Conquer Your Weight

Dr. Sarah Stombaugh: This is Dr. Sarah Stombaugh, and you are listening to the Conquer Your Weight Podcast, episode number 39. Announcer: Welcome to the Conquer Your Weight Podcast, where you will learn to understand your mind and body so you can achieve long-term weight loss. Here's your host, obesity medicine physician and life coach, Dr. Sarah Stombaugh. Dr. Sarah Stombaugh: Hey everyone. Thank you for joining me today. Today we are to talk about hunger. And hunger is interesting because it is a sensation in our bodies, a physiological signal, yet we often make it mean so much more than that. So like I said, it is really just a signal in our body. It's driven by hormones like ghrelin and leptin, and it is a normal part of human physiology to feel a hunger sensation. And in that way, it's really no different than other sensations like thirst, the urge to use the restroom, feeling fatigue. Our body has physiological signals to communicate those needs to us. In other ways, though, hunger feels really different in its truest form, it's that physiological signal. Our body is sending us a signal to say, Hey, it's probably time to seek out food. But often we make it mean so much more than that. For many of us, hunger is really loaded. We don't look at hunger as a neutral fact. Oftentimes it feels urgent, maybe it feels scary, or maybe it feels anxiety provoking. And so I want to spend some time talking about that today. When you feel hungry, what do you make that mean? So often people feel hungry and they're like, oh my gosh, I need to eat right now. Or alternatively, they're so afraid of ever actually feeling hungry that they're always just eating just in case. Because what if they don't have a chance to eat later? Or is it bad if they feel hungry? And if you've never stopped to think about this, it probably sounds a bit funny. You're probably thinking, well, if I'm hungry, shouldn't I eat? Or if I know I'm going to be in work meetings all day long, shouldn't I find a way to eat beforehand? And you can absolutely use your logical planning brain to make those type of decisions for yourself, but that's not what I'm talking about. I want you to think when you feel the hunger sensation in your body, does it lead to any sort of emotional reaction for you? Because it's just this hunger sensation, it's just a physiological signal. Emotionally, it should be completely neutral. And if it's not neutral, you probably have work to be done. So I wanna give you some examples in my own life where I was feeling scared or feeling, you know, afraid of being hungry. The first is from a job that I had between college and medical school. I worked as a consultant for my sorority. And in that role, every week I was traveling to a different college campus to meet with that local sorority chapter. And during that week, I would meet with each of the different officers. I'd meet with the whole chapter and the leadership boards. We would do different leadership training. Sometimes we'd be there to help with a specific event like recruitment or initiation. And this was a one year position. So every year there were eight women who were recent college graduates, and we would serve in this role. And at the very beginning of the year at orientation, the outgoing team provided guidance to us incoming team to talk about the upcoming year. And we got all sorts of great advice, like how to keep your suitcase organized, different travel hacks. But one piece of advice that really stood out to me was this dogma that if you have the opportunity to eat, you better take it because you never know when you'll get a chance to eat again. And I remember as we all did, taking that advice so seriously. And to be clear, our schedules were planned often by 20 year old women, some of whom were very organized, others of whom were not. And there were times that a recruitment event might go into the wee hours of the morning, for example. So it's certainly fair to say that there were times our eating schedules were a bit erratic, but this idea that if you have an opportunity to eat, take it because you never know when you'll have a chance to eat again. Y'all, that's kind of crazy. We were not living in a third world. I was literally in America traveling to college campuses. If there was food not immediately available to me, you know, like if it wasn't immediately in front of me, it was probably available. And even if it wasn't readily available, I could have made it readily available, even if it had been, you know, one or two hours wait, there was no period of time that it was like, oh my gosh, there's no food here. But me and all of my colleagues, we really took this advice to heart. And we knew that we needed to take every opportunity to eat because God forbid we got hungry. And as you might guess, we all gained a couple of pounds along the way. Or here's another story from when I was in residency. Um, during residency, we worked night shifts in the hospital, and I often had a lot of drama about food availability while I was on night shift. And if you've ever been in the hospital overnight, it's usually busy in the evening hours, but then towards the late night, it starts to settle in. Things are quiet, there's no visitors, and you certainly do need to plan ahead to make sure that you have food available to you because it may not be readily available at one o'clock in the morning, for example. And so on this night shift, I had come in, gotten sign out, and it was my plan to go down to the hospital cafeteria and get food before the cafeteria closed. I think the cafeteria closed at seven, let's say it closed at seven. And I had gotten an admission and sort of rushed through, you know, not rushed through, but done that as quickly as I could with the idea that I'm gonna get back up to the cafeteria quickly before they closed and grab my food because that was my plan for the evening. And they closed at seven, and I walked in the door at like 7:02 and they hadn't locked the doors to the cafeteria. All the doors were on, all the lights were on, but they had shut down the cash register. So all the food is still setting out, the workers are still back there, sort of bopping around cleaning things up. But they've set the cash registers down. And I walk in and I