appetite has returned to what it was before surgery (one year post gastric sleeve)

[girlnow]

My surgeon, the nutritionist and the RN who works with patients long term at the bariatric center are all aware of this and working with me. So while I am not looking for "advice", I am looking to hear from anyone else who regained their appetite in full! I am so depressed. Again, the "team" is working with me and will do anything within their power. This is a high powered hospital with all the bells and whistles and all the latest updated data.... but but as a patient I feel so alone. All of the people in my in person bariatric support group are brand new to having the surgery. No one who had it a year or more ago even come to the meetings. Again, just looking to touch base here with anyone who can understand an appetite returning to what it was prior to surgery! Thank you!

 

[Blakleykl]

What do you mean by revision? My husband had the Duodenal Swirch that had to be partially reversed. He became severely malnourished and anemic. It caused him permanent cognitive damage and damaged his kidneys to the point he’s on dialysis now.

 

[Roni]

I am pleased to see that your team is there for you as you face your issues. Like you said and your doctor said, each individual’s journey is different. Last summer I went down to 203 pounds putting me at 91 pounds down at 16 months post surgery. I reached size 16 clothes currently at 18. At fall I went into a mental funk. life didn’t feel right, husband had heart problem, food/meals were a problem. Mentally I was being challenged as to what counted as a meal at 4-6 oz portions. Everything was a snack per husband. He wanted his ice cream, chips and real meals. But he was a 1950’s “leave it to beaver“ person, inside was woman’s work. as a farm kid living in town he was clueless, so outside yard work was mine too. The bariatric team at annual in feb had issues with the sources of my protein/meals and milk intake. I was feeling down. I videoed appointment with prime doctor, VA bariatric dr and we went over my weight increase (15 pounds) and I had asked about meeting with dietician after major events occurred this year. Husband passing on Good Friday, emotionally stressing for 2 weeks about husband’s biological daughter who at 35 was adopted by her foster family from high school and announced at family gathering that he was no longer her dad. (My choice was to not inform her of his passing, figuring she was not his daughter per her choice. Heard she was looking for an old will so she could gain financially over his passing.) i over stressing my lower back in June removing stumps and tree limbs from chain link fence and was barely able to move, stand, sit or walk, followed by major dental root surgery (broke a crown) three days later followed by 11mm kidney stone For the Fourth of July. And 15 days of a stent in my right scarred ureter 1 inch above my bladder. Very uncomfortable. In the meantime I have been hiring and getting house projects done that were left undone for last 15 years. Some were said to not be able to be done, others just never addressed. Bariatric Dr is going to check back in October for further evaluation. My mind has gotten to a better place but I still have things to put in order. I met with bariatric dietician last week. Very informative and productive visit. I still have a major sweet tooth, at 2 years out. need to add more self discipline on that. I have a new log page similar to the 1500 calorie bubble diet page before surgery. It is 1200 calorie bubble page. Then the meal thing…. The dietician recommended a site. I searched for “bariatricfoodcoachme.com”. I am currently researching the recipes. It also had ideas/suggestions on how to set up portion controls, using silicone muffin/mini muffin pans. I have friends (one friend diabetic, neighbor lady who needs to gain weight, and son’s wife with gluten intolerance) who are looking for better food options and we are thinking of doing a meal/food co-op. I can mix stuff, prep meals, freeze it and put in portion bags with date made, name of food, with cook temp and length of time to cook. The milk issue finally figured out how to meet it. Puddings with pro shake drinks instead of lactose free milk. I also invested in a mini ice cream maker, again with protein shake milks Instead of whipping cream and maybe some powders too. We discussed how to better set the 30 min before and after meals time intervals. I am admitting to drinking to close to meals and after meals. last item addressed was the need to get some more focused exercise. Boo …Boo….. well May your journey merge to your needs and wants.

 

[missyinacage]

I am 3 years post op (bypass) and am stunned by the amount of certain foods I can eat. I have 4 family members who have had the sleeve as well. Everyone is hungry lol But some are managing more successfully than others.

I believe this is due to WHAT you eat. If you stick to lean protein and veggies, your stomach just can't hold as much no matter how hungry you are. So, you might be eating 4-6 times per day but it's healthy stuff that's good for you.

If you are eating out, or eating slider foods that are higher in calories, you're going to eat more and more calories. We've all put on a few post op but that's the main difference I see between a few and gaining all to most back.

