After undergoing bariatric surgery such as gastric sleeve surgery, patients normally lose a significant amount of weight and this typically happens very quickly. It is not unusual for patients to regain some of this rapidly lost weight but if the regain is substantial, or continues, it can sabotage all previous efforts. Today we are going to discuss what causes weight regain after bariatric surgery, what can be done to stop it, and how to restart weight loss after gastric sleeve or any other bariatric procedure.
First Let’s Look At How Gastric Sleeve Surgery Works
Before undergoing gastric sleeve surgery, patients are put on a very restrictive diet to help shrink their liver and then move to an all-liquid diet for a few days just before the procedure.
During gastric sleeve surgery, a portion of the patient’s stomach is removed reducing its capacity to about 25% of the original size. The patient can no longer eat as much and the food that is consumed takes longer to digest.
A benefit to removing a large portion of the stomach is that it also greatly reduces the amount of Ghrelin that is produced. Ghrelin is a naturally produced hormone and the culprit that keeps sending signals to our brains telling us that we are hungry. Having Ghrelin’s incessant nagging quieted helps many patients to avoid in-between-meal snacking and consuming too many calories in a day.
After gastric sleeve surgery, a special diet must be followed to give the stomach time to heal, and then a healthy diet must be maintained forever to maintain their weight.
The combination of the time needed for the stomach to heal, the smaller stomach size, and the “all liquid” diet the patient must follow right after bariatric surgery translates into rapid weight loss.
What Causes Weight Regain After Gastric Sleeve Surgery?
The main reason patients regain weight after bariatric surgery is because they are not diligent in sticking to the lifestyle changes necessary to maintain their weight loss. This means small portions of healthy foods, the recommended amount of physical exercise, adequate sleep, etc. Many factors can contribute to patients regaining weight after weight loss surgery such as:
- Phycological issues;
- Lack of motivation;
- Metabolic issues – sometimes the patient’s body metabolism begins to work against them and slows down in response to the lower caloric intake.
Can Your Stomach Get Bigger If You Eat Too Much?
Many people believe that the human stomach can stretch out and can permanently become a bigger size, allowing them to overeat and gain weight but this is not exactly the way it works.
Our stomachs get a signal from our brains that food is on the way and a process called gastric accommodation happens. The muscles (rugae) that allow the stomach to expand after we consume foods or liquids relax so the stomach can expand to accommodate the incoming food. Most human stomachs can stretch to be 5x bigger than their “fasting” or normal size. After digestion, the stomach returns to the fasting size. The stomach itself does not actually get any bigger, the element that changes is the amount of elasticity (distensibility) the stomach has. How much capacity do our stomachs have when they relax.
Scientific studies have discovered that eating habits and patterns have a profound effect on stomach elasticity. Individuals who binge eat have increased elasticity over those who do not have binging habits. A Mayo Clinic report concluded that an individual’s gastric capacity was linked more to eating behavior than to body weight after studying patients who suffer from bulimia and discovering their extremely high gastric capacity.
Another study from 1996 placed 1000 obese patients on a 1000 calorie diet for 30 days and their gastric capacity was reduced by an average of 36%.
Can You Reset Your Pouch After Gastric Sleeve Surgery?
Anecdotal examples that are floating around that describe “how to reset your gastric pouch” in just 5 or 10 days, etc. Can an individual do “a pouch reset”?
This question has been circulating since 2007 when a former bariatric patient wrote about her experience of getting back on track after experiencing weight regain after losing it as a result of weight loss surgery. She gave an example of a diet plan to follow for 5 days that would “reset your gastric pouch” meaning, it would provide that initial very restricted feeling experienced immediately after surgery.
Bariatric specialists have said that the initial “very restricted” feeling experienced directly after bariatric surgery is due to the swelling and inflammation caused by the surgery. Eventually, the stomach heals and begins to function normally again. Stretching to accommodate food, and retracting after digestion.
These specialists agree that most patients regain weight after bariatric surgery because of what they eat, the timing of when they eat, how they eat (their meal environment), and snacking between meals (this includes beverages) and not because they have stretched out their stomachs.
How Is The Pouch Reset Supposed To Work?
Depending on where you are getting the information, the pouch reset appears to be a very restricted diet that runs from 5 to 10 days. The suggested diet is very similar to what most bariatric patients experience immediately after surgery to ease the stomach back into doing its job after reducing its size.
The suggested diet looks something like this:
- Day 1 – Clear Liquids, e.g. water, broth, green tea, etc.;
- Day 2-3 – Full liquids, e.g. protein drinks, soup, thinned apple sauce, etc.;
- Day 4-7 – Pureed type foods, e.g. cottage cheese, hummus, scrambled eggs;
- Day 8-9 – Soft foods, e.g. veggies, cereals, mashed fruit, foods that can be mashed with a fork;
- Day 10+ – A balance of healthy foods including proteins and veggies eaten first, healthy carbs, and fruits.
