Clients who regain weight after bariatric/weight loss surgery often ask us about the ‘5 day pouch test’. This much debated ‘test’ promises to ‘reset’ your stomach and help you lose more weight. It’s so popular in fact, it has its own acronym – the ‘5DPT’. So what’s the deal, is it too good to be true?

Let’s start with a bit of background
The pouch test was ‘created’ in 2007 by a fellow gastric bypass-er named Kaye. She struggled, like many, with discouraging and disheartening weight regain after bariatric/weight loss surgery. In an attempt to recreate that ‘tight newbie feeling’ again, she developed the pouch test.

To start off the 5 day pouch test, she instructs you to ‘get back to the basics’. Or in other words, she wants you to return to the post-op liquid phase that is required in the first few days after surgery. She then recommends that you progress slowly from soft/puree protein, to firm protein and then lastly to solid protein (what’s the difference between firm and solid protein? We don’t know either...). Following this, you are supposed to feel a renewed sense of self.

MYTH...

The 5 day pouch test WILL NOT...
- shrink your stomach
- reduce hunger and increase satiety (feeling of fullness)
- ‘reset’ your body
- cut your cravings for carbs and sweet/salty foods

FACT...

We do however agree with some of Kaye’s suggestions.

1. Always delay your fluids from your solids foods.
--> Stop drinking 15 minutes before your meals/snacks and wait at least 30 minutes after eating to start drinking again. WHY? - Drinking and eating at the same time ‘flushes’ the food out of your stomach too quickly. This causes you to feel hungry soon after eating.


2. Take your time to eat.
--> Eating slowly and savouring your food without distractions increases satiety at meal times. WHY? - This gives your brain time to process that you are eating and lets you get the flavor fix you’re looking for.


3. Ask yourself if liquid protein snacks (aka ‘slider foods’) keep you full long enough (Ex. milk, yogurt, soft cheeses, cereal).
--> While these foods are nutritious and provide good quality protein, they may not help you feel as full as you felt in the first few months after surgery. WHY? - These liquid foods spend less time in your stomach which is why you maybe feel hungry soon after eating.

4. Include a high protein food at every meal and snack.
--> WHY? – High protein foods help keep you full longer.

In our opinion, the ‘5 day pouch test’ is just another diet in disguise. Anything that promises to ‘reset your system’, ‘boost your weight loss’, ‘cut cravings’, ‘kick start your metabolism’, ‘burn fat’, etc. is unfortunately wishful thinking.

There are no short cuts to healthy eating and lasting weight loss. 
There is only you, your pouch (i.e. your little stomach) and knowing how to use it!

How do I know if my pouch is still small?
Believe it or not, the majority of weight regain after bariatric/weight loss surgery is NOT related to having stretched your stomach. This is good news! In our experience, weight regain is more related to what you eat, the timing of your meals and snacks, and how you are eating. For example, if you feel comfortably full for 2-3 hours after eating the amount of food that fits on a bread plate, which includes a combination of protein, a small amount of grains, and some vegetables, your pouch is likely perfectly fine. 


We even asked one of our favourite bariatric/weight loss surgeons about the 5 day pouch test! Here is what he said:
"The major reason for weight regain is the recurrence of unhealthy eating habits and/or lack of exercise. Maintaining weight loss requires a lifelong commitment to keeping up good habits and having support from family, friends, and your health care team. 

Searching through the medical literature, I could not find any evidence or scientific papers studying and discussing the 5 day pouch test. When something is not discussed in the whole of medical literature, even as a simple case report, it leads me to believe that there is no scientific basis for this reset diet. And simply thinking about how the gastric pouch and anastomosis works, it does not make logical sense to me how a 5 day regimen of liquid and puree diet could possibly shrink the gastric pouch. The original feeling of tightness immediately after surgery is probably because of inflammation, since the stomach was cut and stapled, and also there was inflammation from the creation of the anastomosis (suturing). This inflammation resolves after days/weeks during which time the stomach is healing, and hence the original tightness feeling resolves with it". 

Dr. Simon Chow, Bariatric Surgeon, MD MSc FRCSC FACS

Need help?
If you are looking to get back on track with your weight loss and healthy eating, sign up for our Get Me Back on Track package. Whatever the cause of your weight gain, we will give you realistic strategies and tips to tackle your triggers and barriers to healthy eating. Even simple changes to your home and office environments can make a big difference.

- Monica & Lisa

Do you have a bariatric question or rumour that you have been wondering about? Post it below and we might highlight it in our next Fact or Myth blog post!
 


Comments

27/08/2016 18:58

I gained back 30lbs because I was laid up for 3mos because of bad knee and back problems. I'm 5yrs out have done well with diet but couldnt exercise.I was In bed In pain most of the time. I have since had a knee replacement in June still In PT What do you suggest to get this weight back off...FAST, i WORKED SO HARD AT THIS AND NOW i HAVE TO DEAL WITH GETTING THIS 30LBS OFF ME!!!

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