 

[dianeseattle]

My surgeon, the nutritionist and the RN who works with patients long term at the bariatric center are all aware of this and working with me. So while I am not looking for "advice", I am looking to hear from anyone else who regained their appetite in full! I am so depressed. Again, the "team" is working with me and will do anything within their power. This is a high powered hospital with all the bells and whistles and all the latest updated data.... but but as a patient I feel so alone. All of the people in my in person bariatric support group are brand new to having the surgery. No one who had it a year or more ago even come to the meetings. Again, just looking to touch base here with anyone who can understand an appetite returning to what it was prior to surgery! Thank you!

This isn't advice, but are you confusing "appetite" with "eating disorder?"

Bariatric surgery addresses the PHYSICAL aspect of obesity. It's designed to make your stomach into a pouch that only holds a tiny amount of food. If you were obsessed with eating certain amounts or certain foods before, that doesn't go away without some kind of mental therapy.

My approach would be to plan your daily diet every day, and weigh and measure everything that's going into your mouth. Don't eat more or less than that.

Make sure you get at least 6 glasses of water in all day, sipping and sipping all the time. Never be more than an arm's length away from your water bottle or glass. The water is SO IMPORTANT, and I mean water, NOT liquid. Do an internet search that includes information on the physical effect of water on metabolism and digestion. Again, it's so important to drink water.

Let me suggest that you keep a journal for 2 or 3 days where you do this precise thing. You should already have a list of foods and a suggested diet from your bariatric RN or doctor. Draw from that, creating 3, 4 or 5 meals a day (small bites so you can feel like you're snacking, not stuffing yourself), and use check boxes to make sure you've eaten or drunk the food you've listed.

For the most part, I still have the exact urge to overeat (or in my case, binge & purge) as I had before my surgery. Only the revision of the size of my stomach has saved me from being obese like I was before.

I've smoked cigarettes on and off for 50 years, sometimes quitting for 5 or 10 years, then starting up again. But I'm just lucky I don't have an obsession for tobacco that so many people have, where they need a pack or two or three a day. Still, I have it. The urge to light up might pop into my head a dozen times every hour. I just go, "Oh. Wish I had a cigarette." Then I move on until the next urge arrives. But I don't smoke.

A lot of people find some form of hypnosis helpful. Even a positive affirmation can be a hypnotic command. The importance in any of my suggestions is REPETITION. Get your desire in order, then turn it into an affirmation, and whenever an urge pops up, say your affirmation over and over until it goes away.

You have an eating disorder of some sort. If you didn't, you would be at a normal weight and food wouldn't haunt you. Like any disease, you can't make it go away magically. You will have to fight it for the rest of your life. But you can win the fight, just by weighing what YOU want vs. what your obsession wants.

You're not alone in this. Virtually everyone in the world has some nearly uncontrollable bad thought or habit that they have to fight all the time.

I had a friend I used to complain to about my struggles with overeating, and basically, she'd just suggest I give in to it a little bit, in a very deliberate way, savoring the food in order to make it last and taste more intensely. I'd argue with her about the bad things that would happen and she'd say, "What are they gonna do, take away your birthday?" She just cracked me up. Thinking of it that way always helped me put my obsession into a manageable perspective.

Look, you had the surgery. You have rules about what and how much to eat. You are supposed to drink a lot of water. And this will be with you for the rest of your life. But you can step up to the line and say NO, I will not be controlled by an obsession. I'll live with it, I'll feel pain because of it, but I want something else more than I want to pig out. I want health, life, high self-esteem.

So gradually you can gain ground and become the boss who struggles with the task but lives with any pain or discomfort that brings.

The alternative is giving up and giving in. How does THAT feel to you?

Babbling. Hope that made sense.

 

[Blakleykl]

I am 3 years post op (bypass) and am stunned by the amount of certain foods I can eat. I have 4 family members who have had the sleeve as well. Everyone is hungry lol But some are managing more successfully than others.

I believe this is due to WHAT you eat. If you stick to lean protein and veggies, your stomach just can't hold as much no matter how hungry you are. So, you might be eating 4-6 times per day but it's healthy stuff that's good for you.

If you are eating out, or eating slider foods that are higher in calories, you're going to eat more and more calories. We've all put on a few post op but that's the main difference I see between a few and gaining all to most back.

I agree. I know 4 people who have gained their weight back. My brother in law gain his back within the first year.

 

[KristiLyn]

My surgeon, the nutritionist and the RN who works with patients long term at the bariatric center are all aware of this and working with me. So while I am not looking for "advice", I am looking to hear from anyone else who regained their appetite in full! I am so depressed. Again, the "team" is working with me and will do anything within their power. This is a high powered hospital with all the bells and whistles and all the latest updated data.... but but as a patient I feel so alone. All of the people in my in person bariatric support group are brand new to having the surgery. No one who had it a year or more ago even come to the meetings. Again, just looking to touch base here with anyone who can understand an appetite returning to what it was prior to surgery! Thank you!

