When my hunger returned, it felt as though my stomach was burning from the inside out.
It was acute, painful, and very physical. I pushed everything else aside and concentrated on getting rid of it. There was no negotiating with hunger that intense. My attention narrowed to what I could eat to make it stop.
I am a registered nurse with more than thirty years of clinical experience. I have had bariatric surgery and used tirzepatide. I understood that medication changes appetite. That knowledge did not prepare me for how consuming this experience would become, or how quickly the fear of failure would attach itself to the need for relief.
I lost access to tirzepatide for about six to eight weeks. The first two weeks felt manageable. By the third, the hunger was unfamiliar in its intensity. I tried eggs, biltong, avocados, and protein shakes, hoping they would satisfy me. I ate amounts I could not have managed while receiving my injections. During a night shift, I found myself at the vending machine, although I had previously lost all interest in sweet food.
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Food had become urgent again. Alongside the discomfort was the fear of what eating more might mean for my weight and everything I had worked to achieve. I wanted the hunger to stop, yet eating more felt frightening.
My clinical knowledge had not disappeared. It simply did not protect me from feeling frightened, anxious, and ashamed. I found myself pushing away that voice of reason.
What the hunger pushed aside
Looking back, I needed help understanding what had changed and whether the painful sensation I called hunger needed assessment. I needed to think about nourishment and managing without medication. Those questions were crowded out by the need for relief. Advice to distract myself or wait did not address the burning I felt. I could not negotiate with this hunger.
I use “hunger” to describe what I felt; it does not establish the cause of the burning. Persistent or painful abdominal symptoms need medical assessment, including after bariatric surgery. Sudden or severe pain that does not go away requires urgent care. Readers should not assume that burning pain is an expected part of stopping medication.
The fear needed attention too. I had begun treating hunger as evidence that my progress was slipping away. This experience led me to write When Hunger Returns. I wanted to understand appetite changes before judging myself for them.
Hunger during treatment matters too
These questions also matter to people taking semaglutide, liraglutide, or other glucagon-like peptide-1 (GLP-1) medicines who notice more hunger while still receiving treatment.
If a quieter appetite has become your reassurance that treatment is working, hunger can unsettle much more than your meal plan. You may question the medication, worry about weight, or wonder whether to eat less. An ordinary need for a meal can start to feel threatening.
Treatment may already involve nausea, constipation, or difficulty eating enough. My experience included fatigue, dry mouth, and brain fog alongside quieter food thoughts. When hunger becomes difficult to manage, attention needed for work, family, and rest can be drawn back toward food.
Semaglutide and liraglutide act on GLP-1 receptors involved in appetite regulation; tirzepatide acts on both GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptors. These medicines influence food intake and slow stomach emptying. They do not remove the body’s need for nourishment. Hunger alone does not establish treatment failure.
What I called hunger was not always the same. Sometimes there had been a long gap without food. At other times, exhaustion, familiar routines, and comfort were involved. Memory, learning, emotion, and surroundings influence eating alongside physical need. Recognizing those influences should help us respond without dismissing the experience as “just emotional.”
When medication stops, its appetite-regulating effects fade. The body may also be responding to weight loss: Research following diet-induced weight loss found increased hunger persisting a year later. Maintaining weight can require continuing support.
In the STEP 1 extension, participants regained, on average, about two-thirds of their lost weight in the year after semaglutide and structured lifestyle support stopped. Those figures support planning continuing care. They cannot predict an individual’s outcome or explain what caused my painful symptoms.
What I want clinicians to ask
“I am hungry again” did not convey the urgency. “It feels like burning, and it is taking over my attention” would have given a clinician a clearer starting point.
Ask what the sensation feels like, when it starts, and whether eating helps. Ask about nourishment, other symptoms, and changes in treatment or access. Then ask: “What is this stopping you from doing, and what are you afraid it means?”
Patients need practical help beyond an instruction to eat protein. I had already tried that. Meals should provide enough nourishment, with protein, fiber, and variety suited to individual needs. For shift workers, a plan must include when food can actually be eaten. After bariatric surgery, nutritional support and prescribed supplements remain important.
Agree on follow-up, accessible treatment options, and safe restarting after an interruption. If fear drives severe restriction or eating feels out of control, offer support before weight changes become the reason to intervene.
At that vending machine, my attention was on making the hunger stop. I needed help understanding the painful sensation and nourishing myself without being ashamed to ask.
Returning hunger is not the return of failure. But when it is taking over your life, reassurance alone is not enough. You need help understanding what is happening and a plan you can live with.
Patience C. Ennis is a registered nurse, author, Results Coach, glucagon-like peptide-1 (GLP-1) user, and the founder of Body Compass, an education and navigation platform for people living with, considering, or moving beyond GLP-1 treatment. A graduate of King’s College London, she draws on more than three decades of clinical experience across emergency, community, palliative, and aged care, bringing together clinical knowledge, lived experience, and patient education to address the questions that often sit beyond the prescription.
Through Body Compass, she develops evidence-informed resources, books, practical tools, news updates, and non-clinical coaching support designed to help people understand changing appetite, side effects, strength, food noise, treatment adaptation, maintenance, and stopping. Her work is grounded in clarity, dignity, and honest interpretation of evidence, without hype, shame, or false certainty. Her aim is not to tell people what to decide, but to help them understand the terrain, ask better questions, and navigate metabolic health with greater confidence in everyday life and care.
She is the author of When GLP-1 Feels Different: Plateau, Food Noise, Adaptation and the Fear of “Resistance” (2026), available on Amazon and through Body Compass. Her other titles include Living Well on GLP-1 Medication: A Practical Guide to Everyday Life Beyond the Prescription, The Body Compass 30-Day Navigation Diary: A Reflective Daily Companion for GLP-1 Treatment, and The 30-Day GLP-1 Navigation Companion: Observation, Reflection, Preparation, Navigation.
She shares updates on LinkedIn, Facebook, the Body Compass Facebook page, Instagram, X, TikTok, and YouTube.
