food · nutrition

The weak link in intuitive eating, our hunger signals aren’t terribly reliable

imageI wrote the other day about my brand new life experience, missing meals and forgetting to eat. That’s not me. (See Forgetting to eat? Who are these people?)

And it’s really shaken me, got me thinking about the role of hormones in appetite regulation and about the ideas behind intuitive eating.

You know the drill, eat when you’re hungry, stop when you’re full. Pay attention to satiety clues and eat mindfully. In terms of the blog, roughly Tracy is a fan but Catherine and I have both expressed doubts. See here and here.

Intuitive eating sounds great for the person who eats when they’re supposed to, because of what the clocks says, or who starves him or herself, for whom hunger has become meaningless.

But aside from the ignoring hunger bit (been there, done that) that’s not me. I’m routinely hungry. Like stomach growling, weak feeling, dizzy hungry. So when people have said, in the past, just eat when you’re hungry, I’ve often been puzzled. “You mean, like always.”

The context for the change is that I’ve had my thyroid removed and I’m taking medication as a result. I’m in the stage where they’re fiddling with various levels. I’m doing fine, receiving excellent health care, and it’s all settling into the new normal for me. But there’s one big change: For the first time in my life, I’m not hungry all the time. Often I’m not hungry at all and I’m having to eat because of external factors, like going for a bike ride.

It’s a bit disconcerting, like when I discovered drugs that took away my fear of flying. All that anxiety, just gone. I thought my anxiety was part of my identity. But it turned out to be pretty fixable. Now I’m no longer the person who wakes up hungry and that feels strange too.

All of this is making me rethink intuitive eating. It’s clear now that our hunger signals aren’t perfect at all. They’re pretty darn flexible. And I guess I knew that. I knew that formerly obese people have much higher levels of the hormones that signal hunger.

Here’s one such study, from Science Daily.

The study involved 50 overweight or obese adults, with a BMI of between 27 and 40, and an average weight of 95kg, who enrolled in a 10-week weight loss program using a very low energy diet. Levels of appetite-regulating hormones were measured at baseline, at the end of the program and one year after initial weight loss.

Results showed that following initial weight loss of about 13 kgs, the levels of hormones that influence hunger changed in a way which would be expected to increase appetite. These changes were sustained for at least one year. Participants regained around 5kgs during the one-year period of study.

Professor Joseph Proietto from the University of Melbourne and Austin Health said the study revealed the important roles that hormones play in regulating body weight, making dietary and behavioral change less likely to work in the long-term.

“Our study has provided clues as to why obese people who have lost weight often relapse. The relapse has a strong physiological basis and is not simply the result of the voluntary resumption of old habits,” he said.”

Why does it matter? What’s this got to do with intuitive eating?

My worry here is that intuitive eating assumes that our bodies are right about various things, that the signals they send us are correct. But if the formerly obese person eats when hungry, they’ll be eating a lot more often than is consistent with maintaining their weight.

It’s trickier than I thought. And it feels weird to me to be eating because I ought to–I can’t ride my bike if I don’t–and not because I’m hungry. This gives me a chance to be more deliberate about nutrition and I’m liking that aspect of it all.

Still thinking about this? Want more information? Here’s two articles from Precision Nutrition that do a pretty good job of explaining the hormones that regulate hunger: Leptin, ghrelin, and weight loss and  Weight loss & hunger hormones.

 

 

21 thoughts on “The weak link in intuitive eating, our hunger signals aren’t terribly reliable

  1. It is quite a complicated topic. Thanks for talking about it! Open conversations about weight and hunger and food are much harder to have in real life. I’m closer to your original hunger state – not quite hungry ALL the time, but stomach-growling, weak and shaky hungry probably half the time at least (when I haven’t just eaten). People often think I’m exaggerating or don’t believe me when I say that I” need to eat something now!” I think many people have never experienced that level of hunger.

    And I’m in the middle of a physiology class, so even though we haven’t specifically discussed hunger yet, I can definitely see where hormones could play a huge role that we don’t think about.

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  2. “My worry here is that intuitive eating assumes that our bodies are right about various things, that the signals they send us are correct. But if the formerly obese person eats when hungry, they’ll be eating a lot more often than is consistent with maintaining their weight.” The way I see that, the signals from the body are correct, the weight attempting to be maintained isn’t. I read the results of that study as support of good signals from ones body, but I completely agree that intuitive eating for everyone assumes we’re not getting false messages ever. I do eat when I feel hungry, but I know that means I’m eating when I’m bored or experiencing certain emotions and only think I’m hungry.

