Why am I hungry after a Gastric Bypass? Gastric Sleeve?

If you are thinking “why am I hungry after my Gastric Bypass?” or “why am I hungry after my gastric sleeve?” Then this article is for you!

One of the best selling points for bariatric surgery, especially Gastric Sleeve, is how rare it is to feel hunger afterward. “You can’t eat much and you’ll never be hungry.”

Hmmm. Let’s play two truths and a lie.

Truth: the hunger hormone ghrelin is significantly lowered after Gastric  Sleeve.

Truth: portion sizes are restricted after a bariatric surgery

Lie: you’ll never be hungry and you’ll never be able to eat much.

Instead of scrolling through social media posts about how someone is never hungry after Gastric Bypass or Sleeve, keep reading. I will guide you through hunger after surgery and tips on how to manage your hunger (and body needs) well.

Don’t assume hunger is only in your head

Hunger is a fascinating thing.
Most body cues can be.

Pain, for example, might be intense or might be dull. Might be achy or sharp. The pain might come and go or never ease.

Pain management is a bear and most of us know the key is to (say it together) stay on top of it! The last thing you want to do is get behind pain (comment below if you know this painfully well! pun intended).

Hunger is another body cue that can take on different shades. It might be achy. It might be shaky. You might be hangry.

After a Gastric Sleeve, Gastric Bypass, or one of the many other bariatric surgeries (there are more than just three these days) hunger is that much more confusing.

Should I be hungry 5 days after a Gastric Sleeve?

I don’t feel hungry since Gastric Bypass but I get shaky when I need to eat.

I eat a meal but I’m hungry an hour later.

I know I’m full when I sneeze.

Hunger is a cue that comes in different shapes and sizes for all of us, on different days. In some ways, it can be easier to ignore than pain. Eventually, it will sound some alarms but similar to pain management, the key is to stay on top of it.

How do you stay on top of it? The first thing is to understand it. Listen to it. Ask it questions. Decode it. Get to know your cues and study yourself well. No one can know as well as you! Become an expert in your body cues.

Don’t brush it off

The trouble (in my opinion) with the phrase “head hunger” is the impulse to dismiss hunger cues for something else.

Because hunger is different after surgery, one might say “it’s in my head” because it’s a dull hunger or it’s not the same as before surgery. This can also become more of a negative thought pattern that something is wrong with you when in fact, your body is cueing an energy or water need.

Now, head hunger is a real thing. It could also be called emotional eating and we will talk more about it in a moment. My first point here is to not assume it’s head hunger before you’ve gone through a series of reflections to be sure it’s not a physical cue.

Withholding food will not get you further on your weight loss journey and in fact, can make your journey harder down the road. Programs differ but my hot take is to eat three meals a day (protein snack if needed) but avoid skipping meals. This is important for hunger control and for the metabolism which helps your weight loss and maintenance to continue past the initial honeymoon year.

Become a MANAGER of your hunger

We have a lot of things in life we have to manage! Money, time, energy, resources, and so much more.

Hunger is another thing we manage.

This is my favorite way to view a weight loss journey or “weight management.” It’s more than okay (and a normal human experience) to be hungry after Gastric Sleeve or Bypass. You don’t have to be afraid of hunger, you can take control of it.

I would WAY prefer to make food choices and think about “how will this impact my hunger?” instead of “how will this food impact my weight?”

Making food choices based on how it impacts my waistline is way more emotional. I am personally more likely to feel guilty for eating the cinnamon coffee cake if I am focused on the scale. If instead, I am thinking of my hunger control I might either a) decide I don’t want to be hungry all day and not order it or b) enjoy it and be ready to manage my hunger later with more water, a healthy protein focused dinner, a walk in the evening.

The second way of looking at it leads me away from guilt and towards healthy choices. Me, I want to manage my hunger. My weight will follow that. Btw, I did not have surgery but have maintained a 40-pound weight loss for 12+ years following bariatric eating but with larger portions.

5 main reasons patients are hungry after Gastric Sleeve or Bypass

After over a decade of coaching patients on bariatric eating, I can still boil hunger issues down to 5 root causes.

1- Water

2 – Bite Sizes and Speed

3- Texture of protein

4- High-intensity exercise

5- Sleep patterns

These five areas are a great starting place to assess your hunger needs. Remember, you want to be a good MANAGER of your hunger. Taking an inventory of these areas will put you in a wonderful position for the manager of the month award!

