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Wednesday, December 03, 2014

Speaking Back: Reply to Bariatric Foodie

Before you review the plan get the facts: 
The 5 Day Pouch Test: Express Study Guide

Hello LivingAfterWLS Friends!

Today I'm taking a turn to speak out. Over a year ago, Nik at Bariatric Foodie (whose blog I follow here and refer you to on occasion) "Reviewed" the 5 Day Pouch Test on her blog in this post:
The 5-Day Pouch Test, The Cottage Cheese Test (and other destructive things we do to ourselves...)

"So here we are. I’m going to be 100% raw and honest about why I hate, hate, HATE these two so-called methods of “getting back on track.”  Nik - Bariatric Foodie

I put the word "Reviewed" in quotes because the irony here is that Nik has clearly not read the 5 Day Pouch Test plan, she admits she will not visit, and her knowledge of the plan is based solely on anecdotal reports from people who have done the plan. I like Nik and I enjoy her website and recipes. However, her willingness to review something based on hearsay gravely discredits her and her body of work. I am lost to understand how one can "hate, hate, HATE" something based on second hand information? Because this post has been messaged to me so often in the last year I have elected now to address her criticism. Primarily because her "review" does a disservice to her own credibility and misleads readers who could truly benefit from the authentic 5 Day Pouch Test. 

The following is the full text of my response, which I posted in abbreviated form to her blog:

Hello Nik - Kaye Bailey here from LivingAfterWLS and author of the 5 Day Pouch Test. I bet you didn't know I'm a fan of yours, and in fact, link to your site from my blog. I think you do good work.

However, I feel you are quite unjust in this review of the 5 Day Pouch Test. I have been sent this post link numerous times and elected to ignore it, but that isn't fair to me, my work, or the people who may be mislead by your lack of familiarity with the plan, so today I am responding. I am especially crestfallen that you would undermine your own credibility by "reviewing" a program that you obviously have not read, not visited the website, and are going on hearsay from Heaven knows where. I won't address all your criticism, but I do wish to take advantage of your comments section here to present my position.

Point #1: Credibility
No, I am not a medical professional and I have never presented myself as such. I am a professional research journalist  who happens to also be a RNY post-op of 15 years. When I was told by my surgeon (Dr. Alan Wittgrove, past president American Society of Metabolic and Bariatric Surgeons) to "go back to basics" I didn't know how to get there and he didn't give me a plan. So I did what research professionals do and I studied the topic. I read thousands of pages, interviewed over 30 medical professionals including surgeons, nutritionists, and mental healthcare providers. In the 5 Day Pouch Test Owner's Manual you will find a 2-page bibliography with over 60 citations. The book is also footnoted. In addition, I own the LivingAfterWLS Neighborhood (currently shuttered) in which I collected data from over 2,500 WLS post ops who were more inclined to be honest about their experience and habits in the safe haven Neighborhood than they would be with their health care team (as you say-a trip to the principals office.) My professional research background gave me the methodology to collect a vast amount of data. My experience as a WLS patient gave me knowledge of the questions and feelings that are common after WLS. If you had read the book you would find a treasure trove of information that addresses the physical, mental, environmental, and social factors that affect weight management. In addition you would find page after page of hints for managing these factors in support of healthy weight management. Finally, you would find compassionate empowering encouragement that comes from the heart of someone who really understands how difficult this life after weight loss surgery truly is.

Point #2: DisclaimerYes, all of the LivingAfterWLS properties and publications carry this boilerplate disclaimer, "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." It surprises me you don't have a disclaimer on your website, did you not work with a legal-media consultant in creating your web space? If you take a look at they have a similar disclaimer to the one on my properties. "The WebMD Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on the WebMD Site!"

You might give some consideration to a similar disclaimer, it is industry standard.

Point #3: "It deals with regain/overeating in terms of FOOD not your MENTALITY TOWARD FOOD: this is important."
The 5 Day Pouch Test deals extensively with all aspects of weight management including food, activity/exercise, mental issues, the physicality of the pouch, environmental, social, economic, and historic. People who say it is a simple eating regimen have not taken the time to learn the plan fully, to journal the 5 days, to revisit past goals and make new goals and map a plan. I often see people using the 5DPT to knock off a few pounds and go right back to doing what they were doing before that caused weight gain. Contrary to your review, the plan does address how to avoid the bounce back and how to use the momentum and enthusiasm of the 5 Days to keep us focused. Few people can sustain the post-op euphoria day in and day out for years. I know this personally after 15 years. I have confirmed this with the experts I consulted and the countless WLS individuals I interacted with in developing this plan.

I have to wonder, what you think is wrong with a plan that renews a person's sense of empowerment and capability, while also breaking a snacky-simple carb eating habit, and returns them to a mental state of prioritizing their own health?

Point #4: The role of the bariatric team
Throughout the 5DPT Manual, the newsletters, and blog I constantly encourage folks to stick with their bariatric centers and use the center as their first line of defense. The sad reality is, and bariatric surgeons will admit this, that their role is to build the tool - the WLS. Most surgeons have not struggled with obesity or had wLS (Less than 2% of ASMBS certified surgeons in 2013 have undergone WLS). Surgeons and their nutritional support experts are good for 18-months post surgery follow-up. The numbers drop off drastically after that from patient withdrawal from support groups (It seems like they are all for pre-ops or newbies many post-ops report), and lack of resources in the bariatric center to serve the ever increasing number of post-op patients.  And of course, insurance plays a role in this as well.  I want people to stick with their bariatric team long-term. But sadly, this is more the exception than the rule.

Point #5: Shrinks the Pouch
There is no place where I claim the 5DPT will shrink the pouch. In fact, there is no conclusive evidence that the pouch stretches or shrinks - several studies are conflicting on this. What I do claim is that systematically returning to our prescribed diet of protein first, no slider foods, observing the liquid restrictions, restores the sense of pouch tightness we enjoyed in the early weeks and months after WLS. We get away from those rules because pouch tightness is uncomfortable and eating soft slider foods while drinking liquid eliminates pouch discomfort, the very signal that our pouch is working and it is time to stop eating. So many times people say, "I don't think my pouch is working any more." What is wrong with giving them a plan to learn for themselves that yes, the tool is still there and when used properly it works as it is intended? As your commenter Nora B said, "This program stopped me in my tracks and made me realize what all I had been doing wrong without even realizing it. It took me back to the mindset where I was at early out and got me motivated again."

As you said, there isn't enough room here to address all the issues. I am sorry you have taken such a strong dislike of what you think the 5 Day Pouch Test is, and I'm extremely sorry the facts you present do not represent the 5DPT in the least. Perhaps if you were to read the plan or even visit the website you may take away a different impression than the one you contrived through anecdote.

I wish you the best and if you don't mind I'll keep you linked up on my blog.

Thanks for your time,

Thanks for taking time to listen to my side of the story.  I welcome your comments.

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