was like, oh, can I still eat? And they said, no, I'm sorry, the cafeteria is closed. And mind you, it's me. You know that glass wall in front of which there's all the food sitting out that just needs to be served. And then there's server. So I'm staring at all the food and they say, no, I'm sorry, the cafeteria is closed. And I was like, but the food's right there. And they're like, well, sorry. It's closed. The cash registers are closed and y'all, I kid you not, when I say I started crying, like full on, my eyes were welling up. And I literally started crying. I was like, but I'm so hungry. And the funny thing is, I wasn't, I was just anticipating that at some point I was going to be hungry pretty soon. And they were so shocked that they actually just gave me food for free, which was really kind and lovely for them. But it's really interesting when I reflect back on that story, that was really a lot of drama that came up. I literally cried in front of the hospital workers because I was so afraid of not having food available to me. And mind you, this was in the days before Uber Eats and DoorDash and all of the, you know, all of those delivery options became so ubiquitously available, but there were still certainly restaurants in the area that would've, there was always some patient foods tucked away that we had access to, like the sandwiches and that type of thing. There was always peanut butter and graham crackers. I really was not going to starve to death. But the fact that I had sort of built this up in my mind, like, oh my gosh, God forbid I was hungry. And those are probably pretty drastic examples. But this fear of hunger comes up in many small ways too. Like this idea of like, oh, I better make sure to have a snack available, or I better meet before or eat before I go into that meeting. Or maybe I need to eat before bed. I don't wanna feel hungry in the middle of the night. And I want you to think back if you've ever had experiences like those. And I want you to think, what if hunger didn't have to be so loaded, such a negative feeling? What if it was just information with which we could choose how to respond? Because again, hunger is not an emotion, it's just a physiological signal. And if you compare that to how we respond to our other physiological signals, it stands out as quite a bit different. Because when you feel tired, do you immediately stop what you're doing and lay down for a nap? When you have the first sensation of needing to use the restroom, do you drop everything to relieve yourself? Honestly, no. Right. More likely you recognize that physiological sensation and you respond to it without any drama. You finish your meeting and you go to the bathroom, you probably finish your task for the day and go to bed. So you might ask yourself, are you treating your hunger any differently than you would treat any other signal? And if so, it may be worth exploring that. How is it serving you to feel differently about hunger, to feel emotional about hunger? How is it serving you in your weight loss journey? And would you like that to be any different? Because there are a few different ways we can work to change your perception of hunger. I often recommend for my patients to use a hunger scale to help determine in a quantitative way how hungry or how full they are. This can help to differentiate between true physiological hunger and between cravings, which are more psychological and nature. If you haven't listened to my episode on hunger signals, go back to episode two to check that out. And while hunger is the physiological signal, we know that chronic excess weight can contribute to changes in our hormones like ghrelin and leptin, leptin. And when those hormone hormones feel out of whack, we might feel hungry too easily. Maybe we take longer to feel full. So there are things we can do like changing up our choices to make sure that we have plenty of fats and proteins and fiber that can help to increase satiety, to regulate those signals. Or you might decide to work together with an obesity medicine physician to also use anti-obesity medications to help regulate those signals. And then psychologically, there's lots of things that we can do too. Recognizing if you have a lot of mind drama around hunger is a really helpful first step. You can start to pay attention to the thoughts you're having when you're feeling hungry, and then come up with a plan to manage those. So for example, if you're afraid, I don't know when I'm going to have a chance to eat again, you may end up overeating or eating even though you're not hungry. But what if instead you had a healthy backup snack available? You don't even have to eat it ever. You just have to know that it's there just in case you do need it. Maybe it's a protein bar or a bag of nuts that you keep in your desk drawer or your purse or wherever it is that you find that fear of, I don't know when I'll get a chance to eat again, coming up. And so when you have that thought come up, you could remind yourself, no, no, no, you're not gonna starve to death. I could always eat that backup snack that I have stashed away. Or maybe you do have a history of food scarcity during a time in your life and you're having trouble breaking those thought patterns because there was a time in your life when you really were not sure where your next meal was coming from. And to recognize that that was the past and those thoughts aren't serving you now all these years later. That can be a really challenging transition to make though. And so working together with a therapist or maybe a health coach is a really important step in your weight loss journey. If you'd like to learn more about these things like medications, things like coaching, and how to help manage your hunger or your thoughts around hunger so it doesn't feel so dramatic, please reach out to me. If you live in Illinois or Virginia where I'm licensed to see patients, I would love to see you for a free meet and greet visit to decide if you would be a good fit for my telemedicine based weight loss practice. Please visit my website at www.sarahstombaughmd.com. That's S-A-R-A-H-S-T-O-M-B-A-U-G-H-M-D dot com. And go ahead and fill out the form on the individual visits page. Thank you for joining me today. I'll see you all soon. Bye-bye.