Ok so I’m going to ‘fess up.
That title? Total click bait! I’m sorry. That may have been wrong. But this is important stuff and I wanted you to click on it. My intentions were totally honorable.
I don’t believe in “pouch resets.” Or sleeve resets. Or (whatever you call your digestive apparatus) resets. I just don’t. You have the anatomy you have. When you have surgery, it’s at its most restrictive. The further you get out from surgery, the more likely you’ll feel less restriction, although probably never the level of hunger and eating capacity that you felt prior to having surgery.
Now I will disclaimer this to say that some people’s pouches do stretch (I’ve heard it’s rare but it happens), and for RNY patients sometimes your stoma (the opening between your stomach and intestines) can get too wide, which causes food to empty too fast from the stomach which, in turn, causes you to feel hungry more frequently. If you feel like you may be experiencing either of those problems talk to your bariatric surgeon. There is no diet that can fix that for you. It requires medical intervention. K?
But I did recently experience a dramatic reduction in both my appetite and my eating capacity and I’ve been documenting it. So I figured I’d share the results with you.
But first, a bit of background…
Because the title was click bait I should probably back up a bit and introduce myself. Hi! I’m Nikki. I’m 8 years out from RNY gastric bypass surgery and I am the owner of this fine website you’ve found yourself reading. Be sure to click the “Home” button when you’re done here so you can get access to the yummy weight loss surgery (WLS) friendly recipes this site has to offer!
In the beginning of my WLS journey I had extreme restriction and extreme food intolerance. Translation: I couldn’t eat much and everything I ate made me sick! But as I got further out, I found I could tolerate more foods. I also saw my eating capacity go up, and up, and up.
Scared the living daylights out of me.
Like many of you I had this intense fear of regain. And, unfortunately, my fear was realized. At my highest weight post-op I had regained nearly 40 of the 155 lbs. I’d lost.
I’ve been working on that with slow success (it’s always slower coming off the second time after WLS) but my appetite was sort of off the hook. I could eat a LOT. And when I say I could eat a lot, I still mean far less than before surgery but enough where my meals didn’t raise eyebrows in a restaurant. And enough for me to be taking in way too many dang calories each day.
The ways we sabotage ourselves post-op
I’m very up front about the fact that I identify as a food addict.
This, of course, means I do some really junkie-like sh*t. Pardon my French.
What is junkie-like sh*t? Well, it’s when you exhibit behavior that’s clearly meant to pass for normal but it’s obvious to everyone (including you) that you are still sorta trying to practice your addiction.
Let me give you an example.
Well after my intolerance/restriction issues started to clear up, I noticed something. If I ate a chicken breast, I couldn’t eat all of it and I couldn’t eat anything else. Nothing. Nada. Lockdown.
But by contrast…if I ate Greek yogurt…I could eat a lot of that. I could even mix stuff into it. And better yet, I could still eat an hour later if I wanted because, you know, sometimes folks come along and want to eat after you’ve eaten and it’s nice to be able to eat when they eat, right? (Yes, that’s the actual thought that went through my head. I told you…junkie-like sh*t!)
Now you don’t have to be a food addict to do that. Many folks latch onto the fact that some foods are easier than others to eat. Some cause fullness (or over-fullness) very quickly while some we are able to eat in decent amounts quite easily.
I’m not here to create disordered thinking, but for me there are certain behaviors that lead into self-sabotage. They include:
- Like I said, gravitating away from firm proteins. (Newbies, you are off the hook for this one because it’s not always prudent for you to eat firm proteins when you have just had surgery. Follow your plan! In fact, everyone follow your plan. If it’s between what I say and your plan? Your plan wins!)
- Not eating my protein first. (A good rule lots of post-ops follow is two bites of protein to one bite of anything else, so that you get in veggies…cuz your body likes them!)
- Drinking with or directly after my meals.
- Not eating a balanced meal.
- Eating too quickly to recognize when I am satisfied.