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  3. Intuitive eating works when a person already instinctively gravitates to a healthy diet. And I say “diet” in terms of whole produce, method of food preparation that isn’t fatty, high chlorestrol, not too salty/sugary, least amount of processed foods, etc.

    I grew up with a palate that didn’t like fried foods (and I still don’t care much for fried. I have a doughnut 2-4 times per year, fried chicken like once a yr.), doesn’t like pop drinks (I have them..um 1-3 times per yr.), etc.

    So it helps to start children on healthy foods for the whole duration until adult. Sure, they will binge on junk when they earn money..but they will remember WHY they were healthier earlier.

    Even an intuitive eater like myself does regularily eat with certain time ranges for breakfast, etc. I actually have 2 breakfasts within a 3 hr. time span. Last small breakfast is at work. But no/little lunch. For instance, I intuitively eat dinner ..but no later than 7:00 pm, preferably even earlier.

    If I have a huge lunch, ie. a business lunch, then dinner is very small/snack-like or I eat regular dinner and pay the price later… I go to bed feeling way too full.

    Intuitive eating also is helped if one doesn’t want to stock kitchen with tempting foods. I have a pint of lovely handmade ice cream..it’s taking me over 1 month to finish. Am half way..

    And yes, I do eat desserts..my downfall. So intuitive eating isn’t to me, about eating when I feel like, it’s eating the right foods/portions.

    Intuitive eating …may also fall to the credo..eat feeling 80% full. I believe it’s the traditional Japanese that has this embedded.

    Maybe we should be like traditional Chinese and Japanese, food is medicine. Therefore you choose foods and have meals balanced for your body/your health. After that’s where the ying-yang priniciples of meal design comes from.

    Thinking of food as fuel…might cause us to overeat for some of us, when most of us aren’t even professional/super athletes.

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    1. We are all born as intuitive eaters…a lot of us ruin that for our kids with junk (addictive food preferences), not letting kids just eat when they’re hungry (scheduled feedings), and making them members of the clean plate club (forced overeating). Oh to go back and make my mom parent me differently! 😉

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      1. Well, I’m not sure letting kids whenever they want…there’s a balance of letting them eat within a certain time range..for lunch/supper. ..if it’s possible. But then, eating together as a family is important in terms of conversation and social skills.

        My mother didn’t rigidly feed us at certain time for supper –in my dim memory, it was what SHE could get manage to get supper on the table –anytime between 5:00 -7:30 pm. And she was full-time housewife with 6 children. We might have occasionally complained to her that we were hungry….but we learned where to get cheese, have a slice of bread or fruit, while she could finish cooking.

        Lunch was more time scheduled, I was raised in the days when as a schoolchild, we went home for lunch. (We walked home for lunch and back to school. Very few kids even get that 15-min. exercise by themselves now.)

        Breakfast: we made our own breakfast after approx. age 9 or so. Parents still sleeping. That was just bread and milk or cereal. We made our own lunch by the time we were 13-14…to take to school. We were too poor to buy lunch at school.

        Overeating because made to finish our plate: Most of the food prepared by mother was healthy. She didn’t spend energy specializing in dishes per child. When family was poor, message to children was: Please eat, we can’t afford time and money to cater to individual needs.

        And most cases, we did. But it is stressed, my mother was/still is a very healthy cook. Traditional Chinese home cooking is quite different from Chinese restaurant food (though some restaurants are getting healthier.). Her cooking is abit more bland than restaurant dishes..because hardly any salt, fat, etc.

        I noticed for myself in past years (only for a few months), when I scheduled supper, I would get hungry right at that exact hr. I don’t anymore.

        What might have been scheduled …or sort of, was my mother would cut up fruit for us as a snack, when we were studying as teenagers. She would walk upstairs and quietly provide each of us fresh fruit. I don’t even know what time it was. But she did do this for us individually, several times per wk.

        Ah, the things we take for granted of parents….and not until decades later…!

        I do owe the foundation of my health to my mother and learned a suite of home recipes…that I was happy to cook my own meals at university when living away from home.

        Cooking and eating to me is not fuel: it is cultural memory/heritage preservation/legacy and now, thinking about food is medicine. View what you eat…as medicine: it must be good enough for your body’s health.

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  4. I am also ALWAYS hungry. I have a t shirt that says “I’m sorry for what I said when I was hungry”. I don’t understand how people can skip meals because I would literally faint if that happened. It’s interesting how different people have different reactions to low blood sugar.

