5 ways for better appetite control after bariatric surgery

Are you looking for better appetite control after bariatric surgery? Check out our audio transcript.

Dawn (00:00):

Hello and welcome to the Gastric Health Show. My name is Dawn Boxell and this week’s topic is Five Ways for Better Appetite Control After bariatric surgery. This week we’re going to dive into your appetite. Last week we were discussing hunger and we kind of broke down the differences between hunger, appetite and cravings. And we’re just really going to elaborate more on the appetite so you have a better understanding of that. So what I want you to see is that appetite changes are very normal after bariatric surgery.

Dawn (01:00):

So if you are looking for reasons why your appetite has changed after bariatric surgery you are not alone. This is a very normal occurrence to happen after bariatric surgery. And let me kind of break down or kind of refresh you on the differences between hunger, appetite and cravings and. Hunger is your need for food and appetite is your interest in food. And then cravings are your desire for a specific food. So they’re all very similar but kind of unique in their own way.

Dawn (01:30):

And it’s important to kind of know the differences so you understand what you are really dealing with. So some people will say, oh my hu, I’m having cravings, I’m having craving issues when it’s really truly they’re just hungry. They aren’t fueling their body well enough, so they’re just hungry. So understanding these differences can really make a difference in how you respond to this occurrence.

The gut-brain communication signaling fullness

Dawn (02:00):

But appetite I want you to understand is not only just your interest in food, so it’s your desire, your interest but it’s also kind of the amount of food that it requires for you to feel satisfied. Your appetite or your interest is also the interest will change when you feel satisfied. So in the end, your appetite is it can be very complex. So there are many things that can influence it, and these are things like the gut brain communication that signals fullness and life experiences. Maybe you know, live a very stressful life or your life is just you’re going through some changes and some

Dawn (02:58):

Figuring stuff out and that can influence those emotions and what drives that. Even your relationship with food or your exposure to the right types of food can influence your appetite. Gene variations can influence eating patterns. So certain genes can make you more predisposed to snacking and binge eating and those types of things. Hormone fluctuations, we know as a prime example is in pregnancy.

Dawn (03:30):

When I’ve had bariatric patients who’ve been pregnant and they had full restriction prior to getting pregnant and they could only eat a certain amount of food, they get pregnant and the amount of food or the volume of food that they can consume doubled. And they felt freaked out by that because it was the hormone fluctuations was driving that increase in their ability to consume a bigger volume of food. And then blood sugar imbalances that can drive it. Poor sleep stress, all these areas can influence your appetite.

Life experiences

Dawn (04:23):

But here’s the big picture is it’s very individual. No two people are going to experience satiation and fullness the same. Now there’s probably groups of people that are very similar, but none of us are the same because we’re all genetically different. We all have different gut bacteria. Our blood sugar balance, which is also genetically driven how well we sleep, how well we manage stress, our relationship with food, all those things can influence how well you experience fullness.

Dawn (05:20):

And I would say if we’re being honest, this is where bariatric patients get confused because they have this unrealistic idea. Or I will say some of you have this unrealistic idea that your desire for food should remain the same month to month and year to year. And many of you have wanted that extreme restriction that you feel right after surgery. You want that same restriction to last forever, and that’s just not how your body works.

#1 Quality matters

Dawn (05:50):

And that’s not going to be the case even after bariatric surgery, even though it’s changing those different hormones and it does influence your genetics. So even though those things are shifted, it doesn’t mean that it remains there forever. Nor would I want you to remain there forever because you can’t survive on a couple of ounces of food forever. I mean, that’s just a phase after surgery that you actually do that small volume and then it kind of ramps up that you consume more food at a meal.

Dawn (06:30):

So it should be expected that your appetite or your interest in food increases as the months go on. And as the years go on now, by the time you get to a year, you should be able to experience the fullness pretty much. You would kind of be maxed out on your volume. Usually what we say is your pouch starts out at a golf ball and it grows to about the size of an orange.

