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Gastric Sleeve Pouch Reset

Gastric Sleeve Pouch Reset

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      Have you had, or are you considering having, vertical sleeve gastrectomy? If so, educating yourself before surgery, and throughout the journey, will help improve your long-term post-surgical success. No matter what stage of the process you are in, keep in mind, there are times that you will feel the process is more natural and then times when you think things are more complicated. Everyone who undergoes gastric sleeve surgery feels this way.

      Weight loss is a journey, and no two people experience it the same. Even the most determined people will experience highs and lows following gastric sleeve surgery. Having difficult moments is not a sign of failure. The success of any weight loss surgery depends on several factors, including following the advice and guidance of the surgical team, adhering to a post-operative diet and learning how to identify and modify unhealthy eating habits following surgery.

      Woman holding out her pants to show how big they are.
      Weight loss is a journey, and sometimes a fresh start is all you may need to reset your weight loss.

      Is It Really “All In Your Head”?

      The first year following sleeve gastrectomy is known as the “honeymoon” phase. During this time, patients have limited hunger, eat tiny amounts of food, and often struggle with consuming the recommended amount of food daily. As the body adjusts to a smaller stomach size and the incapability of consuming large amounts of food, the weight seems to disappear rather quickly.

      Unfortunately, the honeymoon period does not last permanently. As individuals get closer to the first anniversary of the surgery, it becomes easier to consume larger volumes of food, and the feeling of hunger becomes more pronounced. For this reason, it is crucial to learn to distinguish between head hunger and real physical hunger. Failure to do so, coupled with the ability to eat more food, can result in regain.

      Colorful, abstract painting of a woman's face.
      Learning to differentiate between physical hunger and head hunger may feel overwhelming.

      Perhaps one of the most frustrating issues to deal with is the fact that changing the size of the stomach does not automatically change the way the mind relates to food. Head hunger, often referred to as emotional hunger, is the desire a person feels to eat for any reason other than physical hunger. Head hunger is real, and it is a common barrier to weight loss. Nevertheless, despite this hurdle, you can overcome it!

      Learning to identify and modify unhealthy eating habits is one of the most important things a person can do to help improve the chances of success following any bariatric surgery. Talking with your surgeon and care team will help you learn what to expect both pre- and post-surgically. Additionally, close follow-up with your medical team will be of great benefit as the team can help monitor your progression through your weight loss journey.

      The Dreaded Question: What If I Experience Regain?

      Despite being a great tool to fight obesity, bariatric surgery is not a magic “fix-all”. The post-honeymoon weight regain that many experiences can be attributed to several factors.

      As time progresses, some individuals revert to making poor food choices, similar to those they made before surgery. One of the most common mistakes that bariatric patients make is consuming slider foods.

      Slider foods have little to no nutritional value. As the name suggests, these foods can easily slide through the stomach pouch and into the intestine rapidly. When this happens, carbohydrates will be absorbed quickly and will result in a stall of weight loss and regain of weight. Don’t give up, though! There is still hope.

      Blue plate with scrabble words spelling out "weight gain".
      If you have experienced regain following sleeve gastrectomy, don’t give up!

      Gastric Sleeve Pouch Reset: What is That?

      To experience continued success after gastric sleeve surgery, it is essential to stay focused on the recommended diet and weight loss plan and to continue follow-ups with your physician. If you have experienced a setback and have begun to see some regain following gastric sleeve surgery, a gastric sleeve pouch reset, or VSG pouch reset may be beneficial to help you get back on track. A gastric sleeve pouch reset is a plan that is designed to take an individual through the post-operative diet progression but at a faster pace.

      Following sleeve surgery, a regular bariatric diet typically has up to five stages and may last between 8 and 10 weeks, depending on the surgeon’s recommended guidelines. In contrast, the reset uses similar guidelines but lasts between 5 and 10 days. The reset begins with clear liquids and progresses to full liquids, soft foods, and then solids.

      Walking sign with button that says, "Push to reset the world".
      When there is a need to refocus and get back on track with healthy eating habits, a gastric sleeve pouch reset may be helpful.