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  5. Great post, which made me remember this: I had my gall bladder removed 5 years ago, which changed my hunger and satiety patterns (permanently, as far as I can tell). I used to want to eat first thing in the morning ALWAYS. Since then, I just haven’t wanted to eat in the morning. I have coffee with milk, but am not hungry until 10:30–11am. So this moves my eating back several hours, and changes the times during the day when I’m hungry. It’s a drag for cycling/other activity– I have to make myself eat anyway, AND I can’t eat as much as I would need. And this is not uncommon among post-gall bladder surgery patients (who are many– about 500k such surgeries per year in the US). More evidence that the notion of intuitive eating really needs to be reexamined in order to figure reliably in any health-directed eating plan.

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  6. I’m rarely hungry. Or, rarely hungry enough to that I think I should eat.
    But once I go too long I become defiant and refuse to eat. Low blood sugar hangry.

    Intuitive eating has good aspects, but perhaps it’s not quite enough for some.

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  7. A diet higher in healthy fats is more satiating, too. I switched to higher fat lower carb and stopped having the blood sugar swings, and feel better. Not that I don’t occasionally eat something unhealthy, but the switch made it way easier. No insulin spikes and drops.

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  8. I don’t get what people mean when they say they’re “always hungry.” Does that mean that even when you’re eating a meal you never feel as if you’ve had enough to eat? I find that hard to believe but let’s say that’s the case in some cases. Then there are the people who are never hungry. What does that tell us? To me, nothing more than that intuitive eating isn’t the answer for everyone. But that’s not a worry about intuitive eating — why should we think that any one thing is a cure-all or the right approach for every single person?

    Intuitive eating was and is a great help to me because it’s not that I was never hungry or always hungry, but because a history of restrictive dieting left me with no sense of eating in response to hunger. I didn’t even really know what hunger felt like or what it’s relationship to food was. I also think it’s helpful for people like me who go on auto-pilot when eating. Hungry, and then presto: stuffed past the point of comfort. What happened in between? Intuitive eating and its close cousin, mindful eating, help me stay aware as I eat and make it much more likely that I will know when I’ve had enough.

    I agree that it’s not perfect, but hunger is an important thing to be aware of even if it’s not a totally accurate way of telling when and how much to eat.

    And the “weak link” isn’t weak for all. On a day to day basis, lots of people get hungry, eat, feel satisfied, stop eating and then repeat that when they get hungry again. That seems like a desirable state to aspire to even if some people, due to hormonal conditions or genetic make-up or what have you are not in touch with their hunger signals or don’t have hunger that neatly tracks their need to eat.

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    1. I did some hunger journaling for the online nutrition counseling program and here’s what “always hungry” means to me. I wake up hungry, hungry enough that I need to eat before showering. I’m hungry again by the time I get to work. I can eat lunch at the Wave and an hour later I’m hungry at my desk. You get the idea. People who are like this, though not me, wake up hungry during the night. So that’s what “always hungry” means. It feels urgent. That’s why the “hunger isn’t an emergency” lesson was useful to me then. It’s okay sometimes to ignore hunger.

      I know it’s useful for you but the way people talk about it it’s as if fat people don’t pay attention to hunger and satiety signals. Not necessarily true. Or we’re weak willed. Or eating emotionally. Again not necessarily true. I don’t think hunger signals are, for many people, a reliable signal that you need to eat. It’s hard to eat while exercising, often you’re not hungry, but still we need to eat. I think the hormones that regulate hunger are complicated and fascinating. This is a very weird shift for me these past few weeks. Missing meals! Yikes. Now I’m eating because it’s lunch time…There are advantages and disadvantages to this which I’m going to write about later.

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      1. Interesting. I like that hunger is not an emergency and have incorporated that into my life. I’d rather wait a little, until a meal, than eat at the first sign of hunger. In that sense, I can see why “eat when you’re hungry, stop when you’re satisfied” won’t mean the same thing for everyone. My worst nightmare would be having to go back to eating as a totally scheduled thing that had nothing to do with my physical hunger.

        Again, the main thing is that no matter what, the same thing won’t be effective for everyone. I think it’s interesting that hunger doesn’t map onto the need to eat for a lot of people. It kind of makes you wonder what it does mean then. It sounds as if there is such a thing as “phantom hunger,” where a person feels hungry (physically) but actually doesn’t need to eat.

