Monday, December 10, 2012

Why I hate the 5 Day Pouch Test

In Weight Loss Surgery circles, there is this thing called "The Five-Day Pouch Test". I hate it.

What it claims to be is a way to "reset" your pouch and get you back on track. What it actually is is a crash diet with a fancy name.

Now, whenever I say this online, I get a lot of flack. The first saying "it is not a crash diet!' To which I say:

Oh really? If a friend came to you and said, "I've found this great diet. You consume nothing but liquids for two days, then soft proteins for a day, then firmer proteins, then the last day you do hard proteins."

Would you think that sounds like a well-balanced diet or some sort of gimmick? To me, it's a gimmick and not a healthy one.

The definition of a crash diet is one that "is extreme in its nutritional deprivations, typically severely restricting calorie intake. It is not meant to last for long periods of time, at most a few weeks. Importantly, the term specifically implies a lack of concern for proper nutrition."

The only measure that "The Five Day Pouch Test" doesn't meet for this definition that you aren't supposed to limit your calories on it (though most people who do this test do restrict their calories). But it has all the others.

The idea of this diet is that it mimics how we eat the first four to six weeks out from surgery. This is somehow supposed to "reset" our pouches (or, I guess, sleeves if you didn't get gastric bypass) and "detox" us from carbs. The problems I with this are three-fold:

1) This is not a healthy way to eat

When we first have surgery, we have to stay on a liquid diet because we need to avoid agitating our stomachs until it heals. This is not a time of learning how to eat for live. It's usually miserable because it's so hard get anything down. We consume protein shakes, broth, sugar-free popsicles, whatever it takes to get enough liquid and protein into us.

Does that sound remotely healthy? No. We eat like this early out because of medical necessity, not because it's a good way to eat.

Once we heal, we gradually introduce food that is more solid, starting with soft foods and working our way up. Again, we do that out of necessity. The staple lines may be healed but everything is very swollen and hardly anything fits. Softer foods are less likely to get stuck and be uncomfortable to eat.

So we live off cottage cheese and yogurt and chili and not much else. Again, not a healthy way to eat and not a way we should eat long-term.

2) Eating like this doesn't teach us anything long term or encourage good habits

Once we get to the point after surgery where we can eat regular food, the fun begins. We get to retrain our taste buds and relearn how to eat. We can't eat much so we can experiment to see what works for us and we develop good habits during a time when we aren't feeling much (if any) hunger and so we're not craving a lot of junky foods.

But the "5 Day Pouch Test" stops exactly when you get to this point. It only takes you through the first couple of weeks post-op (at a much accelerated pace) and then stops just when it gets to the point where you need to make choices and develop habits.

Not to mention, five days isn't enough time to develop good habits or much of anything.

3) The name of the diet implies things it can't deliver

Because it has a bariatric name, a lot of people assume that this is some sort of official diet that comes recommended by surgeons and bariatric programs. It's not. It was invented by a bariatric patient and I know of not one bariatric program or surgeon who recommends this diet to their patients.

It also doesn't test anything. Liquids go right through you and the soft and slightly firmer foods that you are on for most of the diet are slider foods. So the diet doesn't show you whether or not your pouch/sleeve still gives you restriction.

Plus, it's not in the name, but the diet doesn't actually "reset" anything either as some people claim. The stomach is an organ and you can't change its size in five days. But I've seen people claim that this diet will shrink your stomach. Sorry, it doesn't work like that.

Now, maybe it might "reset" someone mentally to not consume carbs for five days in a row. Plus carbs are those sort of things where the less you eat, the less you want them so there is a chance it might reset something physically. But there is no requirement to go on a special diet to cut down on your carbs and it's unlikely that five days is long enough anyway.

Not to mention, if you want to make long-term, lasting changes, going on a special diet that forces you to eat in an unhealthy and unsustainable way is not the best way to accomplish that. Since you haven't learn anything or developed new habits, as soon as you start eating carbs again, you'll be right back where you started.

I see this all the time with people who rave about this diet. They say things like "I use it all the time!" as if that's a good thing.

I don't think it's a good thing. I think a good thing would be to do something that causes a permanent positive change that gets you closer to your goal. The best diet in the world would be one that you went on once and never needed to use ever again. But that doesn't exist because:

DIETS DON'T WORK

Which is my final complaint about the diet. It's a diet. It's not a plan to help you develop good habits or improve your relationship with food. It's not a set of rules you can live by either. It's just a diet, a very short diet, that has you eat in an unhealthy way, with the hope that it leads to some sort of permanent change.
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