Weight Maintenance / "Rules of the Pouch"

For all of you who have had Roux en Y surgery, and are in your weight maintenance phase, I have a few questions...

Up until now, while losing weight, I've been following all the guidelines re: not drinking for 30 mins before meals, not drinking with meals, and not drinking for 30 mins after meals.

I'm now 125 lbs (sooo surreal!!!).  I originally thought I'd be happy to lose 80 lbs, but now that I've reached my 4th revised goal and lost 102 lbs, I want to start a maintenance program.  I've been reading and re-reading the "Rules of the Pouch".  I'd like to find out if you follow these rules, and if you find they work.  Specifically, do you stop drinking 15 minutes before a meal?  Do you take only 5-15 minutes to eat and finish each meal?  And, more importantly, do you wait at least 1.5 - 2 hours after each meal before drinking?  This last rule sounds very difficult.  I've adapted (not happily, but c'est la vie) to not drinking with my meals, but I'm thirsty after meals, and even waiting 1/2 hour seems long, sometimes.  I really don't know if I could wait 1.5 - 2 hours to take a drink, following each meal (even if I manage to do the pre-meal "water loading").

Also, how did you approach the transition from weight loss to weight maintenance?  I track my protein and calories (and sometimes my carbs), and thought I was eating more than before, but the weight is still coming off, albeit more slowly.  Don't get me wrong, I'm not complaining, but I want to be realistic and maintain at where I am now.  Did you start adding a certain amount of extra calories each day, for example on a weekly basis, and seeing if your weight stabilized?  I would have thought that the calorie malabsorbtion would be over by now (my surgery was almost 9 months ago), but perhaps it's still happening.

BTW, I wish to God that I was a "dumper", but alas, I am not.  That really worries me!  I know that I can easily get off track of healthy eating, and start going down that slippery simple carb slope.

Would appreciate your input and hearing about your experiences.  Thank you and have a great day!

When we talk with members, we address some of your questions.  In addition, a couple of staff on our MS team have had RNY.  Your surgeon/registered dietician should have given you some guidelines to follow for their recommendations.  Congratulations on your amazing success!!

Don't drink for a minimum of 30 minutes before and after your meals.  It is very important not to drink for at least 30 minutes after a meal is you essentially flush the food in your pouch thus your sense of satiety will not be as long, and you'll get more hungry earlier after your meal. 

Meals should be around 15-20 minutes.  If you reach satiety before that time, stop eating.  Don't go past 20 minutes because you'll consume more calories and a healthy portion meal can be eaten in 15-20 minutes maximum. 

The honeymoon period for most RNY post-ops is between nine months to even 18 months.  It will vary from person to person but that is generally the window of opportunity for losing post-operatively. 

Again, we recommend talking with your surgeon or registered dietician for their recommendations on introducing new foods in your maintenance phase.  Whatever foods you introduce, make sure they are high quality, nutritionally packed foods.  It could be a protein drink as a snack, a few ounces more of protein, more fruit and/or veggies. 

Lastly, just because you don't dump doesn't mean you shouldn't eat the foods that cause dumping syndrome.  Think of yourself as a RNY with dumping syndrome because the foods that cause dumping are not healthy.  Not dumping doesn't give any of us license to eat those foods. 

It is great that you are cautious about introducing foods into your maintenance stage of your WLS healthy lifestyle.  A little bit of caution shows that you respect your pouch and appreciate your amazing weight loss success. 

Check out our OH blog for lots of good articles.  Some of the nutrition articles are written by registered dieticians that are experienced in bariatrics. 

WAY TO GO!!! 

 

I lost all my weight in the first year and have been maintaining since then. I don't do anything differently than I did when I hit the one year out mark that I'm aware of. I still eat protein only or protein forward meals, I am at 1200-1500 calories per day depending on my activity level. I adjust that up or down depending on what I'm doing. I have always - as per my surgeon's rules-not had anything to drink during meals. I drink up to my meal and then not for 30 minutes after. With our food always needing to be moist, the gravy, meat juice, ff sour cream, au jus, or salsa adds enough liquid for me not to be dying of thirst when I'm done eating. I always wait at least 30 minutes to drink. I have friends post op that started drinking during or right after meals and they say it's the easiest way to start putting weight on so I'll never do that. once I eat I can't fit any water in anyway - it hurts. I don't dump either and find it fantastic because I can go to a grad party, wedding or birthday celebration - have a bite or two or three of cake and I'm satisfied and not worried I'll get sick while out and about. I have to police myself but one or two bites usually satisfies me and I'm fine. I didn't knowingly increase calories - I just ate when it was mealtime, added in a protein snack when doing strenuous activity and it's worked for me. You'll find what and how much you need to eat each day to maintain, lose or gain a bit. We all have to find out what works for us. For me it's 3 meals a day, a snack in the late afternoon and lots of water and exercise.

Jen 11+ yrs post op RNY

I have maintained my weight loss of 102 pounds for almost 3 years now.  When I first started going through maintenance, it was suggested that I add back 100 calories a day every wee****il my weight loss stopped and I leveled out.  I started maintenance when I hit a normal BMI and still lost another 12 pounds over the next 3 months.

I still follow all the "rules of the road" regarding protein, complex carbs and drinking my liquids.  I have 3 meals and 2 snacks a day for a total of around 2100 calories, which is what it takes to maintain with my activity level and the only way I can maintain my weight is to still track everything I put in my mouth.  I've found that if I stop tracking, I start losing again.

Fortunately for me, I DO dump, so nothing sugary for me.  12-15g of sugar at once is all I can handle without dumping.  I've compensated by finding sugar free recipes for a lot of my pre-op favorite desserts and I don't feel deprived at all.  :)