I’ve heard it many times: “I can’t wait for gastric sleeve surgery because it’ll make my food cravings go away.” Gastric sleeve is a powerful tool in the battle to lose weight—and keep it off—in order to achieve a more optimal level of health. But it’s not a cure all. And one of things I can’t promise is that your cravings for “bad” food will disappear as soon as you wake up from surgery. Here’s the real scoop.

Truth #1: Your hunger will decrease.
“But Dr. A, didn’t you just say that wasn’t the case?” Hunger and cravings are very different, and learning to differentiate between the two is a big step toward permanently shedding excess weight. During the sleeve procedure, I remove much of the section of the stomach where the “hunger hormone,” ghrelin, is produced. This means that, physically, the sensation of being hungry will be dramatically reduced afterward. And that’s a huge part of the battle my patients are facing. But then there’s what I call “head hunger.” This is a phenomenon where your body isn’t saying it’s hungry and yet you crave something to eat. Hint: It’s usually not vegetables. Even though you have surgery, you still know what your trigger foods taste like. No matter how not hungry you are, you can still want to relive the taste of cheesecake or your favorite potato chips. That’s a craving. So then it becomes a learning (or re-learning) process to listen to your body, rather than your head hunger.

Truth #2: Your “hunger hormone” won’t regenerate.
At some point post-op, you might feel hungrier than you were right after surgery and wonder whether your ghrelin is on the rise again. Nope. As I mentioned above, the sleeve procedure involves removing stomach sections where much of this hunger-causing hormone is produced. That said, you’re not crazy in feeling like you’re hungrier. Right after surgery, the combination of swollen tissues and the dramatic difference in the amount of ghelin being produced practically eliminates your hunger and cravings. It doesn’t stay that way forever, though. Tissues return to normal, the reduced ghrelin becomes your new normal, and a long list of lifestyle factors all lead to feeling hungrier than you were before. But none of it has to do with ghrelin regenerating.

Truth #3: You can set yourself up for success.
It’s nice to understand the “why” behind cravings, but is there anything you can do about them? Yes! My first suggestion is to balance your calories throughout the day, which reduces those nasty nighttime cravings (which tend to the hardest to control). Don’t skip meals. And if you need to snack a bit in the late morning or mid-afternoon to head off more destructive cravings later, try it. Most importantly, don’t keep your “craving” food in the house. It sounds like a no-brainer, but some patients get lax about their environment because they think they can handle it now or because family members start bringing it into the house again. Banish it! Also, make sure you’re getting adequate exercise. It not only burns off some extra calories, but it can actually reduce cravings.

Truth #4: You may need treatment for an eating disorder.
Some of my patients suffer from something much deeper than a simple enjoyment of chips and cookies; eating disorders are, in fact, not uncommon in bariatric surgery patients. While “eating disorder” can bring to mind painfully thin teenage girls, the unfortunate truth is that eating disorders take many forms, including binge eating. With a sleeve, you probably won’t be able to binge the amount of food that you could before, but it’s nearly impossible to achieve your health goals while continuing to binge. Not to mention that the mental stress from this kind of eating disorder is no way to live. Binge eating always needs treatment. It’s not something you can “will” yourself to overcome, nor is it anything to be ashamed of. Think of treatment the same you do the gastric sleeve: a tool that can help you live your healthiest life.

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“Changing lives…one sleeve at a time”.