So you had bariatric surgery and you’ll never be hungry again…..
UHHH…Hold on one second!
If there’s one myth to bust right here and now, it’s the one where people think that bariatric surgery removes all hunger cues, forever.
This simply isn’t true (and in fact, is more than okay).
In this blogpost we’re going to help you make sense of your restriction (for as far as that’s possible, because restriction after bariatric surgery can be as unpredictable as the weather sometimes, ulgh).
You’ll learn what restriction means and what variables can cause your restriction to fluctuate.
Restriction after Bariatric Surgery: the “know-how’s”
Have you ever noticed that one day you can eat a full plate of solid food, while the next you can barely hold down a glass of water because you’re SO full?
Welcome to the side of bariatric surgery where you can’t predict how you’re going to feel next.
Bariatric surgery either removes about 80% of your stomach (in gastric sleeve surgery for example). Or bariatric surgery bypasses about 80% of your stomach as this is the case after gastric bypass surgery.
No matter what bariatric surgery procedure you had, the size of your stomach is drastically altered. In other words: bariatric surgery causes restriction due to reducing the size of your stomach’s capacity to hold a meal.
The feeling of restriction is subjective, meaning that everyone experiences their restriction, aka the amount of food consumed in one sitting, differently.
Unless your restriction causes malnutrition, because you can barely eat a thing – there really isn’t any “good” or “bad” restriction. Because ultimately, bariatric surgery isn’t about eating the smallest amount of food forever. It’s about creating healthy habits, both nutrition and mindset-wise.
But before we drift off into another “Mindset Ted Talk”, let’s look at one of the first reasons why restriction changes over time: the healing of your pouch.
The natural decline of your restriction: time
This one isn’t rocket science. The simple fact that time passes causes your restriction to slowly decrease (in time, it’s natural to feel more hungry again). And there’s two reasons for that:
- Your pouch is healing after surgery
- Your hunger hormones are likely to rise in time
What really happens when the swelling in your pouch subsides
After bariatric surgery your pouch (your new stomach) is still swollen. Your surgeon puts you on a post-op diet and the road to recovery has begun. Not only does the smaller size of your new stomach causes restriction, the swelling plays a part too.
Once the swelling subsides, you’ll notice that you’re able to eat more. This is in line with your post-op diet where you gradually add more foods and textures to your diet.
The second part that changes with time, are your hunger hormones. One of the hunger hormones that often drops after bariatric surgery is ghrelin. Ghrelin is produced in the upper part of your stomach (called the fundus) and in parts of your small intestine too.
After bariatric surgery, the fundus is either removed or bypassed leaving less production sites for ghrelin. This means that you’ll experience less appetite and thus more restriction.
Over time, it’s normal for hunger hormones to increase. How much of an increase are we talking about? There’s no crystal-clear answer as this is very specific for each and every person and situation.
Now let’s move on to the next reason for your restriction to fluctuate: the way you’re eating.
Mindful eating and the link to your restriction
We know, we know – there’s already so much to wrap you head around. The post-op diet, the physcial changes, new taste-buds, mindset shifts and so much more. But we simply can’t forget about one important habit after bariatric surgery: mindful eating.
Mindful eating refers to being in the present moment when you’re consuming your meal. And it could imply the following:
- planning your meals
- savoring the taste and texture of your food; and…
- eating slow and chewing well
The latter is especially relevant when we’re talking about your restriction. You see, it takes about 20 minutes for your stomach to signal your brain that you’re approaching fullness. If you’re eating too fast, you may miss that fullness cue completely – ignoring your restriction.
But eating too fast can also cause an influx in your restriction. And here’s how that works:
If you don’t slow down during your meal digestive issues, like nausea or even vomiting, may arise. This in turn causes a full-blown “shut-down”. In other words: there’s no way that another bite will pass through your stomach without any issues.
So much for predictability right?
