Saturday, March 6, 2010

Getting in touch with my hunger

Something that has been hard for me is dealing with hunger. Before my surgery, I was pretty much hungry all the time. I could eat a very large lunch and be hungry half an hour later. I knew intellectually that I couldn't really be starving, but the voices in my head were screaming at me that I was STARVING and that I would DIE if I didn't get something to eat.

It wasn't until I learned about ghrelin, that I understood what was going on. It was gherlin that was telling my brain that I was starving and, like the men and rats in the various experiments who were injected with ghrelin and then went nuts trying to satisfy their "hunger", I would eventually feel compelled to quiet this urge.

While I was preparing for surgery, I read people's stories online and they talked about being years out from surgery and still not feeling hungry -- that they eat because it's time and they know they have to, not because their brain tells them they they must. It sounded like my idea of heaven and I held on to those stories and minimized the ones from people who still struggled with hunger.


Immediately post-op, I got to experience the heaven of not being hungry first hand. Having my hungry brain go quiet was so freeing. I felt like I had so much energy and I attributed most of it to not having to spend it fighting with myself as the constant argument -- you're hungry; no, I'm not; yes, you are -- was no longer a part of my life. I figured the lack of hunger couldn't be from eating enough because immediately post-op, you are lucky to get in 450 calories a day! It must be from not having ghrelin and I was so happy to be in that state.

But heaven didn't last.

At first, I was disappointed. I felt a bit ripped off, to be honest. I knew some people still experienced hunger after weight loss surgery, but I felt like I'd been promised the nirvana of never being hungry and only eating because I wanted to and I didn't get that.

Because I hadn't had a normal experience with hunger since I was about seven years old, I fell back into my old habits. If I felt hunger, I'd argue with myself. I would deny myself eating because it wasn't "time" or because I didn't want to eat more than a certain number of calories a day.

But the new hunger was different from the old. For one thing, it was no longer a screaming hunger. It was more of a whisper. It was easy to ignore, if I wanted or had to and I had fun ignoring it and seeing what would happen sometimes and not ignoring it and seeing what would happen other times. I was hungry, but I was in control of it and it was okay.

The other difference, I came to realize, is that my hunger was now appropriate. I would feel hunger and my first instinct was to deny it. No, you aren't hungry right now, you just think you are. But, most of the time, I'd check the clock and realize it had been a while since I'd eaten. Or, I'd look at my food log and realize that I hadn't eaten as much as I probably should have so, of course, I was still hungry even though not a lot of time had passed.

I started to understand that hunger is a survival mechanism and something to be trusted. I say "started to" because I'm a year and half out from surgery and I still don't completely trust my hunger.

But I've learned a lot about it. I've learned that sometimes when I'm hungry, I'm really just "hungry". That is to say, I've got heartburn or my stomach is gurgling for some reason or maybe I just saw a trigger food and it's head hunger, not real hunger. I'm getting better at telling the difference between hunger and "hunger", too.

On the other hand, I still don't just eat because I'm hungry. I still argue with myself and I still try to restrict myself to the minimum I can get away with eating and still have energy and not be too miserable, either physically or mentally.

I admit it: I still get that dieter's kick out of denying myself food. It's kind of a badge of honor. I can control my eating and my thin self is the manifestation of my willpower and control.

Luckily, I'm not particularly self-destructive, so I'm not wasting away to nothingness. There's only so much discomfort I'm willing to put up with, which means, if I get uncomfortable enough, I will eat something, even when I feel intellectually that I shouldn't be hungry. Also, if my weight drops below a level I'm comfortable with, I'll do what I have to in order to get it back where it should be.

But what I really want is to be okay with my hunger and have a less complicated relationship with it. I have come to be happy that I have hunger and that's a start. I even feel a bit sorry for people who are still eating because they have to, not because their body tells them to. Or at least I no longer envy them, like I used to.

To get where I want to be, I've been doing some exercises from my The Rules of "Normal" Eating book and looking over the accompanying "50 Tips" document for the tips on Hunger.

They are:

-Check in with yourself often to see how hungry you are using descriptions such as not hungry, moderate, very, famished or a 1-10 scale.

-Every time you think about food, ask yourself if you’re really hungry enough to eat.

These two have been very helpful to me. I remember doing exercises like this when attending classes at Nutri/system and Jenny Craig. It's good advice because a lot of people who struggle with their weight have lost track of their hunger. But back then I had other issues and the exercises couldn't touch them. Now they make more sense.

-Experiment with eating smaller meals more frequently.

I'm not sure exactly what this is supposed to do, but one thing I've been doing is experimenting with the size, type and length between meals and snacks. I've come to realize that "snack" food doesn't really hold me in mid-afternoon. I can only eat so much and 8 baby carrots dipped in hummus is too few calories to last more than an hour. Two ounces of nuts works okay but that's a lot of fat and calories for a small amount of protein.

On the other hand, a second lunch -- which for me is often half a sandwich or 2 oz. of meat with some veggies -- really works well. It's been hard to wrap my mind around having a second lunch at 3:00 pm because I've been conditioned as to what snacks are and that you only have three meals a day, not four. Even if, in the end, it's the same number of calories, in the same ratio of protein, carbs and fat, it just feels wrong. So I'm working on that too.

-Consider your hunger as a signal that you need fuel, not that you have to go out and seek the most fantastic eating experience of your life.

I'm still working on connecting hunger to a need for fuel. I haven't even gotten to worrying about having the "most fantastic eating experience of my life!" But I have gotten fussier about what I eat.  I've always figured that I should enjoy what I eat at least in proportion to how many calories it has. But now that I can't eat a lot at any one time, my standards are higher than they used to be.

So I guess this tip is a warning not to make that big a deal about always picking the perfect food for every hunger pang.

-Practice believing that hunger is for fuel and pleasure, not for meeting emotional needs.

That's another one I can't really relate to as it's stated. As someone who is convinced that the sit-com convention of the pretty girl eating a quart of ice cream when her boyfriend dumps her is something Hollywood gets wrong, just like when explosions make a sound in space in the movies, I have trouble understanding that people do eat to dull their negative emotions.

But, even if I don't connect food with emotions, except maybe happy ones like celebrating, I do have problems in this area.

Mostly, I have trouble wrapping my head around the idea that it's okay to get pleasure from food. I tend to associate getting pleasure from food with gluttony. The idea that you can enjoy your food and that doesn't make you a big pig is a new concept for me and another thing to work on.

So that's where I'm at today. I'm not where I want to be -- last night after I wrote most of this, I had another episode of "I'm hungry, but you can't be. Oh wait, I'm burned 400 more calories than I consumed so I guess I could be hungry after all." But, because I'm not starving all the time, I now believe it is possible to get in touch with my hunger. I suspect I'll never have a 100% healthy and uncomplicated relationship with food, but I now anticipate the day when I can at least pass for normal in this area.
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