Get over it: The Pouch won't save you

January 13, 2006

I had a realization: This process isn't about The Surgery and The

Pouch. The Surgery/Pouch is a lovely 1.5 year distraction from what

ultimately matters: The rest of your life.

Here's is a letter I wrote to a postop person who didn't lose as much

as she wanted to, and then gained some weight back.

Dear A.,

I'm 3+ years out. The truth, from my experience and what I've

observed, is that the pouch gives us 3 things:

Fast weight loss (for a while).

Early satiety: we can feel full on less food, but over time the pouch

expands, so we have to learn to pay attention and not override this.

A feeling of fullness when we're full: This is a signal that some of

us never had. We have to learn and practice with this, too.

Lots of us have believed that our weight gain was beyond our control.

We wanted to be one of those mythical people who never had to say " no "

to food and could eat whatever/whenever and get/stay thin. Our

failures with diets caused us to resign ourselves to passivity and fat.

To most post-ops, the weight loss in the first 1-1.5 years seems

effortless, and it's a fulfillment of our fantasy. Lots of people find

they can eat to their capacity (which in the beginning is small), even

experiment with carbs, and still lose weight. Sure, there's dumping.

But that often wears off. And how do I/we know that? Because we don't

refrain from eating sugary foods. We try them again and again.

Inevitably the easy weight loss stops. The good news: It's unlikely

that, on our own, we could have lost that much in that short a period

of time. The bad news: Most people don't get to the weight they want

to be at. Most people end up craving food and overeating, just like

before. And many people gain significant amounts of weight back. It's

pretty normal to stabilize at 10-15 pounds above one's lowest point,

but after that lots of people go back to their old habits and creep

up. By the 5-year mark many people have reverted to old habits. The

smaller stomach may stop them from getting all the way up to where

they were, but there's no guarantee.

In non-surgery life, only a tiny portion of morbidly obese people lose

more than 100 pounds, and about 1% of those can keep it off for more

than 5 years.

What does this mean?

It means that the pouch is not going to keep your weight off. It's a

tool to get to a lower weight. It's a tool that can help you learn to

eat less. It's a tool that can help you experience fullness. But you

have to use discipline and etc. to keep the weight off, or you'll gain

it back. You have to stick to the basics of the program, and be honest

with yourself about what you're eating.

The pouch does not stop you from snacking. The pouch does not stop you

from telling lies to yourself...like: just this one time a

triple-caramel frappucino with whip won't make any difference; your

body needs carbs to live; etc. etc.

You are doing the right thing to get therapy, and do everything you

can to get back on track. The good news is that you still have your

pouch, it still works, and you can still lose the weight. You just

have to do what all of us have to do: Learn to eat with discipline.

Martha S. (RNY 9/30/2002, size 28 -> size 6)

January 13, 2006