at lunch. Variety (2344+/-200 kJ) increased food intake at lunch compared to the single filling condition (2062+/-171 kJ), an enhancement by variety of 14%. In conclusion, lowering energy density and increasing volume by adding water failed to reduce intake at lunch. Clearly volume effects on intake rely both on amount consumed and energy density. As predicted, variety stimulated food intake and this occurred across volume conditions.

Quote:

Macronutrient and dietary energy density influences on the intake of free-living humans.

de Castro JM.

Department of Psychology, University of Texas at El Paso, El Paso, TX 79968, USA.

The influence of the composition of foods, their macronutrient contents and the dietary energy densities on intake, were investigated by analyzing 7-day diet diary reports from 669 free-living normal adult humans who adequately reported intake. The analyses revealed subtle but small macronutrient specific relationships with intake. Dietary energy density, however, was found to have large reliable short-term relationships with intake. The results support the hypothesis that short-term intake is controlled on the basis of the volume of nutrients in the stomach at the end of the meal and not upon their food energy or macronutrient contents.

ETA: Of course there still is the satiety index which tries (probably more accurately than food volume) to predict satiety after meals. To my knowledge, this too has not been effectively used in long-term fat loss plans.

[Deetee]

Originally Posted by tkingdoll

I usually only eat once a day, and I'm thin. I'm almost never hungry until about 8pm (we eat around 9pm).

However, if I eat breakfast, I am starving by lunchtime, and if I eat lunch, I'm hungry again by about 7pm. If I ate breakfast, I'd be a three-meal a day girl and , presumably, three times the size.

Eating more definitely makes me hungrier.

We know all about you dinners......

If you eat a carbohydrate load, this stimulates insulin production. If the carbohydrate you ingest is rapidly metabolised (unlike the slower release
types) there will be a form of insulin overshoot, where the insulin you produced is still active, lowering your blood sugar an hour or 2 after the meal. This prompts hunger, to cope with your low blood sugar. This explains why often a huge feast (of the "wrong" type of food) only satiates you for a few hours, rather than the whole day.

[hgc]

I don't know much about the stomach shrinkage thing. But it is as always the number of calories primarily to be concerned about, as El Greco stated. Last year, I dropped 50 lbs in 6 months, and kept it off for over a year now. The most important thing I did to achieve this was eating less (measured by calories), obviously. But how? My initial detox period wasn't focused at all on portion control, but on types of foods to be avoided - namely carbohydrates from most sources (including fruit). I then re-introduced foods gradually, such as fruit, brown rice, whole grain breads, sweet potatoes, etc. It's important to be aware of the difference between food bulk and caloric value. If you are filling up on nutritionally non-dense foods, you will feel full before you have consumed an unreasonable number of calories. You may even be eating more by bulk, and still losing weight. I suggest cutting sugar, especially from liquid sources such as soda and fruit juices (I've completely and permanently eliminated orange juice); white rice, white flour, potatoes. Fill up on lean meats, high fiber veggies and fruit in it's solid original form. Avoid pre-processed foods; get foods as close to natural state as possible, and let your body do most of the processing. This slows down the absorption rate of carbohydrates into your blood stream, avoiding insulin spikes and crashes, and that whole vicious carb craving cycle.

[blutoski]

Originally Posted by El Greco

I'm aware of such studies. I have even posted a couple here myself. However, I still have to see any long-term follow-up studies that show any worthy results in fat loss attributable solely in food volume. As I'm sure you know, there are lots of short-term intervention methods that seem promising and even have studies in favor of them. Eg, more and better sleep seems to reduce caloric intake in obese individuals, but has anyone permanently lost weight just by adjusting his sleep patterns ?

Originally Posted by El Greco

Anyway, I'm interested in this and if you have the time I'd like to see such studies. Are they cited in Barbara Rolls's book ?

Yes, each chapter has footnotes, most of which include citations. There are hundreds, so I'm not sure where to start. The chapters are organized into themes, some of which discuss comparison between successes of different strategies. Others are just about one or two different strategies and their mechanisms.

