Mindful eating after a sleeve: slow, small, stop when full

After a gastric sleeve, your stomach holds much less, and fullness can arrive quickly. Eating too fast or too much can bring pressure, pain, nausea or vomiting. Mindful eating is a simple way to work with your new stomach: you slow down and pay attention to what your body tells you, before, during and after a meal.

What mindful eating means

Mindful eating is not a diet, and no food is forbidden. It means noticing why you are eating, how hungry you are, how the food tastes and smells, and when you have had enough. Guidelines for life after bariatric surgery already include parts of it: eat small meals, take small bites, and chew them thoroughly before you swallow.

Slow and small

• Use a small plate and small cutlery, such as a teaspoon or a salad fork.
• Cut food into small pieces and chew each bite until it is soft.
• Put your fork down between bites, and pick it up again only when your mouth is empty.
• Eat the protein on your plate first.
• Drink before and after the meal, not during. Canadian guidelines advise no liquids within 30 minutes of eating solids.
• Give each meal time. Your dietitian can tell you how long a meal should take at your stage.

Notice hunger and fullness

A hunger and fullness scale from 1 to 10 can help. On the scale from Alberta Health Services, 1 means extremely hungry, weak or dizzy, and 10 means so full you feel sick. It suggests starting to eat around 3 to 4, when hunger starts, and stopping around 5 to 6, when you feel satisfied and comfortable.

After a sleeve, the signals may feel different from before, and fullness can come on suddenly. Stop at the first sign that you have had enough, even if there is food left. In the first months, appetite is often low, so your team may ask you to eat on a schedule rather than by hunger, to get enough protein and fluids.

Eat with fewer distractions

• Sit down at a table, rather than eating standing up, in the car or at your desk.
• Turn off the TV and put your phone away while you eat.
• Take a breath before the first bite. Notice the colours, the smell and the taste.
• Pause halfway through and check in with your body.
• Keep regular times for meals and planned snacks, so you are not grazing all day.

Hunger or feelings?

Sometimes we eat to manage feelings rather than hunger: stress, boredom, sadness, or even celebration. Some emotional eating is normal. It becomes a problem when you often eat more than you want or need, or feel out of control around food.

Before you eat outside a planned meal or snack, ask yourself: is this hunger, or is something else going on? If it is something else, try a short walk, a call to a friend or writing down what you feel. In a small pilot trial of 18 people one to five years after bariatric surgery, a 10-week mindfulness program reduced emotional eating at six months, though it did not change weight. Larger studies are still needed.

When to ask for support

Talk to your care team if you often eat until you are uncomfortably full, vomit after meals, feel guilty or out of control around food, or find that food is still your main way to cope. These are common, and you can work on them with your dietitian, a counsellor or a support group such as 360 Community. Asking early makes a difference.