Question:
Cottage cheese test

My beautiful twin, Carolyn, sent me this information to share with you. Actual instructions on how to do the "test". This was presented at the 2000 meeting of the ASBS by Dr. Latham Flanagan, MD. I have read about it before but didn't really have instructions on how to do. "How big is my pouch? This is a question that just about all patients ask. It is expected and appropriate that the stomach pouch will enlarge somewhat as the months pass after gastric bypass. Some of this enlargment is an actual increase in size and some represents a softening (regaining of elasticity) of the pouch and its outlet. The real answer is that the FUNCTIONAL size varies with many factors such as the time of day, the amt of time taken to eat, the type of food eaten, mood of the patient, and other factors. It is expected and appropriate that the pouch will handle a much larger amt of mushy foods such as mashed potatoes and less of solid food such as chicken. This test is meant to be a standarized, reproducible measurement of the physical size of the stomach pouch in a person who has undergone gastric bypass surgery. 1. Purchase a container of small curd, lowfat cottage cheese. Begin the test with a full container and in the morning before you have eaten anything. This will be your breakfast that day. Eat fairly quickly for less than five minutes or until you feel full. The idea of the rapid eating is to fill the pouch before there is much time for food to flow out of it. 2. After eating your "fill" of cottage cheese, you will have a partially eaten container that has empty space where the cottage cheese used to be. 3. Start with a measured amount of water (16 oz for example) and pour water into the container of cottage cheese until the water is level with the original top level of the cottage cheese. 4. Voila! The amt of water poured into the container is the FUNCTIONAL size of the pouch. IF THIS IS YOUR FIRST TIME DOING THE TEST, DON'T PANIC. You are likely to find that the cottage cheese size of your pouch is way bigger than your surgeon told you he/she made at the time of surgery. Dr. Flanagan's data indicates that the average size of the mature pouch by cottage cheese is 5.5 oz. HE ALSO FOUND THAT SIZES RANGING FROM 3 TO 9 OZ HAVE NO IMPACT on the person's success in weight loss". Hope you all find this as interesting as I did! I will do the test as soon as I get some small curd cottage cheese! Thanks, Carolyn Gilliland, for sending this to me and Dr. Flanagan for this simple test! Good luck all.    — Marilyn C. (posted on August 21, 2001)

August 21, 2001
I've read about this but wouldn't it be easier to start with a measured amount of cottage cheese then eat what you can and see how much is left in the measuring cup? (For example -- put 10 oz of cottage cheese in a measuring cup, then eat what you can, then see what is left and subtract that from the original 10 oz). Just an opinion. By the way, I'm 9 weeks and really curious but I hate cottage cheese! :-)
   — Kimberly L.

August 21, 2001

   — carou1313

August 23, 2001
Thanks! I too read the excellent article (you can find it at www.oregoncenter.com) but wondered how to actually do the test. I think the reason you use water to measure is to keep it consistant, and more accurate.
   — blank first name B.

August 23, 2001
Almost 10 months post op RNY and I can hold 6.5 oz of cottage cheese. This I can live with! The reason for the water is to measure the volume of the pouch. I guess water measures better than anything for volume. I don't know what else would work besides cottage cheese as the consistency is just right for this test. Any ideas for those who hate cottage cheese? Maybe sugar free tapioca? Not sure.
   — [Anonymous]

August 24, 2001
Another suggestion, if you want to get a real feel of the size of your stomach, would be to take that container of cottage cheese with the water in it, and put it in the freezer. The water would probably freeze before the cottage cheese and then you could take it out and hold it in your hand and really "feel" the size of your stomach.
   — Monica H.