Sunday, February 7, 2010

The difficulties of hunger and fullness

I just read this blog post over at 360 Degrees of Mindful Living about fullness. From the blog:

First, the sensation of hunger goes away. This is a moment of hunger relief. This happens almost too fast for us to have time to enjoy a meal. If you stop eating at this point, then you no longer feel the painful emptiness of hunger, but you also do not yet feel full.

If you keep on eating, you will next experience a moment of pleasant fullness as the food distends the lining of your stomach, but not so much as to cause pain.

If you keep on eating, you will eventually experience a moment of unpleasant fullness as the stomach distends to a painful degree.

I wish feeling satiety and fullness like this was so easy. For many of us with eating disorders or are in recovery, we have a hard enough time establishing, distinguishing, "being in touch" with our hunger cues. For so long, we have ignored them that when they arise, they feel foreign and uncomfortable (what my body needs food now?). After awhile of continually neglecting these signals, our body stops producing them. And then there is just silence. Ahh, sometimes, I admit, I kind of miss those days where I did not have to make such decisions and efforts about food, or my body telling me it actually needed something to live on. But the aftermath is not so pretty as we all know.

And so when we eventually head toward recovery, one goal is to relearn these hunger and satiety cues (aka intuitive eating). For me, it's really been more about mechanical eating--it's a certain time of day, I need to eat something, etc. This isn't to say that I completely ignore intuitive eating, but just that the mechanical technique for me has been easier right now. I find if I am hungry, and my stomach roars, and I don't eat right away, well, it will either go away completely, leading me to forget it or something like what occurred on Friday will happen.

My schedule was different, and I didn't plan it out well. I had a hunger attack and nothing to eat at the time (was at a client's house). Since I was two hours off of my scheduled time, my stomach felt horribly awful-distended and bloated which half the time makes me not want to eat. But since I knew this was probably from not having eaten in several hours, I found something to eat at home while letting the dogs out which my stomach did seem to thank me for. (If it could smile, it would)

Besides the hunger cue thing, we have to tackle fullness as well. The post above distinguishes from pleasant fullness and unpleasant fullness. In the early stages of recovery, for many of us, there is an unpleasant feeling of fullness, not only physically but emotionally as well. It takes a lot of time to reach a feeling of pleasant fullness where our bodies realize it can rely on food substances and our minds can feel at peace with it and maybe even content too.

The post offers some good suggestions for pleasant fullness and unpleasant fullness words. It might be something good to do as an exercise or in explaining to someone how you may feel after such a meal.

Note--*There's been some research on the poor or lack of interoceptive awareness (ability of an individual to discriminate between sensations and feelings) here, here, here, and here among those with eating disorders.


Cammy said...

This is exactly what my dietitian is working on with me right now. My hunger/satiety are still completely screwy, and I rely entire only on 'clock and calories' to tell me when and what to eat. When I first started weight restoration I was really frustrated that I actually spent MORE time hungry than I had when I was restricting, it didn't seem fair.

My assignment has been to rank hunger (1-10) both before and after each meal as part of the food records I'm keeping for her. It helps just to have to stop and think about it, and writing it down lets me go back and see what other factors might have been affecting it.

Thanks for this post, this is definitely a big issue in recovery!

Kim said...

My hunger/fullness cues are still way off too. Like Cammy, I eat by the clock and a general calorie amount. I love the days when I have a good appetite because then I feel like my body is working and I can listen to it. But I have many days when I have no appetite at all. I don't know if this is an anxiety thing or what; if it is, I must have anxiety 90% of my waking hours. Ha. I do keep a little "mood log" to track my moods, and I have a category for appetite, just to see how it's affected. I haven't drawn any conclusions at all yet, but I'm hopeful ;) Intuitive eating is an aspiration of mine, but I realize it may take a good while. I have days when I can and do eat intuitively, but I have way more days when I need structure.

sayhealth said...

Oh yes, it seems so easy when described on paper like that! And yet, it's so complex to put into practice, especially for people with eating disorders! I'm doing the mechanical eating thing too. I'm not in tune with by body enough yet for intuitive eating. AND I recognize mechanical eating as a step toward intuitive eating. It may be a long step, as my therapist has said, AND it's still movement in that direction!

Lou Lou said...

I am still working by the clock to ensure i eat my meals and snacks, most of the time not being hungry, i still follow my meal plan and am looking forward to being able to develop more body trust. maybe there are more ways to bring it on, being minfulness, thank you
thanks for this post

Eating Alone said...

I'm trying to eat without using the clock or calories, I have exchanges, but it just doesn't work. I go from the intense hunger feeling to after like three or four bites a feeling of "Oh my god what did I do! way too much your full, your bloated STOP!" Well that has nothing to do with hunger or fullness that's an ED thought. Crap back to the drawing board.

sophia said...

That's true, that our hunger/satiety cues are messed up from our ED past. But the good thing is that it can totally correct itself. The key is to eat ENOUGH, and to gain weight to our normal weight first. I think the first months of recovery, you've got to eat mechanically, so that your body gets used to an appropriate amount. And then, it's time to learn to eat intuitively by letting go of the rigid plans and schedules. Otherwise, it would be really hard to socialize with others.

I Hate to Weight said...

i always say that i can 'get' hungry but i have a much harder time with satiation.

it sticks with me that when i was bingeing, i could eat soooo many calories. somehow i think i have some crazy capacity.

i'm not exactly sure what's the right time to stop eating, so i kind of guess. sometimes, i eat more than necessary. sometimes, i can get it just right.

i do understand the use for planned eating. when in doubt, follow the plan at the planned time. and i also see how intuitive eating is really so healthy.

no one right answer. darn

Tiptoe said...

Thanks everyone. I'm really glad to know I'm not the only one to eat mostly by clock. Somehow, for some, it just seemed like I got the impression that other did not do this. So it's all quite comforting. And hopefully, well all get to a point when we can fully listen to our bodies.

Colby said...

I can definitely relate to your post. I know so many people who struggle everyday from an eating disorder. I think the first step is recognition. I’ve found Silver Hill Hospital, a substance abuse and psychiatric hospital, to be a really good source of information about treatment options.