Gastric Bypass Surgery: Protecting Your Pouch

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Gastric bypass surgery patients often have concerns about stretching their stomach pouch and reversing the positive effects of weight loss surgery. Many times, these concerns are born out of patients’ past experience with food and a history of emotional eating.
Before gastric bypass surgery, patients may have used food as a pacifier to manage uncomfortable emotions – a habit that, when left unchecked, turned into the addiction that furthered their obesity. Although the physical changes to the stomach and small intestine from the procedure limit the amount of food that a patient can comfortably eat at one time, a change of mindset and proper “pouch management” are needed to ensure that the benefits of gastric bypass surgery will last for a lifetime.
Putting an End to Emotional Eating
One of the most difficult transitions for many patients is learning to recognize when they are “full,” so that they stop eating at the appropriate time. Emotional eating is not driven by a feeling of physical satiety, and patients are often unfamiliar with the signals their body sends when they have consumed enough ...
... food.
“We teach our patients the difference between what we call ‘head hunger’ and ‘physical hunger,’” says Dr. David Provost, a bariatric surgeon who performs a variety of weight loss surgery procedures, including gastric bypass surgery in Denton, Texas.
“Head hunger is when you tell yourself that you deserve a treat because you had a bad day, or you had a great day, or nobody is looking, or because you don’t want to let those last three donuts go to waste,” he explains. It is driven by the little voice in your head, rather than what your body is telling you. In contrast, physical hunger is indicated by a churning, empty feeling in the stomach – a sensation to which many weight loss surgery patients surprisingly are not attuned.
Adhering to the Pouch Rules
Bariatric surgeons frequently advise gastric bypass patients to think of their new stomach as a funnel. They should never force food through the funnel by washing it down with liquids or eating until they are physically stuffed. Similarly, they shouldn’t purposefully choose foods that will pass easily through the mouth of the funnel, like ice cream or bite-size sweet or salty snacks. Instead, patients should follow the “pouch rules” provided by their weight loss surgeon to ensure their new stomach pouch does not stretch back to its previous proportions:
• Avoid drinking beverages for at least a half-hour before a meal, and do not drink a beverage with your food.
• Avoid carbonated beverages in general, as the gasses from the carbonation can cause uncomfortable bloating and also stretch the pouch walls. (This includes diet sodas.)
• Eat several smaller meals throughout the day; for example, have three meals that are about 1-1½ cups of food each, and two healthy snacks in between meals, like an apple or a handful of roasted almonds.
• Chew, chew and chew some more. By chewing food thoroughly, you will be more “present” during your meal and also can reduce the risk of blocking the opening to your stomach pouch.
• Keep mealtimes brief. Don’t wolf down your food, but don’t linger at the table longer than 20 minutes, or else chances are you will eat too much.
Finally, gastric bypass surgery patients need to be mindful of the fact that their pouch will stretch a little bit over time, but should not expand further than about 8-9 ounces, if they practice healthy eating habits. Also, although feelings of hunger can be nearly non-existent during the first year after gastric bypass surgery as a result of hormonal changes, the body will gradually return to homeostasis and patients will begin to feel hungry again more frequently. The feeling of physical hunger does not mean that the pouch has stretched, but rather that the body is simply operating as it should.
Dr. David Provost performs weight loss surgery, including gastric bypass surgery , in Denton, Texas. He also specializes in revision surgery for patients who have experienced challenges following a previous gastric bypass or other weight loss surgery procedure.