5DPT Bulletin
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May 2014

May Theme:

Traveling the bumpy WLS road Together Fighting the Disease!  
"If we are to achieve a healthy life we absolutely must fight like a mad dog against everything that made us obese in the first place."
~ Kaye Bailey
5DPT Owner's Manual

Many factors influence body weight-genes, though the effect is small, and heredity is not destiny; prenatal and early life influences; poor diets; too much television watching; too little physical activity and sleep; and our food and physical activity environment.
Harvard School of Public Health

The Four Rules:  

 Before surgery most of us were taught the Four Rules we must follow in order to achieve the best results with weight loss surgery - any procedure. Those rules (with minor variations from one bariatric surgeon to the next) are:

  • Protein First
  • Lots of Water
  • No Snacking
  • Daily Exercise  

In order to maintain weight loss and keep the obesity from which we suffer in remission we must follow these rules for life. When we meet patients who have maintained a healthy body weight for several years with weight loss surgery we learn that in most cases they live by the Four Rules. 


If it has been a while since you have given consideration to the Four Rules I invite you today to spend a little time refreshing your knowledge and enthusiasm about Protein First. Actually, this is my favorite rule because it means good food without the guilt! Link to the articles of interest and take a look at some of our great WLS recipes. There is something for everyone as we get excited again about the Four Rules!  


 5 Day Pouch Test Owner's Manual 2nd Edition

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Q: What if I mess up again? I'm tired of starting over.

A.  As a lifelong person struggling with the disease of obesity the all-or-nothing mentality of falling off the wagon is something that continues to perplex me. Do you know what I'm talking about? I will have good intentions to have an omelet and tomato slices for breakfast but for some reason I chose instead to have a toasted bagel slathered with cream cheese. Naturally the high carbohydrate and high fat breakfast makes me feel sluggish and miserable so I think, "To hell with it" and continue to make poor dietary choices the rest of the day. Now you know what I'm talking about, I see you nodding your head. (This still happens to me once in a while, I'll be honest with you.)

Years ago in one of the many diet programs I was following, and I am not sure which it was, a counselor talked about dropped eggs as the theory applies to the scenario above. She asked if any of us, while in the kitchen baking, had accidentally dropped an egg on the floor. We all nodded yes. She then asked if we said, "To hell with it" and proceeded to drop the remaining eggs on the floor. We all nodded no, of course not! "Then why, when you drop the metaphorical diet egg do you say to hell with it and break the diet for the rest of the day?" Great allegory!

Dropped eggs happen. We are human. We live in a difficult world. So the next time you drop the diet egg visualize getting a paper towel, wiping up the spill and moving forward. Dropped eggs happen and a great deal of life and living is all about cleaning up messes.

Shared with permission from "Day 6: Beyond the 5 Day Pouch Test" by Kaye Bailey. Copyright 2012 - LivingAfterWLS ~ All Rights Reserved. Pages 26-27.

Day 6: Beyond 5DPT


5DPT Infographic:
Was my 5DPT a Success?

(Click image for full scale image)
5DPT Success Infographic
Was my 5DPT a success?

Memorize this:

"Every meal stands alone. I understand I have the opportunity to select nutrient rich food at my next meal and each meal choice is completely independent of any previous dietary selection."  

Project 2014: Season I - Unit  7 


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Four Rules Refresher

Four Rules

We lived by the Four Rules during the early weeks and months following weight loss surgery. Then we became a little more comfortable and let the rules slide a bit here and there as we tried to "get back to normal." But the fact is, our weight loss surgery will never allow us to be "normal" again. By embracing the Four Rules -- not just during weight loss, but for life -- we can maximize our weight management with the surgical pouch.

It is remarkable how many people report a renewed sense of empowerment when they return to the Four Rules because again they feel the power of the pouch and often weight loss results or weight regain is halted.

As a refresher the Four Rules are:
  Protein First
  Lots of Water
  No Snacking
  Daily Exercise

Learn More:
5DPT Featured Articles


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Welcome back to the 5 Day Pouch Test Monthly Bulletin from LivingAfterWLS! Great to see you. Earlier this year we ceased publication of this newsletter to concentrate on our Project 2014, our new year-long education and support program. So many of you missed the Bulletin we are pleased to bring it back full of great content and inspiration to support you on the 5 Day Pouch Test and beyond.