I'm not that far out but my triggers smack me in the face everyday. Seriously! I never realized how all of my stopping points in town included getting food. Not healthy food. It was so much a part of my everyday. I love this group because you aren't alone. I finally feel like I'm not alone. And my Kaiser group is phenomenal but in Zoom we aren't able to all talk about what we feel in addition to what we're actually doing. Sometimes my cravings hit so hard it's all encompassing. But I know my pouch can't take it. And I'm thankful for the pain of eating too much. I'm a slow learner. It's like the person who keeps touching a hot stove knowing it's still going to burn. "Sss. Ouch! Sss. Ouch!" Ha, ha.

 

[missyinacage]

So much of the path to success is mental. I don't necessarily like to suggest everyone who's ever been overweight has or had an eating disorder, since obesity has so many underlying causes. (And I'm not medically qualified to do so) It suggests that willpower (pulling yourself together) will fix it, when that has been proven false time and time again. Which is why surgery is even necessary.

That being said, success does require a mental reset as well. People are creatures of habit. So many of us come from obese families, where everyone eats in an unhealthy way. So from your first bite, you're taught to eat in that manner. It is a hard habit to break, even after practicing for months or years.

What its really like trying to learn to write with your other hand. You can absolutely do it. But its a long term struggle and the results are nowhere near perfect. And even if you get good at it, you'll still grab a pen with your dominant hand most of the time.

And that's okay. You do the best you can and you keep trying. Some days are harder than others. The key is to give yourself some grace. You are not a perfect human being. You are never going to make 100% perfect decisions, eat 100% healthy foods, or hit 100% on anything else 100% of the time. Do the best you can. Forgive yourself for your failed effort of yesterday and make a plan to be a little more successful today.

Actually research the success rate of WLS. You are only expected to lose 50-70% of yoir excess weight. And the vast majority of people gain a small percentage of that weight back. Most of us will not get to a healthy BMI (which is BS anyway!!) . Most of us will gain back 10-20% of what we lost. Those are medical facts. Some people will do better. Good for them. Your success should be based on your results. We have to learn to be happy with our success instead of judging them as failures.

Today I weigh 169. Its not my lowest or even my norm ( 153 for 1 week lol and 166 is the 3rd year norm for me) I'm still down 94 pounds. Am I a success or a failure? What would you say to me vs what you say to yourself?!?

Self care is more than pedicures and massages. Its positive, realistic self talk.

 

[dianeseattle]

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[dianeseattle]

So much of the path to success is mental. I don't necessarily like to suggest everyone who's ever been overweight has or had an eating disorder, since obesity has so many underlying causes. (And I'm not medically qualified to do so) It suggests that willpower (pulling yourself together) will fix it, when that has been proven false time and time again. Which is why surgery is even necessary.

That being said, success does require a mental reset as well. People are creatures of habit. So many of us come from obese families, where everyone eats in an unhealthy way. So from your first bite, you're taught to eat in that manner. It is a hard habit to break, even after practicing for months or years.

If something is not working, it's out of order. People don't like to think of obesity as an eating disorder, but if you're obese, something is out of order, and it directly relates to a problem with the mechanism of eating. I'm splitting hairs here because people are often afraid "eating disorder" automatically means they're mentally ill, or they are anorexic or bulimic. No. It is, as you said, a problem that requires a mental reset. These are disorders that originate in the mind. Something happened to your thinking that caused you to have an urge that seems, or is, impossible to control.

I believe it's important for people to name the monster so they can use the right tools to fight it.

I remember the first time I went to a 12-step meeting and I had to say, "Hi, I'm Diane, and I'm an ..: I almost choked on the word. But it was only by saying it that I was able to be honest about it.

I also found that by admitting I had a disorder of some kind, I was able to find tools within me and from outside sources that helped me form an army to fight it.

Finally, being unable to admit that I had an eating disorder had confused me. I didn't know how to deal with the fact that I behaved in so many self-destructive ways, ate so often, ate so much, why I couldn't get back to my thin body. I ended up blaming myself or trying to blame my upbringing or society or anything to find an answer.

So my opinion is that it's important to say, "I have an eating disorder." In fact, it takes so much shame away when I realize I'm not doing something deliberate to hurt myself, but I have an illness like alcoholism or diabetes that requires a multifaceted approach to healing.

 

[missyinacage]

An eating disorder is a medical diagnosis, which I am unqualified to make make for another human being.

