Cravings After Bariatric Surgery: A Neurobiological Journey

Bariatric surgery is a transformative step for those seeking to combat obesity. It offers hope and a path to healthier living.

However, understanding the complex interplay of our brain’s reward system and how it changes after this surgery is essential.

The fascinating realm of food cravings following bariatric surgery will be examined in this article, along with the neurobiological influences that mold our connection to food.

Cravings Post-Bariatric Surgery

Emotion-based eating and cravings may resurface post bariatric surgery, often due to a lack of consistent support (1). Another reason for the resurgence of cravings post bariatric surgery relates to patients’ dietary patterns and preferences in the first year after bariatric surgery. Patients typically avoid highly palatable foods due to care team recommendations and negative physiological responses (e.g., dumping syndrome) in the months following bariatric surgery. However, these physiological reactions may eventually fade, which could result in a rise in cravings or a rise in the intake of low-quality foods (1).

Additionally, improved emotional states in the short term after bariatric surgery can reduce the desire to use food as an emotional coping mechanism. As negative emotions may return, patients may find themselves craving food to manage these emotions (1).

Cravings: Beyond Willpower 

Contrary to the common belief that willpower alone drives our food choices, our eating habits are predominantly shaped by our neurobiological reward system. This intricate system, which includes several brain regions and gut-brain mechanisms, is largely responsible for regulating our food intake, including cravings (1).

The scientific community largely recognizes that biology, rather than sheer willpower or personal responsibility, is the primary driver of our daily food decisions (1).

Two Key Components: Liking and Wanting

Understanding food cravings requires acknowledging two critical components: “liking” and “wanting.” “Liking” refers to the sensory pleasure or enjoyment derived from consuming food, while “wanting” encompasses the cravings and the implicit drive to consume specific foods. This pleasure-driven eating is associated with weight gain and obesity. Individuals with higher body weights exhibit increased activation in brain regions associated with food reward, impacting food preferences and choices (1).

Post-Bariatric Surgery Changes

Bariatric surgery leads to reduced activation of the brain’s reward system (1). This suggests that food becomes inherently less rewarding for individuals who have undergone a bariatric procedure. Particularly in the first two years following bariatric surgery, there is a significant decrease in cravings. Post bariatric surgery patients often experience changes in taste preferences and reduced food cravings.

Moreover, the dopamine signaling in the brains of those who have had bariatric surgery changes, diminishing the inherent rewarding properties of many foods. These changes in the brain primarily impact highly palatable and energy-dense foods, which consequently lead to a decrease in cravings (1).

Honeymoon Period

During the first few months following bariatric surgery, patients have referred to them as the “honeymoon period”(2). During this phase, “weight loss is easy, and the bariatric surgery does the work,” as appetite, hunger, and cravings diminish (2). However, five years after bariatric surgery, on average, patients’ food preferences and cravings seem to return, despite immediate post bariatric surgery reductions in the pleasure derived from most foods and the continued avoidance of high-fat and high-sugar foods beyond the first year (2).

Strategies for Managing Cravings and Emotional Eating

As we’ve explored, the journey through cravings and emotion-based eating post bariatric surgery can be complex. It’s essential for patients to have a toolkit of strategies to navigate this terrain successfully. We’ll talk about intervention strategies and offer helpful advice in this section for patients who want to keep losing weight and improving their general health.

Consult with Your Healthcare Team

Maintaining open communication with your healthcare team is crucial. Regular follow-up appointments are not only for tracking your physical health but also for addressing any emotional or psychological challenges. Don’t hesitate to discuss your cravings, emotional eating patterns, and any struggles you encounter. Your healthcare team can offer guidance and support, and they may recommend additional resources, such as psychological counseling.

• Seek Psychological Support: Professional psychological counseling can be an invaluable resource. Therapists and counselors can help you understand and manage emotional eating triggers, providing you with coping strategies and emotional regulation techniques. 
• Practice Mindful Eating: Mindful eating involves paying close attention to your food choices and eating habits. Focus on savoring each bite and listen to your body’s hunger and fullness cues. Mindful eating can help you develop a healthier relationship with food, reduce cravings, and prevent emotional eating episodes.
• Educate Yourself: Understanding the science behind these challenges can empower you to make informed choices.
• Keep a Food Journal: Keeping a food journal can make you more conscious of your eating patterns and help you spot trends associated with emotional eating and cravings. Keep track of your food intake, timing, and feelings during each meal. This practice can reveal triggers and help you make informed decisions.
• Develop Healthy Coping Mechanisms: Instead of turning to food when you’re experiencing emotional distress, explore alternative coping mechanisms. Engage in physical activity, practice deep breathing exercises, or pursue creative outlets like journaling, art, or music. Finding healthy ways to manage emotions can reduce the reliance on food for comfort.
• Set Realistic Expectations: Understand that cravings and emotional eating may occur occasionally, even after bariatric surgery. Set realistic expectations and view these challenges as part of the journey. The key is to learn from each experience and make healthier choices moving forward.
• Create a Supportive Environment: Surround yourself with a supportive environment. Inform your family and close friends about your goals and challenges. Having a network of individuals who understand your journey can provide encouragement and accountability.
• Plan Meals and Snacks: Preparation is key. To guarantee you have access to wholesome options when hunger strikes, plan your meals and snacks in advance. This reduces the likelihood of making impulsive, less healthy food choices when cravings arise.
• Stay Hydrated: Dehydration can sometimes be mistaken for hunger or cravings. Drinking water can help reduce false signals of hunger and minimize the urge to snack unnecessarily.
• Connect with Support Groups: Consider joining a bariatric support group or an emotional eating support group. These communities provide a platform to share experiences, gain insights from others who have gone through similar challenges, and receive encouragement.

Incorporating these strategies into your daily life can empower you to manage cravings and emotional eating effectively. Remember, the journey post bariatric surgery is about more than just physical changes; it’s a holistic approach that encompasses emotional well-being and lasting health. 

Contact Us Today

Our team is ready to help you. At LIMARP, patients will always receive warm, sincere and professional
answers. For a free evaluation please call us at (619) 270 8823, fill out a contact form at
our website, or message through any of our social media pages.

References

1. Ames, G. E., Koball, A. M., & Clark, M. M. (2022). Behavioral interventions to attenuate driven overeating and weight regain after bariatric surgery. Frontiers in Endocrinology, 13. https://doi.org/10.3389/fendo.2022.934680
2.  Lynch A. “Cuando termina la luna de miel, comienza el verdadero trabajo:” Trayectorias de pérdida de peso y experiencias de cambio dietético de los pacientes con bypass gástrico . Soc Sci Med (2016) 151 :241–9. doi: 10.1016/j.socscimed.2015.12.024