How to Manage Cravings After Bariatric Surgery and Weight Loss

December 18, 2019

Manage cravings after bariatric surgery: Patients report decreased hunger and cravings after bariatric (weight loss) surgery. This results in smaller portions and rapid weight loss for most patients. This period of time is often referred to as the “honeymoon phase,” where most don’t have to work very hard for quick results.

However, the length of this phase can be inconsistent from patient to patient. Some patients report experiencing the “honeymoon phase” for one year or longer, while others report only six months until their hunger starts to return, including cravings. As a result, the portions start getting bigger, cravings may increase, and staying on track becomes a challenge.

What Are Cravings?

What are cravings, and why do we have them in the first place? A craving is an intense desire or an urge for a specific food. Most people experience cravings on a daily basis. They stem from our thoughts and usually have nothing to do with physical hunger.

A craving is associated with three parts of the brain that involve pleasure, reward, and memory.  Specifically, it is part of your brain’s reward system that is critical to human survival.

Our brains are hardwired to seek out behaviors that release neurotransmitters, including dopamine, that help us seek out things we need to stay alive.

There are other reasons we have cravings, as well. Emotional cues, such as stress or when someone uses food to help comfort themselves when they have uncomfortable feelings, can increase cravings. Environment and memory can also play a role in the intensity of cravings. Driving past a favorite fast-food restaurant or donut shop can increase cravings. Just by remembering the last time you enjoyed that particular food can also increase the desire for it. And, the more we think about the craved food, the more we want it.

Having cravings is normal and part of our human physiology. However, because most craved foods are often unhealthy, such as chips, chocolate, and other simple or refined carbohydrates, they can sabotage your weight loss and maintenance efforts. Check out the strategies below to help you manage and decipher the return of the cravings.

How to Manage Cravings After Bariatric Surgery

• Don’t wait too long between meals. The larger the gap between your meals, the lower your dopamine levels are in your brain. You may experience higher cravings and overindulge because your body wants to increase your dopamine levels to normal.
• Controlling hunger. Schedule regular meals and planned snacks to reduce getting overly hungry. Waiting until you are ravished usually leads to increased cravings and unhealthy food choices. If you need to, eat on a schedule, even when you are not hungry. This way, you can stay ahead of the hunger and control the cravings better.
• Stay hydrated. Hunger and thirst have similar sensations in the brain. Dehydration can make you feel hungry and increase cravings. Bring a refillable water bottle wherever you go to help ensure you are getting in the adequate amount of fluids.
• Control your environment. Don’t buy foods you crave. You will eventually want to eat them, especially when food triggers and cravings hit. Take a different route home as well if tempting fast-food restaurants are on your way home.
• Get plenty of sleep. Studies show that when we get fewer than six hours of sleep, our hormonal balance is altered, thereby decreasing our metabolism, increasing our hunger throughout the day, and increasing cravings (and usually for sweets and other simple carbohydrates).
• Reduce stress levels. Stress has been shown to increase the chances of emotional eating and cravings for comfort foods. Serotonin, another neurotransmitter, is negatively affected by stress, and our body will seek emotional balance.  The hormone cortisol is also released with stress and is linked to weight gain and especially abdominal fat.
• Identify emotional triggers. Emotional triggers can lead to unhealthy food cravings. Even happiness and boredom can lead to mindless eating. Take the time to think about the situations in which you have cravings. Was it when you were bored, happy, lonely, upset, or stressed? Once you have identified the emotional trigger that led to the craving, have a plan in place to help you deal with it in a healthier way. Maybe you will go for a walk or call a friend. Or, perhaps, you will find a hobby that you can work on each time a craving hits. Make a list of distractions that you can do when cravings hit.
• Know the difference between head hunger and true hunger. Head hunger is emotional, is above the neck, is sudden and urgent, and demands a specific food, and no other food will do. It often leads to mindless eating and guilt. On the other hand, true hunger is physical, starts in your gut, is gradual and steady, and open to different foods. It usually involves mindful eating to nourish your body without guilt afterward. It is essential to know the difference between the two types of hunger.

Strategies to Use for Cravings

• Distract yourself. It’s important to involve yourself in an activity that does not involve eating, such as washing your car, reading your emails, painting your nails, organizing a drawer, gardening, tinkering in the garage, walking your dog. Plan ahead for these activities by making a list of 5-10 activities, so you are prepared when a craving hits.
• Avoid problem environments. When you start thinking about a craved food, make sure to avoid the environment related to that food. Take a different route home away from your favorite fast-food place, avoid the vending machines in the break room at work, or don’t walk past the candy jar on your supervisor’s desk.
• Change your thought process. Concentrate your mind on something other than the food. Try looking at pictures in a magazine, check your email or social media, or start reading a new book. Telling yourself not to think about it may not do the trick and may increase your craving. You want to occupy your mind on something other than food.
• Support is important on your weight loss journey. Find support in friends or family or perhaps another post-surgery patient. Be sure to continue to attend your surgery center’s support groups. There, you can share your challenges and struggles with others that may be able to offer helpful advice and coping strategies they have tried.  You may find yourself helping another patient through a challenging time.
• Know the feeling is temporary. The more you focus your attention on something other than the craving, the faster it will dissipate.
• Keep a journal. Start writing your emotions down in a journal as you feel them, especially if you eat to avoid dealing with the feelings. It also helps you identify head hunger and have a plan in place that includes choosing a healthy snack.
• Try drinking water.  As mentioned earlier, hunger and thirst have similar sensations in the brain. Drinking a large glass of water may help decrease the intensity of the craving.
• Control portions. Sometimes it is better to satisfy the cravings with a small and portion-controlled sample of the craved food so you will stop thinking about the craving. However, if you are prone to binge eating, it may be better to replace the craved food instead. For example, try having a healthy portion of salted nuts in place of potato chips or fruit in place of sweets.

Remember that cravings are perfectly normal. Early on after bariatric surgery, you may experience decreased hunger and cravings, making it easier to eat smaller portions and lose weight. It’s important to be aware that hunger and cravings can pop up, which makes your weight loss efforts more challenging. Therefore, it is important to have strategies in place for preventing them from happening in the first place and knowing what to do when they do occur.

ABOUT THE AUTHOR Natalie Buntzen, MS, RD is a registered dietitian for St. Joseph Heritage Healthcare, Center for Health Promotion in Santa Ana, California. She specializes in weight management and bariatric nutrition. She is the primary dietitian for patients pre-and post-weight loss surgery for the Bariatric Surgery Program at St. Joseph Hospital in Orange County, CA. Read more articles from Natalie!

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