Dawn (07:00):

So by the time you hit a year, you’re going to be maxed out on your volume in that aspect. But just know that month to month you should, from month one to month 12, you should see an increase in your appetite or your interest in food and you should see an increase in the amount of food that it takes for you to feel satisfied, all normal and all expected and should happen. So having a better understanding of what drives appetite can help you get better control after bariatric surgery. So I want to explain how gene variations influence your eating patterns because to me this is a big one.

Exposure & relationship to food

Dawn (07:30):

This is something that many people aren’t thinking about. And if you work with a provider like myself who can help you turn these genes off so that they are not influencing your appetite at extreme levels you’re going to have a better ability, one to protect your sanity so you don’t feel crazy when you feel an increase in your appetite and feel frustrated.

Dawn (08:16):

But it’ll also help you maintain better balance and maintenance of your weight. So we know that there is evidence that genetic factors may play a role in appetite regulation after bariatric surgery. And one study found that individuals who have certain genetic SNPs in related to appetite and weight regulation may be more likely to experience an increase in appetite after bariatric surgery. So those of you with those genetic SNPs that are connected to appetite and weight you likely will have compared to somebody who doesn’t have those genes you will likely have more issues with your appetite is really what it’s saying.

Dawn (09:00):

These SNPs may influence the way that your body responds to diet and physical activity and really may contribute to your overall risk of obesity. So that just means you may have to approach things a little differently than someone who doesn’t have these genetic variations. So it mean it’s right or wrong or bad or good, it’s just this is what you are facing. To me, this is good information.

Dawn (09:30):

This is information that can help you determine if you have to approach eating and your meals in a different way. And you might have to structure them a little bit differently. And that again, I think working with somebody like myself who can help you dial this in a little tighter can really make a big difference.

Dawn (10:10):

Now, some people, I will say are very sensitive to the sensation of fullness and then other people require it will just take longer to register when they’re full. And I guess some people just believe that serving sizes and eating behaviors should be equal for all of us. And unfortunately that is just not how our bodies work. Certain gene variations determine your appetite level and your satiety.

Gene variations that influence your eating patterns

Dawn (10:30):

So the amount of food that needs to be on your plate to feel satisfied is different for each of us. So you might have to be more diligent at putting different things on your plate than someone who doesn’t have these genetic variations. And in essence, these genetic variations can affect eating patterns like snacking, binge eating your serving sizes, the number of meals that you eat. These are very real biological things occurring in your body that are influencing this. So regardless of your genetics it is possible to experience better appetite control after bariatric surgery. I’m giving you five ways for better appetite control, and these are things that can influence your genes positively. So

Dawn (11:52):

This is how you turn those disease state genes off. So if your appetite, if you have these appetite genetic SNPs and they’ve been turned back on, these are the things that you can do that will help turn them back off by following these five things. And the first one is quality matters. The quality of your food choices matter. The more ultra processed foods you consume, the more quantity of the foods you’ll need to eat to feel satisfied because it takes more ultra processed foods to provide fullness when compared to quality proteins, vegetables, fruits, and whole grains.

Dawn (12:30):

As a matter of fact, one study found that the participants actually consumed 500 more calories per day on the ultra processed diet compared to the unprocessed diet. So if you are eating more whole real foods, you will likely eat fewer calories. And not only can it increase your appetite for more food, the quality of your food can lead to consuming increased quantities of food.

Dawn (13:20):

So kind of like a double whammy. You are putting the odds against you when you consume more ultra processed foods. That’s where eating whole real foods is important, but specifically eating foods that digest slowly. So these are things like healthy proteins. So think of chicken, fish, Turkey, pork, beef, flam eggs and dairy. You just want to lean heavier on the leaner meats and less on the saturated fat type of meats including dairy.

#2 balance your brain chemicals

Dawn (14:00):

So those have dairy, has saturated fats, and even if you do a low fat version, there is more saturated fats in those. So you’d wanna do more of the lean where you get less saturated fats. The next is eating foods high and resistant starch. So those are cooked and chilled potatoes and rice, eating more beans and lentils, oatmeal and buckwheat. All of those digest slower and will provide you with optimal fullness and satiation when you consume these regularly.

