Nutrition Strategies: Are you hungry or just plain greedy?

Weight management has always been one of the most common queries I get as a nutritionist from both my athletes and patients. With the amount of information floating about on the internet from individuals with PhDs in Nutritional Science to acclaimed ‘nutrition coaches’ who got their certificate from an online course, to someone who has watched one too many six pack shortcut videos, you would think that this problem will be less prevalent.

In all honesty, weight management is based off the laws of thermodynamics making it rather fool proof. Basically, if you are in a state of negative or positive energy balance, you will lose or gain weight respectively (give or take minor differences in rates).

To determine what your caloric intake should be, you will have to:

1. Determine your basal metabolic rate (BMR)

2. Determine your physical activity levels (PAL), more specifically how many hours you spend doing physical activity. If this is too tedious, just settle on sedentary

3. Multiply BMR with PAL to determine your total daily energy expenditure (TDEE)

4. Subtract or add calories to your TDEE to lose or gain weight respectively

This is relatively easy to understand and do for highly driven individuals who embrace the burden of counting their calories but this might not be the case with the other facet of the population who would rather eat ‘intuitively’ as they might have actual jobs to do. Unfortunately, ‘intuitive’ normally means ‘eating whenever and whatever I want even though I am not hungry’ and it seldom works. Not because it is ineffective as a technique but because it is executed wrongly as people confound and confuse physiological hunger with psychological hunger.

Physiological vs psychological hunger

Physiological hunger is defined as having a blood glucose level that is below 4.54mmol/L but we do not always carry a glucose meter around with us unless you are a diabetic [1]. Fortunately, there are other ways of identifying hunger caused by low blood glucose levels such as:

1. Inanition characterised by a general feeling of fatigue, weakness, light-headedness

2. Empty Hollow Syndrome (EHS) caused by the contractions of the walls of the duodenum and stomach [2-3]

Psychological hunger is characterised by anything that is not physiological hunger. Examples are largely external factors affecting your appetite such as being in the presence of others eating, food marketing, advertisements, boredom, and societal norms which elicits the hunger response (appetite) that we feel [4-9]. These factors typically pose as physiological hunger, confounding the both.

How is this applicable to intuitive eating?

We might be more susceptible to psychological hunger, than we think. Take food timings like breakfast, lunch, and dinner for example; these are eating habits imposed on us since we were children through school and parental instruction and has a lasting impact on us through adulthood. Not to mention, everyone interprets hunger rather differently [10-12]. We do feel an innate need to consume something when the clock strikes twelve or six. I am sure that some of you have headed out for lunch with colleagues despite not feeling hungry just because they asked you to. All done in a bid not to become the office's social pariah (been there, done that, got the t-shirt).

If you are looking to take a break from the stress of calorie counting, macro partitioning or just freeing up space in your life to focus on other things than this, learning to recognise the signs of physiological hunger might help refine your intuitive eating in the long run which confers many health benefits like reducing body mass and improving insulin resistance [13]. This does not mean waiting till you are on the verge of fainting before you eat, but perhaps recognising the mild symptoms before it actually happens and fine tuning your senses in the long run to improve accuracy.

What if my friends ask me out for lunch?

So perhaps the next time your colleagues ask you out during lunch when you are not hungry, tell them ever so politely "I’m sorry I have to decline because I am not feeling hungry now. This body doesn't shred itself, Sharon."

Remember that staying shredded year-round is better than having loads of friends.

Oh and to all these fitness gurus and nutrition coaches out there- intuitive eating works; you are just not doing it right.

- Mahavira @mousehavira

Bibliography

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[5] Slochower J. Emotional labeling and overeating in obese and normal weight individuals. Psychosom Med. 1976;38(2):131–139.

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[9] Spence, C., Okajima, K., Cheok, A., Petit, O. and Michel, C., 2016. Eating with our eyes: From visual hunger to digital satiation. Brain and Cognition, 110, pp.53-63.

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[11] Birch LL, Fisher JO, Davison KK. Learning to overeat: maternal use of restrictive feeding practices promotes girls’ eating in the absence of hunger. Am J Clin Nutr. 2003;78(2):215–220.

[12] Bruch H. Instinct and interpersonal experience. Compr Psychiatry. 1970;11(6):495–506.

[13] Sumithran P, Prendergast LA, Delbridge E, et al. Long-term persistence of hormonal adaptations to weight loss. N Engl J Med. 2011;365(17):1597–1604.