It's probably self-evident that there's no one perfect diet, but volumetrics as a strategy is demonstrated to work. Where it fails is that it is a substitution diet. Certain foods cannot be eaten in the quantities that their fans would like: you can't consume unlmited soft drinks. For some people, that's a sacrifice, and the diet isn't sustainable. But compared to other diets where this also holds true, this shouldn't be a criticism.

[Dr. Imago]

Originally Posted by blutoski

The stomach *can* stretch over time, though. This is partly why 'stapling' surgeries are only a temporary solution: many patients re-enlarge their newly shrunken stomachs and end up right back where they started.

I would like to comment on this, however I cannot at this time because there are several different techniques (I've personally see 6 done in the OR) of gastroplasty you may be referring to. Do you have a particular technique about which you are making this claim? Or, do you believe this will happen with all techniques?

Most "failures" I've seen with gastroplasty (i.e., patients not achieving their weightloss goals) have more to do with failure to exclude high-calorie liquid components from their diets. Most will continue to drink large amounts of sugar-containing sodas, milkshakes, puddings, etc. and/or eat more easily digestible food more frequently. In other words, they "adapt" their eating habits to the new stomach, and not the other way around.

-Dr. Imago

[Dave1001]

Originally Posted by Luciana Nery

I have many questions about it, as the whole thing is very confusing to me.

From what I understand, stomach walls stretch or shrink depending on the amount of food you're used to having. So if you overeat for a week, or even less, your stomach will be larger and you'll need more food to feel satiated. Similarly, undereating for a few days will make your stomach shrink, so that from now on you'll be satisfied with a small portion.

I know this is how I start a diet - eat very little for three days. The hunger is bad, but soon enough it's less of an effort to eat very little and the diet feels smoother from day one.

Do liquids influence in this stretching/shrinking thing? That is, once you drink more than what you need, will the "extra" water contribute to expand your stomach?

Many times I see dieticians suggesting that if you're feeling hungry, a glass of water would help. And I can't help but wonder if that's not counterproductive. Not to mention the dreaded "water is good for you" so you should drink it as much as possible. Aside from making my kidneys overwork, I don't see the benefit. And if it keeps your stomach large... come on.

The other question pertains to how fast a stomach can shrink/expand. I'd say two or three days, but I'm not sure.

This thread was prompted by the "detox" diet one, which I did not mean to derail. The general idea is that two days of feeling hungry, be it with juice-only routine or any other way, is not entirely bad because if you start a diet soon after you will have paved the way for consuming smaller portions and being happy with that.

My experience mirrors yours. It's usually easier not to eat or drink anything, than to only drink water.

A good technique is what I call the "ramadan diet", don't eat or drink anything until a couple hours before you go to sleep, then injest the water and calories you plan to have for the day. That way your body has 8 hours of sleep for your stomach to shrink again.

[blutoski]

Originally Posted by Dr. Imago

I would like to comment on this, however I cannot at this time because there are several different techniques (I've personally see 6 done in the OR) of gastroplasty you may be referring to. Do you have a particular technique about which you are making this claim? Or, do you believe this will happen with all techniques?

Most "failures" I've seen with gastroplasty (i.e., patients not achieving their weightloss goals) have more to do with failure to exclude high-calorie liquid components from their diets. Most will continue to drink large amounts of sugar-containing sodas, milkshakes, puddings, etc. and/or eat more easily digestible food more frequently. In other words, they "adapt" their eating habits to the new stomach, and not the other way around.

-Dr. Imago

That's probably true. The case I'm most familiar with was a coworker who underwent stapling in 1988, and again in 2002. Allegedly, the stomach had more capacity the second time around. This is a 24-year time interval.

[Luciana]

Folks, I appreciate the replies, but I need some times to digest some of those long words. I'll get back to you later.

[blutoski]

Originally Posted by Dave1001

A good technique is what I call the "ramadan diet", don't eat or drink anything until a couple hours before you go to sleep, then injest the water and calories you plan to have for the day. That way your body has 8 hours of sleep for your stomach to shrink again.

Of course, there's always the "paranoia diet":

PartiallyClips

[blutoski]

Another possibly relevant new paper re serving size:

nytimes: Seduced by Snacks? No, Not You