Feel like I'm starving, Day 6

[LouLouM 70]

Forgive me for so many posts, but I am concerned. Day 6 after surgery and I feel like I'm starving. I am so hungry. My stomach is growling. I've been having Protein Drinks, broth with Protein, and pureed Soups. I get full very quickly, but I am on three "meals" a day and am so hungry in between meals. Will this improve when I'm on purees? Solids?

I also feel very weak and tire very easily. I did have both the sleeve and hiatal hernia.

[Tony B - NJ 642]

Yes....it will get better for sure. There are a lot of feelings you are having that may even be related to gas, medication, bloating, swelling etc. You will start to feel a lot better very quickly. Stick to it and don't waiver. Make sure you are taking your Protein Shake in the morning which gives you a feeling of fullness and will get you through to lunch. If you are feeling hungry between meals, have some Bone Broth which helped me feel a little less hungry and it has Protein as well...only 45 calories for a 10 ounce serving. You get your Water AND you protein. Do not miss on your water. When you don't get enough water it can make you feel hungry as well.

[Spinoza 1,376]

I was ravenous for over two weeks LouLou - my hunger really only settled yesterday (day 18). It's so hard but I found that Hot Drinks filled me up more than cold if that's any help. Also I added dried skimmed milk to coffee and Soups because it's easy additional Protein. Keep going, you're already over the hardest few days 💪

[LouLouM 70]

24 minutes ago, Spinoza said:

I was ravenous for over two weeks LouLou - my hunger really only settled yesterday (day 18). It's so hard but I found that Hot Drinks filled me up more than cold if that's any help. Also I added dried skimmed milk to coffee and Soups because it's easy additional Protein. Keep going, you're already over the hardest few days 💪

Yes to the hot drinks! The best for me currently is low sodium vegetable broth and chicken Soup flavored Protein Powder.

THANK YOU for sharing your experience of the hunger settling down. I am a teacher and I will be back to work next week. HOW will I have the stamina to deal with 6th graders excited for winter break???

[LouLouM 70]

53 minutes ago, Tony B - NJ said:

Yes....it will get better for sure. There are a lot of feelings you are having that may even be related to gas, medication, bloating, swelling etc. You will start to feel a lot better very quickly. Stick to it and don't waiver. Make sure you are taking your Protein Shake in the morning which gives you a feeling of fullness and will get you through to lunch. If you are feeling hungry between meals, have some Bone Broth which helped me feel a little less hungry and it has Protein as well...only 45 calories for a 10 ounce serving. You get your Water AND you Protein. Do not miss on your Water. When you don't get enough water it can make you feel hungry as well.

Thank you. Tony. I am in need of encouragement and that's just what you gave me.

[Spinoza 1,376]

Oh lord I have no idea. In the same way that I have no idea where you get the stamina to deal with them all year round! Are you sure you're ready to go back so soon?

[LouLouM 70]

I don't think that I am, but I have such teacher guilt about taking more time off. We have two weeks left until winter break and so that would mean I would work for a week before a three week break. But rain is in the forecast all next week and here in California, that means we stay inside with our students ALL DAY. Very tiring days because you never get any quiet time.

[rjan 164]

Oh yes, I was ravenous until I got on semi-solid food like eggs and cottage cheese.

Personally, I attributed that to getting more Protein. I really did not like the taste of Protein Shakes, and even though I was choking them down, I don't think I was getting as much protein as my body needed.

But also, solid food makes you feel more "full" than fluids, no matter what their nutritional content. Studies of gastric emptying show that fluids leave your stomach much faster than solids, even if they have the same calories. (Water goes through your stomach even quicker than liquid food.)

Once you start eating solid food, the fact that your stomach is smaller will really start fully working. Bariatric surgery doesn't just work because you can't eat as much. It also changes your hormones. Ghrelin is called the "hunger hormone" and your stomach makes it when it is empty. You make less of it after bariatric surgery because you have a smaller stomach. But you also make less of it when your stomach spends more time feeling full.

[LouLouM 70]

4 minutes ago, rjan said:

Oh yes, I was ravenous until I got on semi-solid food like eggs and cottage cheese.

Personally, I attributed that to getting more Protein. I really did not like the taste of Protein Shakes, and even though I was choking them down, I don't think I was getting as much Protein as my body needed.