Those are big problems for me. And I never realized it more than one day when I was at a function for work. I’d had a BIG blood sugar drop a few days before (too many carbs in a sitting does that to me) and so I was taking it easy (read: biding my time until I would probably do something stupid again). So I was generally averse to eating starches. When I was served lunch I had a chicken breast – and it was good! I swear. I don’t know what they seasoned that thing with but it was delicious. I ate the whole 4 oz. of it!
And afterward, I found I couldn’t eat anything else. Nothing.
Later that day I noticed it had been hours since I’d eaten and I wasn’t hungry. I also noticed that it had been a long time since I had anything to drink so I grabbed a water and guzzled it. (Yes, at 8 years post-op I can guzzle.) And…WHAMMO! Hunger. Almost immediately after the first sip.
Now guys…I’ve been at this a long time so these things didn’t shock me but it did make me take pause. The bariatric rules are in place for a reason and, yes, I rebel against them, but damn if they don’t work! So that’s when I decided, based on that experience that day, to do a little experiment. I was interested in working on those five things I listed above, because I am prone to doing them all. But I was also interested in learning if I’d made any progress in coping with food addiction and accepting healthier eating behaviors.
(PAUSE: That’s another important point. I see the term food addiction used in a very cavalier way sometimes. I don’t take offense. It’s sometimes the best term to get folks to understand your issues with food. But if you SERIOUSLY think you are a food addict? That requires intervention by a doctor, mental health professional, etc. We now return to my regularly scheduled ramblings.)
And because I’m very into SMART goals I decided to take that approach to each of those five things above. Here’s how that shook out:
- Goal #1: I will eat firm proteins with each of my meals. For me that means animal protein like chicken, beef, pork or fishes like salmon. I will avoid making dairy the main source of protein at any meal.
- Goal #2: I will two bites of firm protein to one bite of anything else.
- Goal #3: I will not drink for at least 30 minutes after my meal.
- Goal #4: My meals will consist of at least a 4 oz. portion of firm protein + 3 – 4 oz. of vegetables (depending on how hungry I was). My meals will not include any startch.
- Goal #5: I will chew my food thoroughly and wait 5 seconds between bites.
So I admit I was a little skeptical at first about how this was all gonna go. If you’ve read this blog before you’ve heard me joke about having the “Wonder Pouch” or the “Pouch of Steel.” That’s just how much I was able to eat at the height of my appetite.
Now I began to notice downward shifts in my appetite in January, so in February I started getting intentional about what I was doing. This also coincides with Lent, when I usually give up something. This year I elected to give up starches. For whatever reason, even when I can’t take a promise to myself seriously any other time, I will during Lent! And I worked in earnest on the other things too.
Here are 6 things that have happened since I started working the above five goals:
- My eating capacity has greatly diminished. I was eating a full salad plate with some protein, some veggies and, yes, some starch and I was able to eat the entire plate. Now once I get through the protein, I can still eat my veggies and that’s about it.
- My appetite has greatly diminished. (Note: appetite and eating capacity are different. You can have a situation where you are able to eat but don’t want to or want to eat and are not able to. We on the same page? Lovely!) Luckily I am good at noticing when it’s been too long since I’ve last eaten. The body needs fuel. But I wasn’t getting the munchies throughout the day. In fact, I’ve had a fair amount of strictly “three good meals a day” type days.
- My caloric intake has dropped. As has the composition of my calories. I was getting a fair amount of calories from fat and carbs with protein coming in strong but not the dominant picture. Now I am getting about 40-ish% of my calories from protein, 35% from carbs, 25% from fat. I was pushing 2000 calories/day (if I am honest with myself) before this. Nowadays I hang out around 1500. Which brings me to another point.
- I’m food journaling! Now that I am not trying to hide from my food choices, I’m back to journaling. Even when I eat something that is less than healthy.
- My blood sugar has been stable. I don’t officially have reactive hypoglycemia (meaning my doctor has not diagnosed me as such) but I’ve had some big blood sugar drops. Crazy thing is I know what causes them. When I eat too many starches in a meal for too many consecutive meals. This begs the question, why’d you do that Nik? Because I wasn’t being an active and accountable participant in my own process!
