One of the most significant setbacks that bariatric surgery patients can face is weight regain after gastric bypass, or more commonly after a less invasive procedure like gastric sleeve or Lap-Band. Others become dissatisfied with their results, feeling they have not lost enough weight, so they consider revision surgery. However, some bariatric patients have successfully jumpstarted their weight loss through a gastric pouch reset diet.
What is a Gastric Pouch Reset Diet?
The gastric pouch reset diet is essentially a post-op psychological tool to help you get back on track to avoid additional weight loss surgery. The pouch reset diet or method 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 bariatric pouch reset mimics your immediate post-surgery diet. A normal post gastric bypass diet typically has four to five stages and lasts 8 to 10 weeks. The pouch reset uses similar guidelines but lasts only 8 to 10 days.
The Question of Stomach Stretching
Weight loss surgery patients often want to know if you can stretch your stomach after gastric sleeve surgery. Medical experts are divided on whether this is an actual phenomenon as the stomach is a muscular organ that expands and contracts. A regular size stomach can stretch to hold more than four liters of food and returns to normal when food exits into the rest of the digestive system. Following surgery, your new stomach pouch continues its normal flow of expansion and contraction. Tissue within the stomach called rugae remain present in sufficient amounts to continue the process. When you overeat, even on a bariatric diet, the rugae stretch to accommodate the food you eat. When you overeat repeatedly, the sensation of fullness takes longer, and before you know it, you have lapsed back into unhealthy eating habits.
Even after bariatric surgery, the stomach continues to stretch and then contract. Folds of tissue within your stomach, called rugae, expand and contract in response to food. When you overeat, the rugae in your stomach stretches, and with a constant flow of food it never returns to its normal size.
Read also: Comprehensive Review: Body Reset Diet Cookbook
Does a Pouch Reset Really Work?
Just as when you first underwent bariatric surgery, a stomach reset may help you lose weight again. Whereas before, you couldn't eat because your stomach was swollen and healing, this time you'll contend with a healthy stomach is you'll need serious willpower and support from your doctor, family, and friends. The pouch reset plays into bariatric patients’ fears of putting on weight because they’ve ‘stretched’ their stomachs. It does not consider 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, after healing, it will continue to work as a normal stomach by expanding and contracting. Thus, your capacity to eat more increases. The size of your pouch has less to do with whether or not you regain weight after your gastric sleeve surgery or gastric bypass surgery. What you eat and the amount of food you have is key to losing weight once again.
The pouch reset diet is essentially a test to demonstrate that you still have the will and commitment to follow a disciplined post-op diet and exercise plan. Once you succeed in this short-term pouch reset plan, you will regain the confidence to restore your mindset, behavior, and lifestyle for long-term weight loss. The bariatric pouch reset is not a fix all it is simply meant to restrict your caloric intake, which then causes you to lose weight.
It is said that when one persistently eat excessively, the fold stretches out and never returns to its original size. Pouch resetting is one of the several options available for those who are not losing weight as expected or who regained their weight following gastric sleeve. A pouch resetting is a way of returning your stomach to the size it was immediately after gastric sleeve surgery.
How to Tell if Your Pouch is Stretched
If you are unsure if you need gastric bypass pouch tightening, you can perform something referred to as the gastric bypass pouch reset test, also commonly referred to as the cottage cheese test. Scientific studies have not verified this procedure, so take it for what it's worth. Measure eight ounces of cottage cheese or mashed potatoes, and then eat until full. Subtract the remaining food to determine how much cottage cheese or mashed potatoes fit into your post. Eating five or more ounces of either food will indicate you do you know if you stretched your gastric sleeve.
How to Do a Pouch Reset
Essentially, a pouch reset mimics the post-bariatric surgery diet given to you by your surgeon and dietician. Contrary to popular opinion, a pouch diet will not "shrink" your stomach long-term. The point of the pouch reset diet is to restrict the types and amount of foods you eat to return to the mindset of healthy eating. Although it is similar to your original post-op eating plan, each phase is shorter as your stomach doesn't require healing. A pouch reset, usually done over 5 to 10 days, aims to recharge your body and mind and put the focus back on your successful weight loss post-bariatric surgery. Whether you choose a VSG pouch reset or a gastric bypass reset, the plan will begin with a liquid diet, followed by a pureed diet, and then back to solid foods.
Read also: Comprehensive Guide to the 5-Day Reset Diet
Before embarking on pouch resetting, it is important to notify your doctor and dietician and work closely with them to achieve a successful outcome. In pouch reset, you try to change your diet to mimic the post-operative diet.
