Stuck at weight 4.5 months after surgery and always starving

[eggplantMan 3]

I had my surgery around 4.5 months ago in the middle of the summer. It was a gastric bypass and it went well. I've lost 23% of my bodyweight from surgery date or 350lbs to 270lbs. But I have largely been stuck at 270-280 since late September and it's now December. I'm a male and 6'2".

I try to get my Protein in but it's very hard to do. Not because it is too filling like some say but just because I don't like it very much. But I do try eating meat, cheese, Protein Shakes and bars.

I couldn't tell you how many calories I eat a day. All I know is that I'm always starving. just after surgery I was starving and then it went away for a month but it's been back. It's something I struggle with because if I knew I had to have this much willpower I probably wouldn't have gotten the surgery. I always read people saying that protein is filling but to me it just isn't. I can eat an entire chicken breast that I overcook no problem. I eat it and I'm still hungry after. My sugar and carb cravings are worse than ever. i was never ravenous before surgery but now because I can't be satiated i just want want want. it's crazy. I try to stay away but one thing leading to another and I do end up having this or that cookie, cake or candy. I was hoping dumping syndrome would be bad and cause me to not eat poorly. But the threshold to make me dump is higher than the amount of sweets I'd normally eat before surgery anyway. I have dumped but it's mostly if I eat something really bad.

The only thing that does fill me is carbs. That was true even before surgery.

I'm just looking for any advice or wisdom on this matter. Thank you

[catwoman7 10,921]

sometimes eating something that's high in fat (like peanut butter) or Fiber helps me when I'm having days like that...

[summerseeker 1,869]

I think that you really need to contact your team. You need some real help here. Its not normal to feel permanently hungry after this surgery. Occasional head hunger is more usual. Do you feel a restriction ?

You really need to fill yourself with good quality food now. Has your team said you must keep carbs out of your diet ? I ask because you sound as if you eat Protein or carbs. Your body needs the protein to function well. Eat your protein first, then the vegetables and then you can eat the carbs. Try to eat better carbs like fruits, skin on potatoes, brown rice and Pasta and quality wholemeal or seeded bread.

You are more than likely eating 2000 plus calories a day because you are at a plateau now. The only way to reverse this is to reduce your calories and eat better. Find a calorie tracker you like and be honest with it.

[CelticSoul 16]

Tracking what you are eating may help you.

I have not had my surgery yet, but I use an app to track what I eat. It is called Bariatastic and is free. It will track your calories, Protein, carbs, fat, etc. It also will remind you about drinking Water and taking Vitamins. Also has some really good recipes.

[eggplantMan 3]

9 hours ago, summerseeker said:

I think that you really need to contact your team. You need some real help here. Its not normal to feel permanently hungry after this surgery. Occasional head hunger is more usual. Do you feel a restriction ?

You really need to fill yourself with good quality food now. Has your team said you must keep carbs out of your diet ? I ask because you sound as if you eat Protein or carbs. Your body needs the Protein to function well. Eat your protein first, then the vegetables and then you can eat the carbs. Try to eat better carbs like fruits, skin on potatoes, brown rice and Pasta and quality wholemeal or seeded bread. 

You are more than likely eating 2000 plus calories a day because you are at a plateau now. The only way to reverse this is to reduce your calories and eat better. Find a calorie tracker you like and be honest with it.

Thanks for your help. While I do have a team, Unfortunately they don't really function like I see many other people say on the internet say their team does. My team did the surgery and now they just say eat less and the surgeon says go to PCP for every concern. Even if I had to go to the hospital for an obstruction I'd likely go to a completely different hospital at random.

I felt permanently hungry right after this surgery for about 5 weeks. It did pass once I got on solids again but that feeling of fullness only lasted maybe 6 weeks. Now 4.5 months out I'm essentially always starving. For example I had a Premier Protein bar and felt nothing from it. I then had another one 40 minutes later and only then did I feel some sense of fullness but only for about 10 minutes. But that's just Breakfast and that's already 40g of protein and probably 370 calories.

I do sometimes feel restriction but it passes very quickly and I'm left starving again. For example if I ate a piece of chicken and broccoli. Maybe a chicken breast and a cup of broccoli florets. Just plain. I'd get through half and would feel full but that only lasts maybe 10min.

As for keeping carbs out. The team did say to prioritize protein and have carbs last as you mention. As for no carbs, well they may have said it but at the same time I don't recall it.

I figured I was eating way more calories. But I'm quite hungry so it's not always easy when they voice in my head says hey you need to eat. That month where the hunger went away was amazing. That's what I was expecting things to stay as. But they haven't. Now I eat lean meat and more or less it just passes quickly. Leaving me unsatisfied.

[NickelChip 792]

First, I should say I am coming from a pre-op perspective, so I still have a normal appetite and no restriction from surgery. I'm sharing two recipes that I use most days for my breakfast and lunch. If I eat these earlier in the day, I can barely eat dinner. Combined, this gives you 823 calories and 75g Protein in a day. Your jaw is going to hurt after chewing this much salad, and I think it will likely take you most of the day to eat it. There is a lot of fiber. Obviously, I'm not a professional so this is not medical advice, and I have no idea how much you will be able to consume with your bypass. I imagine you would have to go slowly. But there's a good chance, if you even manage to eat all of it, you will not feel like you are starving throughout the day. You could still add a dinner if you need to. The goal here is to give you food that will take away the hungry feeling without adding calories. Natural, unprocessed foods tend to do that better than shakes and bars.