- I’ve lost 12 lbs. That’s since the beginning of the year, not from the beginning of the experiment, but still it’s not nothing. I also seem to have gone down one pant size. Most of that happened after I started limiting my starches.
There are a few other things I noticed while doing this. For instance, I did not cut all carbs but I did cut most starches (bread, crackers, rice, pasta, potatoes…but I did eat beans). At first I’m pretty sure I wasn’t getting any carbs because most of my carbs were starches before. And in cutting them out I’m also pretty sure that I threw myself into ketosis there for a minute. (Click that link if you don’t know what that is.) I rectified that pretty quickly by filling in with other types of carbohydrates. Why? Because no-carb was not my mission! I’m not scared of carbs nor do I want to limit them. I just want to be smart about them.
Lastly, I noticed that indulgences didn’t seem to have a big impact. I wasn’t sure whether or not to share that information with you or not. (Use it for good, Foodies, not evil!) For example, I had a few really life-changing burgers over the past few weeks. They were made with regular beef, regular cheese, regular toppings…just no bun. I ate as much of it as I wanted (which, with regular fat items isn’t much because fat fills me up quick!) and moved on. I also tend to have a few squares of dark chocolate every day. (Yes. Every day.) Neither of those things caused regain nor did they affect my appetite up or down. I ate it. Logged it. Moved on.
Disclaimer: I am not creating a diet plan
Not for me or for anyone else! Seriously…I’ve shared this information not so that you can do what I did but to encourage you to be an active participant in your process. Always be aware of what you are doing with regards to food, exercise, vitamins – and don’t be afraid to ask for help or change something up if you feel like it’s not working. This is a process, a healthy lifestyle. Any person calling themselves a Bariatric Foodie is NOT “on a diet.”
So if you think that’s the point of the post…I clearly didn’t make the point of this post well!
Anyhoo…I know the question you may be asking. “But, Nik, are you going to stick with this?” Enhhh. I don’t see it as sticking with anything so much as recalibrating. I had veered off in the wrong direction and I set myself straight. Will I continue to do that? For today I will. As of the time of this writing, Lent isn’t over yet so no starches until at least that is done with but my body feels a lot better than it did before I started tweaking. So I will do what I always do and take it one step at a time.
But here are my take-aways from this little experiment:
- The bariatric rules are the rules for a reason and we should follow them! Eating protein forward meals, lots of fresh veggies (when you are cleared), and sensible fats are the rules for a reason. They not only lose weight but enable you to control cravings and appetite. I don’t know if I bought into that until this experiment but I now whole-heartedly believe this is true.
- I probably need to be in better contact with my dietician. Both for accountability’s sake but also because she can remind me about good bariatric eating practices. I honestly had gotten very far away from them and didn’t see a thing wrong with it. That’s partly my junkie-like sh*t at play, but also over time you can move away from your plan in baby steps until one day you are on one side of the world and your goals are on the other!
- In general, accountability is important. But not just accountability to myself. Accountability before others. I am more prone to do the right thing when folks are watching, after all.
- It’s good to shake up your habits sometimes. The body actually loses weight that way. When it doesn’t know what to expect and you challenge it, interesting things happen.
So there you have it…how I accidentally (and then not-so-accidentally) got back in control of my eating capacity and appetite. I hope something in this post was helpful as you live your best healthy lifestyle!
Need help getting “back on track”?
In the interest of full disclosure, I’m not terribly fond of that term, but I do believe that if you take action, intentionally, you can get back to living your best healthy life!
To help you do that, I’ve put together a toolkit. It will help you to:
- Identify where you are now, where you want to be, and how to get there
- Set some fast-action goals to get the train moving
- Provide protein-packed, easy, and convenient meals you can make yourself to transition back to bariatric eating
If you need support, I’m here for you. Order your copy of the Bariatric Foodie Back-on-Track Toolkit today!
My doc recently encouraged me to do the exact same thing you talked about since I have gained 20 plus lbs recently. I was wondering if you are still drinking protein shakes as well as eating firm proteins?
I do protein shakes but not as a “meal” so much anymore. They just weren’t working well for me to control my appetite. I could get more fullness on less calories from actual food!
