“I don’t feel hungry…do I feel hungry? Am I hungry? Should I eat? Am I eating too much? Have I just eaten too much ? Have I stretched my stomach? Am I eating the right things? Should I go on a diet? Do I need to restrict my intake more? Has the surgery failed? “
The post-surgical bariatric mindset and the mind games that many subject themselves to are enough to drive most, face first into a triple chocolate cheesecake.
The voice of doubt and its endless chatter seem relentless, so what do you do about it? The best course of action is to answer each question one by one and become informed about the ins and outs of your surgery and your body.
1. I don’t feel hungry.. Do I feel hungry? Am I hungry? Should I eat?
There are many factors that influence this line of thinking.
- The reduced surface area of your stomach, in particular the removal or bypass of the fundus (upper part of the stomach) which is responsible for the production of Grehlin (our hunger stimulatory hormone).
- Nerve damage from surgery, which can disrupt and interfere with hunger signals and fullness register.
- Reduced capacity leading into the failure to drink sufficient hydrating fluids, resulting in dehydration, which coincidentally can trigger the same sensations as hunger.
- The memory of routine. You know you ‘used to’ eat at certain times, you used to be hungry at certain times, so ‘shouldn’t you be hungry’ now?
While these many varied factors influence the level to which you feel or register hunger and satiety post-operatively here’s some things you can do to put your mind at rest.
- Eat regular meals at regular mealtimes and snacks in between; this way you know that you aren’t mistaking any signals.
- Drink fluids (mostly water) regularly throughout the day. Aim for a minimum of 64oz./2 litre per day. Start the day with a glass of filtered water when you get up in the morning, and a minimum of 1 glass every 2 hours there after. Hydrating your body will ensure that you don’t mistake thirst for hunger. Also, drinking adequate water aids in weight loss since is necessary for the fat oxidation process.
2. Am I eating too much? Have I just eaten too much ?
Have I stretched my stomach?
This happens to be one of the BIGGEST overplayed records in the jukebox!
Take a sip of your water, take a deep breath and turn that song off!
Let’s look at it from a different angle….
What is your post-surgical stomach capacity? Well if you have had a bypass it is approximately half to 1cup per meal, and vertical sleeve owners, about 1-1.5cups per meal (on average). Of course everyone is a little bit different.
Do you exceed those cup sizes per meal? Do you ‘feel full’, or uncomfortable pressure in your upper abdomen?
If you are regularly exceeding your portion sizes, if you regularly experience uncomfortable fullness, and you are either stalling or gaining weight, then the answer is yes.
Being mindful of your portion sizes ensuring you don’t overdo it is the best way to get on track and stay there.
Regular over indulgence will lead you to the possible stretching of your sleeve/pouch, but once, one meal, one occasion will not…. so chuck that broken record in the bin.
Again, you may very well be like a lot of the people I consult with and actually do not eat enough (which will also cause stalls)
3. Am I eating the right things? Should I go on a diet?
Do I need to restrict my intake more?
Are you eating from all the food groups, wholefood and fresh, a mixture of healthy protein, fat, carbohydrate, fibre and water?
Do you eat lean fish, chicken, meats, legumes, nuts, seeds, fresh fruits and vegetables?
Do you meet your macro requirements and meet your caloric needs?
Do you make choices based on Points #1 & #2 ?
If you answered yes, then you are eating the right things. Well done.
If you answered No to any of them, then start making choices that illicit a yes.
Do you need to go on a diet? NO!
You simply need to make those changes.
Do you need to restrict your intake?
Another hard NO.
4. Has the surgery failed?
In somecases there are complications that accompany bariatric surgery that can impact your long term success, however in the absence of complications you will need to remove this question from the list. Your surgery has not failed, you simply need to:
• Eat the right things.
• Eat enough to meet your biological (not psychological) needs.
• Eat the right portions.
• Drink enough water.
• Do not regularly exceed your capacity.
• Stay away from anything that is labelled a ‘diet’. You won’t be doing yourself any favours by adding further restriction.
And change that darn broken record !
I think the point that I am trying to make here is that you need to disconnect the negative thought process away from food, and disassociate happiness from weight loss… aim for health sustaining nutrition and habits to ensure that you are nourishing your body with your diet and creating joy in your life .. not stress and added restriction.
Mental Nutrition 
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