Today's Bulletin includes a thoughtful essay on the definition of obesity as well as our trending FAQ's, some inspired peer support. Just for fun we included healthy smoothie recipe for refreshing nourishment as warmer weather arrives. Thanks for joining me and I hope you are happy to see the Bulletin back. But don't miss out on Project 2014 - we have a great group on Facebook and are eager to see you there.
Kaye Bailey

"I believe in you.
You deserve to be healthy.
 You deserve to be kind to yourself.
You deserve to achieve your greatest level of success with weight loss surgery when you harness your inner resources."
--Kaye Bailey
5 Day Pouch Test Owner's Manual

Copyright Consideration:

You are our valued reader. We respect your rights and privacy by never sharing your information with a third party. Please respect our creative rights by honoring copyright laws and prevent plagiarism.

If science calls obesity a disease,
Why do we call ourselves fat?

We are not the disease!

By Kaye Bailey
(Please note this article was published last month in our Project 2014 newsletter. We've had so many requests for re-sends that I have chosen to include it here for our 5DPT friends. You can get all our free Project 2014 files on the LivingAfterWLS website: Project 2014).

In June 2013, the American Medical Association (AMA) made headlines when its governing body adopted a policy that recognized obesity as a disease requiring a range of medical interventions to advance obesity treatment and prevention. Previously obesity was considered a condition resulting from behavioral and environmental factors and a contributor to other diseases rather than a stand-alone disease. This new designation produced passionate opinions both in favor and against categorizing obesity as a disease, and the debate continues a year later.

People in favor of the disease designation say it brings attention to the intervention, prevention, and treatment of a debilitating metabolic disorder. Opponents say calling obesity a disease overlooks the dominant effect of lifestyle choices that contribute to obesity, specifically food intake and energy output. Both schools agree that obesity is a complicated health problem with factors of genetics, biology, environment, social, and behavior all playing a role.
What I know about the weight loss surgery population is that understanding and accepting obesity as a disease is crucial in our individual approach to lasting weight management with surgery.

My Take: Why I consider obesity a disease
First: Medical intervention for a medical condition.
I must accept that obesity is a disease because in 1999 I consented to go under general anesthesia so a surgeon could cut-and-paste my digestive system in a fairly new radical abdominal surgery (Lap-RNY). I conceded to this desperate intervention and treatment of my chronic obesity in order to improve my health and longevity that was otherwise catastrophically compromised. It is impossible to reconcile having major life-changing abdominal surgery for the purpose of correcting lifestyle choices or habits, or to make a cosmetic improvement to body weight for the sake of vanity, don't you think?

Second: Medical conditions merit serious attention and care.
If I have a medical condition that is being treated with surgery and lifestyle changes then I must take seriously the post-surgical protocol and make my health management a priority. Obesity as a disease takes our perception beyond the glossy headlines "Eat less, move more, lose weight." Obesity as a disease opens the door for understanding that a comprehensive approach to treatment must be ongoing and include resources such as nutritionists, fitness coaches, support networks, and medical and psychological wellness care.

Third: A medical condition is not a moral character flaw.
Once we recognize the disease we can separate from the self-defeating perception that we are the disease. We can change our language from "I am fat" to "I have obesity" which means something very different. Obesity is a disease, not a definition. Once I remove the moral label and social stigma that comes with the words "I am fat" I am able to sensibly approach my treatment plan without the emotions of blame and failure that so often get in the way.

Fourth: Relapse and remission are part of the disease cycle.
A disease is seldom cured but rather a disease is put in remission. A remission is a temporary end to the medical signs and symptoms of an incurable disease while a relapse is a recurrence of the past condition. A disease is said to be incurable if there is always a chance of the patient relapsing, no matter how long the patient has been in remission. For the person with obesity relapse is manifest in weight gain. Understanding this relapse as part of the disease cycle liberates us from moral blame and self-declared failure. We can marshal our resources and intelligently work toward remission by making the lifestyle changes necessary with the support of our medical team.