Nikki, I read this today and thought that is what I need to start doing. I have been losing consistently since my surgery in July of last year (110 lbs), but lately I have found myself grazing all day on junk food. I have been fortunate so far not had a gain, but that won’t last. I also have days when I don’t eat anything till supper, today is one of those days. I add Genepro protein to my Powerade Zero in the mornings and occasionally do two bottles with protein. Starting tomorrow morning I am going to work on getting my protein in the right way.
Thank you, Nikki for your Blog.
I am in the same boat as you, grazing all day on junk food. It has finally caught up to me and I have regained 14 pounds. I am getting back on track so the regain doesn’t continue. I haven’t been eating protein foward meals.
I too am doing something very similar as I regained 7 kgs (15 lbs) over the last 6 months and am feeling the extra weight. I went back to the gluten free diet I was eating before(because of my mother requiring it) and lessened how much I put on my plate. I am journalling my food intake, writing my blog, and making sure I walk for at least 1-2 hours every day. I try to get to the higher range even if it means 2 walks.
I walk in the early morning before the rest of the family gets up.This is usually a longer walk. Later in the day I walk to our local library or to the shops for things we might need. It is good to understand that it does happen and to look at yourself to find out why it has. I love food but I emotionally eat as well and we have had a lot of stress over the last year.That has settled so I am looking at what I am doing and changing it as needed.
OMG! You just wrote my story! I just celebrated 9 years out and have been struggling with ALL of this. I WILL get this 35 pounds of regain off!
Amen. That is exactly why I have been researching this topic. 10 years out and gained 30 over my ideal weight. be happy to get 20 off and control it.
I had an SRVG in 1991. I lost 130 lbs, and kept it off for 20 years. Five yrs ago, I took an office job, had a debilitating foot injury, and quit smoking, all within a year. Oh, and add slowing metabolism due to age in there. Wham. Sunk. I am now working hard to follow these rules as well. I tried several things first, but I know I have to get back to these basics. I need to lose 50. 🙁 at least.
I had RNY back in 2002. I have gained 40lbs back, I constantly drink before during and after my meals. I thought it was only in the beginning after surgery that you aren’t supposed to do that? Can you refresh my memory about that rule.
Reading this has so helped and encouraged me! I’m about to get back on it.
Mic – this is a “pep talk” that I needed! You say things I need in such a down to earth way and I can really relate and understand. Thank you for your honesty, candor and encouragement. We all benefit from you – especially me!!
I meant Nic ( slippery thumbs)!
THANK YOU! I’ve followed your page for a while now & read many of your posts, but none of them have resignated with me as much as todays. I’m 2.5 yrs post VSG and in the last 6 months I’ve gained back 40 lbs of the 100 that I lost. I’ve been so depressed and felt like I had failed again at weight loss! I’m so relieved to know this isn’t uncommon and now I feel like I know how to get back to basics and stop sabotaging my WL & health. All thanks to your great tools and goals!
Thank you Nikki! I’m 3 1/2 years out and eating way too many carbs! I need to evaluate my food choices and make better ones. This article has inspired me to do just that!
Nikki what a godsend you are to me today I have gained back 16 of my 92 pound loss with vsg all I have done is compare myself to others which makes me feel like a failure but reading this blog for the first time today I can’t thank you enough.
it’s a very long blog and I have skipped past a few things but I will go back and reread everything.
thank you so very much and I will be looking forward to following you
Thanks for a great post, Nik. I’m 4.25 years post op RNY and, while I lost way too much initially, have regained about 40 lbs. I too now have a “wonder pouch”, and have found that if I eat solid proteins first (without the 2:1 ration with veggies) I fill up completely and don’t even think about food for a long time. BUT I also routinely drink in excess of 160ozs of liquid a day (mainly coffee and water), always observing the 30/30 rule, and can gulp it down. I’ve lately been wondering if that is actually increasing my hunger by moving things too quickly through my system and need to cut back some. When I don’t have liquids for long periods of time I don’t feel hungry at all when “it’s time” to eat. But when I do drink a lot my “wonder pouch” shows up.
