Why Test Your Pouch?
Weight loss surgery is a powerful tool, not a solution. As time passes, it is not uncommon for people to fall back into old habits that are not beneficial to weight loss and may even stretch the pouch, making it even harder to lose weight. The pouch test is for you if you feel that your pouch, or stomach, is not as effective in restricting food intake as it should.
This may occur if you have hit a stall or even started to gain weight back after weight loss surgery, especially gastric bypass or gastric sleeve surgery. You may also need to test your pouch if you have noticed that your portion sizes have gotten noticeably larger and you are not feeling as much restriction as you once felt.
*Please note, your pouch will not stretch back to normal size. It is very limited in the amount a pouch can stretch. Also, re-sleeving has a very low success rate. If you think you need revision surgery, click here.
Signs That Your Pouch Has Stretched
- Portions have gotten larger
- You don’t feel as much restriction with food intake
- You have gained weight or hit a long-term stall
- You are consuming more than 9 ounces during a meal
How Did I Stretch My Pouch?
It is normal for there to be a slight increase in pouch size or volume over time. Pouches average around 5 ounces in size at one year post-op and typically enlarge to 6 ounces in the second year post-op. Pouch sizes can also vary quite a bit. At one year post-op, a pouch size can vary from about 2.5 ounces to 9 ounces.
Pouch stretching is natural and may or may not reflect you doing something wrong. Your pouch does not stretch by one unhealthy meal, nor does it stretch by one single large meal. You can, however, stretch your pouch by eating just a small amount of excess food over and over again.
Tips to Avoid Your Pouch from Stretching:
Be mindful of your body while you eat. Pay attention to cues of hunger and fullness without feeling uncomfortable, starving, or overly full. Figure out how much your pouch can hold using this pouch test, then make that your maximum meal size moving forward. For best results, keep meals to 6 ounces or less, even if you know your pouch can hold more. Measure your portions to be sure. It’s best not to guess!
How to Test Your Pouch
Fast (no food or drink) 60 minutes before the test. Test your pouch during your first meal of the day.
Step 1: Measure Food
Measure (by weight) 8 ounces of cottage cheese or mashed potatoes on a food scale. If you are doing this on a plate or bowl make sure to tare out the weight of the bowl so it is not included in the 8 ounces.
Step 2: Fill Your Pouch
Eat as much as you can to feel full. In other words, stop eating when you feel like one more bite could cause nausea or discomfort. This will help determine how much fits into your pouch.
Step 3: Subtract Food Intake
Measure by weight the remaining mashed potatoes or cottage cheese that you could not eat. To do this you will need to place these leftovers back in the bowl and tare out the weight of the bowl again.
Step 4: Find Out Pouch Size
Subtract the weight of the leftovers from 8 (the 8 ounces that you started with). This will equal the number of ounces your pouch can hold. Keep in mind pouches may vary in size depending on how long it has been since your surgery.
Repeat these steps every 3 months if you want to see how your pouch size increases in time.
What to do if Your Pouch Stretched
If you have tested your pouch and you can hold more than 8 ounces or you just need help getting back on track with your diet, we recommend you start the 10 Day Pouch Reset Diet or the 5 Day Pouch Reset Diet. This will take you through the transition process as you did right after surgery and will lead you to a healthy diet that you can continue long term.
Key Tips for Long-Term Success:
- Eat solid food at mealtimes
- Avoid liquid with meals, 30 minutes before and 30 minutes after
- Eat a minimum of 60 grams protein/day
- Eat until you feel full but not uncomfortable or nauseous.
- Measure out 6 ounces of food maximum, even if you feel you can eat more.
If My Pouch Stretched, Can I Still Lose More Weight?
No. In fact, as surprising as it may seem pouch size has no significant difference in excess weight loss. Research has shown that pouch volume is not a predictor of weight loss, but rather how it is used.
Individuals that continued the post-op diet recommendations long term, regardless of pouch size, continued to see the best results. This has proven that proper use of weight loss surgery as a tool is the most important variable for successful weight loss results.