The other side of hunger cues: fullness cues
So my treatment team talks a lot about hunger cues and when the return and what they mean. I’m not saying I never had trouble with hunger cues because I did. But hunger cues aren’t the only game in town. Fullness cues are the flip side of hunger cues, and the generally receive the short stick. They were also something I found far more difficult to manage than hunger cues.
One of the most common myths about eating disorders is that people with EDs don’t feel hungry. It’s not hard to believe, especially when one of the most frequent phrases I uttered while ill was “No thanks, I’m not hungry.” And I said it All. The. Time. Another fun fact about EDs is that many sufferers also report early feelings of fullness.
Given these experiences, along with brain imaging studies that suggest there is a neural basis for these feelings, it’s not surprising that many ED sufferers have a pretty serious disconnect with hunger and fullness. I was one of them.
Interestingly, my hunger cues came back relatively soon. Now, it’s true that I wasn’t able to respond to them for a really long time, but I started to actually feel hunger at least marginally normally fairly quickly. I might not have felt as hungry as others might have in my situation, and I very rarely actually did anything productive about what hunger I might have felt, but the hunger was, in fact, there.
Fullness was a different beast. I had those early feelings of satiety for a long time. Actually, I still have them somewhat. Part of my problem was that I figured that not actively feeling I was going to immediately starve meant that I was full. At least, that’s how I interpreted it. So I would eat a little bit of a meal or snack and feel full. Of course, I wasn’t actually full, I just got confused and thought that I was full.
Even thoughts of fullness, however, triggered extreme anxiety. So I stopped eating. Then I’d get frustrated when the little niggling hunger cues started to return an hour or so later. It made so sense. My mind immediately went to the place of “OMG I’m such a pig!” I wasn’t trying to undereat, but I would feel insanely full.
As time progressed, it wasn’t that I was eating ridiculously small amounts and being full as I was when I was actively ill or new in recovery. They were almost normal amounts. They didn’t look tiny or freakish. I looked like a light eater. I looked a lot like your standard dieting female, even though I wasn’t actively trying to alter my weight, shape, or appearance. But not long after I finished eating (certainly not long enough for the next eating time to be at hand), I would start to get hungry or antsy.
The problem was this: I felt like I was eating enough. In fact, I would have sworn up and down that I was eating enough. In the moment, it felt that way. But in the long run, I wasn’t.
This led to the really difficult bit of pushing myself to eat more and stick more closely to a meal plan (you eyeball it, you plate it, you eat it, regardless of how hungry or full you may be feeling. Seconds were always allowed, but what was on my plate was the absolute minimum I needed to eat) to get more used to how I should generally be expecting to feel after a meal. I still often feel overly full after eating. But since my weight is stable and my hunger feelings go away for longer, I know that I’m not eating too much. I do have to frequently talk myself down off the ledge, but I can do it.
I know intuitive eating is seen as the gold standard of ED recovery, but there are a lot of us who just can’t quite make it work. If I were left to my own devices, I would probably undereat. Not intentionally, but I probably would. I have to eat fairly mechanically and rigidly in order to stay well. I’m not saying that I eat the exact same things every day or measure my intake down to the grain of rice–not at all. But I have number of meal and snack options that I know work well for me, and I stick pretty closely to those. I can be flexible when I need to be, but I’m a creature of habit as well.
There might not be an answer to this. Still, there’s much less emphasis (at least as far as I’ve seen) about noticing and responding to fullness cues vs. hunger cues, and I think they’re just as important and can just as easily be mucked up by an eating disorder.
Tell me: what sort of practical workarounds have you found to problems with hunger/fullness cues? Share your thoughts in the comments.