How I Accidentally Reset My Pouch and Got Back in Control of My Hunger & Appetite

 

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:

1. 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!)
2. 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!)
3. Drinking with or directly after my meals.
4. Not eating a balanced meal.
5. 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.

The Results

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:

1. 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.
2. 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.
3. 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.
4. 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.
5. 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!
6. 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:

1. 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.
2. 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!
3. 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.
4. 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!

Take the first step!