Pouch Reset Meal Plan
Most pouch reset meal programs are based on a rigorous 5-day or 10-day bariatric diet divided into three broad phases. Once again, you'll restrict yourself to liquid, pureed, and soft foods before finally transitioning back to solid food. The pouch created by your bariatric surgery won't necessarily shrink, but the pouch reset diet should leave you feeling fuller faster, just as your original bariatric diet did. Although you can figure out how to do a pouch reset on your own, you should do it under the guidance of a bariatric surgeon and dietician.
Typically, any pouch reset diet will focus primarily on protein, with added healthy vegetables and fruits. When attempting a pouch reset, you should focus on the guidance you received from your bariatric surgeon and dietitian.
Back-on-Track Bariatric Eating
Track what you eat daily. Remember, the goal is not to drink or eat anything in amounts that will stretch your stomach.
48-Hour Pouch Reset
The 48-hour pouch reset plan is essentially a ploy by online companies to get you to buy their bariatric food products, especially their protein shakes.
Read also: Comprehensive Guide to Metabolism Reset Diet
The first day consists of consuming only a protein shake for meals to flush your digestive system of sugars and simple carbohydrates.
The second day is merely a test to see if you can eat one cup of shredded chicken. The idea behind this 48-hour plan is to inspire confidence that you don't have to eat as much. For a more comprehensive diet to help you get back on track, try either the 5-day plan or the 10-day plan.
5-Day Pouch Reset Test
The five-day pouch reset test is the original system developed in 2007 by bariatric patient Kaye Bailey who struggled with weight regain following her bariatric surgery. The pouch reset menu varies slightly on whether you are doing a VSG pouch reset or a gastric bypass pouch reset.
The “5-day pouch reset” is a specific diet or plan followed by patients who have undergone gastric bypass surgery or other weight loss surgeries (like gastric sleeve) involving the creation of a small stomach pouch.
- Liquids only on day 1: the patient must consume only clear liquids, such as water, broth, and sugar-free beverages.
- Pureed foods on days 2-3: During these days, the individual consumes pureed or blended foods that are easy to digest.
- Solid foods on days 4-5: Soft, solid foods must be introduced on these days.
As you see, the idea behind the 5-day pouch reset is to gradually reintroduce foods with smaller portions and healthier choices. The purpose of this diet is helping to promote healthier eating habits. As we mentioned, before considering any dietary changes, especially after your surgery, it’s crucial to consult with your healthcare provider or a registered nutritionist.
5-Day Pouch Reset Diet: Your Day-by-Day Guide
The 5-day pouch reset, or metabolic reset diet, is a condensed version of the post-op diet. The only difference is that the pouch reset diet is done over a five-day period and designed to get you back to eating smaller amounts of food. By following this plan, you can “tighten” your stomach pouch and jumpstart weight loss again.
After completing the reset, you can either continue the diet or return to your personalized post-op eating plan for long-term success.
Day 1: Clear Liquids
The pouch reset diet begins with the most challenging phase before working your way back to eating solid foods. During day one, clear liquids will help flush your body and disrupt ghrelin and leptin levels, which are the hormones responsible for hunger and feeling satisfied. You can have unlimited sugar-free drinks, but try incorporating nutrient-rich clear broths to give your body energy.
- Water
- Tea
- Broth (chicken, vegetable, beef)
- Sugar-free drinks (Crystal Light, Gatorade Zero, Vitamin Zero water, Powerade Zero, Mio, etc.)
- Unsweetened tea
Day 2: Thick Liquids
If you make it to day two of the pouch reset diet, you are doing great! From here, you can enjoy protein in the form of thick liquids. Blending protein shakes is the most effective strategy for consuming full liquids as it breaks down all the nutrients from fruits and vegetables. Protein powders are the easiest way to incorporate protein into your smoothie or shake. Space out your three protein shakes every 2 to 3 hours.
- Must drink three protein shakes
- Weight Loss Magic Soup (as many servings of the vegetable soup recipe spaced out every 2-3 hours)
- 64 ounces of water or a sugar-free beverage
Remember, you can always incorporate foods from the previous day!
Day 3: Soft Solids
- 3 protein shakes
- Unlimited Weight Loss Magic Soup (link above)
- Choose two 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 4: Firm Solids
- 3 protein shakes
- Unlimited Weight Loss Magic Soup (link above)
- Choose two servings of protein per day:
- 4 ounces chicken
- 4 ounces fish
- 4 ounces tofu
- 2 eggs
- Choose two servings of fat per day:
- ½ avocado
- 15 almonds
- 1 TB oil, butter, or peanut butter
Day 5: Whole Foods
Same as day 4, protein can be any lean protein (including beef, pork, venison, etc.). Add 2 servings of your choice:
- ¼ cup beans
- ¼ cup berries
- ¼ cup quinoa
- ¼ cup sweet potato
- ¼ cup vegetables
10-Day Pouch Reset Meal Plan
The 10-day pouch reset is similar, with the stages approximately twice as long.