      It’s important to note that the gastric sleeve pouch reset VSG is not intended to be repeated weekly or even monthly. Instead, it is designed to help reset your body to the immediate post-surgery way of eating. Keep in mind that the VSG pouch reset will not shrink your stomach, cut your cravings for sweets or carbs, reduce hunger, or increase the feeling of fullness. It will help get you back on track with proper food and portion choices. Like the surgery, however, the gastric sleeve pouch reset is a tool.  This fact means it only works if you do!

      There are several variations of the pouch reset VSG. Those variations range from 48 hours, 5 days, and up to 10 day resets. Below is an example of a 10-day pouch reset after gastric sleeve:

      Day 1: Clear Liquids

      • Water
      • Tea
      • Broth (chicken, vegetable, beef)
      • Sugar-free drinks (crystal light, propel, vitamin zero water, Powerade zero, Mio, etc.)
      • Unsweetened tea

      Day 2 and 3: Thick Liquids

      • Must drink 3 protein shakes and as many servings of this vegetable soup as you want, spaced out every 2-3 hours
      • Vegetable soup: Click here for recipe
      • 64-ounces water or a sugar-free beverage

      Day 4 and 5: Soft Solids

      • 3 protein shakes
      • Unlimited vegetable soup
      • Choose 2 servings out of these soft solid protein options:
      • ½ cup cottage cheese
      • 6 ounces Greek yogurt: plain or flavored Dannon Oikos Triple Zero
      • ½ cup beans (whole or refried)
      • 2 scrambled or poached eggs
      • 4 ounces tofu

      Day 6-10: Long-Term Diet

      • 3 protein shakes
      • Can substitute these options for 2 out of the 3 protein shakes:
      • 20 almonds
      • 1 Greek yogurt and up to ¼ cup berries
      • 1 cheese stick and 5 whole-grain crackers
      • 2 eggs (scrambled, poached, or hard-boiled)
      • 2 meals consisting of 4 ounces lean protein (chicken, fish, turkey, pork loin, shellfish, tofu, or beans) 1 Tablespoon olive oil, 2 ounces vegetables
      • Unlimited vegetable soup

      Stay on Target After Your Gastric Sleeve Pouch Reset

      Gastric sleeve surgery requires long-term maintenance. Once the surgery is performed, it cannot be undone. Some things need to be done right to help increase the chances of maintaining long-term weight loss success.

      Some of the crucial things to keep in mind are:

      • Diet Maintenance: Follow your surgeon’s dietary guidelines for the rest of your life. Picking up old habits is easy and can result in regain.
      • Exercise: It’s important to get at least 30 minutes of exercise 3 to 5 days weekly. The goal is to get moving, which increases your heart rate. This increase in heart rate, in turn, results in burning calories and losing weight.
      • Monitor your Mood: Having a positive attitude all day every day is not always possible. Everyone has days that are more difficult than others. For individuals who have struggled with food addiction, fluctuating moods, especially feelings of depression, can trigger an emotional craving for food.
      • Follow your post-surgical diet: This means choosing a protein first and drink fluids no closer than 30 minutes before or after a meal. Avoid drinking while eating.
      • Weigh your food: Eat only a small amount of food at once. A half-cup or cup of few (4-8 ounces) is plenty. Remember, you are retraining yourself to eat less, just like you did after weight loss surgery.
      • Drink at least 64 ounces of water or other calorie-free fluids each day.
      • Take your nutritional supplements.
      Dart board with a dart in the middle.
      There are some tips to follow that will help you stay on target after doing the Gastric Sleeve Pouch Reset.

      Whether you are experiencing your first significant stall in weight loss or if you’ve begun to feel the result of poor choices and regain, you can take control of your health and get back on track. Before starting a gastric sleeve pouch reset or any other dietary changes, it is recommended that you speak with your surgeon and continue to have close follow-up throughout your weight loss journey.

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        Darby Faubion, RN, BSN, MBA


        Darby is a nurse and Allied Health educator with over twenty-five years experience. Most of all, she loves empowering patients with the knowledge they need to live full, healthy lives.

        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.