The Hunger Wars in the Weight Loss

The last post on yoyo dieting explored the very real phenomenon of weight regain and talked about some strategies that you can use to keep the body from bouncing back up to a predetermined set point.  We talked about how there are many factors that cause a person to gain weight over time.  These causes include processed food or excessive eating, unhealthy muscle, sleep deprivation, chronic stress, disrupted circadian rhythms (shift work or a disrupted sleep-wake cycle), and weight inducing medications.  Our internal medicine and weight management practices in Schaumburg and Vernon Hills specialize in helping people understand the causes of their weight gain, and enact SMART (specific, measurable, achievable, relevant, timely) goals to help people get back to and stay at a healthy weight.

Today we’ll talk about one of the most common causes of weight gain – eating unhealthy foods or consuming too much food.  Now you may be saying – “Duh…. So you’re telling me to eat better and eat less!  Brilliant!”  I agree, giving this sort of advice is like telling a smoker that cigarettes cause lung cancer.  Not very helpful.  Often, we know something isn’t good for us and we find ourselves doing it anyway.  Seeing that we’re engaged in an unhealthy behavior is simple, changing it is less so.  I can’t tell you how many times I hear people in my practice telling me that they plan to get more serious about eating better, as if this conscious choice were under their control.  Now we’re getting into the question of free will – a fascinating topic, and outside the scope of this post.  For today’s purposes, we’ll assume that we do have choice over what happens to us.  It’s under our conscious control to decide whether we put food into our mouths or not.

After taking care of thousands of patients at both my Schaumburg and Vernon Hills Internal Medicine and Weight Loss practices, I would argue that there are many other forces at play that affect when we start eating and how much we eat.  What does make a person start eating?  The most obvious answer is the physical sensation of being hungry.  Pause a moment.  Check in.  How physically hungry are you right now?  Imagine a scale from one to ten with one being the absence of hunger and ten being absolutely starving.  What sensations in your body help you to know what number you are?  Is there an empty sensation in the pit of your stomach?  A growling?  Do you feel weak or have a headache when you get really hungry?  Maybe you start noticing that you get crabby, or what we call “hangry”?

It may help to know that these experiences have a biological basis.  All animals have strong internal drives to find food and eat it.  In fact, most animals have no control over how often or how much they eat, which is why we can’t leave unlimited amounts of food or treats out for our dogs.  The part of the brain that makes humans different from dogs is the prefrontal cortex.  This is the part of our brain that can inhibit our animalistic impulses.  It’s why we have the capacity to make more skillful choices when it comes to feeding ourselves, our sexual behaviors, and how we handle our feelings of anger or aggression.  This is where mindfulness can be incredibly helpful.  By cultivating a regular mindfulness or meditation practice, a person can learn to experiences cravings for food, sex, or other pleasure without always having to act on those impulses.  This does not mean that people who practice mindfulness or meditation go without pleasure.  Not at all.  In fact, experienced mindfulness practitioners actually can experience more pleasure from more moderate experiences which leads to no feeling of sacrifice at all.  What would it be like to be able to eat without stress and feel in balance with our food choices?  Can you imagine wanting to nourish yourself in the healthiest way and not wanting to overeat anymore?  This is possible with mindfulness and meditation training.  Where we’re starting today is with the simple practice of hunger awareness.  I invite you to get to know your body.  How does it tell you when you’re hungry?  Do you even notice milder levels of hunger, or do you go most of your day without eating and then overeat once you get to dinner? 

It’s almost impossible to eat in moderation when you’re experiencing higher levels of hunger (8-10 on our hunger scale).  If we go too long without eating, the body starts experiencing stress, and the adrenal glands get activated.  The heart rate may go up, you may start breathing faster, and you may become more tense.  Everything in your body starts becoming uncomfortable and your brain starts shifting its energy to one singular task – getting you to eat!  Unfortunately, we can be so distracted by work, our kids, or some other activity that we can disconnect and not mindfully take care of our bodies.  It’s not until the signals from the body are really strong that we finally prioritize finding food.  The bigger problem is that in this state the brain wants us to find the quickest source of fuel out there – sugar and carbs!  So, whether you like to overdo the sweets or the savory, it’s all directly converted into glucose, or sugar that that body can quickly use.  Taking in large amounts of high carbohydrate food leads to spikes in our insulin levels which can start to have a wide array of metabolic consequences.  Our practitioners at both our Schaumburg and Vernon Hills locations screen all our internal medicine and weight management patients for such metabolic disease.  We also ask people about their stress levels because we have a wide array of mindfulness and meditation training programs to help people get more regulated.  This is important because the prefrontal cortex, that part of the brain that keeps us acting out unhealthy behaviors that feel good in the short term, doesn’t work when blood sugar levels are low and we’re getting “hangry”.

Hunger awareness is important because it colors all the experiences we will subsequently have with our food.  How differently do you eat if you’re super hungry versus not sensing hunger at all? Do you notice that there’s a difference in the speed that you eat based off your hunger level? Simply being aware of how hungry we are can prepare us to engage more mindfully with our meals.   Many discover that it’s not the best idea to go grocery shopping when we’re hungry.  If we do, certain items have a way of finding their way home with us that we wouldn’t have bought if we were more satisfied. 

People trying to lose weight may choose to live with sensations that I assign about a 6/10 on the hunger scale, hungry, but still comfortable.  If we get used to experiencing some hunger without panic, we often find that the sensation passes, or can sometimes be managed with water.  If the stomach is used to being overfed it stretches out over time.  Living with moderate levels of hunger gives the stomach a chance to shrink down and feel satisfied with more moderate amounts of food.  In my experience, people who eat 100-150 calories of low carbohydrate food every 2-3 hours can navigate hunger pretty effectively and keep their total calorie counts low.  If this is not your experience, schedule an appointment at one of our weight management practices in Schaumburg or Vernon Hills, because there are people that really benefit from medication to help with unmanageable hunger which our providers can prescribe.  Hunger does not have to be the enemy.  When managed effectively, it simply becomes another body sensation to be mindful of because it gives important information on how to best care for our bodies.  Keep following us in the upcoming weeks to learn more.

Author

Kara J. Nance, MD, FACP General Practitioner & Obesity Medicine Specialist