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.



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