Weight gain and stomach stretching are issues that many bariatric patients worry about after their weight loss surgery. In order to combat weight gain and weight fluctuations, many patients resort to the pouch test (also known as the five-day pouch test) to reset their stomach to its ‘original size’ after surgery, gain control of their unhealthy eating habits, and to help them kick start their weight loss. Many people swear by it, but does the pouch reset test work, or is it another weight loss myth?

How does your stomach work when you eat?

Your stomach is a muscular organ. When empty, your stomach is the size of your fist. However, it can stretch to hold as much as four litres of food or more than seventy-five times its empty volume, before returning to its resting size when empty.

Most people think that the size of a person’s stomach is related to how much food they eat, but this isn’t the case. A person’s body weight does not correlate with the size of their stomach. Rather, when you eat large quantities of food i.e. Christmas dinner, you’ll stretch your stomach more than you would when you eat less.

What is the pouch reset and how does it work?

The pouch reset was created in 2007 by a gastric bypass patient named Kaye Bailey. Like many bariatric patients, Kaye struggled with weight regain after her surgery and in her attempt to ‘shrink’ her stomach back to its post-surgery size, she developed the five-day pouch reset. The pouch reset severely restricts and limits your food and nutrient intake. It works by mimicking your immediate diet after bariatric surgery.

A normal post diet after the gastric sleeve, gastric bypass and SIPS Surgery has four to five stages and lasts at least weeks. The pouch reset follows the eating guidelines but lasts five days.

The stages are:

• Day one: clear liquids only e.g. water, broth, sugar free popsicles
• Day two: full liquids only e.g. low-fat yoghurt, very thin oatmeal, thinned applesauce
• Day three: pureed food only e.g. hummus, low fat cottage cheese, scrambled eggs
• Day four: soft foods only e.g. soft cereals, soft steamed fish, soups, mashed fruits
• Day five: healthy, solid foods.

By following the strict rules of the five-day pouch reset, you are supposed to feel healthier, fuller and lose weight.

Is the pouch reset a myth?

The pouch reset test plays into bariatric patients’ fear that they are putting on weight because they’ve ‘stretched’ their stomach. It does not take into consideration that the stomach has the natural capacity to stretch because it’s a muscle. After weight loss surgery, the stomach is restricted due to swelling and scarring. However, when your stomach heals from surgery, it continues to work like a normal un-sleeved stomach, and your capacity to eat more increases.

The size of your pouch has nothing to do with whether or not you regain weight after your gastric sleeve surgery, gastric bypass or SIPS surgery. The majority of weight gain is caused by what you eat after surgery, the timing of your meals and snacks, and how you are eating.

For instance, if you feel comfortably full for two-three hours after eating the amount of food that fits on a small plate –this includes a nutritious combination of protein, vegetables, and a small amount of grains—your pouch is fine. Dr Padovan recommends that with your resized stomach capacity, you shouldn’t be able to eat more than ¾ of a metric cup in one sitting.

The pouch reset is a myth. It does not:

1. Shrink your stomach back to its post-surgery size
2. Reduce hunger and increase the feeling of fullness (satiety)
3. ‘reset’ your body
4. Drastically reduce your cravings for carbs and sweet/salty foods

The pouch reset simply works to restrict your caloric intake, which then causes you to lose weight. As soon as you start to eat larger meals, your stomach will respond to the increased volume.

Furthermore, respected bariatric surgeons such as Dr Simon Chow, have looked into the five-day pouch reset and have not found any evidence or scientific papers studying or discussing it.

Read what he had to say about it in full:

“Searching through the medical literature, I could not find any evidence or scientific papers studying and discussing the five-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 five-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”.

How do I keep the weight off after bariatric surgery?

So, we’ve learned that the pouch reset test doesn’t work. So, what works?

Following the guidelines provided by your surgeon and dietitian is key to keeping the weight off after bariatric surgery. Eat healthy and nutritious meals, exercise often, and listen to your body’s signs when it comes to hunger and satiety (read our blog about mindful eating here).

Are you struggling with weight regain after weight loss surgery?

Contrary to popular belief, the pouch reset doesn’t work. It is not backed by science and will not shrink your stomach, reduce your hunger or change your unhealthy habits. Contacting us at 9544 5200 and booking your follow-up appointment with us will put you back on the right track.  At Emerge Surgical, our professional team are committed to helping you achieve your goal weight and empower you to keep the weight off after surgery. Give us a call today and let us put you on the right track.