Expert: Cathy Wilson, ACC-ICF, CLC - 9/19/2008

Question
I have gastric bypass six weeks ago and somethings I feel hungry. I would like to know if this is normal?

Answer
Hi Santa,

Congratulations on your surgery!!

In your question you don't indicate what you are currently eating.  Yes, you should be physically hungry.  Obviously from your new smaller pouch, you can't eat nearly as much as you used to or as often.  The best nutrition to feed your body at this point as you are healing and with the small amount you can consume is protein.  Protein will provide you with the most satiety (give you that full feeling) for longer.  Even as you are further and further post-op, protein is key for maximum weight loss and maintenance.  

That's about physical hunger but there is also head hunger.  Before we had surgery, we had physical hunger but it was usually not as often as head hunger.  Head hunger is when we want to eat, usually for emotional reasons, but aren't physically hungry.  Head hunger is tricky because it can be so strong that it seems like physical hunger.  

One of the things that early post-ops have problems with is learning the difference between physical hunger cues and head hunger.  Head hunger can also result from wanting to emotionally eat.

Some of the ways you can detect the difference between physical hunger and head hunger are:

→  If you are craving a certain food, and only that food will do (such as cookies, chips, pizza, or an unhealthy food item), that is head hunger or emotional eating.  If you eat because you are experiencing physical hunger, you are open to food choices to satisfy that hunger.  

→  Head hunger strikes suddenly while physical hunger occurs gradually.  Emotional hunger happens instantaneously and wants to be satisfied NOW.  Physical hunger does not demand to be satisfied immediately and can be delayed.  

→  Head hunger is usually a process that is ongoing and prolonged.  You can’t seem to be satisfied and continue eating.  One of the behaviors associated with emotional eating is searching.  You eat something and then search for more or something else to feel full and satisfied.  With physical hunger, you can stop eating when you feel a sense of satiety.

→  Head hunger causes you to feel guilt and shame afterwards.  Negative self-talk usually results after emotional eating.  Eating in response to physical hunger does not result in negative emotions or self talk.  Eating to satisfy physical hunger is an act of self-care and nurturing, resulting in positive feelings from taking care of yourself.

→  Head hunger can occur in a short period of time after eating a meal and feeling satisfied.  If it has been a few hours after eating and you feel the physical cues from your body that it needs nourishment, that is physical hunger.  

Yes, being six weeks post-op you should feel hunger.  Most post-ops report they don't get hungry as often but you will get hungry.  Start the habit of checking in with yourself to make sure it is true physical hunger rather than pesky head hunger.  That will be a fantastic skill to be able to distinguish between the tool.  That will maximize your weight loss and play a big part in maintaining your weight.

All the best to you,
Cathy