Hunger: What Your Surgeon Didn’t Tell You…

Today, instead of food, I thought I would share some stuff I’ve picked up over my nearly four years as a post-op bariatric patient.

You may (or may not) have noticed on the sidebar that this month Bariatric Foodie is going to take on the subject of hunger – what it is, how we experience it post-op and how hunger should (or should not) guide how we behave. I admit I’m a bit behind on my production of this but it is on its way and I hope it is helpful to you all!

The title of this post was SORTA tongue-in-cheek. But it’s sort of true too. One thing I became keenly aware of post-op is that I didn’t have a great working understanding of hunger. When you take away the stomach growling, the pains in the midsection, etc., what is hunger? And why, if I don’t feel all those things, do I still feel compelled to eat (and eat things I am not supposed to eat)? Those questions are what started this investigation for me.

So in order to really delve into the series (tentatively due out in December), I thought I’d share some things I’ve learned about hunger and eating that might help folks who are a little more “recently cut.”

Hunger and Appetite are Two Different Things

Merriam-Webster defines hunger as, “a craving or an urgent need for food or specific nutrient.” Conversely, they define appetite as, “an inherent craving, taste or preference.”

To the naked eye these may seem like the same thing but they are not. Distinguishing the two becomes supremely important in post-op life. I have my own definitions for both which may be a bit more helpful.

HUNGER is the need to eat. APPETITE is the desire to eat. Many people assume the two are mutually exclusive but they are not. You can need to eat even when you have no desire to eat and you can have a desire to eat even when you don’t need to eat. As I go through my other few points, this information becomes important.

Snacking vs. Grazing: Can you Tell the Difference?

Sometimes it’s easy to distinguish. For instance, if I plan to have a 200 calorie “mini-meal at 4 p.m., which falls in between lunch at noon and dinner at 7, we would commonly regard that as a snack, right? Conversely, if I ate lunch at noon, had a bite of a bagel at 1, a handful of nuts at 2:30, a yogurt at 4 and some popcorn at 5 then dinner at 7, we would easily call that grazing.

But sometimes the distinction is not so clear. Is grazing still grazing when you are snacking on “no cal” food like carrots or lettuce? And when does meal planning cross the line into grazing? Say you’ve planned your meals so that your day ends with a perfect 1200 calories (for the sake of argument) but you’ve broken that down into 8 meals that have you eating every two hours throughout the day. Is that a meal plan, planned snacking or grazing? See…it’s not always so simple to tell.

Going back to what I said above about appetite and hunger, that can be a good measure to start with. Many simply don’t feel hunger post-op, but our bodies find ways to tell us that we need to eat. Learn those cues (light-headedness, shaky hands and fatigue are common ones). Then use what you know to determine how much and how often you need to eat. You might enlist your nutritionist in this effort if this is hard for you.

There is really no such thing as “tiding you over.”

For those unfamiliar with this term, it’s when you eat a little something to “get you through to the next meal” which would be very soon after that snack. Many newbies right now, I know, are looking at the computer confounded, thinking, “how is this possible?” But as you get further out from surgery your eating capacity rightfully increases, making you able to do things like have a “tide you over snack.”

I’m here to tell you it’s not a good idea. It wasn’t a good idea pre-op and it’s STILL not a good idea now. Why?

Hunger (in whatever way you experience it) indicates the need for food. If you are feeling hunger that means you probably need a meal (preferably one that contains a good balance of nutrients and micro-nutrients). It’s a warning sign and you should regard it as such. Rather than consistently “tiding yourself over” with a snack, if you feel hunger during a certain part of the day, you might consider putting a meal there.

This becomes problematic to people like me, though. I am a self-professed food addict. I don’t WANT to have a full meal in these situations precisely because it eliminates the possibility of eating more later. (To other food addicts this will make perfect sense.)

Rather than trying to tide yourself over with a snack, it may be smart to face a few essential facts:

• Hunger is NOT an emergency. Yes you are hungry. No you will not die if you have to wait 20 minutes or so until your next meal. For those who have reactive hypoglycemia or diabetes, this may be different. But barring those circumstances, it truly is your head freaking out. Your body has a defense mechanism against starvation. It’s called fat.
• Those feelings you are feeling that are pushing you to have that “tide you over” snack? They come from somewhere. Something is driving them. Figure out what that is and you’ve done yourself a great service.

Impulse

It’s happened to us all. We see something, we grab it and eat it. Five seconds after we swallow, we think, “Why did I eat that? I wasn’t even hungry!” Impulse eating.

In my estimation, impulse eating is a result of allowing your appetite to dominate your food decisions. Like I said, appetite can exist outside of hunger. You can WANT something you don’t need at that moment. Appetite is further complicated by the fact that we don’t simply get an appetite for food in general (that’d be easy to remedy – we’d all eat lettuce every time we got the impulse to eat!) but we get an appetite, a craving for certain foods. Many times these are NOT the foods we should be eating.

Overcoming impulse eating is a matter of slowing down the situation. It takes a certain commitment to stopping yourself (sometimes when you are in “mid-reach”) to ask yourself some questions. Why am I reaching for this food? Am I hungry? What am I feeling? How will this food make me feel after I eat it? Is it going to make me sick? Is it going to make me depressed.

I stand before you, food addict and all, and tell you this: if you can master slowing down that “reach” process, you are well on your way to overcoming impulse eating. If you can just give yourself that 30 seconds to think about what you’re doing, most of the time you can talk yourself out of it.

Of course, this is not as easy as it seems. That urge to eat is powerful. Your brain has actual chemicals backing it up. Your body’s every inclination is to act on that impulse. It doesn’t want to slow down. And for us food addicts, it’s even worse. It’s a gauntlet. We MUST have what we want now or we will never, ever be happy or satisfied. Crazy as it sounds, these are common thoughts to food addicts.

I’ll stop there. But that’s just a taste of what’s coming in “BF Investigates: Hunger.” We’re going to really dive into the subject of hunger, what our expectations are before and after surgery with regards to hunger and how we should manage our hunger for long-term success.