In reading through several of the posts here, it sounds like people are perpetually hungry

Also wanted to add...

The metabolic effects are real. I have an auto-immune disorder that is in remission in no small part to the surgery.

I also have done a lot of research into set points, and believe that WLS works to re-set our set points, which gives us a metabolic advantage. There are other ways to re-set the set point but it's laborious and takes years. Likewise, it's possible to work our set points back up to higher weights if we don't work to prevent it.

As far as hunger, I'm still in a pattern where I'll have 1 or 2 days where I feel ravenous all day. Protein-forward meals help me feel satiated on those days. Following that I'll have 3-4 days where I have to be reminded to eat and end up still relying on protein shakes to meet minimal protein goals.

As part of my recovery from emotional overeating, I'm learning to listen to and respond to cues my body is giving me. That doesn't mean I eat the chocolate cake because I'm getting cues that it would be good, but if I'm hungry all day, I eat more volume perhaps than I would have planned, but I still try to choose nutritious food without empty calories. My caloric intake averages out over a week or two and the result is my weight stays fairly stable.

As I've said often, my only regret is that I didn't do this years ago.

Awesome post. So insightful and helpful. You really are a poster child for what this journey is all about, not only physically, but emotionally and psychologically.

All I can say is "Bravo!"

I wouldn't call myself a poster child.

There are a number of people here on this board who are veterans and have maintained their loss for years. I'm in awe of the control many of them have over their eating, and I am definitely not there.

I do a lot of things very different from them, and I'm not far enough along to be able to say that my way works. I don't eat ultra-low carb because ketosis makes me ill. I am working on intuitive eating because I am working to resolve some very deep seated eating disorders. I have a number of health challenges that have caused me to work my own way through this process. I could be setting myself up for a huge failure down the road.

That being said, I am working with my medical team on all of this, including my therapist. I'm not going rogue and eating cookies and cake all day. My goal is to become healthier including mentally. That means I'm never going to reach a "healthy" BMI and I am fine with that. My medical team is thrilled with what I've done so far, and it's up to me to maintain the successes. I'm not striving for perfect, I'm striving for a balance across the entire landscape of my health, and one that I can maintain.

Maybe when I'm 5 or 10 years out you can call me a poster child. LOL. Right now, I'm just someone trying to find the best path for myself through this morasse. If my experience helps someone else, that's fantastic. That's why I blog (though infrequently) and offer my experience here. But I never want anyone to think that my path is better than the paths that have been blazed by our true veterans here and go astray because I'm doing things a bit differently.

As others have mentioned, the ghrelin advantage goes away over time as your body starts making ghrelin in places other than the stomach fundus. The restriction from the sleeve is most pronounced in the first 4-5 months while there is inflammation from the surgery and this is the time when the most weight loss is possible. I would agree that people have to be on restrictive diets for the rest of their life in order to continue losing and to maintain. The successful people make it their new normal.

I think of the surgery as a reset button, helping me to get down to my ideal weight and hopefully resetting my setpoint to somewhat lower than it used to be. Keeping my weight stable over time is all on me.

I don't typically feel hungry at all (9 months out and still losing). I can easily skip meals and not notice it, until I start to feel weak and out of sorts. I do still get "head hungry", especially if I am bored. We don't keep bad foods around the house and I would not eat them if we did, but especially on weekends there is always the temptation to fix myself a snack. Usually I try to drink a cup of decaf coffee or a glass of water first and see if I still feel hungry. At least now I can recognize it as "head hunger" and try to deal with it for what it is. And yes, my stomach will growl if it has been empty for too long (over 5-6 hours).

This surgery has been life-saving for me and I would do it all over again in a heartbeat. I have had no problems with the surgery or the weight loss diet. I eat what I want, keeping in mind that I must get proper nutrition first, and tempting myself with more new clothes as I lose weight. As has been mentioned above, those of us who have had uneventful recoveries and easy weight loss seldom post about that to a forum as it may appear that we are bragging.

From my personal experience, all but 2 of the people I know who have had WLS have had amazing success with it. One of the ones who did not developed a pretty severe infection and the surgery had to be reversed. Another simply blew it by failing to confront her eating issues and choosing to consume ice cream, milk shakes, and chocolate all day long.

So in summary I would say that a majority of the people who have WLS are successful, but you don't hear as much about the successes as you do about the problems.

I'm thinking the people saying there hungry are the ones who just started our journey! I'm one of them but now that I can eat other things I'm less hungry and more full and I'm 1 week today !