I do also have reactive hypoglycemia, and starches and sugar give me huge sleepy spells and sweats, so they are not a regular part of my diet. When I do cheat with them, it’s always before bed so I can sleep through it. Talk about work rounds!
Thanks for what you do.
Thanks for the pep talk.
I just discovered these things myself recently. I’m 6 yrs out and was using protein shakes, protein bars and dairy as my meals as well as a whole lot of carbs. My hunger has decreased. I’m no longer spending the day grazing and consuming large quantities of food/ calories. I’m losing some of my regain and my body feels better. Awesome article.
Thank you so much. This gives me strength to do what i need to do. I had RNY in 2009 and have regained 40 pounds. I feel like such a failure. I know i have to get a grip on this before i regain 40 more pounds. I am inspired to get back on track thanks to you. This has helped me to see i am not alone in this battle,i am not a failure. I can do this!
I really needed this! This describes exactly where o am 1.5 years out. Thank you so much!
Hi Nikki, I am almost 4 years out and I lost 100 pounds starting out but then I too started noticing that I could eat the things that I was unable to tolerate in the beginning, I am a sugar addict and sweets were one of things that did not make sick, this is really weird because I hear of people having dumping syndrome which I have only experienced 3 times early on. Now I can drink small amounts 15-20 minutes after I eat but I mostly try to wait for at least 30 and I find that if I eat chicken which I no longer like I do get full so I make my self a big pot of chili beans with the celery bell peppers an onions in it I found that this one of the few foods that I really like, as far as the protein shakes I do have those with milk and I have the protein bars in between meals as my snack but I find myself eating them quite often so I have to not buy them, I did not know that the milk I use in my shakes is the cause of me being very hungry 45 minutes after I have it and the large amounts of water I drink also, I am getting your Back On Track Toolkit today, because I am fighting this weight I cannot get below 260 pnds I get there and then go back up to 267-270 this has been going on for a year and I do the liquid back on track but I fail every time my hunger gets the best of me, so I am going to do yours and pray that I have success because you have given me a lot of aha- moments when I read your blogs, thank you it gives me relief to know I am not a complete failure that this happens to some us we just have to retrain ourselves one step at a time.
I’ve followed your blog for awhile but don’t think any post touched me as much as this one. I am going to re-start following these rules that seemed to slowly slip my mind. I need to work on #1, #4 and #5. I’m hoping this will help tremendously with my appetite and my hypoglycemia.
Thanks for your blog!
Can you please comment on artificial Sweeteners – I am allergic to everything it seems. Splenda, Sweet and Low, Sweet Leaf, Truvia, Equal, stevia etc. They all will give me a migraine headache that lasts for 2 days. I’m just getting ready to have surgery and I’m trying to prepare for my “sugar-free” post op time frame. I had a hard time finding a protein shake also so any ideas or input would be greatly appreciated.
I was encouraged to read this Nik! I am 40# over goal but you give me hope I can lose it and get myself back on the program. I’ve come too far to lose all the progress I’ve made since surgery although before I read this I’d kind of accepted that my journey was over. I feel really motivated now.
Hi Nikki, thank you for your blog. This is actually the first blog I have followed and I only started today. I had a band in 2007 and due to serious complications it had to be removed. A new one was put on but within a day it had slipped again. I regain all the weight I lost, about 30kgs and was on the waiting list for my only option gastric by pass. After you have had an unsuccessful band you can’t have a gastric sleeve etc.
Now I am about 6 weeks post op with gastric bypass and generally managing well. I spent four says in ICU due to problems with my diabetes, lungs, kidneys and taking sling time to come out of the anaesthetic. Anyway everything young well. I have lost 14kgs and stopped taking insulin, now just taking oral diabetic medications. I have noticed a big changed in my mood and am feeling really positive and ready to move forward.
I appreciate so much what you had to say, it has reminded me how to eat successfully and intelligently. I don’t see a Dietition, this doesn’t seem to be what they offer in the ‘public health’ system, in Australia. Or maybe they just assume because I’ve had the band previously I know what to do. So I am using my general practiser and therapist as my accountable people. I really need that.