If naming your issue as an eating disorder helps you, that's wonderful. Not everyone needs that label to heal. Think of it like a pronoun. To each his/her or their own. : )

I did not binge or purge, or show any other symptoms of an eating disorder. I did eat in a very unhealthy way. Now I don't. Not everyone who takes pain killers is an addict. There are set criteria besides sharing a common symptom.

 

[AliceWoolf]

Hello!
While I am not your target audience and cannot speak from experience, I thought what little knowledge I had of “hunger” could maybe be of some help. However, I would like to emphasize first of all that you are not a failure and should not place any shame in weight gain. I also would like to say I am glad you have a supportive team on your side and reaching out to people who can relate. It shows you are taking an active role and you should recognize the goals you have met and your journey so far. It’s easy to focus on everything that didn’t go according to plan, but such an approach devalues all your effort so far, which is unfair to you.
The next thing I would like to address is your word of choice. You said “appetite” and we can understand “appetite” as hunger, though they are not exactly the same thing.
“Hunger” is a physical cue designed to make us seek food, but cravings produce almost the exact same sensation. In my case, the hardest part of my journey so far has been the preop diet, where I felt both hungry and anxious to eat. My body’s reaction to stimuli made me realize some things: when I have not eaten, I get hungry. When I have eaten too little, I get hungry. When I am idle and become bored, I get hungry. When I am sad, I get hungry. When work has been stressful, I get hungry. When I see something that looks tasty, I get hungry. When I see my family eat, I get hungry. When I am watching TV, I remember popcorn and I get hungry. When I am anxious, I get hungry. When I am walking with my dogs, I see a bistro I used to frequent and I get hungry. Sometimes, I get hungry when I have just eaten and cannot realistically eat anything. As it was, I had to ask myself what was hunger and what felt like hunger. The sensation was almost identical. I didn’t really experience hunger before surgery. I could eat once a day and sometimes not even that. I could eat a lot and then nothing at all for several hours. I could eat without realizing I was, in fact, eating (specially when bored). When I had to restrict my eating patterns, I felt actually hungry for the first time in a long time. I could also see I craved things I didn’t before, because now they were out of bounds. It was maddening. It also gave clarity to things I could not see before. So I had food addiction and used food as a coping mechanism. Of course I knew that, but could not actually believe it until I saw it in action.
To be fair, cravings and hunger are very alike. I have become to understand cravings as an emotional hunger, a need I am trying to repress and makes itself known in another way. I know it is not hunger, but it feels just the same. Awareness of how my head works has enabled ways to work around it. Surgery has been immensely helpful in physical restrictions that allow me to address the mental aspect of my eating habits. It is also difficult and sometimes even sad. For me, that is the mental facet of hunger.

There are, however, physical aspects of hunger that are invisible, but for their obvious effect. Hunger can be hormonal (bariatric surgery takes out a good portion of the stomach, including the place where most of the ghrelin is produced, which translates in very little huger for some patients). Fluctuations in blood sugar can trigger hunger cues. Inflammation in the digestive tract can feel like a hollow place, which our brain translates as hunger. Depression causes chemical imbalance in the brain that can make you feel hungry. So does anxiety. That’s why some antidepressants can cause weight gain or weight loss. Psychiatrist are unable to say why, though some theories have been proposed. The stomach has the highest concentration of neuro transmitters, so gut microbiota influences hunger too. The food we eat influences micro biota in turn. Artificial sweeteners affect metabolism and hunger. So does sugar. There are many other factors. As you can see, actual physical hunger has so many correlations, they are very hard to pinpoint. I don’t think hunger as a mechanism is all that well understood. There is a video by John Pilcher, a bariatric surgeon, where he explains it much better than I could. There are many studies about it, but they make for dry reading material (Google Scholar can help you find some, if you are inclined to consult them). Understanding hunger is very difficult, but our reaction to hunger can be trained. It will force you into a fight with yourself every day, and sometimes you will lose that fight out of sheer exhaustion. Battling ingrained impulses is a lifetime of work. Sometimes you will not feel like resisting it. That’s completely okay. Every day is a choice, and every day you can chose how to act. It’s okay to need help. It’s okay to need more help after that. Some people need revision surgery, and that is fine. Some people can lose weight (a lot of it too) without surgery. I was not one of them and felt very ashamed of it for a long time. I thought I was weak willed. I thought I needed to try harder. I was wrong. I needed help, got help and I am doing much better. If I ever need more help, I hope I can be strong enough to ask for it. Kind enough to accept I need it and allow myself to receive it. You are not failing at anything. You just need more guidance and another crutch. It’s okay. Please don’t be ashamed. Please don’t be so hard on yourself. Look after your mental health. Look after your physical health. You deserve to be happy. You deserve to be comfortable in your body. You deserve to be healthy.

I wish you all the luck!