Oh, I top the salad with a fresh squeezed lemon, some salt, and Italian herb blend instead of dressing. And this much salad requires a large serving bowl, not a regular salad bowl. I use a kitchen scale to measure everything. The smoothie fits better in a 20+ oz blender cup as the 16oz is too small. If it's too thick, add some Water to get the consistency you like.

(Apologies, this smoothie recipe says flax seed twice. It should be flax and hemp seed, or chia. Also, the mango and strawberry is frozen, and the spinach can be too for convenience)

Edited December 4, 2023 by NickelChip

[eggplantMan 3]

Thank you @NickelChip. These look great.
Good idea @CelticSoul

[Arabesque 6,558]

It may be time to discuss additional help such as with GLP- 1 medications. If your team isn’t being supportive have this conversation with your PCP. Dr Matt Weiner has some videos on you tube about combining these meds & surgery. See what you think & they may be helpful in your conversation with your doctor.

But yes, definitely start tracking your food. If only to get you back I track. And maybe make an appointment with a dietician to ensure you’re getting in all the nutrition you need & advice on better food choices.

[SleeveToBypass2023 1,896]

So it's not that you can't have any carbs. You want them last, and you want them not to be "bad" carbs, like from Pasta and breads and white potatoes. You should be eating 5 times per day. 3 meals and 2 Snacks. You want Protein first, then veggies, then carbs. No sugar, low salt (himalayan is the best if you need it). Avoid carbonation because it stretches your stomach out.

My bariatric diet stated 60-80g of protein per day, 1000-1200 calories per day, less than 50 net carbs per day, and less than 50g of fat per day. If working out, or if you have a very physical job, then it would be slightly modified to 75 - 90g of protein, 1200-1400 calories, no more than 65 net carbs, and no more than 65g of fat per day.

It seems like a bariatric therapist might be a good thing for you, because it sounds like your relationship with food never changed, and you never learned to tell the difference between real and head hunger. And lastly, you should be eating very slowly. You're filling up fast because you're cramming a lot of food into your stomach all at once. After it makes its way through, the food is gone but you're hungry again. Eat slowly, chew it well, follow the bariatric diet, find a bariatric diet, and reach out to your nutritionist and see what they can do to help you get back on track and maybe map out an eating plan for you.

[eggplantMan 3]

@SleeveToBypass2023 was my relationship to food supposed to change? I do think I can usually tell the difference between head and real hunger. real hunger usually causes physical symptoms down in my gut like an ache. while head hunger is just that desire for more or for something specific. I can't say I never have head hunger and I deny it all the time and sometimes do give in. But when I say I eat and I don't feel full. I don't believe that's head hunger. Though I could be wrong.

You're right that I do eat fast or normal speed. I just eat until I guess I feel full. but it seldom ever comes.

Thanks for your lovely advice.

[SleeveToBypass2023 1,896]

9 hours ago, eggplantMan said:

@SleeveToBypass2023 was my relationship to food supposed to change? I do think I can usually tell the difference between head and real hunger. real hunger usually causes physical symptoms down in my gut like an ache. while head hunger is just that desire for more or for something specific. I can't say I never have head hunger and I deny it all the time and sometimes do give in. But when I say I eat and I don't feel full. I don't believe that's head hunger. Though I could be wrong.

You're right that I do eat fast or normal speed. I just eat until I guess I feel full. but it seldom ever comes.

Thanks for your lovely advice.

Yes, your relationship with food is supposed to change. How you view it, how often you eat it, what you eat, etc... Also, having a specific meal plan to follow helps a lot while you navigate your new normal. Definitely slow down your eating, start looking at what you're eating and what your calorie/carb/fat/protein intake is, look at your activity levels and adjust them accordingly, and look into speaking with your nutritionist and a bariatric therapist. This is all stuff that should have been gone over with you long before you actually had your surgery.

[Arabesque 6,558]

I agree. Yes your relationship with food is supposed to change but the surgery doesn’t do this you have to do this work. The surgery just gives you the time to reflect on your relationship: the how, why, when & what you eat. Many find the support of a therapist helpful during this time.

The pain in your tummy you feel is likely stomach acid not real hunger. Much like a rumbling tummy is often called hunger pangs/pain but usually is that excess acid & just your digestive system working & again not real hunger.

There’s a lot to learn about your body & your signals. My real hunger signals are restlessness. I feel like something is wrong but at first I don’t know what & there is a reason I feel hungry - I haven’t eaten in a few hours or I only ate part of my earlier meal.. I never want a specific food, flavour or texture (that’s head hunger) just food & I choose Protein dense food.

I’m 4.5 yrs post sleeve & have basically maintained. Things I found that helped include eating to a routine. I don’t eat unless it’s time to eat. I eat slowly. I ask myself if I need the next bite or just want it. I watch my portion sizes & never eat more than the portion. (Don’t mind if I don’t eat all my portion.) I consider the value of the food I choose - nutrient dense, predominantly low processed foods. Highly processed food is know to suppress your satiety hormone & stimulate your hunger hormones. (Recently I read that an easy way to judge how processed a food is, is to read the ingredient list. The more synthetic ingredients or ingredients you don’t recognise as real food the more processed it is. Ingredients in traditional rolled oats are just oats so low processed. In Quakers instant oats, as an example, there’s oats, sugar, flavours, salt, Calcium carbonate, guar gum, pyridone hydrochloride, etc. so more highly processed.) Just some things you might want to consider.

Edited December 6, 2023 by Arabesque