I also thank you for your very honest summary. Another thing the doctor did say ear protein first now I understand what he meant and about solid protein.
I will write soon.
wow! good info! i was always doing the dairy and especially greek yogurt, usually before anything else and couldn’t figure out why i was getting hungry in a short period of time. i have changed things up on my own the last few days b/c i have been having issues with hypoglycemia. and, like you nikki, i feel it is b/c i too was doing starches to “fill in the gap” between meals. the last few days i have been having “solid” protein and basically today, i had a couple strips of bacon for breakfast and it’s lunch time now and i’m still not hungry. thanks for a great post. btw ~ i am almost four years out and have probably gained back 10 pounds. i say probably b/c you know, we just don’t like to use the scale. but i promise i will start using it again
My RNY was 6 years ago, I lost almost 200 lbs , but have gained back 25-30 over the last two years. No matter what I do, I can’t seem to lose any more. On the positive side, I’m stable and not gaining anymore either. I’m wondering if it’s possible that I’ve stretched the pouch? I can’t eat beef at all since the surgery, the only meat I can eat is fish, white chicken, and pork. I can’t tolerate pasta or dairy products either, both make me sick.. I’m going to try what you suggest here. Otherwise, I’m considering seeing my surgeon again.
Thank you for this article! I haven’t been following my program and I knew it would catch up with me eventually. I hadn’t weighed myself in a very long time but I knew I had started gaining because of the way my clothes were fitting. Finally got brave and got on the scale. 14 pounds up. UGH!! The tips in this article were just what I needed to hear!
I was feeling sorry for myself, thinking I was the only one who struggled with this gaining weight. I feel better knowing I am not the only one but, it still stinks! I have done a lot of research the past few days and today starts day 1 of getting back on track. I have found I graze on food all day long. A bite here and there. I always drink with my meals, never got that rule down. I have 30 lbs to goal and I AM GOING TO MAKE IT!!!!! I may be extreme here I am starting over with liquids, I feel I need to get out of the grazing habit and think this is the best way for me.
Hi after 3 years of surgery my stomach has gained an intolerance to meat. I can eat it but it within 45mins it comes up and causes severe pain. Do you have any suggestions on other solid proteins?
I had the RY bypass and dropped a lot of weight as well I went from 425 all the way down to 225 and loved it….Now over the years Food I should be eating was making me sick while that darn bad food was staying down………..and with that it brings me back to today and I hit the scales at 361. Don’t know what to do anymore……I have started to exercise more but we know at this weight that’s not a lot of exercise…….I need to be here for my kids so any help would be appreciated………..
I lost 226 with my bypass since 2010 and had put 100 pounds back on. I started low carb,sugar calorie diet and on 14 days lost 14 pounds. I’m hoping I lose the other 86 pounds again
I had a Sleeve gastrectomy 6 years ago. My top weight was 244#. My low weight was 133#. Im currently at 145#. I have coffee with creamer in the morning. I dont eat breakfast. Im drinking beverages with my meals. Not doing protein shakes. I need to drink my water. Not eating enough protein rich foods. No exercise…..i need a reality check and a reset asap. Thank you everyone for the tips. Ive been living like i never had a weight problem before. I want to see the scale go back down. I want to have control.
Thank your for the blog. I had bypass in 2009 and revision surgery in 2014 after ending up with feeding tube due to malnutrition! Still having problems and more surgery scheduled next month. During this time I’ve had four children and ate crap – mainly biscuits as only did to go down for a long time and then bad habit got me and have put 60lb back on. I need to look at these rules again especially the drinking and eating proteins not just the easy foods that are calorific. Thank you.
the most important thing i think is to have a support group. i am glad to see that i am mot the only one who fall of the wagon. i really need support to stay on tract
Hi I am 4 years post Gastric sleeve. I also got pregnant 10 months post op. I got down from 326 to 220. I only gained 14 lbs with pregnancy but have gained back some. So, here I sit at a plateau for the last 8 months @ 256. I am wanting to start the decline again toward my 180 goal. Thank you for the article It is a good read and I will be revisiting it.