Are you in tune with your internal signals of hunger and fullness? More often than not, we are not in sync with our body’s cues for appetite regulation. Instead, we seek out food in response to an emotional trigger, such as stress or boredom, or because something in our environment prompts us to eat. Poor appetite regulation can influence weight maintenance.
Obesity is a national health crisis, and increases risk for numerous chronic conditions, including heart disease, stroke, type 2 diabetes, and certain types of cancer. These are among the leading causes of preventable and premature death. In this country, we are challenged by our food environment, or the physical surroundings that influence what we eat. Certainly, the choices we make about eating are informed by our surroundings: from the food offered in our home by parents, spouses, or roommates to how close we live to a grocery store, and a host of other factors. Indeed, in the U.S. it can be extremely difficult to choose healthy foods, despite its abundance (Harvard Health).
Historically, one of the earliest treatments for obesity was to begin a diet. Diets, however, usually set us up to fail. For example, it is easy to get into a pattern of yo-yo dieting, or frequently starting and stopping diets. Most begin hopeful, excited at the opportunity to lose excess weight. However, soon after the diet begins, a sense of deprivation may begin. When our bodies feel deprived, the pendulum swings the other way; we start over-eating and gain the weight we lost, plus more.
What can be done?
Intuitive eating or eating according to your biological signals of hunger and fullness, provides us a path to make peace with our relationship with food. Instead of dieting, intuitive eating is based on four principles: a) unconditional permission to eat; b) developing a healthy relationship with food and body; c) eating for our physical rather than emotional reasons; and d) relying on hunger and satiety cues to guide our eating choices (Tribbole & Resch, 2013).
Our bodies are equipped to give us helpful biological cues. If we listen, they help us regulate our body weight. When we listen to our appetite, we focus on listening and honoring our body’s cues of hunger and fullness, rather than concentrating on a specific diet program.
One of the most well-known studies demonstrating the benefits of intuitive eating was done in 2005 by lead author Lindo Bacon, PhD. In their study entitled, Size Acceptance and Intuitive Eating Improve Health for Obese, Female Chronic Dieters, Bacon’s team examined a model that encouraged health at every size as opposed to weight loss. The study randomized a sample of women into two groups and provided them two separate interventions: a) Health at Every Size or b) Diet. Below we provide some of the components of each intervention.
|Health at Every Size (Group A)||Diet (Group B)|
|Body Acceptance||Moderately restrict their energy and fat intake|
|Nutrition to honor good health||Use a food diary to write down what they ate|
|Eating according to biological signals of hunger and satiety||Physical activity|
|Physical activity/joyful movement||Sessions on counting fat grams, understanding food labels|
The results of this study demonstrated that Group A had an initial decrease in cholesterol, with decline at follow-up. Group A also had a significant decrease in systolic blood pressure which was sustained at follow-up. The sum of time spent in moderate and vigorous activity also significantly increased in Group A, with participants being able to maintain their weight and BMI. Though there was a significant decrease in systolic blood pressure in group B, it was not sustained at follow-up. Further, their physical activity increased greatly at the start but was not sustained at follow-up. Participants lost 5% of initial body weight at the end of the program, but again it was not sustained at follow-up. In summary, this study provides some preliminary evidence that receiving training to eat intuitively may be of benefit to long-term weight maintenance.
A 2014 review study* found that intuitive eating was associated with:
- Decreased likelihood of eating disorders
- Decreased likelihood of dieting
- Decreased body weight
- Weight maintenance
- Lower cholesterol
- Lower blood pressure
- Increased self-esteem
- Reduced body dissatisfaction
How do we learn to eat intuitively? One beneficial tool is Appetite Awareness Training developed by Linda W. Craighead, PhD, of Emory University. She explains how to self-monitor our eating habits and behaviors in The Appetite Awareness Workbook.
Though we have biological cues that tell us when and how much to eat, over time, we are often socialized by our culture and our environment to no longer listen. Thus, it is more common for us to eat for non-hunger reasons. For example, we eat because we are stressed, lonely, and/or bored. Or sometimes we eat because there is food available, like at a party or work event. Sometimes we do not eat regularly, and risk allowing ourselves to get too hungry.
It may be helpful to re-learn how to eat according to our biological signals of hunger and fullness. It takes work and practice to recalibrate our appetite. We also have to distinguish between psychological (emotional) and biological prompts to eat. Psychological eating is a desire to nourish our spirit and emotional needs, while biological eating is solely for nourishing our physical body. Though it may take practice, differentiating between the two will be a helpful tool to help guide your eating decisions. Please see chart below to learn more:
|Physical Hunger||Emotional Hunger|
|Fast vs Slow||Comes on gradually||Sudden urge|
|Originates||Sensation of the stomach; rumbling and growling||Desire for food is mostly in the mouth and the mind|
|What you want to eat||Any food you like, to satisfy hunger||Craving for a very specific food|
|Characteristics||· May feel shaky, light-headed or weakness
· Tired feeling, low energy
· Sense of emptiness in stomach
· Mood changes
|· Automatic or absent-minded eating
· Eat to avoid unpleasant emotions
· Eat in isolation
· Cued because food is available
· Feeling bored, lonely, stressed, or sad
|After eating||Hunger feeling leaves when you are finished eating||May feel insatiable; still searching for just the right food|
We need to pay attention and make conscious decisions to eat. If you can identify why you want to eat, it can help you decide if you need to eat. Listening to your biological cues will help you increase your ability to maintain a healthy weight and will increase your control over your eating habits. You can regulate your appetite and become in tune with your internal signals of hunger and fullness.
*Schafer & Magnuson (2014). A review of interventions that promote eating by internal cues. Journal of the Academy of Nutrition and Dietetics. https://doi.org/10.1016/j.jand.2013.12.024
This article is based on a talk presented March 4, 2022, at Appetite for Life, a series of community programs that brings the latest scientific research down to earth in educational and interactive lectures and events. View Dr. Goode’s Appetite for Life presentation here.
Rachel Goode, PhD, MPH, LCSW is an Assistant Professor at the School of Social Work and an Adjunct Assistant Professor in the Center for Eating Disorder Excellence, Department of Psychiatry, University of North Carolina at Chapel Hill. Her research interests include developing, implementing, and evaluating equitable and community-engaged interventions to treat obesity and eating disorders.