Looking back to when I had my gastric bypass surgery in 2003, I don’t believe that my bariatric surgeon really discussed the gastric bypass pouch rules or stressed their importance with me. I recall him saying, “I do the surgery. The rest is up to you.” So, I am very glad that I came across the “Pouch Rules for Dummies” published free online.
The “Dummies” version of the pouch rules was adapted from an original article written by Dr. Edward E. Mason, the “father of obesity surgery.” It is well-worth your time to read and follow these rules. They should be an intricate part of your bariatric lifestyle so as to achieve permanent weight loss.
Gastric Bypass Pouch Failure
In gastric bypass weight loss surgery, part of the stomach is used to form a small pouch. This pouch is separated from the remainder of the stomach and connected directly to the small intestine. Food enters the small stomach pouch and exits directly into the intestines, bypassing a part of the normal caloric absorption process.
A year or two after gastric bypass surgery, a common problem for patients is that they plateau at a level above their goal weight. Or patients regain weight from the total that was lost. The good news is that the gastric bypass pouch still works, and additional weight can be lost.
Following the Pouch Rules
Gastric bypass patients desiring to lose additional weight need to return to following the pouch rules. Namely: Fill oneself quickly with hard to digest foods; water load between meals; and increase exercise.
Excess weight should drop more easily than if the patient followed conventional diets designed for the average overweight individual who has not had obesity surgery. In fact, patients should be careful not to follow the advice given to the average overweight person, which is to eat several small meals and/or substitute a liquid protein meal for a solid food meal. This does not spell success for gastric bypass patients. Read, “Success Habits of Weight Loss Surgery.”
My personal experience confirms the value of the pouch rules for weight loss. I tried two well-regarded diets, neither of which resulted in weight loss after several months. I then returned to the gastric bypass pouch rules and lost 10-pounds in one month.
Ideal Mature Gastric Bypass Pouch
The gastric bypass pouch works best when the outlet, called the stoma, is not too small or too large. Keep in mind, regardless of the outlet size, liquids empty faster than solid foods and you will feel hungry sooner. Also, high calorie liquids surely will create weight gain.
Additionally, the pouch itself should hold only 1-½ cups of food. Following gastric bypass surgery, it is not important what the size is of the newly created pouch. By following the “rules of the pouch,” the feeling of fullness with 1-½ cups of food can be achieved.
How to Eat with a Mature Gastric Bypass Pouch
1. The ideal bariatric meal consists of the following:
½ of the meal is low fat protein
¼ is raw or lightly cooked low starch vegetables, and ¼ is raw fruit
This type of meal will stay in the pouch a long time and maintain satiety.
2. Eat meals five hours apart.
3. Fill the pouch full quickly at each meal:
Eat the entire meal in 5-15 minutes.
A 30-45 minute meal will cause failure.
4. Stay full by slowing the emptying of the pouch:
Eat solid foods only.
No liquids 15 minutes before meals, and no liquids until 1 ½ to 2 hours after the meal.
A scientific test showed that a meal of egg/toast/milk had almost all emptied out of the pouch after 45 minutes. Without milk, just egg and toast, more than ½ of the meal still remained in the pouch after 1 ½ hours.
Fifteen minutes before a meal, drink as much water as possible as fast as possible (“water loading”). This will keep you from getting thirsty during and after the meal.
You can water load at any time 2-3 hours before your next meal if you get hungry. This will cause a strong feeling of fullness for 15-25 minutes.
Three Principals for Permanent Weight Loss
1. Weight loss surgery patients need to understand how the new gastric bypass pouch physically works.
2. Weight loss surgery patients need to be able to evaluate their use of the tool, compare it to the best use of the tool, and determine where they need to make changes.
3. Weight loss surgery patients need to understand not only how, but also why they need to learn to use their gastric bypass pouch. The goal is for the patient to become an expert on using the pouch.
For further reading, check out, “4 Strategies to Weight Loss Surgery Success.”
Living larger than ever,
My Bariatric Life
Photo: Everyday Health