Read more in this important issue of LivingAfterWLS Project 2014

5 Day Pouch Test Owner's Manual  2nd Edition 
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Learn more about the new second edition:

LivingAfterWLS Project 2014
Peer Support: Facebook Groups
Connect with like-minded friends

We enjoy high caliber membership and positive support in our active Facebook groups: 5 DAY POUCH TEST SUPPORT Group and the LivingAfterWLS Project 2014 Group. The 5DPT group actively supports, educates, and encourages people using the 5DPT correctly as a tool to get back to the basics of WLS post-op living. For sustained support turn to LAWLS Project 2014. We are actively empowering individuals to harness their inner strengths for life-long weight management with weight loss surgery. Personal empowerment through education, thought, community support, and validation. We are LivingAfterWLS. (Please note both groups are closed and require membership admittance by an administrator before participation is allowed. Please review the Facebook terms of service to understand the conditions of a closed group and join us today!)

"This is my second day on the 5 Day Pouch Test and I can already feel the difference. I was dreading to try it, but it is just fine. I am not starving! My pouch still works!"~ CKC

"I did this program (5DPT) and lost 12 pounds. It's amazing and my pouch felt tight and eliminated carb cravings. I am starting it again Monday to remind myself how good it is. Then proceeding to move forward with the tools I was given after surgery and not eat snacky foods like I was. Love it. Thanks Kaye. Most of all this makes your get back to the basics and the purpose for going through surgery.~ FT

"I'm on day 5. Just a HAPPY reminder folks...It's only 5 days..to start...to feel awesome to feel fresh, to feel renewed! You can do this. FIVE days ONLY!"~  EEH

"With the support of Project 2014 the best change I've made to my health this year is remembering the 4 rules; Protein FIRST, LOTS of water, NO snacking and Daily Exercise." ~ KMMW

"With the support of Project 2014 the best change I've made to my health this year is to remember that I am not alone in my struggles and that with the help of others I can reach my personal goals."~ LD

"With the support of Project 2014 the best change I've made to my health this year is to reach out for help when I can't do it alone." ~ JG-P


LivingAfterWLS Publications on Kindle

Get your favorite 5DPT books on Kindle for immediate download. Don't have a Kindle device? No problem. Download their free software for computer, laptop, tablet, or mobile phone and enjoy your books on any and all devices. Check out our page here:
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Up Close Look at Soups & Sliders
Questions and Answers
Add a description
Veggies: The healthy carb choice.

Q: "How are slider foods defined and what are some common ones?"

A: "To the weight loss surgery patient slider foods are the bane of good intentions often causing dumping syndrome, weight loss plateaus, and eventually weight gain. By definition slider foods are soft simple processed carbohydrates of little or no nutritional value that slide right through the surgical stomach pouch without providing nutrition or satiation. The most commonly consumed slider foods include pretzels, crackers (saltines, graham, Ritz®, etc.) filled cracker snacks such as Ritz Bits®, popcorn, cheese snacks (Cheetos®) or cheese crackers, tortilla chips with salsa, potato chips, sugar-free cookies, cakes, and candy." (5 Day Pouch Test Owners Manual 2nd Edition, page 34).

At a Glance: By definition slider foods are soft simple processed carbohydrates of little or no nutritional value that slide right through the surgical stomach pouch without providing nutrition or satiation.


Q:"I understand the rule about not drinking with meals or 1/2 hour before and after. So how does soup fit in?"
  A:  A well made soup that provides protein, complex carbohydrates (beans, veggies, grains, etc.) is rich in vitamins, minerals, and dietary fiber while at the same time being soothing and easy to digest. To take advantage of all of soup's goodness the portion needs to be measured (see "Good Idea" below) the soup eaten within 15 minutes and the no liquids before/after/with meal. Because the nutrients are warm and have already started to break down during cooking you want to give your little pouch as much time as possible to absorb and digest them. Please there is simply something comforting and nurturing about a warm cup of soup.

Download Project 2014 Winter Season Unit 6:
The Sensational Power of Soup

Reminder: We have a choice when the carb cravings hit: simple carbs or complex carbs. That is why I believe soup is a key food choice in health and weight management with weight loss surgery. Studies confirm that people who include one cup of soup in their diet each day are more likely to lose weight and sustain a healthy weight. Soup is always an intelligent choice when used as a meal or snack. I cannot think of a better way to feed the carb monster.