Does The Pouch Reset Work?
Here are some facts supplied by bariatric nutrition experts:
The proposed 5-10 day pouch reset diets will NOT shrink your stomach, reset’ your metabolism, curb hunger or make you feel full longer, or stop food cravings.
Bariatric dietitians agree that a 5-day pouch test is simply a 5-day diet that may shed some pounds but will not accomplish all it professes.
Truths Found In The 5-Day Pouch Reset Diet
Some of the suggestions that are included with these proposed diets are factual. In fact, they are the very same tips and guidelines provided by the bariatric surgeon for patients to follow after surgery to help them effectively lose weight and keep it off. These tips include:
1. Eat Slowly and with Purpose
Eating slowly and chewing food the recommended number of times will help your weight loss efforts by preventing you from overeating while still feeling satisfied. This will allow time for the brain to acknowledge the intake of food and register satisfaction.
2. Always Separate Fluids from Meals
After weight loss surgery, it is important to wait 30 minutes before and after a meal to drink your beverage or daily water intake. It is important that patients eat enough of the right foods to keep them nutritionally healthy but also to not flush the food through the system too fast.
3. Eat Foods in the Correct Order with Protein First
High protein foods are critical in keeping the body functioning properly. With the decrease in stomach capacity, it is critical to make sure that protein is always included in the meal, and eating protein first will ensure it does.
4. Limit The Use Of Slider Foods
Foods like protein shakes are nutritious and provide a good dose of protein but they may not help create the feeling of fullness because they travel through the stomach faster than other types of protein.
So The Question Becomes Can You Restart Weight Regain After Gastric Sleeve?
The answer is yes, you can! Whether you are trying to stop weight regain, shed the excess pounds that have shown back up, or are trying to get past a weight plateau after gastric sleeve surgery, there are a few different options available to help you restart your weight loss after gastric sleeve surgery. The first thing you need to do is decide that you want to continue your weight loss journey and then follow the 4 important steps below.
How to Overcome a Weight-Loss Plateau - IBI Healthcare Institute
Even bariatric patients can hit a weight-loss plateau. As we try to lose weight, there are many changes that happen to our bodies. The pounds come off with ease. As weight is lost, you do lose some muscle along with fat. Muscle helps the rate at which you burn calories. Slowly as you lose more weight, your body will burn calories at a slower rate which can be the thing that causes a stop in weight loss.
4 Steps To Take Immediately If You Want To Restart Weight Loss After Bariatric Surgery
- First, make a commitment to yourself that you are in this for the long haul and you will not quit. Even if you slip up, get back up and keep going.
- Then, call and set up a consultation with your bariatric surgeon to explore all factors contributing to the weight gain. The professionals at the bariatric center will help point you in the right direction to get back on track.
- You may be eligible for a bariatric revision through ESG (endoscopic sleeve gastroplasty) which is a non-surgical procedure that is performed to tighten up the original surgery so it becomes greatly restrictive again.
- You may be a candidate for weight loss medication such as SlimMed, Wegovy, or Saxenda. That can help you make a weight loss breakthrough and facilitate ongoing weight loss.
- Next, modify your lifestyle and behavior immediately to reflect what you were doing directly after your bariatric surgery. This would include strictly following the post-bariatric diet and exercise plans, getting adequate sleep, and water intake.
- Finally, assemble or reassemble a support team of friends, family, or like-minded individuals to talk with or learn from. Many online groups are available that help supports each other through weight loss. Some of them meet in person and participate in activities together that are fun and provide physical exercise.
Weight Loss Requires A Long-term Lifestyle Change
Unfortunately, when it comes to long-term weight loss there are no shortcuts. There is no 5 or 10-day solution that can do a “pouch reset” and solve all our weight loss issues. If we want to change the gastric capacity of our stomachs we must alter our eating habits over time – around 30 days according to the previously mentioned study from 1996)
Currently, there is no medical, scientific evidence, studies, or research papers discussing the validity or effectiveness of “a pouch reset” or a “5-day pouch test”.
There is your determination and commitment to hanging in there and making the lifestyle changes necessary to lose weight and keep it off long-term.
The number one reason patients regain weight is due to recurring, unhealthy eating habits, or a sedentary lifestyle. Keeping weight off requires a lifetime commitment that includes the help and support of your bariatric team of professionals, friends, family, and support groups.
If you have undergone bariatric surgery and are experiencing weight regain please contact IBI Healthcare Institute for a consultation. The caring professionals at IBI Healthcare Institute are there to help you get back on track to living your best life.
Weight loss is not easy and we are here to help you on this lifelong journey. You do not have to do it alone, contact us today to find the options available to you to restart your weight loss.