It’s not surprising that a surgical procedure on the stomach would change a person’s perception of hunger and fullness, but WLS (weight loss surgery) doesn’t just change the size of the stomach, it also leads to complex neurohormonal effects. Hunger and fullness after WLS is different for each procedure, each person, and at different points in time. Mindfulness can help you recognize and adjust to this “new normal.”
Here are some of the changes you may experience in hunger and fullness after WLS:
- You may not feel hungry at all for a period of time after WLS. This honeymoon period lasts anywhere from one week to six months or more, depending on what kind of procedure and how much swelling there is. Therefore, you may need to supplement your body wisdom by eating on a schedule for a period of time.
- Before WLS, your empty stomach is about the size of your fist and can comfortably hold a handful or two of food (see chapter 2 of Eat What You Love, Love What You Eat). Right after WLS, your stomach may be as small as your thumb. Over about three to six months, your stomach capacity may increase, even if you’re doing everything correctly. Typically, by eating slowly, most people can eat between about a half cup to one cup but that depends on the type of surgery—and even the particular surgical center. This is why it is so important to learn to tune into your sensations of fullness.
- Your signs of hunger may be more subtle after WLS. Some people describe pangs or emptiness rather than growling. Others are only aware of symptoms caused by a decrease in their blood sugar such as a dip in their energy, irritability, and difficulty concentrating.
- If you miss the gentle hints of hunger or go too long without eating, you may “suddenly” experience an urgency to eat. At that point, you are at high risk for eating too fast and/or eating too much, leading to uncomfortable consequences.
- Fullness feels different and comes on more quickly after WLS. Most people describe a sensation of pressure in the upper abdomen or chest; others experience burping or hiccupping. If you ignore fullness and keep eating, even one or two more small bites can lead to discomfort, chest pain, or vomiting.
For all of these reasons, it is very helpful to use mindfulness to develop your personal “Hunger and Fullness Scale” and become more aware of your body’s signals and understand what they mean.
(From Workshop 2 of the Am I Hungry? Mindful Eating for Bariatric Surgery Program and Workbook.)