Hunger and Fullness Scale: What Is It and Why Dizziness or Fatigue Might Be Your Only Sign of Hunger

Your body has a built-in fuel gauge so to speak. Everyone has this hunger and fullness scale when they are born. Think of a toddler, somedays they just pick at their food and other days they eat so much you wonder where it all goes. Those days they are likely going through a growth spurt, their hunger is increased as their body prepares to do the exhausting work of growing. The toddler doesn’t care or even know that eating more or less is cause for concern. In most cases, they eat or don’t eat because they are either hungry or they are not. Simple.

As we grow up we hear messages that convey what we are “supposed to” look like. These messages directly impact how we eat. We LEARN to hate our bodies; we are not born disliking aspects of ourselves. Over the years we internalize these messages. They may come from our family, like a mother that criticizes her own body not realizing that her daughter is learning to talk to her own body the same way. Or they may come from media, friends, culture, etc. Check out this post for more information about raising kids that have a healthy relationship with their bodies.

The point is they are everywhere and hating our bodies makes us susceptible to the allure of diets and how just losing X amount of weight brings happiness, acceptance, or success. We typically learn an oversimplified lesson that calories in > calories burned equals weight gain and being overweight is bad.

What research shows about diets:

• Long-term follow-up studies document that the majority of individuals regain virtually all of the weight that was lost during treatment and there was little evidence to support the notion that dieting results in significant health improvements.
• Participants in weight loss programs lost approximately 10% of their weight within a year but one third to two-thirds of the weight is regained the following year and almost all is regained within 5 years.
• Dieting has been shown to reduce bone mass and increase the risk of osteoporosis.
• Evidence from the eating disorder literature indicates an emphasis on weight control can promote eating disordered behaviors, body dissatisfaction, and low self-esteem.
• Dieting is a strong predictor of future weight gain.
• Dieting contributes to body dissatisfaction, food and body preoccupation, food cravings, a distraction from other personal health goals, reduced self-esteem, and weight stigmatization and discrimination.

Unfortunately, many fall for the dieting trap and for some it can develop into an eating disorder. (It is important to note that pressures to have a certain body and dieting are not the only reason an eating disorder develops; trauma, genetics, alterations in brain chemistry can all play a part). Concerned someone you know has an eating disorder, read more about what signs to look for.

This brings us back to that built-in fuel gauge. After chronic dieting or developing an eating disorder hearing and trusting our body cues is difficult, if not impossible.

Why ‘hearing’ the biological cues of hunger and fullness are difficult:

• Dieting is asking us to do the opposite of listening to our body’s cues over and over again and erodes trust that we can eat an appropriate amount.
• Under-fueling and chronic malnutrition slows down digestion. Our gastrointestinal system is a complex system between mind and body and part of it relies on smooth muscles to move food through our system, this process is called peristalsis. Like other muscles the less you use it, the weaker it becomes and can cause early satiety and prolonged fullness.
• Binge eating makes it hard to recognize ‘gentle fullness’.
• Neuro-chemical cues caused by stress and anxiety about eating may blunt hunger or cause nausea.
• Others may be disconnected from their body as a whole, possibly due to trauma.

For these reasons, Intuitive Eating is not always appropriate. Recalibrating your fuel gauge at this point is necessary. For some, including those with an eating disorder, a structured meal plan is crucial. You might be thinking this is the opposite of Intuitive Eating- you’re right, following a plan that tells you when and what to eat is but it is necessary at this point. Evelyn Tribole, MS, RD, one of the authors of Intuitive Eating, uses the analogy of a cast on a broken arm. The cast provides structure and is temporary support until the bone is strong enough. Similarly, a meal plan provides structure and support while the body heals.

During this period of nutrition rehabilitation, a structured meal plan is a necessary form of self-care regardless of the absence of hunger or the presence of early fullness. It can be represented by this formula:

Meal timing + fuel balance + repetition = rediscovering hunger and fullness

Meal Timing

When someone has lost their hunger and fullness cues consistent fuel is necessary for a few reasons.

• Helps your brain heal. The brain uses glucose as its primary fuel and getting enough of it helps with mental clarity.
• Stabilizes metabolism. Consuming too few calories reduces metabolism, bodies go into ‘cave person mode’ to reduce how many calories are burned until the next time food is available.
• Sustains energy. Increasing intake creates energy stores to pull from if needed and regular intakes provide continuous nutrition of macro and micronutrients that the body cannot store.
• Clarifies thoughts. The ‘cave person brain’ responds to starvation by becoming more vigilant and anxious.
• Eating regularly helps foster body rhythms, which include hormonal patterns that help the body gear up for digestion.
• Meal timing helps establish a habit of self-care in the form of nourishment.

Fuel Balance

Balanced food choices are also important in rediscovering hunger and fullness. A balanced meal consists of a mix of carbohydrates, fats, and proteins from all different food groups as tolerated. This honors your physical needs for nourishment and pleasure. This may require adding back in foods that were previously eliminated because of falsely founded food and nutrition beliefs.

This is when a dietitian play a key role to decipher what nutrition messages are true and what messages are perpetuated by fatphobia. For example, dairy may have been eliminated from the diet. Questions that need to be answered are why was dairy eliminated and when (was it before or after some disordered eating patterns came up)? There are valid reasons for eliminating some dairy like lactose intolerance but a dietitian will also evaluate intakes to see if calcium or vitamin D needs to be supplemented and how some forms of dairy can still be enjoyed.

Repetition

With continued meals and snacks gentle hunger and fullness cues begin to reemerge. The challenge now lies in honoring those hunger and fullness cues and deciphering some of the nuances of hunger, like physical vs emotional hunger.

What is important to remember during this phase is self-compassion. You are relearning something that is innate but through no fault of your own, you have forgotten how to do. Let’s use the broken arm analogy again. After the cast is off some rehabilitation is required to get strength and functionality back. You wouldn’t be able to go lift weights right away, it takes time to build up to that. Stay curious during this period. Unlike retraining your arm, judgments and fears may arise with hunger and fullness reemerging. Don’t ignore those thoughts, ask yourself what is coming up for you at that time.

Hunger and Fullness Scale

Reconnecting through nutrition rehabilitation may be the first step for some on a path of rediscovering hunger and fullness cues, depending on what their starting point is. A dietitian that is familiar with eating disorders, chronic dieting, and Intuitive Eating can help determine this.

Developing a hunger fullness scale can help fine-tune what the new cues mean and when to honor them. The longer you wait to nourish your body the more intense those feelings are. Previously maybe you noticed you were dizzy or fatigued before it even registered that it was hunger or lack of food, now you may experience it as a gentle gnawing in your stomach.

A helpful way to get in touch with hunger nuances is creating a scale from 0 to 10, where 0 is painful hunger and 10 is painful fullness.

0- Painfully hunger. Dizzy or nauseous.

1- Ravenous and irritable. Anxious to eat.

2- Very hungry. Needing energy.

3- Hungry and ready to eat, stomach feels empty.

4- Subtly hungry, slightly empty.

5- Neutral. Neither hungry nor full.

6- Beginning to feel emerging fullness.

7- Comfortable fullness. You feel satisfied and don’t need to eat anymore.

8- Uncomfortably full.

9- Very full, physically uncomfortable and bloated.

10- Painfully full, stuffed. You may feel nauseous.

Inserting your own language and experience in the descriptions can be helpful. It can also be helpful to reflect on what levels you experience daily and how that affects your intakes and feelings when eating. As explained, this hunger and fullness scale is just one helpful part of Intuitive Eating and lays the foundation for further alignment between thoughts, feelings, and physiology.