The 5-Day Pouch Test, The Cottage Cheese Test (and other destructive things we do to ourselves...)

What is up with me writing manifestos lately?

This one is CLOSE to my heart. I’d like to address the 5-Day Pouch Test, the so-called “Cottage Cheese” test and, really, any other type of thing we do when we are afraid we can eat too much.

I’ve avoided these subjects in the past because I thought by talking about them, I’d perpetuate them in some way. But the reality is that the silence is just as dangerous. I won’t name names but I’ve had more than a few post-ops email me who have done or plan to do one of the above because they gained a few pounds.

And while it’s good that they remain concerned and vigilant about maintaining a healthy weight, the thing that concerns me is that their first inclination was NOT to look at what they were eating (or track it), NOT to look at their workouts (and see if an adjustment is in order) and NOT to consult with their bariatric professional (in fact most people I speak with view that as a LAST resort instead of a first). So here we are. I’m going to be 100% raw and honest about why I hate, hate, HATE these two so-called methods of “getting back on track.”

The 5-Day Pouch Test

What is it: A five day eating regiment that begins with an eating plan very similar to when you were fresh out of surgery. As the five days progress, more foods are introduced (mainly protein heavy foods).

What does it claim to do: The website (which I will NEVER link on BF so you’ll have to Google it) doesn’t make many solid promises, but instead seems to feed off of people’s fears about their surgery and regain. I have heard, anecdotally from people who have done this, that they feel it does the following:

•  “Resets” the pouch
• “Cures” carb cravings
•  Gets you back on track

Who developed it:The 5-Day Pouch Test (5DPT) was developed by a company called “Living After Weight Loss Surgery” which is owned by Kaye Bailey, a RNY gastric bypass patient. That I have seen, Ms. Bailey does not have a degree in nutritional science nor is she a licensed medical professional. In fact, a disclaimer at the bottom of HER website reads, “The health content in the LivingAfterWLS Neighborhood is inteneded to inform, not prescribe, and is not meant to be a substitute for the advice and care of a qualified health-care professional.”

Why doesn’t Nik like it: We don’t have enough room in this blog post to go over all the reasons so I’ll keep it to a few:

•  It deals with regain/overeating in terms of FOOD not your MENTALITY TOWARD FOOD: this is important. You know that phrase “it’s not what you’re eating, it’s what’s eating you”? It’s cheesy but true. Our bodies are designed to be ok with a moderate amount of food. Unfortunately our minds often require more food for things that have nothing to do with the body’s caloric needs. This “test” doesn’t even attempt to guide you through WHY you are overeating. I don’t even see a suggestion that you should participate in such a process of discernment.
•  It does not recognize the fact that over time, most pouches mature. This is also important. You are SUPPOSED to be able to eat more at a year out than you did at a week out. And most of us know that. What we don’t tend to know is how much more is too much? And that’s not a determination we can easily make ourselves (it is my contention that if most of us knew how to do that we might not be WLS patients to begin with).
•  In and of itself the 5DPT doesn’t give you much guidance on what to do on day 6. Granted, there is a resource you can BUY (from the author of the test who, again, is not a medical professional) about what to do afterward. But in reality you’re going to have to face food and its place in your life eventually. This method doesn’t give much guidance on that, which is why, from my experience, folks who do it tend to do it again and again and again… 

So what do you suggest instead, Nik? I know going to your surgeon to report you’re struggling is akin to getting called to the principal’s office. I think this is because we figure that they already “fixed” us once. What kind of failures are we if we have to keep going back for readjustments?

I am here to tell you that is stinkin’ thinkin’! Your bariatric team wants you to succeed. They want you to succeed not only because they care about you as a person (I hope) but also because, on a more practical level, YOUR success affects THEIR bottom line. If all their patients regained, who would want to have surgery from them? So they have a vested interest (either in reputation, finances or humanitarian interest) to help you if you are struggling. You may not LIKE the way they support you but sometimes medicine don’t taste good, you know what I mean?

