Most patients off track after weight loss surgery tend to always think that they have sabotaged their tool. Many will come in saying “I have stretched out my pouch” “I can eat as much as I want”. This thinking is ultimately so far from the truth. It comes down to their actions and behaviors that make them feel like they have ruined their tool and it will not work. Over and over I have worked with 100s of patients just like this and once I show them why what they are doing make them feel this way, they are able to make small changes and get back to that feeling of fullness and satisfaction with smaller portion. There are important rules to follow after surgery. These are rules that are specific to people who have had surgery and don’t really apply to those that don’t. The rules are important to follow in order to get the most out of your tool! Breaking these rules is why patients feel they have sabotaged their tools.
One important rule after surgery is the drinking rule. The drinking rule states that you should not drink while you eat and you should not drink for one hour after you eat. This goes for meals and snacks. It has to do with the significant change in your anatomy of your stomach after surgery. You have to think of your pouch or sleeve has a funnel after surgery. The goal is to put the right foods in the pouch or sleeve therefore clogging up the funnel allowing you to feel full on small amounts. Now if you drink at the same time as you eat, you are constantly washing the funnel out and refilling it. You eat you fill it up, you drink, you wash it out, you eat you fill it up , you drink you wash it out. This pattern is why you feel you can eat so much because you are washing the food out quickly. The goal is to fill the pouch or sleeve once at each meal, not 4-5 times at each meal. Now the rule also states no drinking for one hour after a meal. The reason for this is that in order for you to get and keep that full feeling there must be a small amount of stretch on the pouch or sleeve to stimulate the nerve to send the full signal to the brain. Therefore if you eat and fill the pouch up, but then 10 minutes later drink and wash all the food out, there is no more stretch on the pouch and the signal is no longer sent and you will be hunger in an hour. However, if you eat and fill your pouch up and then wait an hour to drink, the signal is being sent the whole time helping to keep you full and satisfied for a much longer period between meals.
So drinking with your meals makes you feel like you have stretched your pouch or sleeve because you can eat more. It allows you to fill your pouch multiple times at each meal therefore causing you to overeating. It also makes you feel more hunger between meals therefore leading to the need and want to nibble and graze between meals.
So one step to getting back on track and getting the most out of your surgical tool is to get back to the drinking rule. Start with not drinking while you eat. Work to get very hydrated before your meal and once you start a meal put the drink far far away. Then start with 15-30 minutes after a meal. Some is better than none. Aim for at least not drinking for 30 minutes after a meal and then slowly work your way up to an hour. Progress not perfection!
If you are interested in learning about the other rules of the pouch and why breaking them leads to weight regain and plateaus consider joining the Bariatric back on track program. This 6 week online comprehensive program will provide you with the knowledge to finally lose the weight and more importantly keep it off!