But also, solid food makes you feel more "full" than fluids, no matter what their nutritional content. Studies of gastric emptying show that fluids leave your stomach much faster than solids, even if they have the same calories. (Water goes through your stomach even quicker than liquid food.)

Once you start eating solid food, the fact that your stomach is smaller will really start fully working. Bariatric surgery doesn't just work because you can't eat as much. It also changes your hormones. Ghrelin is called the "hunger hormone" and your stomach makes it when it is empty. You make less of it after bariatric surgery because you have a smaller stomach. But you also make less of it when your stomach spends more time feeling full.

Thank you for taking the time to so thoughtfully respond.

I guess that's why I'm worried: if I'm making less ghrelin, then why I am so hungry??? I suppose because I am not eating solids. How can anyone get full on Protein Shakes and broth?

Thanks again. These replies make me feel so much better.

[Amidoingit 6]

Since you just had your surgery, an idea would be to contact your Dr or nutritionist to see what they have to say. They might have you increase your Protein Shakes or add something else in addition to the great suggestions already posted.

Sent from my moto g power using BariatricPal mobile app

[rjan 164]

1 hour ago, LouLouM said:

Thank you for taking the time to so thoughtfully respond.

I guess that's why I'm worried: if I'm making less ghrelin, then why I am so hungry??? I suppose because I am not eating solids. How can anyone get full on Protein Shakes and broth?

Thanks again. These replies make me feel so much better.

There's truth in the gherlin explanation, but it's also oversimplified so maybe gives people the wrong impression. There's multiple hormones that affect hunger. Leptin is another hormone that makes you hungry - it is made by your fat cells as they lose energy. Leptin is proportional to the number of fat cells you have, not the volume of fat. Fat cells multiply as you gain weight, but they don't die just because you lose weight - they just get smaller. A normal weight person that used to be fat will be making more leptin than a normal weight person who was never fat because the person who used to be fat has more fat cells. Leptin is part of the reason why people have a "set point," or a weight that their body likes to be at that is maintained by the body by changing your hunger and metabolism. Insulin also increases your hunger in the long term. You make insulin after you eat, while you are feeling full. But if you are constantly making a lot of it, your muscle cells get resistant to insulin and have trouble getting food even if there's plenty of food in your blood already. They will feel hungry and tell you to eat more. This is why sugar is kind of addictive to people who tend towards insulin resistance. If your body isn't getting enough Protein, that will make you feel hungry too, even if you are eating enough calories.

Also, there's two sets of neutrons involved in hunger - your brain is one set, but your gut also has its own neural network, and scientist understand much less about how this "gut brain" works. One of my friends is a scientist in nutrition and physiology, and a member of obesity research societies. He's the one who told me about this "gut brain" stuff.

Scientists in the field don't entirely understand why WLS works. One puzzle is that they've observed that insulin resistance improves right after surgery - within a day or two people will be off their diabetes meds. They know insulin resistance improves when you lose weight and when you exercise, but they don't know why there's this fast change after WLS. Another puzzle is that they've found that a few years out, WLS patients have a higher metabolism that is closer to a person that was never fat, whereas people who lost weight through diet/exercise have a much lower metabolism than a never fat person. WLS somehow resets your "set point," but they don't know how exactly.

Scientists have tried to develop drugs that change these hormones like gherlin and/or leptin. "WLS in a bottle" would be much easier than actual surgery. But none of these approaches have worked yet. That's another indication that they don't fully understand how WLS works.

But it seems likely that resetting your set point is a process that occurs as you lose weight. It's not just a change that occurs instantaneously when the surgery is done. It's not just that your smaller stomach makes you feel less hungry and you can't eat as much, so you lose weight. It's that the process - losing weight while spending a lot of that time not feeling hungry because your stomach feels really full - changes what your neural networks consider to be your set point, and that in turn makes you feel less hungry without your hunger increasing and metabolism dropping in the long term.

If this is how it works, that would explain why the people who stick to the diet more strictly in the beginning have more success in the long term. For instance, if you eat sugar early on, that sugar is going to increase your insulin and insulin resistance and make you feel more hungry over the next week. Even though you may be eating exactly as many calories and have exactly the same stomach size as a person who is more strict about what they eat, that process won't work as well, and your set point won't get as low.