A quick note here: if you are experiencing a lot of hunger and you’re still on the post-op healing diet, nothing is wrong.

It would make sense that your body is still cueing you for food when you’re on a liquid diet, even after bariatric surgery.

Reminder: the liquid (or pureed) phases of the post-op diet are for healing and safety reasons. The main goal during this time is to keep stress off your healing, inflamed pouch. Weight loss is the secondary goal in the first 8 weeks, not the primary goal. The primary goal is to heal.

When you advance from your liquid diet and can eat something again, you’ll be far more able to manage your hunger. Some patients don’t have to feel hungry in the early weeks after Gastric Sleeve or Bypass, but many do. It’s normal and it’s going to get better. (And I wish I could hug you!)

I go into the 5 areas of hunger control in much more detail in my video course or you can grab your free “Am I Really Hungry Flowchart.” For today, let me give a high-level overview of these common hunger causes.

Water: the area in the brain that detects hunger is next door to the area that detects thirst. We confuse thirst and hunger all the time. This is why water gets attention for being the cheapest appetite suppressant out there. It’s not about suppressing your appetite, it’s about meeting your body’s water needs!

The other reason water can be a culprit of hunger issues is drinking with your meal or within 45 minutes afterward. Programs differ on if it should be 30-60 minutes after a meal before you drink. Assess for yourself! I would go at least 30 minutes to keep protein in your pouch longer. If you can go to 60 minutes and still hit your water goal for the day, try it out and see if it helps.

Bite sizes and speed: A very common reason for hunger issues is what I call “premature fullness.” When you eat too quickly or have too large of a bite (larger than a black bean can cause this) you may feel full on a small amount but hungry before your next meal. Use the Baritastic timer to slow your bites and/or cut your food before you eat to help.

You can also check out my “Don’t Jump to Conclusions” mat to help you eat mindfully and learn from your meals!

The texture of protein: For best hunger control, a lean and solid protein source will win out compared to a soft texture. Think hamburger patty versus cottage cheese. You can eat more cottage cheese because it’s softer, but it also leaves the pouch more quickly. A dense protein requires extra caution with bite sizes and speed but when you use those two tools – dense protein + tiny bites you will be a seriously good manager of physical hunger.

High-intensity exercise: Movement with high intensity like running or a boot camp is great for heart health but burns more from glycogen stores which are from carbohydrates. This will increase hunger and specifically hunger for carbohydrate foods to replenish. When someone has the goal of burning fat and losing excess body weight, they may benefit more from low-intensity cardio and light weights for longer reps to maintain a little lower heart rate zone. This helps burn more fat and improves appetite control.

Sleep patterns: This can also fall under a head hunger category but it is also a physical need of the body! Studies show poor sleep increases ghrelin (that hunger hormone again) so it can impact physical hunger. If you think your hunger control is related to sleep patterns, consider what you can do to improve getting consistent sleep. Sometimes this requires seeing a professional because sleep can be HARD. Comment if this is you so I can show my compassion!!!!

5 main reasons for head hunger after surgery

Now that we’ve covered the 5 main reasons for true hunger after surgery, now let’s talk about head hunger.

First let me say, head hunger is ALSO cueing you for something. If physical hunger is cueing you to eat, head hunger is cueing you for something else, possibly mental or physical.

Head hunger doesn’t mean you “don’t need anything.”

After you’ve identified your body does not need food or water, the next step is to identify what else it needs.

Here are 5 common reasons for head hunger:

1- boredom

2- stress (& anxiety)

3- loneliness (& depression)

↻ 4- female cycles

5- fatigue

This is another area I have a full video course on (Emotional Eating) because there is a LOT here.

A quick example to illustrate my point. When we are bored, we are experiencing a dip in dopamine (a neurotransmitter that plays a big role in pleasure). If you’ve identified you are not hungry for food but are bored, you can find natural ways to boost dopamine outside of food.

When you engage in activities you enjoy, you get that natural boost of dopamine. This could be a good book, a walk in nature, the music you love, a phone call with a friend, and the list goes on. I recommend making a list of your own!

Let me round us out by saying a few things about these reasons for head hunger.

There is real biology going on here. It’s worth spending time to understand. Spend more time learning about dopamine and cortisol (the stress hormone).  Here is a link to get you started.

If you found any of this helpful, comment below and let me know! Don’t forget to grab your free Am I Really Hungry Flow Chart and spend some time learning about dopamine and cortisol!

Wishing you happiness and hunger control,

Steph