Why Does Appetite Decrease or Increase After Surgery?

Bariatric surgeries such as sleeve gastrectomy or gastric bypass affect appetite not only by reducing stomach volume but also by altering hormonal balance. While some individuals experience a significant decrease in appetite after surgery, others may notice an increase in appetite within a few months. This variation depends on individual metabolism, type of surgery, and psychological factors.
Managing appetite changes after bariatric surgery is crucial for long-term weight control and establishing healthy eating habits.

The Role of Ghrelin Hormone and Stomach Reduction

One of the main reasons for appetite changes after surgery is the reduction of the hormone ghrelin. Known as the “hunger hormone,” ghrelin is primarily produced in the fundus region of the stomach. Since this area is largely removed during sleeve gastrectomy, ghrelin levels drop, leading to reduced appetite.
However, over time, the body may adapt by compensating ghrelin production in other regions. This adaptation is a common reason why appetite tends to increase starting from the sixth month post-surgery.

Physical Hunger or Habit? How to Differentiate

A key aspect of appetite management is distinguishing true physical hunger from habit-driven cravings. Here are some tips:

Ask yourself: “Would a plate of steamed vegetables satisfy me right now?” If the answer is no, it might be emotional rather than physical hunger.

Recognizing Emotional Eating Triggers

Emotional hunger is often triggered by:

• Stress, loneliness, anxiety
  
• Boredom
  
• Social settings (celebrations, home visits)
  
• Low self-esteem or feelings of failure
  

Food is not a tool for emotional regulation. However, many bariatric patients may continue pre-surgery eating behaviors postoperatively. Recognizing triggers is the first step to restructuring eating habits.

Mindful Eating Techniques and Breathing Exercises

Mindful eating involves recognizing physical hunger and eating slowly and attentively. This approach is highly effective for both portion control and appetite management. Some practical steps include:

• Putting down the fork or spoon after each bite
  
• Chewing each bite 20–30 times
  
• Avoiding screens during meals
  
• Taking three deep breaths before starting to eat
  

These simple practices directly support appetite control.

Confusing Thirst with Hunger

Since bariatric patients often struggle with fluid intake after surgery, thirst is frequently mistaken for hunger. To prevent this:

• Plan fluid intake throughout the day (take 3–4 sips every hour)
  
• When feeling hungry, drink a glass of water first and wait 10 minutes
  
• Use mobile apps to track daily fluid intake (minimum 1.5–2 liters)
  

Behavioral Strategies to Reduce Snacking Urges

Appetite can be triggered by specific times, emotional fluctuations, or visual cues. Ways to manage these include:

• Reduce visual triggers: keep unhealthy snacks out of sight in the kitchen
  
• Avoid going to the kitchen at non-meal times
  
• Engage in distracting activities such as crafts, reading, or walking to suppress snack cravings
  
• Brushing teeth or drinking herbal tea can occupy the taste buds and reduce desire to eat
  

Sample Routines to Cope with Appetite Waves

Appetite often comes in waves. Structured daily routines help manage these fluctuations effectively:

Example Routine:

• 07:30 Wake up + 1 glass of water
  
• 08:00 Protein-rich breakfast
  
• 10:30 Herbal tea + short walk
  
• 12:30 Balanced lunch
  
• 15:30 Planned healthy snack (e.g., yogurt, almonds)
  
• 18:30 Light dinner
  
• 20:30 Breathing exercises, meditation, or relaxation activity
  

When to Seek Professional Psychodietary Support

Some individuals may develop eating disorders such as binge eating disorder (BED), night eating syndrome, or uncontrolled eating attacks. Psychodietitian or bariatric psychologist support is essential in cases of:

• Uncontrolled binge eating episodes
  
• Persistent feelings of guilt and regret
  
• Body image disturbances
  
• Long-term mood disorders and using eating to suppress emotions
  

Remember, surgery is only a tool. Cognitive and behavioral support is inevitable to use this tool effectively.

Handling Increased Appetite After 6 Months Post-Surgery

Although appetite is significantly reduced in the first 3 to 6 months after surgery, it may increase again later. Causes include hormonal adaptation, some return of stomach elasticity, and resumption of psychological habits. To manage this period:

• Plan your meals carefully
  
• Increase quality protein and fiber intake
  
• Maintain fluid intake between meals
  
• Establish a regular exercise routine
  
• Pay attention to sleep hygiene
  

Appetite increase can be discouraging but is natural and manageable with proper strategies.

Conclusion

Appetite changes after bariatric surgery should be addressed both physiologically and psychologically. Differentiating physical from emotional hunger, practicing mindful eating, maintaining hydration, and developing behavioral strategies are among the strongest supports during this process. When necessary, professional psychodietary support should be sought.

Remember: A healthy lifestyle requires nourishment not only for the body but also for the mind.