Redefining “Satisfied”: Learning to Listen to Your Pouch

Patients who undergo weight loss surgery frequently have a history of emotional eating. They eat to manage sometimes difficult feelings, such as loneliness, boredom, anger, grief and insecurity. For some, emotional eating is a habit; for others, it’s an addiction.

If this describes your past experience, then you should be aware of the changes that take place after weight loss surgery, both physically and psychologically. One of the first issues you will face is learning to redefine what it means to be hungry and how it feels to be satisfied. Here are some pointers to help you navigate the new landscape and manage your pouch post-surgery.

Recognize Head Hunger
Often, we think that we’re physically hungry when really we are “head hungry”. Head hunger is that nagging or impulsive voice that you want to satisfy with food. The voice often repeats the same message, like, “I had a bad day”, “I deserve a treat”, “Just one more…” or “It’s the weekend.” Typically, we reach for unhealthy food choices when we’re feeding our head hunger. (Really, when was the last time you had an insatiable craving for carrot sticks?) Physical hunger, on the other hand, is the gnawing sensation in the stomach, which is easily remedied with a nutritious snack or meal. So, the next time you feel “hungry”, ask yourself which one you are feeding – your stomach or your head.

Mark Yourself Present
Before weight loss surgery, being “satisfied” after a meal might have meant eating until you thought you were going to burst. Or, you might have eaten large quantities of one particular item – say, cereal, chips or ice cream – to feed a craving rather than actual physical hunger. Once you have a new, smaller stomach pouch – whether from a gastric bypass, Lap-Band or gastric sleeve – you will become physically full after just a few bites. To recognize this feeling of satiety, however, you need to be both physically and mentally “present” when you eat. (That means no multitasking during meals!)

We teach patients to stop eating when they feel a pressure sensation at the breast bone. If you feel chest pressure, you already ate too much, and if you feel pressure in your throat or esophagus…be prepared to spit up. Becoming attuned to these physical sensations as you learn to navigate your bariatric pouch will help you determine when you should stop eating.

Think of the Funnel
Think of your post-weight loss surgery stomach as a funnel. Your goal is to fill the funnel with foods that will make the walls stretch just enough to tell your brain to quit eating. DO NOT eat foods that pass through funnels, including liquid calories (such as juice, milk, and soup), soft mushy calories (like yogurt, cheese, cream of wheat, and grits), all sweets, and small salty crunchies (like pretzels, chips and Cheetos®).

Back Off the Beverages
Another habit that many patients have to break is the custom of drinking a beverage with their meal. When managing your pouch, you need to forgo liquids for at least 30 minutes before and 30 minutes after eating. This is so that food is not washed through your system too quickly, which can negate the effects of the pouch and cause you to consume more food (and calories) before you feel full.

Remember the Pouch Rules
Regardless of which procedure you have, pouch rules are universal to all bariatric surgeries. The pouch rules are there to help you maintain your pouch size and decrease the chances of complications or weight regain. Here is a recap of the essential pouch rules:

  • Meals should take only 15-20 minutes. (If you’re taking longer, odds are you’re eating too much.)
  • No drinking with meals or within 30-60 minutes of mealtime, and no carbonated beverages ever.
  • Eat 1 – 1½ cups of solid food at every meal.
  • Eat proteins first to fill your funnel, then produce and carbs if you still have room. Let satiety (not pain!) tell you when to stop eating.

Above all, remember that your pouch is your friend! You suffered from the disease of obesity, and your pouch is part of the treatment plan designed to help you get healthy and live a more fulfilling life. Yes, you will need to change the way you think and feel about food, change how you approach holidays and events, and learn how to feel your way through emotional upset rather than stuff down those feelings with food. In short, you are going to have to change everything. If you partner with your weight loss surgery as if it were your best buddy, you can keep your pouch happy and enjoy lasting post-surgery success!

Questions? Call our weight loss surgery practice at 254-724-2397.

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