Hunger is about 90% mental and 10% physical. Generally, you do get a break from any kind of hunger for a bit after surgery (that will vary by person). I personally didn't feel hunger in any form for 3-4 months post surgery. Then the mental hunger started to come back and that's something you need to develop coping mechanisms for.

I was just discussing with my husband last night how the VSG has taught me to distinguish between mental and physical hunger. I had a very light food day yesterday. I was busy and had only jerky and a protein bar all day. By dinner time I was legitimately hungry. Growling stomach, the works. It's always a light bulb moment when I realize that the vast majority of hunger isn't actually hunger.

This surgery is on our stomachs and not our brains. Those that fail at it let the brain take over and give in to cravings (and often times don't seek help to develop those coping mechanisms).

Do you consider thin/normal sized (non-WLS) people on a perpetual diet or experiencing deprivation?

The majority of obese people have distorted eating and thinking about food, and the overconsumption of food has caused metabolic, psychological, and physical issues. Bariatric surgery provides a tool that if used properly can allow one to become more normal in how food is utilized in the body. This does not mean we now have a free pass to eat junk and not gain weight; instead, like other healthy people we need to fuel our bodies properly for maximum health. This means we need to make lifestyle changes (diet and increased physical activity) for long term success.

Some other thoughts I have picked up on OH:

1. Hunger is not an emergency.
2. Real hunger vs head hunger does not push you to specific food, meaning if you are craving a very specific di****em (e.g. bread, sweets, pizza) than what you are experiencing is not real physical hunger. So that is where therapy can really help with tackling emotional/comfort eating.
3. Dehydration may mimic hunger, as well as overproduction of acid. So when you think you are hungry, try drinking some water first and see if that helps. And also take PPIs right after surgery while your body adjusts to making less stomach acid for your smaller stomach.
4. Learn to eat to live not live to eat.
5. Most of us have lost weight many times over the years, so our challenge is not knowing how to lose weight but how to MAINTAIN weight loss. That is the true beauty of WLS - improved opportunity to successfully maintain weight loss long term.
6. During WLS, nerves are cut in the stomach so initially you may not feel restriction. This is the period where it is crucial to measure out your food and not rely on your body to give you signals of satiety. Over eating in the early months can damage your healing stomach and cause serious complications.

Close to seven months out I live a very structured life as far as nourishment goes. I'm a creature of habit and as long as I maintain good habits I feel that I'm going to do well. As far as hunger goes I rarely feel hungry. Most times it will occur when I'm out and away from my normal routine. In those cases I drink fluids to get a feeling of fullness or I eat sunflower seeds which I keep in the car for these occasions. As I've noticed on this board everyone is different. Some feel hungry some don't.

Having your stomach size reduces hunger for many reasons - ghrelin being one of the more minimal ones. It does cause a "reboot" of many of the gut hormones, however, which is thought to be the driving force behind most WLS rather than malabsorption or restriction. The biggest benefit is you have a metabolism on speed, basically, for about a year with a VSG. The RNY and DS have a far longer period of time (the DS has the longest I want to say?) as they involve an intestinal bypass. Additionally, the afferent parts of the vagus nerve are severed during the surgery which also temporarily alters hunger.

My hunger did not return post-op aside from GERD - the GERD absolutely mimicked it, but I had very few hunger issues aside from that. Again, though, hunger is greatly variable between patients.

The thing is that while there is a standard idea of a sleeve surgery, because surgeons are independent practitioners largely, their work varies based on anatomy and skill. Some make larger sleeves and others smaller. Also, we have chemical, physical, and emotional/behavioral hunger.

I was also not hungry before surgery...it was more like an endless drive to consume. That actually improved with treatment and surgery both.

As for a very difficult diet, I've been eating extremely low carb for many years. I am not so sure I'd call it difficult; difficult is a matter of perspective. It's a non-issue to me most of the time because I choose to eat for sustenance rather than pleasure. A very difficult diet is what landed me in the 750 pound range and almost killed me. My previous omnivore diet was one of deprivation, except that what I was depriving myself of was life and living. However, this is highly variable too, and obviously only my own perspective. Everyone is different. :) I guess what you mean by deprivation. Before my revision I ate a wide variety of things.

Thing is, what we eat can also control whether or not we are hungry in many cases. Carbohydrate for many triggers hunger and cravings for many reasons; it raises the levels of hormones that raise hunger, such as insulin. Protein and fats typically cause far more satiety.

And, never underestimate behavioral/psychological hunger, either. Just because we feel hungry doesn't mean it's biological hunger; rather, it can be habit, conditioned responses to things, etc. Pavlov taught dogs to salivate and get hungry in response to stimuli, but that doesn't mean it was actual or healthy hunger.