Pouch Guide

INTRODUCTION

A common misunderstanding of gastric bypass surgery is that the pouch causes weight loss because it is so small that the patient eats less. Although this may be true for the first six months, that is not how it works over the longer term. Some doctors have assumed that when a patient experiences poor weight loss it is because he or she isn’t really trying to lose weight. The true reason is probably that the patient hasn’t learned how to get the satisfied feeling of being full to last long enough.

IDEAL MEAL PROCESS (“Rules of the Pouch”):

1. Eat your meals five hours apart or you will get too hungry between meals.
2. Eat finely-cut meat and raw or slightly cooked vegetables with each meal.
3. Eat the entire meal in 5-15 minutes. A significantly longer meal will cause failure.  It shouldn’t take any longer than it would to play a game of free bingo.
   
4. Drink no liquids for 1½ to 2 hours after each meal.
5. After 1½ to 2 hours, begin sipping water and over the next three hours slowly increase water intake.
6. Three hours after the last meal, begin drinking lots of water/fluids.
7. 15 minutes before the next meal, drink as much as possible, as quickly as possible. This is called “water loading.” IF YOU HAVEN’T BEEN DRINKING OVER THE LAST FEW HOURS, THIS ‘WATER LOADING’ WILL NOT WORK.
8. You can water-load at any time during the 2-3 hours before your next meal if you get hungry, which will cause a strong feeling of fullness.

THREE PRINCIPLES FOR GAINING AND MAINTAINING SATIETY

1. Fill the pouch full quickly at each meal.
2. Stay full by slowing the emptying of the pouch. (Eat solids. No liquids 15 minutes before and none until 1½ hours after the meal). A scientific test showed that a meal of egg/toast/milk had almost completely emptied out of the pouch after 45 minutes. Without milk, i.e., with just egg and toast, more than half of the meal still remained in the pouch after 1½ hours.
3. Protein, protein, protein. Three meals a day. No high-calorie liquids.

Also, feel free to view/download the complete Pouch Rules PDF document, which goes into much more detail.