How to Deal with Hunger after WLS

 

 

 GUEST POST: According to Merriam-Webster’s Dictionary, satiety is defined as “a feeling or condition of being full after eating food. The quality or state of being fed or gratified to or beyond capacity.” What precisely causes satiety is not fully understood and is currently the focus of extensive research. For many Weight Loss Surgery (WLS) patients getting and staying “full” is an important part of the weight loss, and ultimately, the weight maintenance journey.

It is important to note, WLS patients should only eat to the point of being comfortable at meals and never eat beyond capacity.

Many bariatric surgery patients usually feel full quickly during the first year post-surgery, but as time goes by, some notice their appetite comes back and can often eat more at a meal. WLS patients often ask, “What can I eat so I am not hungry?” or “What can I eat so I don’t get hungry so quickly after a meal?” or “My appetite is back, what can I do?”

What types of foods increase satiety? What can a WLS patient do to increase satiety, maximize weight loss during the first 1-2 years and maintain the weight they worked so hard to lose? Below are five tips to help WLS get and maintain satiety.

1. Eat Protein-Rich Foods

Most bariatric patients know protein is the focal point of a WLS meal plan. Patients are told to eat protein-based meals, always have a protein source at each meal (or snack if needed) and eat protein foods first. In addition, most patients are told to get in 60-80 grams of protein daily (protein range may vary depending on individual patient’s needs).

So, what is special about protein? Protein increases satiety as it gets you full quicker and keeps you full longer.

Protein foods such as lean meat, poultry, seafood, low-fat/fat-free milk and milk foods (cheese and yogurt), eggs, beans and other plant-based proteins tend to help people get full and feel full longer. Protein foods have been shown to better increase satiety compared to carbohydrates and fats (1).

If you find you can eat more in one sitting – reevaluate what types of foods you are currently eating by keeping food and beverage records for several days. Are you eating mainly carbohydrates at meals and snacks? Carbohydrates especially dry, crunchy, overly processed types (i.e.: crackers, chips, popcorn, etc.), do not have the same effect on satiety (they do not make you feel full) and often are easy foods to graze on. If you find your meals are higher in carbohydrates – getting back to protein-based meals may help you get full and feel full longer. Protein-rich foods should replace high carbohydrate foods in the diet and not be eaten in addition to them.

Some research suggests that an added benefit of protein based meals is better long term compliance, which can aid in better weight loss and more successful weight maintenance (2).

2. Increase Fiber-Rich Foods

Along with protein, foods high in fiber may also help improve satiety and aid in weight loss. High fiber foods such as non-starchy vegetables and whole grains can play an important role in the diet of a WLS patient. Non-starchy vegetables such as carrots, broccoli, salad greens, beets, peppers, tomatoes and summer squash should be the second type of food eaten after the protein. Whole grains and other high-fiber, whole carbohydrates are the last type of food eaten at a meal (if there is room). Examples of high fiber carbohydrates are whole wheat pasta, wild rice, quinoa, sweet potato or a whole grain flat bread. Look for grains with at least 3 grams of dietary fiber per serving as a general rule. Non-starchy vegetables and whole grains are a good source of fiber as well as, vitamins, minerals, and antioxidants. As an added benefit, high fiber foods help avoid or alleviate constipation, which is a common problem post-surgery.

3. Solid Foods vs. Liquids

Solid foods compared to liquids, may increase satiety as well (3). This is especially important for WLS patients who have been out for a while. You may find the protein drink that once satisfied your appetite is not “working” anymore. Liquids more easily pass through the stomach pouch and may not impart a feeling of fullness. If the protein drink you have relied on at breakfast is not that satisfying anymore, it may be helpful to switch to a solid form of protein such as rolled up lean ham or turkey slices or low-fat Greek yogurt with a spoonful of granola. Some WLS patients find it better to “eat” meals rather than “drink” them.

4. Eat Regular Meals

People who skip meals and/or eat erratically tend to eat more at later points in the day or night. Eating a healthy protein and high fiber meals on a consistent basis helps control hunger and helps better meet protein goals and other nutritional needs. Skipping meals or eating meals erratically can often lead to a lack of satiety and more grazing.

5. Avoid Grazing

When we graze (nibble, snack or nosh) we wind up eating more than we think, and we never achieve any level of satiety. Weight Loss Surgery patients who graze, often have poor weight loss and are at higher risk for weight regain. Once again, when we eat regular meals, that are rich in protein and fiber, we tend to achieve and maintain satiety, which leads to more effective weight loss and weight maintenance.

Conclusion

Protein-based meals can help WLS patients get and maintain satiety, which may increase long-term success with weight loss and weight maintenance. Additionally, fiber-rich foods such as non-starchy vegetables and whole grain carbohydrates, may also increase satiety and provide additional nutritional value to a WLS patient’s diet. If you are not feeling full, get back to your bariatric basics – protein, then produce, followed by healthy, whole grains. Opt for solid foods over liquids, eat regular, consistent meals and avoid grazing. If you still feel you cannot achieve satiety – make an appointment with your bariatric dietitian and your bariatric surgeon for a more thorough evaluation.

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References

1. Astrup, A., The Satiating Power of Protein-a key to obesity prevention?. The American Journal of Clinical Nutrition. 2005.
2. Paddon-Jones, D., Protein, Weight Management and Satiety. The American Journal of Clinical Nutrition. 2008. Vol. 87 no. 5 1558S-1561S.
3. Muntel, Sarah. Bariatric Surgery: What to Eat When the “Honeymoon” Wears Off. obesityaction.org. Accessed: 6/21/16

Feature courtesy of ObesityHelp

About the Author Lori Skurbe, RD, MPH, CDE, is on staff at Sterling Surgicare in Holmdel, NJ, a bariatric and laparoscopic/general surgery practice headed by Ayotunde Adeyeri, MD. She has more than 20 years of experience in weight management, bariatric nutrition and diabetes education. She earned her Bachelor’s degree in Nutrition from Penn State University and a Master of Public Health from Rutgers University.