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Feeling Hungry Post Bariatric Surgery.

We all believe that after we have bariatric surgery “POOF” the feeling of being hungry will just disappear and never come back again – at least that’s what we have read online so why shouldn’t it be true ?  Once you are no longer in the honeymoon period and you are fully recovered and eating solids again, one day that hungry feeling can come back.  What can we do to make sure that we have continued success and satisfy our hunger ?
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During the first year post surgery, patients feel that they are satisfied after a very small meal but as time goes on they sometimes notice that their appetite has come back and that they are able to eat a larger portion at mealtime.  A question I often get from clients is “what should I eat so I don’t feel hungry either after a meal or between meals? What can I do”?
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Let’s turn this into a discussion about what bariatric patients can do to be certain that they are satisfied, hit their goals during the first two years post surgery and also maintain their weight which they worked so hard to lose in the first place.
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Protein Needs To Come First.

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We all know that protein rich foods are always the main point in each meal or snack.  We also know that we need to eat approximately 60 grams of protein per day.  What’s so darn special about protein and why does it fill us up more quickly and keep us feeling satisfied longer ? High quality protein rich foods such as seafood, poultry, meat and some dairy foods such as cheese and yogurt, eggs, beans and other plant-proteins help us eat and feel satisfied longer when compared to carbohydrates.
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If you find yourself eating larger amounts in one sitting, it’s a good idea to take a look at what exact types of foods you are consuming by keeping a food journal for a few days.  Is it the carbohydrates at meals making you crave more after you eat ?  Especially the processed kinds that are dry and crispy like crackers, popcorn and chips etc.  These types of foods are not going to fill you up and they are considered grazing foods.  When your meals are high in carbs, going back to your protein based meals is going to help you feel better and more full and satisfied for a longer period of time post meals.  Try replacing carbohydrate foods with protein foods and see how you feel.
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We Need to Eat More Fiber.

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Protein and Fiber can go hand in hand to promote satiety post eating.  If you are more satisfied after your meal, you are less likely to snack and will have better weight loss and maintenance overall.  Add high fiber foods to your menus such as carrots, broccoli, bell peppers, spinach and squash.  High fiber carbs like whole grains, pasta, quinoa – are the last type of foods that we should eat at our meal (if space allows).  A common issue post surgery is constipation and high fiber foods will also help to alleviate this problem as an added bonus.
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Liquids or Solids.

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Once surgery is behind us and we are fully recovered and back to regular life/ stresses etc, we may find that the same protein shake that we once had post surgery no longer satisfies and fills us up like it once did.  When the pouch is formed and healed and there is no inflammation any longer, liquids can pass through our pouch and not fill us up any longer.  You may have relied on your shake to keep you full but if it’s no longer doing it’s job, it may be time to exchange that shake for a more solid form of protein such as a slice of turkey or some greek yogurt.  Some patients find a higher satisfaction level when eating their meals vs drinking their meals in the form of a shake.
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No More Grazing.

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If we are picking at foods all day long we can end up eating more food that we think we are eating.  This means that if you graze, you may have poor weight loss results and a harder time maintaining your results.  When we nibble, we never achieve full satisfaction and we continue feeling hungry.  If we go back to eating regular meals instead of snacking all day and those meals are made up of protein and fiber, we will feel more satiety which is going to lead to more weight loss and better maintenance.
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Eat Meals and Snacks at the Same Time

Don’t skip meals or snacks because this can lead to night time snacking and binging.
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In conclusion, if you are not feeling satisfied with your meals and snacks post bariatric surgery it is time to take a look at what your meals consist of and possible make the changes required to get back to basics.  Always choose protein and fiber rich foods before carbohydrates and opt for solid foods for meals over meal replacements.  Journaling is a great tool to help you determine what you are eating and how that specific food makes your feel during your meal and then again afterward.  Bariatric is a journey and even once the weight is lost, the learning continues.
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About the Author: Sheri Burke is a Registered Nutritionist and Bariatric Coordinator at International Patient Facilitators in Tijuana and Cancun, Mexico. She has worked with bariatric surgery patients for 10 years and especially enjoys providing nutritional guidance to pre and post bariatric patients.  In her free time, she enjoys spending time with her husband and two teens and cooking up a nutritional storm in the kitchen.

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