Guest guest Posted August 3, 2005 Report Share Posted August 3, 2005 Thanks for this information Robynn. I think this is great and will be very useful as I will be six month post op on Aguust 9th (yeah!!). Pam Marsh --- Robynn VanPatten robynnsf@...> wrote: > : I found this interesting article that might > offer some insight to you in your struggle.... > > Robynn > > INTRODUCTION: > > > > A common misunderstanding of gastric bypass surgery > is that the pouch causes weight loss because it is > so small, the patient eats less. Although that is > true for the first six months, that is not how it > works. Some doctors have assumed that poor weight > loss in some patients is because they aren’t really > trying to lose weight. The truth is it may be > because they haven’t learned how to get the > “satisfied” feeling of being full to last long > enough. > > > > HYPOTHESIS OF POUCH FUNCTION: > > > > We have four educated guesses as to how the pouch > works: > > > > 1) Weight loss occurs by actually “slightly > stretching” the pouch with food at each meal or; > > 2) Weight loss occurs by keeping the pouch tiny > through never ever overstuffing or; > > 3) Weight loss occurs until the pouch gets worn out > and regular eating begins or; > > 4) Weight loss occurs with education on the use of > the pouch. > > > > PUBLISHED DATA: > > > > How does the pouch make you feel full? > > > > The nerves tell the brain the pouch is distended and > that cuts off hunger with a feeling of fullness. > > > > What is the fate of the pouch? Does it enlarge? If > it does, is it because the operation was bad, or the > patient is overstuffing themselves, or does the > pouch actually re-grow in a healing attempt to get > back to normal? > > > > For ten years, I had patients eat until full with > cottage cheese every three months, and report the > amount of cottage cheese they were able to eat > before feeling full. This gave me an idea of the > size of their pouch at three month intervals. I > found there was a regular growth in the amount of > intake of every single pouch. The average date the > pouch stopped growing was two years. After the > second year, all pouches stopped growing. Most > pouches ended at 6 oz., with some as large at 9-10 > ozs. > > > > We then compared the weight loss of people with the > known pouch size of each person, to see if the pouch > size made a difference. In comparing the large > pouches to the small pouches, THERE WAS NO > DIFFERENCE IN PERCENTAGE OF WEIGHT LOSS AMONG THE > PATIENTS. This important fact essentially shows that > it is NOT the size of the pouch but how it is used > that makes weight loss maintenance possible. > > > > OBSERVATIONAL BASED MEDICINE: > > > > The information here is taken from surgeon’s > “observations” as opposed to “blind” or “double > blind” studies, but it IS based on 33 years of > physician observation. > > > > Due to lack of insurance coverage for WLS, what > originally seemed like a serious lack of patients to > observe, turned into an advantage as I was able to > follow my patients closely. The following are what I > found to effect how the pouch works: > > > > 1. Getting a sense of fullness is the basis of > successful WLS. > > 2. Success requires that a small pouch is created > with a small outlet. > > 3. Regular meals larger than 1 ½ cups will result in > eventual weight gain. > > 4. Using the thick, hard to stretch part of the > stomach in making the pouch is important. > > 5. By lightly stretching the pouch with each meal, > the pouch send signals to the brain that you need no > more food. > > 6. Maintaining that feeling of fullness requires > keeping the pouch stretched for awhile. > > 7. Almost all patients always feel full 24/7 for the > first months, then that feeling disappears. > > 8. Incredible hunger will develop if there is no > food or drink for eight hours. > > 9. After 1 year, heavier food makes the feeling of > fullness last longer. > > 10. By drinking water as much as possible as fast as > possible (“water loading”), the patient will get a > feeling of fullness that lasts 15-25 minutes. > > 11. By eating “soft foods” patients will get hungry > too soon and be hungry before their next meal, which > can cause snacking, thus poor weight loss or weight > gain. > > 12. The patients that follow “the rules of the > pouch” lose their extra weight and keep it off. > > 13. The patients that lose too much weight can > maintain their weight by doing the reverse of the > “rules of the pouch.” > > > > HOW DO WE INTERPRET THESE OBSERVATIONS? > > > > POUCH SIZE: > > > > By following the “rules of the pouch”, it doesn’t > matter what size the pouch ends up. The feeling of > fullness with 1 ½ cups of food can be achieved. > > > > OUTLET SIZE: > > > > Regardless of the outlet size, liquidy foods empty > faster than solid foods. High calorie liquids will > create weight gain. > > > > EARLY PROFOUND SATIETY: > > > > Before six months, patients much sip water > constantly to get in enough water each day, which > causes them to always feel full. > > > > After six months, about 2/3 of the pouch has grown > larger due to the natural healing process. At this > time, the patient can drink 1 cup of water at a > time. > > > > OPTIMUM MATURE POUCH: > > > > === message truncated === __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.