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 toaddress 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 bytalking 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:

  • – 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!


  1. See also; Juice "cleanse" – there is absolutely NO SCIENCE backing up the claim that juiced fruits and vegetables have any more benefit than actually eating the fruits and vegetables. No proof. Juice will not detox you any better than eating the actual produce.

  2. Actually, the Cottage Cheese test was developed by a bariatric surgeon as part of some research he was doing on restriction and satiety at the suggestion of another bariatric surgeon. It's basically just a quick way to measure pouch/sleeve size without having to get an Upper GI which your insurance may or may not pay for particularly if you just want to know and have no medical reason to know. (They usually pay if you have a medical reason, but they aren't going to pay if you are just curious.)

    You can read more about it here

  3. I did the pouch test over a year ago. it got me back on track, cut my crazy carb cycle and I'm now down 80 pounds! what do u do on day 6 u asked? Uhhh..follow the diet u were sent home with post surgery? seems obvious to me! stop bashing something u know nothingv about..Bzzzt!

    • Not bashing. But I am expressing an opinion. Glad it worked for you. Fad diets often do work for some people, but rarely all. Good luck with your journey.

    • It's not a fad diet! And..u do it for a whopping 5 days! Oh my..the harm it could r crazy..

  4. Hey Nik! I used to think like you do about the 5 day pouch test. I am 5 years out now and I am up 20 pounds after a loss of 140 which technically is very good by most standards. My problem is the name of this "diet" First of all let me say, I never I thought my pouch was "broken" I would lie if I said I didn't care what the scale said. After all the work I did on this 5 day plan I would be dissapointed to not see some sort of loss!
    This program however helped me reset my brain. I was getting into some bad habits (hence the weight gain) My cravings were getting bad and my carb intake was out of control. I was also starting to not pay attention to refraining from water at least 30 minutes after my meals. ALL the things I was so attentive to the first few years.
    This program stopped me in my tracks and made me realize what all I had been doing wrong without even realizing it. It took me back to the mindset where I was at early out and got me motivated again. Most of all when sticking to this plan I realized I wasn't hungry anymore. I realized I felt in control once again.
    So my opinion of his is as follows:
    1. This should NOT be done by someone as early out as 2 years and under.
    2 After the 5 days is over if your brain hasnt reset then take 2 days of eating sensibly and try it again for another 5 days.
    3. This should not be done because you think you "ruined" your pouch or you're only doing it for quick weight loss.
    In fact I wish the name of this program would just be changed to , "Back to the EARLY basics of your tool….relearn how to USE it wisely"

  5. I completely agree with Nora about the 5 Day Pouch Test. Nothing has gotten me to so quickly snap back into reality as it did. Nothing stopped the terrible carb cravings like it did. Nothing got me thinking about the details like it did. I struggle every single day of my life…basically every single minute. This has been the only thing that has given me a sliver of hope.

  6. Hi Kelly,

    Thanks for your honest feedback. While my opinion hasn't changed I think it's important to have voices on both sides of that debate!

  7. I just finished the 5 day test, and I agree with the people that feel it does it's job. I am 9 years out, and went up 20 pounds above what I settled at about 2 years after my surgery. My first choice had turned to carbs and a little protein, and little water. This has reset my mind to what I should be doing. I did drop 10 pounds during the 5 days, so that was a plus.
    By the way….everyone….keep up with your vitamins. I slowly got out of the habit of taking them…I didn't think I needed them. Within 2 years my teeth started decaying faster than my dentist could fix them. I had dry mouth all the time, sores in my tongue, my mouth and my lips, and I ended up with dark circles under my eyes, like a racoon. I then lost 20 pounds in 2 months without any change in my diet, not good, though I liked the loss. My doctor finally ran some tests and found I was very low in a lot of vitamins, and I almost had to resort to iron infushions! My body was starving itself, and taking nutrients wherever it could find them. It has been 13 months now that I have been back on track with my vitamins and all is back to normal. I had to get all my teeth recapped as I was on the brink of getting full dentures. And, I gained back the 20 pounds, again in 2 months, but then went another 20 up. That is when I resorted to the pouch test, and it has gotten me back on track. Sorry for the lengthy reply, but I try and remind all WLS patients not to forget the supplements or there are repercussions!

  8. You know, I came to this site to read another opinion about the 5 Day Pouch Test and I have to admit, the authors responses have been so vile and arrogant that I will never come back.

    Whoever writes under the guise of Bariatric Foodie, your cracks are showing as a person. And by cracks, I mean just how miserable you are in your own life.

    Peace out! No need to respond as I wont be back.

  9. Well Anonymous, I will respond because it's my website and I want to!

    I don't claim my opinion is right or anyone's gospel. This was written a few years ago and although my opinion remains unchanged you can see that many folks don't agree with me – and that's ok!

    I believe everyone is entitled to their opinion and everyone is in charge of their own journey.

    So if you chose not to return, I respect that choice. I won't even address the "cracks" crack cuz…well because I don't have to! Good luck on your journey. And keep playing with your food!


  10. Nik,

    I have always LOVED LOVED LOVED your blog. I am doing the 5 day pouch plan right now. I love hearing your opinion on it because I have always had so much respect for you. I know that my problem the last 6 months has been a mental thing. I have caused my regain by munching on CRAP. I am not using this as a method to "reset" my pouch or "fix" anything. I am following the guide to A) get the carbs out of my body and B) get myself back in a mind set of disapline and control. Thank you so much for being such an open and honest person.

    Much Love to Bariatric Foodie!!!!!

  11. I know this is old, but wanted to comment. My doctor recommended that I do this and follow my diet as though I was post op at like 3 months. Keep my calories around 1200 to keep losing 1500 to maintain. I needed to do this, my carbs are out of control and can’t seem to get back what I need to do. He suggested this as a way to restart my thinking and go back to the basics. My nutritionist signed off on this and agreed.

    • Hi Stefani,

      I’m glad you reached out to get yourself back on track. I admit my opinion of the 5-Day Pouch Test has not changed much since I wrote this post. I see time and again that many folks do NOT do what you did (which is also seek out the help of your medical team) and think this plan is some sort of cure-all. So while my overall opinion of it has changed little, I do respect your opinion and that it worked out well for you. And I’m glad it did! I wish you all the best.

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