So that is to say, there are three strong recommendations I am making here:

• If at all possible, belong to a WLS support group. This helps you identify abnormalities (“Hey why come I can eat a whole pizza and Joe can only eat the toppings?) at the earliest stages. Then be honest with yourself about what warrants medical/psychological attention. And yes, you do know the difference between a simple freak-out and when you need help. You really do. Sometimes support group just confirms it for you!
•  If you feel you can eat too much, go see your surgeon. There could be a myriad of reasons for this. Your stoma could have stretched. Something about the anatomy of your surgery could have failed. There could be nerve damage. Heck, it might not even be behavioral (which means it might not be “your fault” so to say). But if you remember nothing else I say, remember this the ONLY way to find out if anything is stretched is by seeking medical attention. There is no way to determine this “at home.”)
• If you feel you are eating the wrong things, go see your nutritionist. There are things they can do to help. Sometimes cravings are a side effect of medicines. Sometimes they are indicative of deficiencies (one of the wonders of the human body is its ability to pair nutrients we need with stuff we like to eat). Or it could be that you're eating junk for convenience or depression or a myriad of other reasons. It's helpful to have someone to work with you and sort it all out

And make sure YOU are working your plan. Are you eating enough protein? Calories? Do you know how many you’re supposed to eat? Are you exercising? Has there been some stressful event in your life? All these things can relate back to how we look at food. This “pouch test” should NOT be your first line of defense!

The Cottage Cheese Test

What is it?: a method of ATTEMPTING to gauge the size of the pouch by the amount of cottage cheese one can eat. (No, I am not kidding)

What does it claim to do?: I am guessing it is supposed to tell you if your pouch is too big (I had to stop myself from hitting the “delete” button seven times).

Who developed it?: After extensive research I gotta say, “I got no idea!” It’s sort of just around. I have no idea who started this thinking. This, in and of itself, should make it suspect!

What do you suggest instead, Nik? The same things I suggested in response to the 5-Day Pouch Test.

But I will say in closing that obesity is a lifelong battle and it is not JUST physical. What we eat is important, but so is what we think, how we feel and how we treat ourselves. Any method of doing anything that tries to bypass one realm of your being (physical, emotional, mental), to me, is suspect.

It’s also suspect if you don’t know WHO developed a certain method. This, to me, is indicative of our collective low self-esteem. C’mon people! You did EXTENSIVE research to find your surgical practice (well if you aren’t me you did, anyway). Why are we so willing to follow a plan developed by some invisible face without knowing whether THEY know the first thing about nutrition?

In the end this journey is about coming to love and accept yourself in such a way that you can handle the ups and downs of life without using food to manipulate how you think and feel. Both the above methods use food as a primary resource to manipulate how you think and feel. THINK ABOUT IT. Think about the long-term. Think about 10, 20, 30 years from now. Do you still want to be doing this? Or do you want to be living an awesome life? The awesome life takes work. It’s hard work. It’s uncomfortable work. Sometimes you’ll feel like a failure. Sometimes you’ll have to scruff yourself off, get up and try again. Sometimes you’ll have to humble yourself and admit you’re not perfect.

But guess what? You’re human. And you’re in control. Don’t give that control away. That’s not how bariatric surgery was designed to work. That’s not how healthy people think. And that’s DEFINITELY not the way of a Bariatric Foodie.

So…anyone wondering my stance on this. There it is in plain view. Agree, disagree, write off this blog, whatever. I will NEVER support shortcuts. We do the hard work and we keep it moving!

Now, as for resources online I would suggest:

• ObesityHelp.com - it's a FREE website where thousands and thousands of post-ops share their experiences.
• Blogs that take a balanced approach to post-op education and living, like:
• Melting Mama (love her or hate her, she tells the truth!)
• Journey to a Healthier Me (I spoke to Pam Tremble, the author of this blog, and she's going to put up some good resources related to getting back on track tomorrow!)
• The World According to Eggface (She has like 7 years post-op or something and not a mention of doing a pouch test. She eats well, moves often...)
• Um...Bariatric Foodie!
• And here are a few resources on Bariatric Foodie that might help you:
• The Bariatric Foodie Guide to Surviving a Meltdown: This is just a few strategies on what to DO (not what to eat/not eat) in the midst of a meltdown. I wrote this because I am a food addict and have had to open a can of "whoop ass" on myself a few times. 
• The Bariatric Foodie "Back on Track" Toolkit (and before I get reamed out, yes there is a small fee for this download. It goes toward paying for the email service I use for the Bariatric Foodie Monthly email newsletter. BUT to my credit, I acknowledge I am not a nutritionist and IMPLORE YOU to go see one in this helpful toolkit!)
• Bariatric Foodie's Facebook Page: Where we discuss the issues that affect our lives every day, all year round
• The aforementioned Bariatric Foodie monthly newsletter, which is written by Foodies (who are not all me) and FOR Foodies! We go into vitamin compliance, product reviews, coping with regain, just everything! Use the form right above this post to sign up for this FREE email newsletter!