SATIETY 101: Satiated vs Stuffed

[Jean McMillan 2,973]

Are you still searching for the feeling we call “full”?

Not once in my life before my band surgery did I ever feel I had eaten enough food. Day after day, meal after meal, I searched for the feeling of “full”. I had no idea what it felt like, for many reasons. Some were emotional, some spiritual, some physical. Researchers now theorize that the internal message system in obese people doesn’t function properly, so that we don’t receive or comprehend “full” messages. Whatever the reason(s), I ate as if I was shoveling food into a bottomless pit that no amount of food could ever fill.

As a new bandster, it took me a long while to even begin to pay attention to my eating, never mind figure out when to stop eating. And no wonder. For over 50 years, I had eaten mindlessly, greedily, endlessly. Every single day, every meal, every moment, I ate and ate to reach what I call Thanksgiving dinner Full. I loved to cook (and still do). I loved to eat (and still do). My business travels took me all over the world, so that in each country I was able to enjoy a huge variety of different and delicious food. Occasionally the food was very strange – I can’t recommend eating the lightly grilled, still wriggling sea slug I sampled in Taiwan – but I was always game for a culinary adventure.

It’s very ironic that during those overseas travels, I witnessed true hunger, deprivation, and near-starvation firsthand. What I ate in one day then could probably feed a whole family for a week. In Southeast Asia I once met a new business associate for the first time. We talked business for a while. Then he said something startling, seemingly out of the blue: “Your family must be very wealthy.”

I said, “Uh, not especially.”

He smiled at my modesty, gestured at my size 24 body and said, “But it is true, because I can see that you eat very well.”

That encounter was mortifying on several levels, as I’m sure you can imagine. When I left that business career and coincidentally began dealing with my weight and eating issues, I also began to feel shame for my eating behavior, for the waste of all the food I’d gobbled up in my perpetual Quest for TDF (Thanksgiving Dinner Full). But how on earth could I end that quest? How could I ever learn to stop eating before I reached the TDF level?

I was extremely fortunate to start my weight loss surgery journey a short while later, and even more fortunate that my Lap-Band® eventually became such an effective tool in helping me eat less and lose weight. Although I felt I’d done a lot of research as a pre-op, I have to smile every time I think of a bandster friend who told me, “I had no idea how much work this was going to be.” I had no idea either. Every bite of food, every sensation in my body before, during, and after I ate, became a big project.

If you’re a new post-op, or even a further-out post-op, are you too discovering how much work is involved in living with and succeeding with your band? Perhaps wondering, “What have I gotten myself into?” If so, that’s OK. Remember that you’re not alone, and that you can succeed even if feels like getting there is taking forever and a day.

So, c’mon, Jean. Get to the point. Tell us: how do you know when to stop eating? Do you eat until you're full? What is “full” supposed to feel like now?

My answer to the first question is no. As a WLS patient, you don't eat until you’re full. You should never again eat that way, not just because that’s how you became obese enough to qualify for bariatric surgery but because eating that way will hinder your weight loss and can cause some nasty side effects and complications. So you’re going to have to figure out a new stopping point. And that stopping point is the satiety point.

Satiety is not quite the same as being full. For a bandster, full means that you have overeaten again and will soon be so uncomfortable you’ll have to take a few breaths before you go on to clean that plate like a good kid. (Which, by the way, is another practice you’ll have to give up sooner or later). Full means your upper stomach has reached its maximum capacity and that at any moment, that food is going to back up into your throat and make an ungraceful exit all over you, the table, and your dining companions. Full means that you sped right past your satiety point. Full means that it’s time to start paying much closer attention to how you feel as you eat.

Satiety happens on your way to being full. With a properly adjusted band, you will be comfortable if you stop eating when you're satiated, but will experience discomfort if you eat until you're full. If you eat to the TDF point, you won’t have that old faithful full-belly sensation that made you loosen your belt while waiting for Mom to bring you a big piece of pumpkin pie.

Instead, you’ll probably feel pressure, even pain, in your upper abdomen and chest. You’ll produce enough excess saliva to make you drool. You’ll think you’re about to power barf. You’ll be very sorry you overate. You’ll promise God and your bariatric surgeon (who are not actually the same person, by the way) that if you can feel relief right now, you’ll never overeat again. You’ll need to learn some strategies to prevent another episode of overeating. In article #3 of the Satiety 101 series, “Recognizing Satiety,” we’ll take a look at some common signals our bodies give us when we’re closing in on the satiety point.