The Pouch Reset – Does it really work???

Very popular on WLS forums, the Pouch Reset diet claims to shrink your stomach back to the size it was right after your sleeve. But, before you jump on board, let’s put a magnifying glass over this diet and see if it actually does what it claims.

What is the Pouch Reset diet?

Often done over 2-6 days, the Pouch Reset makes you go back to post-op liquids, followed by purees then a return to solids. The Pouch Reset diet claims two major things:

1. Going through the Pouch Reset will shrink your new stomach back to the size it was initially after surgery if you’ve stretched it; and because of this,
2. The Pouch Reset will start weight loss again if you’ve plateaued.

Now let me start by saying this… There are no published studies I can find anywhere that have tested the Pouch Reset diet, which is perhaps evidence in itself. However, let’s go through the two claims above and see if what we can find.

Does your stomach stretch after surgery?

First things first, does your stomach actually stretch after surgery? The short answer is YES. Your stomach is very stretchy – it expands each time we eat to hold a meal then reduces in size when it’s empty (think like a stretchy sock or a Tubigrip bandage…) Research suggests that after a sleeve your stomach will stretch by about 50% over the first 2 years after the surgery. It’s very rare for it to expand to the size it was before surgery. Don’t worry though, a small stretch in your sleeve won’t necessarily mean you won’t keep the weight off in the long term (more on that later).

So, does the Pouch Reset diet shrink your stomach back to the size it was after surgery?

The short answer here is no. Your stomach feels very small initially after the surgery due to swelling from the wound. As the swelling goes down and the wound heals you can tolerate thicker textures without putting pressure on the wound. This is why we start you on liquids then progress to purees before going to soft foods and back to normal. So, when a diet is claiming to shrink your pouch back to the size it was just after surgery, it doesn’t really make sense – you can’t because you don’t have the swelling!

Will the Pouch Reset kick start weight loss?

Ask yourself this… Is your stomach size the only reason you struggle with your weight? And, if a diet like the Pouch Reset could shrink your stomach, why don’t all health professionals recommend it? Playing Devil’s Advocate – maybe we could do away with weight loss surgery altogether and just shrink our stomachs this way?!

The problem here is that, like many other fad diets out there, the Pouch Reset assumes that the size of your stomach is the only reason for a stall or for regaining some weight and that the whole reason a sleeve works well is because it leaves you with a small stomach. But we know it’s just not that simple! There are a whole bunch of things from appetite hormones to genetics, to gut bacteria to emotions to culture and everything in between, all impact our weight and weight loss. A sleeve works because it impacts your appetite, as well as changing the foods you like and reducing portions, so simply making the stomach smaller is only part of the equation.

Are there any positives?

Whilst the two main claims made by the Pouch Reset diet are not based in evidence and we need to be more realistic about why it might help to restart weight loss, there is one positive I can see. Often when you go on a diet like this, you’re actually resetting your habits (perhaps some of those old ones that have snuck back in…) and your awareness of when, what and why you eat. A change to eating patterns can help you be more mindful and realise why and when you eat even though you’re not hungry which is great, although there are plenty of other ways to do this without doing the Pouch Reset. .

The bottom line…

The Pouch Reset you find online, isn’t balanced and it doesn’t contain the nutrition you need, not to mention the lack of evidence for it. What we do every day is more likely to have a long term effect than a diet you carry out for a week. So, instead of a Pouch Reset, do you own Habit Reset! Go back to the basics of eating after a sleeve and use the weight loss surgery habit checklist (below) to see what you might work on to make sure you maximise your weight loss in the long term.