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Bariatric Hunger Games: The mental struggle.

“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.

Not knowing can be hard work, Working with a Nutritionist will take out the guesswork.

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.

Stop self-doubt replaying like a broken record. Consider a tailored plan to meet your needs.

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.

About The Author

I try to bring fun into what I do, wellness requires an element of enjoyment

Welcome, I am Carrie Ross, Clinical Nutritionist (BSc), Nutritional counsellor and Bariatric Health Educator. Both my experience and expertise are derived from a combination of over 10 years of focussed study in health, nutrition and mental health, as well as lived personal experience in my areas of interest; being post-surgical Bariatric Nutrition and Mental Health nutrition.

What is a “Clinical Nutritionist”, and why you should always ask for qualifications…

A Clinical Nutritionist, is a University Degree holding (BHSc Nutrition & Dietetic Medicine) Professionally trained clinical practitioner who has undergone:

  • Over 400 hours of observed/supervised Clinical Practice – in a professional Clinical setting, together with;
  • Over 400 hours of combined clinical diagnostic ( health assessment and pathology interpretation), nutritional treatment and case management workshops for the management of complex cases and life stage nutrition; 
  • Over 600 Hours of study in Biochemistry, Nutritional Biochemistry, Pharmacology, Microbiology and Anatomy and Physiology.
  • Over 600 Hours of Study in Communication and counselling, Holistic case management, Sociology and ethical practice. 
    •   Will continue to undergo professional development and training to ensure treatment practice is current. 
  • A health Coach, wellness rep, Weight loss Mentor, Personal Trainer (etc) … Has not, and won’t.

Holistic Integrative Nutrition recognises that illness and disease are complex and seeks to promote the body’s own innate ability to heal itself and regulate balance not only from within but from without too. It appreciates that:

‘You cannot get rid of a weed by simply picking a few leaves’
and that there is a ‘root’ cause behind all presenting issues. Therefore, I seek to support healing from the source, instead of simply treating the symptom. The root, not just the leaves!

My nutritional philosophies are firmly grounded by the concept of creating the balance of all the unique aspects in an individual’s life; considering the interplay of lifestyle, mindset and diet; a unique spin on the ‘body, mind and spirit’ philosophy.

Its not ALL about what we eat, its also about what we do and how we feel.
I believe that balance must be sought for us to reach our goals. This is the BALANCE OF ALL THINGS

Within the consultation process, I assess your current health status and any past/present influencing medical factors, your current diet and lifestyle practices and focusing on wholefood nutrition, food relationship counselling and holistic health I use an individual person-centred approach to develop a nutritional support plan for your health goals and needs.

With the utilisation of personal, specific dietary advice, lifestyle Coaching and mindset/ behavioural coaching techniques, you are provided with a framework to set the gears to your wellness goals in motion with personalised objectives that are easily integrated into your current lifestyle.

My Special areas of focus:
Whilst I work with all client types and models, I have a special interest in Post-Surgical Bariatric Nutrition management together with nutritional healing and focus on:

Over 10 years of focussed study in health, nutrition and mental health, as well as lived personal experience in my areas of interest; being post-surgical Bariatric Nutrition and Mental Health nutrition

* Essential nutrition for post-operative gastric surgeries – including weight loss surgeries (RNY/VSG/SIPS/SADI); and Disease management surgery as a result of IBD such as colectomy, ileostomy, cholecystectomy for example. This special interest comes from my own personal experience with gastric surgery and the health ramifications of poor post-op education. (you can read more about my journey here)

As a  Nutritionist, Educator, Coach and Counselor, that works holistically with each individual, I understand that there  is no “one size fits all” diet that is going to cure all health complaints. therefore I cater specified, personalised planning for the goals of the individual; in areas such as:

  • Obesity & weight education:  As well as weight and muscle gain for sports.
  • Diabetes, Insulin resistance and Metabolic syndrome
  • Pre and Post operative Bariatric weight Management
  • Inflammatory disorders:  Fibromyalgia, RA and IBD
  • Auto Immune: Hashimotos, RA, Celiac
  • Endocrine Dysregulation: Hypothyroid,  Adrenal Stress, fatigue, PCOS
  • Gastrointestinal Health
  • Mental Health: stress management, food behaviour counselling
  • PCOS and Reproductive care – Inclusive of Post-Op Bariatric Pregnancy and IVF care.

    I take the time to have a proper understanding of your personal goals, needs, likes and dislikes, support networks and lifestyle in order to create a food and lifestyle approach that suits YOU.

    If your diet and lifestyle is out of balance, chances are you will not be looking, feeling or performing at your best. Let me help you get things back on track so you can start thriving, rather than just surviving.

    Look forward to working with you.

    If you are interested in booking a consult either in person or via Skype/Facetime please email
  • Email: BiomeWellnessCentre@iinet.net.au 

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BioMe Integrative Nutrition - Wellness Centre & Bariatric Health Clinic  ABN: 88122668963
Rockingham WA 6168 |  biomewellnesscentre@iinet.net.au  |  
Clinical Nutritionist - Carrie-Anne Ross - Western Australia        
BHSc Health Science -Nutritional & Dietetic Medicine - Endeavor College of Natural Health
Diploma Counselling - Australian Institute of Professional Counsellors (AIPC)
Cert IV-Community Services - Social Training - DSC WA

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