3 Questions to ask yourself when you’re trying to make sense of your restriction after bariatric surgery
So far we’ve discussed time out of surgery and the pace of your eating as predictors of your fluctuating restriction. Now let’s move on to 3 questions you can ask yourself whenever you restriction feels different all of the sudden. Let’s see what they are!
1. What did I eat that caused my restriction to feel different?
What you eat can have a major effect on how your restriction feels.
But how does that work exactly?
If you eat meals that are high in protein and fiber, you’re maximizing your restriction. Protein and fiber both promote a healthy way of satiety. In other words: high-protein and high-fiber meals keep you full for longer.
But if you’re eating slider foods, your restriction seems to be thrown out the window. Slider foods tend to slide through your pouch much faster, leaving you unsatisfied and hungrier quicker. Simply put: your restriction is less noticeable when you eat slider foods.
2. Did my restriction change because I was physically active?
A simple question can go a long way. If you’ve been working out more, or increased your daily movement, it’s more likely that your appetite increased as well.
As a result of more appetite, usually, less restriction follows naturally. Having a healthy appetite is part of the human experience and nothing to shy away from. Especially after bariatric surgery when those much needed nutrients from your meals are a warm welcome.
3. Am I stressed? Did this affect my restriction?
Stress can impact your appetite big time. And thus your restriction too.
You may notice that you can hardly eat anything when something is bothering you.
Or maybe it’s the other way around – where you feel like your pouch is a bottomless pit craving mostly slider foods whenever you’re stressed.
Keep in mind that hormones can affect your restriction too. You may feel less restriction and more appetite around your menstrual cycle. Makes sense right?
Unanswered questions about restriction after bariatric surgery
Now that we’ve unraveled a little bit about what may cause your restriction to fluctuate, we have to make one thing perfectly clear.
Sometimes it remains a mystery why you can finish a meal one day and can’t finish that exact same meal the next. Changing your digestive system doesn’t always mean that you have an answer to everything that’s happening in your journey.
And if there’s one reminder that we can share with you today, it’s this:
You’re not failing your surgery when you can eat more than you used to.
Your Onederland
Just because you can eat more today, doesn’t mean that your surgery is a failure tomorrow. There’s so much more to bariatric surgery than the feeling of “fullness”. It’s about creating a whole new mindset and healing your relationship with food. Bariatric surgery is about unpacking the emotional wounds that are hidden beneath the surface. Bariatric surgery is about finding joy in your daily meals with recipes that inspire you. Bariatric surgery is being part of a supportive community that will help you thrive!
If your restriction isn’t the only “wishy-washy” thing after your surgery
Bariatric surgery comes with many questions. And you’ll figure out tons of things while you ride the “bariatric wave” (aka your NEW life once you had bariatric surgery). Bariatric surgery isn’t the easy way out. ‘Cause getting in 80 grams of protein with 80% of your stomach gone isn’t a walk in the park. Just like it isn’t easy when hunger cues get stronger and you start worrying more and more about those never-ending stalls as the days go by.
If this blogpost gave you a glimpse of hope, a little nugget of wisdom or the reassurance you were looking for – then you’re gonna love The Bariatric Blueprint. An easy to read guide that has helped thousands of bariatric patients stay the course (don’t take our word for it, skim through the reviews to see why others loved this book so much).
Grab your guide to success here!
Resources:
- Mechanick J.I., Apovian C., Brethauer S., et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric patient: Cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery, Obesity Medicine Association and American Society for Anesthesiologists. 2020. Surg Obes Relat Dis. 2020;16:175-247.
- Diepvens K., Haberer D., Westerterp-Platenga M. Different proteins and biopeptides differently affect satiety and anorexigenic/orexigenic hormones in healthy humans. Int J Obes (Lond.) 2008;32(3):510-518.
- Aills L., et al. ASMBS Bariatric Nutrition Guidelines, Surg Obes Rel Dis. 2008.
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