Good Idea: Measure Soup Servings
What I've learned is that soups must be measured. Clear soups or smooth soups without solids should be measured in 1-cup servings and eaten within about 15 minutes. Soups and stews with solids must also be measured, but differently. Use a slotted spoon scoop out solids into a 1/2-cup measuring cup. Put that in your bowl, and then add an additional 1/2-cup of the soup - both liquid and solids. This makes a good hearty 1-cup serving that should keep us full and satiated for a long time after the meal. Thick chili with beans and meat is best measured in 2/3-cup servings. It seems like these hearty dishes are much more filling: it is best to start with a smaller portion. Again, with hearty chili and stews avoid exceeding more than 1-cup volume for any meal.


5 Day Pouch Test FAQ's
Trending Questions 

Q: Can I repeat the liquid days instead of going to Day 3?
 A: You can repeat the liquid eating plan of the 5DPT Days 1 and 2, but as soon as you do that you are doing a liquid diet; you are not doing the 5 Day Pouch Test. The intent of the 5DPT is to quickly progress through the post-op dietary stages and get us back to the basics of following our weight loss surgery high protein, low carbohydrate diet. People are sometimes tempted to repeat the liquid days because they have recorded a pleasing weight loss on Days 1 and 2. Keep in mind this weight loss is primarily water loss. In order to keep losing weight one needs to follow a high protein diet that elevates the metabolism into high thermic burn: this is when true weight is lost. Please follow the 5DPT as it is written: it was developed to help you achieve the best results with your weight loss surgery. We tested it numerous times so you don't have to. 5DPT: Days 1 & 2

Q: Are dairy products okay to use on the 5DPT? 
A: If you can tolerate milk and dairy products include them in your 5DPT and beyond. See the recipe section. Many WLS patients become lactose intolerant so that is why there is always a caution about using milk products. For those who can tolerate dairy, when used in moderation, it can be a healthy part of your diet.

Q: Are yogurts or cottage cheese allowed on Days 1 & 2?
 A: No, cottage cheese and yogurt should not be used as stand-alone menu choices on Days 1 and 2. However, they may be used as ingredients in protein smoothies. You can introduce yogurt and cottage cheese to your diet on Day 3: Soft Protein.

Q: I did the 5DPT and lost weight, but gained it right back when I went back to normal.  Why?
A: The motivation for doing the 5DPT should always be to get back on track with the WLS dietary guidelines, not to lose weight. That means we take what we learn during the 5 days and apply it to our lifestyle on Day 6 and beyond. If we do the 5DPT simply to knock-off a few pounds and then go back to the very habits that lead to weight regain we will, naturally, regain the weight and then some. When we consented to weight loss surgery we agreed that for the rest of our life we would follow certain dietary guidelines. If we have drifted from the original guidelines the 5DPT can get us back to basics. At that point we must follow the guidelines we agreed to if we wish to sustain weight loss and keep our obesity in remission. Use this as a means to return to following the instructions you were provided by your surgical weight loss center and nutritionist. Go back to doing what worked for you when you were at your best and losing weight or maintaining weight.

More FAQ's:  5DayPouchTest.com

Kick-Start Your Day!
Green Smoothie from WebMD
Shared with permission fom WebMD
With a scoop of vanilla or unflavored protein powder this could be a super-smoothie after WLS. I've not made this recipe, but similar recipes and the pear really mellows the kale and the orange juice is deliciously refreshing. From WebMD:

2 medium bananas, ripe
1 pear, or apple; ripe, peeled if desired, chopped
2 cups kale leaves, chopped, tough stems removed
1/2 cup orange juice, cold
1/2 cup water, cold
12 ice cubes
1 tablespoon flaxseed, ground

Place bananas, pear (or apple), kale, orange juice, water, ice cubes and flaxseed in a blender. Pulse a few times, then puree until smooth, scraping down the sides as necessary.

Good to know:  Flaxseed is commonly used to improve digestive health or relieve constipation. The monounsaturated fatty acids get credit for this. In addition flaxseed (sometimes call flaxmeal) is an excellent source of vitamin E, B complex vitamins and minerals including manganese, potassium, calcium, iron, magnesium, zinc and selenium.


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LivingAfterWLS, LLC

The health content in the LivingAfterWLS website is intended to inform, not prescribe, and is not meant to be a substitute for the advice and care of a qualified health-care professional.


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Kaye Bailey, Founder
Evanston, Wyoming 82931