One of the great side-effects of the Vertical Sleeve Gastrectomy is my lack of hunger. One of the things the VSG does is significantly reduces the production of ghrelin, the hunger hormone. Some people never lose their hunger. Some people lose it for awhile and it comes back after six months or so. I can say for myself, at nearly 10 months out I rarely experience physical hunger.

It is difficult to describe the difference between my hunger pre-surgery and the hunger I experience now. Pre-surgery, my hunger was a desperate, almost panicky feeling. Even worse, I felt it all the time. I was never ‘not hungry’. I could eat to the point of being stuffed, physically uncomfortable even, and less than an hour later I’d feel as if I was starving again. Since my surgery, I have not felt that way, not even once. When I do get hungry, I can ignore it for a bit. Prior to surgery it was a constant roar in the back of my mind. After surgery, it is a meow and a quiet one at that.

When I see someone who had a VSG panicking because they are feeling hungry again, I don’t really know what to say to them. Hunger is normal, naturally thin people get hungry too. What is not normal is the way hunger affected us before surgery. It can also be difficult to determine if what you are feeling truly is hunger. Is it head hunger? Is it stomach acid? Stomach acid can mimic the symptoms of hunger to the point the two can become very confused.

So what is head hunger exactly? Head hunger feels like real hunger but it’s that thing that makes you think you want to eat when you are full or is triggered by emotional stress and other triggers. You may actually experience hunger pangs but you aren’t truly hunger, you’re obsessing or stressing and turning to food. Surgery can’t fix this, it something that we have to face down on our own and deal with. It can be defeated but it’s important to figure out if you are really hungry or if it’s your head telling you that you are.

Stomach acid can also mimic the symptoms of hunger, which is why you’ll often hear post-op ‘vet’s asking ‘newbies’ if they are taking a PPI. This seems to be most common in the early weeks post surgery, before the acid in our stomachs levels out. There’s a great article by Dr. Nemechek that explains how stomach acid mimics hunger. You can read the full article here but here’s a quote:

We often confuse dyspepsia with hunger because you may feel shaky, slightly nauseated or weak and eating food makes the symptoms disappear.  They go away because food stimulates the stomach to empty.  The food therefore causes the excess acid to be emptied into the small intestine and your symptoms resolve.

The symptoms would also go away if we took an antacid such as Tums since they are truly the result from excess stomach acid.  But since they go away after you eat food, you draw the reasonable conclusion the symptoms were due to low levels of blood sugar or some other nutrient.   Consequently we believe the symptoms were a sign of hunger.  So the next time we feel similar symptoms, we’ll eat food again and the symptoms go away again.  After a while it becomes almost second nature.

When the stomach doesn’t empty as readily as it should, acid accumulates making us feel uncomfortable, bloated, slightly nauseated or even a little shaky.  We eat some food and our symptoms seem to disappear.  This happens because eating food stimulates the stomach to empty its acidic contents and this is the reason snacking relieves our symptoms.  We only refer to these symptoms as hunger because food helps make us feel better.

Once you know whether what you are feeling is ‘true’ hunger or not, I think it becomes easier to deal with.  Hunger is no longer something to fear, for me at least. Thanks to my surgery, I am better equipped to control my hunger, rather than allowing it to control me. It’s not always easy, but it gets easier all the time.

Some ‘food’ for thought.

  • Did your hunger come on gradually or did it hit you all of a sudden like a summer storm that blows up out of nowhere? If it’s the former, it’s real hunger. If it’s the latter, it’s head hunger.
  • Does doing something else make the craving go away? If so, then you’re dealing with head hunger.
  • Are you bored? Lonely? Sad? Examining your emotions when you eat can help you identify true hunger versus head hunger.
  • Are you craving something specific? According to experts, emotional eating cravings are usually specific, generally a craving for a certain ‘comfort food’.
  • Do you feel guilty or ashamed after eating? Maybe you tell yourself you’ll make up for it later by taking a walk or skipping a meal tomorrow. If so, then what you were experiencing is probably not physical hunger (but it could be, and you are still attaching shame with food).

Some suggestions for dealing with head hunger:

  • Go for a walk.
  • Call a friend.
  • Take a nap.
  • Drink a glass of water.
  • Write down what you are feeling to help you identify your triggers.
  • Find a healthy alternative food for what you are craving, you may even discover you don’t really want to eat in the process.

What are your tips for dealing with head hunger?


7 Comments (+add yours?)

  1. Sheila
    Jun 14, 2011 @ 14:04:51

    I am one of the ones who lost my hunger immediately AND I don’t take a PPI, I never have and am hoping I never will have to. lol. You know that phrase, eat to live (instead of the other way around?) well with the VSG I finally feel like I understand what it means to eat to live. I eat because I have to, and that makes dealing with head hunger 100% easier. I don’t always eat the perfect post-op meal (probably do about 95% of the time.) It is a strange feeling for sure, this no hunger thing. Good to know that you are further out than me (I’m 7+ months) and that you still rarely feel hungry. I hope the hunger stays away forever!


    • Jeanette
      Jun 14, 2011 @ 14:52:52

      I’ll be happy if it stays away forever, LOL. Even if it doesn’t, though, I think I’ll be okay because it really IS different. Unless my body finds a way to start over producing ghrelin again.


  2. Julie
    Jun 15, 2011 @ 23:31:37

    The Carb Monster or the Chocolate Whore call me when I’m stressed. You know it’s bead when there are both trying to be heard over one another. I have actual hunger, but not as often as I would think. Head Hunger way more often, I carry Glucose Tabs because I lose track of time when I’m out and forget to eat until the symptom are screeching. I had RnY 18 months ago. I’m trying really hard to stay away from the kitchen right now. ARGH


  3. Maria
    Jun 18, 2011 @ 00:54:26

    Wonderful post! This just happened to me, I thought I was hungry and I ate! Let’s just say the toilet ended up with all of it! I vomited because I wasn’t really hungry it was head hunger! Sigh!!!


  4. vanita
    Jun 19, 2011 @ 23:14:30

    This “I could eat to the point of being stuffed, physically uncomfortable even, and less than an hour later I’d feel as if I was starving again.” explains my eating habits perfectly and sadly i don’t know how to control that. Also? THank you so much for explaining dyspepsia. I didn’t know about this and when I feel it coming on I’ll try the antacid. Thanks so much.


  5. Lisa
    Jul 07, 2011 @ 15:10:02

    LOVE this post. I had the same feelings before surgery. Now, when I start to feel that way, I can remind myself that it is not food I need, I have to look inward.

    – Lisa


  6. BlackBerry Mama
    Jul 21, 2011 @ 00:07:29

    I had this problem early out too. Except, I knew it was acid. The way I was being attacked by the acid, it would have been impossible for me NOT to know.

    Today, I am happy to say, that at almost a year out, I know when I’m hungry, and when I’m not. Sometimes it’s as easy as food not tasting as good when I’m less hungry. Other times, I have asked myself, aloud, “Why do you want to eat that?” It’s funny to hear me do, but it has worked many times.


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