Dawn (14:44):

Now the second one is balance your brain chemicals. So there are neurochemicals in your brain that influence your appetite. These include dopamine, serotonin, Ghrelin, leptin, glucagon-like peptide one or JLP one are a few of them. And to kind of add to the complexity, all of these can be influenced genetically and microbially so your gut bacteria can influence these as well and. We do see that that does play a role after bariatric surgery.

Dawn (15:30):

And genetically, I will tell you that there are some genetic SNPs one specifically that can really play a role in your brain’s reward pathway and . That’s the dopamine receptors and that is the DRD2. And those with this DRD2 genetic SNP have weaker dopamine signaling, which means you will likely be seeking out more dopamine boosts or you need a more dopamine hits to prevent you from binge eating because you likely your body is not likely capable of producing enough dopamine and you are going to need to get it extrinsically.

Dawn (16:16):

But there are some helpful ways, healthy ways that you can boost these brain chemicals. And these are things like daily exercise and adequate sleep are two super powerful ways to boost your dopamine. Some unhealthy ways that people use to boost their dopamine are things like binging on food alcohol, nicotine, drugs. This is part of that addiction piece that comes in that people really struggle and are not doing well with managing their appetite in any way.

Dawn (17:00):

So this genetic SNP really just deals with that brain’s reward pathway and it can really influence big binges and really make it difficult for you to find fullness and satisfaction when you have these. So it’s finding healthy ways to boost dopamine naturally that can put you in a really good place and helping manage that appetite a little bit better. The third one is mindful eating. So if you’re experiencing a change in your appetite after bariatric surgery, this is where your mental presence is required.

#3 practice mindful and intuitive eating

Dawn (17:41):

You need to practice mindful and intuitive eating so that it can help you in portion control. So the better you are at being present at a meal will put you in a better position that you won’t need the same amount of food to feel satisfied. And the best way to accomplish this is less distractions at mealtime and taking 30 minute meals and chewing well and eating slowly, smelling your food, tasting your food and let the food roll around in your mouth so that you get the full experience cuz we should all enjoy our meals.

Dawn (18:00):

And then also kind of really setting yourself up for success with turning on that parasympathetic state or the rest and digest. And you can easily do this by just taking slow deep breaths before a meal to turn on that parasympathetic state. The next is, or the fourth one is blood sugar balance.

Dawn (18:55):

And to me, blood sugar balance is step one for anyone who’s struggling with hunger, cravings, appetite any issues like this. This should be step one is get that blood sugar under control. Because if your blood sugar is going high and low multiple times a day. You are going to crave more especially those sweet carby things. And appetite control is going to be super difficult and you’re going to mess up that biological balance when it is out of balance when that blood sugar is out of balance.

#4 Blood sugar imbalances

Dawn (19:30):

Now really blood sugar balance can look different for each of you. But if we kind of approach it in a general way, most of you could find some improvements. Maybe not all of you, but most of you could find some improvements by trying some of these strategies. One of ’em is they find that eating vegetables first then protein and carbohydrates last will blunt that blood sugar spike.

Dawn (20:07):

So bariatric patients always do protein first. So you may want to flip and try that and see if you do a vegetable, then your protein and then your carbohydrate and. See if you get a better blood sugar response and that you may require a glucometer, a blood sugar meter so that you can really track it. You could also do a continuous glucose meter as well and that would give you better quicker response to that. Another is just making sure that you add some healthy fats at most meals that can help blunt that blood sugar response.

Dawn (20:35):

Getting adequate fiber and resistant starch, both of those can help improve blood sugar response. Walking 10 minutes after a meal can also improve your blood sugar response. And then something that you can add is one tablespoon of apple cider vinegar to a high carb meal. And when you do that, this will prevent that blood sugar from spiking.

Dawn (21:14):

So those are some simple things that you can try. Pick one and try it and see what happens. If you have a glucose meter, then track it and find what works the best for you. That you can keep that blood sugar in the normal reference range consistently and you’re not having too many highs and lows. That is a key thing. And the fifth one is support cortisol awakening response and your cortisol awakening response is the change in cortisol concentration that occurs in the first hour after awaken from sleep.

