By BodyMatters therapist Sarah McMahon
If we are feeling hot or cold, most of us would respond quite effortlessly by changing our outfit or relocating to an environment that is more comfortable. Similarly, an urge to go to the toilet would be satisfied by a trip to the bathroom. And if we get “pins-&-needles”, we might move the affected limb about until it feels “normal” again. However for many of us, hunger and fullness seems to be one of those experiences that is confused & we just don’t respond to it with the same sense of clarity. For many of us, our relationship with hunger is laden with layers of emotion, including shame & guilt. This blog is about learning how to honour hunger for what it is & seeing it as a useful physical cue or “road map” rather than something to be afraid of or confused by.
Learning to appreciate & honour hunger is something that is particularly difficult for people who have experienced disordered eating for a long time. For these people, hunger is a gateway for traumatic memory rather than a cue that can be trusted. Hunger can be painfully synonymous with the perception of having a “defective” body (because damn, our body actually needs food!). Alternatively the experience of hunger is paired with years of “self inflicted” abuse.
Establishing mechanical eating
Before you can begin to establish hunger and fullness cues, it is important to have a period of mechanical eating. Mechanical eating is essentially eating to a regular meal plan that includes sufficient portion size, variety (including all food groups) & frequency of meals. This enables the body to be biological fed & nutritionally capable of building body trust. It also removes the primitive urge of engaging in food seeking behaviour such as binge eating simply because of nutritional deficits.
Once mechanical eating commences, the real work around understanding hunger can begin. Mechanical eating provides the platform to begin to notice even the smallest cues of hunger in your body. In my professional experience, even after 1 week of mechanical eating, biological cues around eating can begin to be experienced. Things like (listed from gentle hunger to ravenous):
- mild tummy rumbling
- growling tummy
- light headedness
- difficulty concentrating
- uncomfortable stomach pain
- feeling dizzy & faint
The biology of hunger & fullness
The reason why we have these physical cues is that the physical experience of hunger is simply a result of a series of events that take place in the body:
- When we eat, our body converts the food into gluecose (which the body uses); alternatively that energy is converted to fat by the liver & is stored for later use
- Between meals, our gluecose levels decrease. The liver communicates with the lateral hypothalamus (the hypothalamus is the part of the brain that controls things like the nervous system, the endocrine system & certain metabolic processes) and indicates that the gluecose levels are low. This communication takes place via the release & increased stores of the hormone ghrelin, & decreased stores of the hormone leptin
- The hypothalamus triggers to urges for food seeking & consuming food
- The paraventricular hypothalamus sends more specific messages about which foods should be eaten, and is responsible for us experiencing particular cravings
- Then as we eat, a hormone called cholecystokinin (CCK) is released when the food begins to move from the stomach to the intestines. This signals to the ventromedial hypothalamus that it is time to stop eating; similarly, leptin is released from the fat cells to decrease our appetite
- As we eat, we may also have some physical indicators of fullness, such as the distension of the stomach and/or intestines which is often experienced as bloating
- Then when we stop eating for a period of time, and our gluecose stores drop, bringing us back to point 1. (above)
Of course this is a simplified explaination, ultimately this interaction is more complex, however as essentially described a hunge & fullness cues are mediated by the interaction between our brains our hormones and various neurotransmitters- our neuro-endocrine system. And whilst there is a biological basis for these hormonal signals, they are processed through cognitive and emotional filters.
Knowing that this is all that is happening at a physical level might be helpful. Learn to revere hunger: as soon as you recognise biological hunger, make time to eat. Your body does not need further confusion by ignoring these cues. Using an intuitive eating diary is an excellent way of learning to listen to these cues.
Cognitive and emotional filters
Second to understanding hunger cues, the other big barrier to revering hunger is the cognitive and emotional filters. Again using an intuitive eating diary can be helpful to at least name and acknowledge whether these are impacting your relationship with hunger. Recognising and reframing cognitive distortions is usually vital. This is best addressed by way of cognitive behavioural therapy in a treatment capacity. Naming and acknowledging feelings that accompany hunger is also vital. The feelings most typically experienced in our practice are guilt and shame. Learning to understand and regulate these feelings is also paramount for the recovery process to take place.