hunger pains

4 Things To Do When Your Hunger Returns

January 20, 2016

You know the feeling… that deep grumble in your stomach reminding you that too much time has passed since your last meal (or snack), signaling your brain it is time to eat again. Many times these physical hunger cues are diminished right after you've had weight loss surgery. As you become further out from having surgery, the physical cues you're experiencing may be that your hunger returns.

One of the sources of physical hunger is Ghrelin, commonly referred to as the “hunger hormone” is secreted by cells in the fundus of the stomach and has an impact on body weight through its influence on our appetite. A significant amount of ghrelin is removed with procedures that remove large portions of the stomach, such as the Gastric Sleeve and Gastric Bypass, therefore initially decreasing the body’s production of this hunger hormone.

Research shows that over time following bariatric surgery, there can be an increase, decrease, or no change in ghrelin levels long-term. Though research is inconclusive at this point regarding the extent to which ghrelin returns after weight loss surgery, it is not uncommon for these hunger pains (also known as "hunger pangs") to return to some extent post-operatively.  The return of hunger can be quite alarming causing fear that weight loss will be decreased.

4 Things To Do When Your Hunger Returns

The big question is what to do when you start to feel those low rumbles of hunger in your stomach? A multitude of factors influence our ability to manage these hunger pains once they return. There are habits you can use such as maintaining a consistent meal pattern, consuming protein first at meals and snacks, and staying well hydrated to live with the return of hunger pains.

1. Eat a Consistent Meal Pattern

Consuming food in a consistent meal pattern proves important for a variety of reasons. It is especially beneficial in keeping hunger well-controlled and ensuring protein intake remains sufficient. Focus on having a meal or a planned snack every 3-4 hours throughout the day. Routinely having breakfast, lunch, and dinner, with a snack in between each meal assists in keeping hunger controlled. Research confirms that skipping breakfast can lead to weight gain because individuals will make up those lost calories at later meals throughout the day. This inconsistent food intake pattern can enhance lipogenesis (or the production of fat) and increase body weight over time.

A 2008 study in the British Journal of Nutrition found that eating three meals, compared with two meals, with the same amount of energy increased satiety over 24 hours.

Planning meals ahead of time, setting reminders throughout the day, and keeping a food log are beneficial ways to establish a consistent meal pattern. Tracking your daily intake of food and your exercise is an important tool to lose weight and successfully maintain it.

2. Eat Protein First

Protein serves many purposes in our diet, but a significant characteristic of protein is its ability to help us feel fuller for longer periods of time. Protein helps us feel more satiated (full and satisfied) than carbohydrates or fats do. Therefore, it is important to focus on consuming lean protein-based foods first at meals, and having protein-based snacks.

In fact, some studies have shown that individuals who consume protein in place of carbohydrates eat approximately 200 to 400 fewer calories daily than individuals with higher carbohydrate diets, and find it easier to self-regulate their dietary intake.

After weight loss surgery, portion sizes are greatly reduced, so it is even more important to consume protein first at meals. By eating protein first, you make the most of the limited space in your pouch, rather than filling up on higher carbohydrate-based foods (though healthy options such as vegetables and fruits should be the next priority on the plate after protein).

By focusing on eating lean protein-based foods first, such as lean meats, eggs, reduced fat cheeses, and low sugar Greek yogurts, it will help keep hunger pains at bay throughout the day. Speak with your registered dietitian to determine the amount of protein that’s appropriate for you.

3. The Best Beverage of All

Water is the best beverage because it does so many healthy things for our body. Water comprises approximately 60-65% of the adult body, and contributes to many functions within our bodies, such as:

  • Regulate body temperature
  • Provides moisture for tissues (mouth, eyes, nose) and lubricating joints
  • Helps to protect body tissues and organs
  • Delivery of nutrients to cells
  • Aids in flushing out various waste products from the body
  • Helps to prevent constipation

Many times, thirst can be misinterpreted as hunger. Sipping water throughout the day will not only aid in the prevention of dehydration, but will also help better control any returning hunger pains. In addition to drinking water, fruits and vegetables contain a high water content, so maintaining a healthy diet by incorporating more of these types of foods will aid in hydration.

4. The Difference in Physical Hunger and Psychological Hunger

It is important to distinguish between “physical” and “psychological” hunger (or emotional eating and head hunger). What do I mean by this? Physical hunger occurs when your stomach begins to growl and grumble. Psychological hunger  refers to eating due to stress, boredom, frustration or a similar emotion. For example, ask yourself "Am I reaching for that snack because I’m overwhelmed and worried, or because my stomach is growling and it is time for my next meal?" Making this distinction will prove important for keeping those hunger pains well controlled, as well as for long-term maintenance of weight loss.

Getting back to the basics and focusing on a consistent meal pattern, protein first at meals and planned snacks, and staying well hydrated are all beneficial ways to maintain weight loss when those hunger pains return.


hunger pains


Elise Hays, RD, LD, completed her undergraduate degree at Baylor University in 2014, and graduated with a Bachelor of Science in Nutrition Science. She completed her Dietetic Internship at the University of Oklahoma Health Sciences Center. Elise gained valuable experience during her Dietetic Internship working at two different bariatric programs with several different bariatric dietitians. Since completing her internship, Elise works with multiple bariatric programs and continues to further her education in nutrition and weight loss management.