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How to Reset Your Gastric Bypass Pouch

How to Reset Your Gastric Bypass Pouch

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      Gastric bypass surgery is the most effective tool for obese patients to lose weight. Although patients typically lose weight rapidly during the first several months after surgery, it’s normal for weight loss to slow or even plateau over time. It’s also possible for patients to regain weight if they fail to continue a healthy lifestyle after surgery.

      Regaining weight can be devastating. The “gastric bypass pouch reset” is essentially a 5-day diet that was created by a gastric bypass patient who was frustrated by weight regain. She claims that following this diet reset tightened her stomach, decreased hunger and cravings, and reset her mindset.

      Person standing on the scale.
      Keep up with a healthy lifestyle to avoid weight gain after gastric bypass.

      Weight Gain After Gastric Bypass

      Although the majority of gastric bypass patients maintain weight loss successfully, 10-20% of patients experience weight regain starting 12-18 months after surgery. Gaining weight is discouraging, leaving patients feeling as if they have failed their most promising option to lose weight for good.

      Many studies point to poor diet, sedentary lifestyle, and lack of follow-up with a nutrition professional as the key culprit for weight regain. Whether you’re considering gastric bypass, you’re freshly post-op, or you’re struggling with weight regain, it’s essential to know how these factors can influence your success with weight loss surgery.

      Diet and Exercise After Gastric Bypass

      The diet that immediately follows gastric bypass surgery is very strict. It is low in calories, high in protein, and restricts foods that are high in fat and sugar. This diet allows rapid weight loss for months after surgery. However, as your body adjusts, you can tolerate a wider variety and volume of food at once.

      It’s important to remember that gastric bypass isn’t a magic solution when it comes to weight loss. It is merely a tool to facilitate weight loss. If a patient returns to unhealthy eating habits after gastric bypass surgery, it is unlikely that the patient will maintain his or her weight loss.

      Likewise, gastric bypass patients need to keep an active lifestyle after surgery to enable ongoing weight loss and prevent weight regain. As your body adjusts and tolerates more calories during meals, staying active will burn calories.

      Diagram illustration of the stomach.
      Gastric bypass surgery replaces the stomach with a small pouch.

      Changes to Your Stomach After Gastric Bypass Surgery

      During gastric bypass surgery, a small pouch replaces the stomach. This pouch only holds 1 or 2 ounces of food and liquid. As a patient heals from surgery and their diet progresses to solids, the pouch will stretch to some degree to hold more food.

      As time goes on, the stoma which connects the pouch to the jejunum of the small intestine may also stretch. Some believe that the larger stoma decreases fullness and satiety, which leads to weight gain. Although the larger stoma may increase the risk for weight gain, some studies argue that the way a patient utilizes their pouch has a more significant impact on weight gain.

      In other words, a patient whose diet consists of foods high in fat, sugar, and calories is likely to gain weight, even if their pouch has not stretched. On the other hand, a patient who sticks to a high-protein diet supported with complex carbohydrates, fruits, and vegetables is less likely to gain weight, even if their pouch is larger.

      Measuring spoons.
      The gastric bypass pouch reset test claims to measure how much a pouch has stretched.

      What Is A Gastric Bypass Pouch Reset Test?

      The “Gastric Bypass Pouch Reset Test” is also referred to as the “Cottage Cheese Test.” This test claims to reveal if the stomach has stretched. However, no studies exist to prove this theory.

      First, the patient measures 8 ounces of cottage cheese or mashed potatoes. Then, the patient eats until he or she is full. Next, the patient subtracts the remaining food to calculate how much cottage cheese fit into his or her pouch. The stomach is deemed to be “stretched” if the reset test indicates more than 5 ounces of food fit into the pouch.

      It is best to consult with your doctor if you have questions about your pouch stretching.

      What Is the “Pouch Reset Gastric Bypass Diet?”

      The gastric bypass pouch reset diet is a 5-day diet designed by a bariatric surgery patient who experienced weight regain. The structure of the diet looks like this:

      Day 1: Clear liquids such as water, tea, sugar-free drinks, and broth

      Day 2: Incorporate thick liquids, as well as 3 protein shakes per day

      Day 3: Continue 3 protein shakes and incorporate soft solids such as cottage cheese and yogurt

      Day 4: Soft solids

      Day 5: Firm solids

      After day 5, patients should resume their regular diet.

      The curator of this diet claims that this plan will get patients back on track for the weight loss surgery lifestyle. She also claims that this diet will shrink the pouch, reduce cravings, and decrease appetite. However, none of these claims are scientifically proven.

      Coffee cup sitting on a table.
      It's important to remember that you can reset your pouch at any time after surgery.

      How to Reignite Weight Loss After Gastric Bypass

      If your weight loss has plateaued or you’re gaining weight, there are many proven ways to get back on track. Remember, gastric bypass surgery is just a tool. Take a look at your lifestyle and see if there are some areas you can tighten up to promote weight loss.

      Back to the Basics With Diet

      Rather than returning to the post-op diet, focus on the weight loss surgery diet principles.

      • Fluids - Don’t drink 15 minutes before meals, and limit drinking for 30 minutes after meals. Liquid moves food out of your pouch more quickly, which may make you hungry sooner.
      • Eat slowly - Chew thoroughly and pace yourself at meals to prevent overeating and increase satiety.
      • Protein - Include high-quality protein with each meal. Also, decide if you are still benefiting from protein shakes. You may not need them if they no longer keep you full, and you get enough protein from food.
      • Limit foods high in fat and sugar - These foods are high in calories and low in nutrients. Furthermore, these foods are likely to cause uncomfortable symptoms of dumping syndrome.
      • Limit or avoid alcohol - alcohol is high in calories, especially in mixed drinks.
      Man running on the road beside a body of water.
      Exercise is essential for a healthy lifestyle after gastric bypass surgery.

      Keep Moving With Exercise

      It’s easy to get off track when it comes to exercise. If you’re struggling to exercise consistently, start small to get back to your goals. Set a step goal for yourself or set a goal to talk 3 short walks per day. Build onto your small goals once you get back into the habit of exercising. Aim to get at least 30 minutes of activity each day.

      Once you have a steady foundation for exercise, build onto your goals with a variety of exercise, or by incorporating weights into your routine. Of course, talk to your doctor before beginning any new exercise.

      Key points to stay on track with your weight loss surgery goals

      • Overcoming obesity is a journey that requires permanent change.
      • Claims that the gastric bypass pouch reset will shrink your stomach, reduce cravings and curb cravings are not backed by science.
      • What you put in your pouch has more impact on weight loss than the size of your pouch.
      • Focus on diet and exercise to continue weight loss.

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        Breanna Woods, MS, RDN


        Breanna Woods is a registered dietitian with over 5 years of experience in the clinical field. She has a master’s degree in food and nutrition, and strives to guide others to a healthy lifestyle.

        Gintas Antanavicius, MD, FACS, FASMBS

        Medical Reviewer

        Dr. G is a co-founder of BariBuilder. A US-based expert surgeon with over 10 years of bariatric experience, he regularly publishes research in medical journals like SOARD, Obesity Surgery, etc.