Food Examples for Pouch Reset
- Clear liquids only.
- Full liquids.
- Protein powder mixed with a sugar free non-carbonated clear liquid.
- Sugar free pudding.
- Soup with soft noodles.
- Non-fat yogurt
- Carnation instant breakfast. Sugar free option.
- Very thin creamed soups. No chunks.
- Sugar free sorbet.
- Very thin hot oatmeal. Check the sugar content.
- Diluted no-sugar added juice.
- Sugar free, nonfat ice cream.
- Thinned applesauce.
- Remember the goal is to not eat or drink anything that is going to stretch your stomach.
- Pureed foods.
- Almond milk or coconut milk makes a great protein shake.
- Hummus
- Cottage cheese (low fat)
- Soft cereals - Let your cereal sit in the non-fat milk until it’s soft.
- Soups - no chunks
- Scrambled eggs - these are a great source of protein. If you can puree the food, it’s acceptable as long as it’s healthy and easy to digest. It’s best to stay away from meat at this point.
- Soft foods.
- Soft cereals - Let your cereal sit in the non-fat milk until it’s soft.
- Soft vegetables - steam or boil them until they are soft.
- Soft cheeses - limit these, they are typically high in fat.
- Ground chicken or beef. Add some beef or chicken stock to keep the meat soft.
- Soups
- Scrambled eggs - these are a great source of protein.
- Soft (steamed) fish. Remember to chew well.
- Canned tuna and salmon (you can add low fat mayo). Great source of protein.
- Mashed fruit.
- Healthy foods.
- Introduce these foods slowly and in healthy portions. The size of your fist should be the size of an entire meal. Typically, a post bariatric surgery diet will focus on protein and vegetables but always consult with your surgeon.
- Drink liquids at least 30 minutes prior to eating and 30 minutes after eating.
- Eat slowly. Allow at least 30 minutes per meal.
- Chew well.
- Fruits are typically OK in moderation.
- Stay away from sugar and nutrient lacking carbohydrates (pasta).
- Track what you eat on a daily basis.
Who Should Try the Pouch Reset Diet?
The pouch reset diet is a valuable tool for anyone who:
- Has hit a weight loss plateau or stall
- Is experiencing weight regain after bariatric surgery
- Notices their portions exceed 6 ounces
- Stopped tracking food intake
- Wants to regain control of their diet
- Feels their pouch or sleeve has stretched
No matter where you are on your journey, this diet can help you take steps toward achieving your weight loss goals.
Tips to Prevent Pouch or Sleeve Stretching
To maintain the results of your bariatric surgery:
- Avoid overeating: Stick to portion sizes that match your surgery guidelines.
- Stay away from carbonated drinks: They can stretch your stomach pouch.
- Chew thoroughly: Eating slowly and chewing food well helps prevent discomfort and overeating.
- Follow your post-op diet: Consistency is key to long-term success.
What If the Pouch Reset Doesn’t Work for Me?
If you’re still struggling with weight regain after the reset, don’t worry-there are other options! Consider:
- Non-Surgical Solutions: New medications, like GLP-1 medications (e.g., Ozempic), can help you with weight loss.
- Revision Surgery: Procedures like the Mini Gastric Bypass or SADI-S can help address any issues with a stretched pouch or sleeve.
Important Considerations
A pouch reset is not a fix-all but a tool to restrict your caloric intake and return you to good habits. If you start to eat larger meals again, your stomach will respond to the increased volume. Before you embark on a gastric sleeve reset, you must be aware that there is no firm scientific evidence but only based on anecdotal evidence. Medical researchers have not explored this type of diet, and according to a recent study “there is no scientific basis for this diet”.
The pouch reset diet is not easy. You’ll need support and some serious willpower. The pouch reset 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. The size of your pouch has nothing to do with whether or not you regain weight after your gastric sleeve surgery or gastric bypass.
The pouch reset diet is a short-term, low volume, high protein diet. We recommend a diet that is low in volume, meaning small portions, low in calories, and high in protein. The pouch reset diet is not a way to shrink the size of your gastric pouch. It is also not a long-term diet. The pouch reset diet should not be used frequently or for longer than the suggested time. The pouch reset diet is not a magic fix! In order to achieve long-term weight loss goals, you will need to incorporate sustainable diet and lifestyle habits into your day-to-day life.
If you already made the decision of doing a pouch reset or any weight loss strategy, keep in mind that medical knowledge and recommendations by experts are the most accurate instructions.
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