[LouLouM 70]

1 hour ago, rjan said:

There's truth in the gherlin explanation, but it's also oversimplified so maybe gives people the wrong impression. There's multiple hormones that affect hunger. Leptin is another hormone that makes you hungry - it is made by your fat cells as they lose energy. Leptin is proportional to the number of fat cells you have, not the volume of fat. Fat cells multiply as you gain weight, but they don't die just because you lose weight - they just get smaller. A normal weight person that used to be fat will be making more leptin than a normal weight person who was never fat because the person who used to be fat has more fat cells. Leptin is part of the reason why people have a "set point," or a weight that their body likes to be at that is maintained by the body by changing your hunger and metabolism. Insulin also increases your hunger in the long term. You make insulin after you eat, while you are feeling full. But if you are constantly making a lot of it, your muscle cells get resistant to insulin and have trouble getting food even if there's plenty of food in your blood already. They will feel hungry and tell you to eat more. This is why sugar is kind of addictive to people who tend towards insulin resistance. If your body isn't getting enough Protein, that will make you feel hungry too, even if you are eating enough calories.

Also, there's two sets of neutrons involved in hunger - your brain is one set, but your gut also has its own neural network, and scientist understand much less about how this "gut brain" works. One of my friends is a scientist in nutrition and physiology, and a member of obesity research societies. He's the one who told me about this "gut brain" stuff.

Scientists in the field don't entirely understand why WLS works. One puzzle is that they've observed that insulin resistance improves right after surgery - within a day or two people will be off their diabetes meds. They know insulin resistance improves when you lose weight and when you exercise, but they don't know why there's this fast change after WLS. Another puzzle is that they've found that a few years out, WLS patients have a higher metabolism that is closer to a person that was never fat, whereas people who lost weight through diet/exercise have a much lower metabolism than a never fat person. WLS somehow resets your "set point," but they don't know how exactly.

Scientists have tried to develop drugs that change these hormones like gherlin and/or leptin. "WLS in a bottle" would be much easier than actual surgery. But none of these approaches have worked yet. That's another indication that they don't fully understand how WLS works.

But it seems likely that resetting your set point is a process that occurs as you lose weight. It's not just a change that occurs instantaneously when the surgery is done. It's not just that your smaller stomach makes you feel less hungry and you can't eat as much, so you lose weight. It's that the process - losing weight while spending a lot of that time not feeling hungry because your stomach feels really full - changes what your neural networks consider to be your set point, and that in turn makes you feel less hungry without your hunger increasing and metabolism dropping in the long term.

If this is how it works, that would explain why the people who stick to the diet more strictly in the beginning have more success in the long term. For instance, if you eat sugar early on, that sugar is going to increase your insulin and insulin resistance and make you feel more hungry over the next week. Even though you may be eating exactly as many calories and have exactly the same stomach size as a person who is more strict about what they eat, that process won't work as well, and your set point won't get as low.

I can't say that I understand it all, but thank you so much for the interesting information. I guess it makes matters a little more complicated that I don't have a thyroid (medullary thyroid cancer), which is when the weight problems began.

[LouLouM 70]

2 hours ago, Amidoingit said:

Since you just had your surgery, an idea would be to contact your Dr or nutritionist to see what they have to say. They might have you increase your Protein Shakes or add something else in addition to the great suggestions already posted.

Sent from my moto g power using BariatricPal mobile app

I did and she suggested refried Beans with a little cheese. I. Am. In. Heaven. Cooked some peruano/mayacoba beans and pureed them with an immersion blender. No oil. What a game changer to have something substantial, even if just a 1/4 cup. I just finished eating them.

[Arabesque 7,240]

Add to all the above is the emotional & stress aspect. You have had pretty major surgery. Are experiencing pain & likely confusion & worry. Plus you’re on a restrictive diet. In the past you likely would have turned to food to provide you with support & comfort when experiencing similar stress & emotional upset. You can’t turn to food this time but the cravings & desire to eat for comfort remains. The surgery changes you physically but unfortunately it doesn’t change how you think & feel.

Wish there was a simple, instant solution. Give yourself time to heal & come to terms with the changes. A conversation with your medical team, dietician &/or a therapist is always helpful.

All the best.

[Tony B - NJ 642]

17 hours ago, LouLouM said:

Thank you. Tony. I am in need of encouragement and that's just what you gave me.

My pleasure....we all need a little help now and again.