Dawn (22:00):

And there is evidence in the connection between your cortisol level and your appetite. So we want your cortisol in the morning to rise. We want it to be at an appropriate level. We don’t want it too high and we don’t want it low, we need it to rise. This will help you manage the appetite.

#5 Support Cortisol Awakening

Dawn (22:26):

In one study they found that in women, the cortisol awakening response was negatively associated to hunger. Bingeing body esteem trait anxiety rigid control. So when this cortisol awakening response was not appropriate, when they did not have the rise in the morning, they were low they had bigger issues with hunger and binge eating. So to improve appetite after bariatric surgery, optimizing your cortisol awakening response can help.

Dawn (23:00):

And this is something that you can do just from sunlight in that first hour of waking. So this is where it gets a little specific where you have to know what to do but it’s important to get your face into sunlight. And some key things are is it can’t be through your sunglasses through a window or windshield. Those won’t

Dawn (23:45):

Give you the same response being right in the sunlight. So here’s how it kind of works within that first hour, you need to get outside as much as possible and get when that sun is rising. So anytime during that sunrise and the early morning sunrise is in that first hour of awakening sun rising. We’ll give you the best cortisol awakening response that is going to increase your cortisol quickly, inappropriately, not too much, not too little, and it won’t be low.

cortisol awakening response

Dawn (24:20):

So on a sunny day, bright sunny day all you need is five minutes on kind of a cloudy day or partially sunny cloudy. Where the clouds kind of cover the sun. You will likely need about 10 minutes. And again, this all is in that first hour of awakening. And then on a densely overcast or rainy day, you’ll probably need about 20 to 30 minutes of sunlight exposure.

Dawn (24:57):

And it doesn’t mean where you have to look right at the sun but you need to be looking towards the sun. Making sure that you are getting outside opening your window. If you can’t get outside and at least sitting in front of that open window. Where you can get that direct exposure to sunlight in your eyeballs. That’s where it has to be. And it shouldn’t hurt your eyes to look at it but you look towards the sun so that you’re getting those sun rays in your eyeballs and that’s where it is occurring.

Dawn (25:30):

So it can’t be that you put your back towards the sun. It needs to be your face where your eyeballs are seeing the sun. And that’s where maybe a morning walk is a great way to do that and. That will regulate that cortisol awakening response and help control your appetite better throughout the day.

Conclusion

Dawn (25:52):

So all of these things, your blood sugar, your cortisol awakening response. Your genetics all of these can really influence how well your appetite is controlled. And I will tell you with this cortisol awakening response. There are some additional benefits with improved sleep and it will make you feel more awake during the day. So if appetite is an issue, so let’s kind of just wrap this up. If appetite is an issue after bariatric surgery and you are on the struggle bus and you are like. I just do not know how to make this better, I want, I have this desire to eat more than I should or how more than I feel like I should. So that is where you want to

Dawn (26:42):

Really dig into these areas, these five areas for better appetite control, and really focus on your blood sugar. Your genetics, the quality of your food you’re eating. Balancing those brain chemicals, being more mindful at mealtimes and really supporting your cortisol awakening response. And it can really change how you feel fullness after eating. So I hope this has helped. I would truly encourage you to check out our gastric calls membership because. This is where we can work through these strategies and really dial in to you. What is driving this piece for you because it’s going to be different for all of us.

Dawn (27:20):

So that’s where I think checking out our membership cuz it gives you that luxury to work. With me over the course of time and not feel rushed and where it’s on a tight schedule to make this happen. This is a way that we can work through what works best for you. And get through all of these different strategies over the course of time. I hope this has helped and given you some new things to think about and to apply. And if you really want to influence your genetics in a positive way. I would encourage you to start working on these five areas to really optimize your genetics in a positive way. I hope this has helped you guys. Have a great day and we’ll see you soon. Bye-bye.
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