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      2. Hunger is driven by our hormones. Acc they’re triggered by a bunch of different things. Anyone who was obese, now thin, will struggle with incredible hunger according to research on hormone levels. It’s tricky and complicated. Pregnancy hunger is the strongest hunger I’ve ever felt at the same time doctors are chiding you not to gain weight!

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  9. Discussion thread shows some personal body differences on hunger. I wake up hungry in the morning. Then eat, not full, but satisfied and then eat again. I am not hungry every hr. nor every 2-3 hrs. unless I am cycling 3-5 consecutive hrs. during ride.

    If I have a normal day…cycling to work..office job for 7+ hrs., then bike home/go for a 15 km. longer ride than normal, then I need to snack. Cycle home. Have dinner. During office hrs. I am not hungry every 1-2 hrs.

    I have noticed myself that if I don’t eat mindfully, then under work stress (or psychological stresses), I munch on junk/eat more OR if I want to socialize, I end up eating double supper. Not good. That is not mindful eating nor is it intuitive eating.

    I don’t see anything wrong with intuitive eating…..people who live in poorer/less developed countries ARE like this, but may still have a decent lifespan and health, go by this..if their diet hasn’t incorporated fast /processed food, etc.

    Please try to remember that over 40% of the world doesn’t eat like we do in affluent North America, unless a) they have local sources for junk food b) influenced by media on diet fad, junk food.

    I’m sorry, I had a father who died at 85 yrs. last year…he ate intuitively for whole of his life –90% low-fat, non-sugary and low-salt Asian dishes. He never had respiratory, cardio problems. He had low blood pressure and excellent heart rate. He was small boned and slightly underweight his whole life because he had a job on his feet as a cook and also genetics. Prostate cancer killed him, which inevitably happens to 80% of men…if they live long enough.

    There is sufficient evidence in my family line with some other family members, that on traditional diets (with some adjustments on lowering salt, fat) and eating intuitively…still works.

    I am not aware of my 4 siblings who are all in their late 40’s to mid-50’s, on timing their eating rigidly. Or weighing their food. None of them have cardiovascular, respiratory nor weight problems. They all live in separate households. I believe they are ALL eating intuitively. Sure they might eat some junk, but my gut feeling is that my mother set the pattern for all of us in terms of our base palate, long ago.

    In some European countries, the tendency for some traditionalists, is to eat large lunch, but smaller supper. I guess that’s adjusted intuitive eating? My partner noticed this when he was with 2 German relatives for 3 wks. visiting in Canada, this past July. They hardly ate supper.. They are in their late 50’s.

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  10. This really is a complicated topic– thanks for sharing your experiences. I understand your change in outlook, it must be a disconcerting shift!

    I know this isn’t what you were saying, but it’s a popular idea that, if the hormones of overweight people were corrected, everyone would eat in a way that our weight would settle into a medically acceptable range. You recognize that you have to eat more than your hunger signals dictate to support your activity, too. I hope you’ll keep talking about this as you continue to learn about your “new normal”.

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    1. I certainly didn’t mean to suggest that!

      And I will blog more about it. Maybe it will go away and I’ll land somewhere in the middle once they the thyroid replacement hormones correct! I’m also hoping I’m not cold all winter the way I used to be. We’ll see. Everyone keeps saying to be patient and I’m doing my best.

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      1. I’m cold all the time too, so I feel your pain! (Except when I’m sleeping…)

        My best experience with really intense hunger cues came when I was doing field work in the far north in summer, and it was light 24 hours a day and I worked odd shifts. My only reference for the time of day was my stomach! Meals were served at set hours, so if I was very hungry I knew a mealtime was approaching…

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  11. A big part of the Intuitive Eating approach is that all bodies are different and some of us are naturally bigger or smaller and by listening to our bodies and being our true selves we can live full and happier lives no matter where we are on the bmi scale. Intuitive eating is not a weight loss technique.

    V ❤️

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  12. I am puzzled. What is the science here? It just looks like someone made up the term: Intuitive Eating, for people who gave up on diets so that they feel they are still following a regimen.

    Do we have an abundance of anecdotal success stories, much less evidence?

    After youth, we all get fat because we simply don’t need as much food as metabolism slows down. Having a fast food environment does not help. It is fine to intuitively eat fruits, vegetables and other low calorie foods, but if intuition is pointing to high calorie foods with sugar and salt, it is more likely an addiction than intuition.

    Nutritionists are just people who have an opinion about diets; they are not experts.

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