Many things change after vertical sleeve gastrectomy, but perhaps the most jarring is the amount of food you’re able to consume. The difference might not hit you until you resume eating “normal” foods following the liquids and soft foods stages. When you do realize how little your stomach allows now, as opposed to the quantities you ate prior to surgery, it’s not necessarily easy to give up the desire to overeat. Here are some common challenges following VSG and how to deal with them.

Challenge #1: You feel guilty about leaving food on your plate
If you grew up in a house where you were expected to clean your plate—“Think of all the starving children!”—you were conditioned to believe that not eating everything you’re served is disrespectful and downright wrong. Likewise, natural-born cheapskates struggle with the idea that food left on the plate = waste. I encourage you to rethink how you view it, though, and instead get excited about saving money. Whether you’re out to eat and get to take two-thirds of that delicious meal home to enjoy over the next few days or have cooked up a (too-large) feast at home, revel in the idea that leftovers aren’t wasteful. They are, in fact, the ultimate way of economizing, especially when they stay appetizing. To that end, Nancy’s plan for non-soggy restaurant leftovers is a good one: “I get all dressings on the side and request a to-go box as soon as the food comes.”

Decreasing the size of your plates and bowls at home can be a good trick, too. And no matter the size of your plate, when it’s up to you, stop serving yourself so much! If you regularly dish up more than you can eat comfortably, start with just a few bites on your plate, knowing you can get more if you’re truly still hungry. Still have waste? Better in the garbage than on your hips or stomach.

Challenge #2: Your “head hunger” is in control
We talk about head hunger vs. physical hunger frequently because it’s common. As a reminder, head hunger is a term for when you’re not physically hungry but want to eat anyway. In this case, head hunger takes over when you’re eating something delicious and don’t want to stop—but your sleeve is begging you to put down your fork. Lori says it’s still a problem for her. “Something tastes good and I get excited; then my stomach says no,” she explains. “When I go out, I try to make an effort to only get an appetizer or something from a kids’ meal now so I don’t overeat. It’s a tough mental game.”

Head hunger can sometimes be driven by a subconscious feeling that there’s somehow a limited supply of food. So you have to eat this food right now because, after all, who knows when you’ll have something this delicious again? But unless your childhood was food-insecure, this response likely has no basis in reality. Remind yourself that you’re an adult. You can eat anything you want on your gastric sleeve diet. You can even eat this same thing tomorrow, if you choose. When you feel in control of your decisions, you’re more likely to make good ones.

Challenge #3: Your compulsion drives you to eat quickly
If you eat fast enough, you’ll be able to eat more, right? Well, yes, and you’ll also pay the price for it. Many VSG patients struggle with compulsive eating patterns, and those compulsions don’t disappear as soon as you wake up from the procedure. Darcy says, “Eight months out and I still make myself sick by eating too fast.” Joel knows exactly how she feels. “My brain still looks at what’s on the table and says, ‘You better pound that down, son.’ This is one part of my journey I did not expect,” he admits.

So what’s the solution? If you’ve tried and failed to stop compulsive eating patterns—or have moved onto other types of addictions such as alcohol—it’s time to make an appointment with a therapist. You may not have to tools to reprogram your mind when it comes to compulsive behavior, but a therapist who specializes in such work does. Just like there’s no shame in VSG surgery, you should never be embarrassed to seek mental help to live your best, healthiest life.

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“Changing lives…one sleeve at a time”.