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Do you feel that fullness is difficult to interpret?
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Do you feel full all the time?
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Do you ever feel hungry even after eating?
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Do you get full early on in a meal?
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Have you ever felt full but not satisfied with a meal?
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Do you ever feel a need to keep eating past comfortable fullness?
If you answered yes to any of the questions above, you are in the right place. When speaking with many of my clients, I often hear how scary fullness is for them. I believe that this is related to not fully understanding fullness, difficulty in sensing fullness cues, and the negative beliefs about fullness our diet culture perpetuates. Today I’m talking all about fullness and hope to answer some of your questions!
The Hunger and Fullness Connection
Oftentimes, people think of hunger and fullness as a light switch. When hunger is “on” then fullness must be “off” or vice versa. However, it is more biologically accurate to think of hunger and fullness on a scale, like on the one pictured here.
This scale helps us understand two things.
First, the scale tells us that our biological hunger and fullness cues emerge over time as opposed to all of a sudden (more on this later). When we can tune into our body states, we are able to become more perceptive to these shifts happening over time and then respond appropriately.
Second, this scale helps my clients understand their hunger and fullness patterns. The scale gives us a way to quantify their hunger and fullness, which allows for us to evaluate trends that repeat over time. For instance, I may have a client note that when they show up to a meal as a “1 or 2” that they tend to finish a meal as a “9 or 10.”
What is Physical Fullness?
Physical fullness is a body cue that happens when there is a presence of food in the stomach and intestines. This is coordinated through a series of chemical reactions in the body that start digesting food and allow your body’s blood sugar to rise back to normal limits.
More simply, if we think about our body as a car our hunger cue is the equivalent to our “low fuel” light coming on. Our fullness cue is when we fill the tank back up – the alarm bell goes away and our car is happy. This simple car metaphor is the most intuitive relationship we can have with our body’s cues -- fill up when we are hungry to the point that we are satisfied and have enough fuel for the rest of our journey. However, our diet culture complicates this relationship by encouraging people to “trick” their fullness making it all the more challenging for us to trust our body’s messages.
Well, maybe I could trust my body’s fullness cues if I just understood what was causing them.
It’s true. Fullness is a complex body signal. There are several “messengers” that coordinate what we call the “fullness cue”. Some of these “messengers” include:
Insulin
Leptin
Amylin
Cholecystokinin (CCK)
Corticotropin Releasing Factor (CRF)
Dopamine
Glucose-Dependent Insulinotropic Polypeptide (GIP)
Oxyntomodulin (OXM)
Pancreatic Polypeptide (PP)
Peptide YY (PYY)
To keep things brief, I won’t go through each of these hormones, but I do think it’s important to know the mechanisms behind the scenes of fullness.
Suppress Appetite – As you start eating, messengers are released that work to make you feel less hungry. Therefore, you may feel neutral (5/10 on the hunger fullness scale) in the middle of a meal.
Slowed Gastric Emptying – When you eat, you chew food first to create a “bolus”. This bolus is what travels through your gastrointestinal (GI) tract. Delayed gastric emptying is a fancy term that means the “messengers” are pausing the bolus in the stomach instead of letting it continue on its journey to the small intestines.
Abdominal Distension – Because the bolus is paused in the stomach due to slowed gastric emptying action, you may experience abdominal distension towards the end of the meal. This can be an alarming symptom for some people, but it’s important to know that this is an important fullness cue. The distension sends a message back to the brain about the level of fullness.
Insulin Release – As digestion begins in the small intestine, “messengers” will stimulate insulin release to increase glucose uptake after eating a meal/snack that contains carbohydrates. This helps manage blood sugar and triggers feelings of fullness.
Stimulate satisfaction and satiety – After a meal, “messengers” from the brain will be released that reward the eating behavior and help us feel satisfied with our eating experience.
Why Can’t I Accurately Feel My Fullness?
There are many reasons why someone may have difficulty with feeling their fullness accurately. If you are not used to purposefully listening to your body’s cues, then it will take some time to practice attunement to what your fullness cues feel like. Physical fullness cues take on many forms, including:
Stomach cues: Abdominal distension, Full feeling in stomach, Nausea
Mind/Head cues: Reduced desire to eat, Food doesn’t taste as good, Experience decreased satisfaction after reaching a level of satisfaction
Change in Mood: Content, Satisfied, Relaxed, etc
Energy: Reenergized, Drowsy, etc
Others
Attunement disrupters (discussed in this post) may be making it more challenging to listen to your body’s cues. This is especially true for those who are healing from a diet, disordered eating or an eating disorder as hunger and fullness cues are significantly impacted.
If you find that you eat while multitasking or eat in a hurried manner, you may have a harder time with accurately identifying your most comfortable fullness as it takes time and attention to notice the emergence of comfortable fullness.
Finally, preconceived negative thoughts about food or fullness make it challenging for us to accurately assess our fullness. If you grew up in a family that enforced a “clean plate” approach to finishing meals that makes it likely that may give you permission to go on autopilot during a meal. Negative thoughts may lead to undereating to a point that we are not satisfied with our eating experience or may lead to eating past comfortable fullness to the point of painfully full.
It is most helpful to work through these barriers with a trained professional.
What can I do to relearn my fullness cues?
There are many steps that you can take to relearn your fullness cues.
Eat consistent meals and snacks throughout the day that include multiple food groups. Multiple good groups help with feelings of fullness and satisfaction.
Create a pleasant eating environment by finding a place to sit for your meal. Add ambience to add an extra layer of satisfaction.
Work through negative thoughts about food and fullness.
Identify attunement disrupters and work to replace them with positive self-care behaviors.
Eliminate distractions as able. If taking away distractions makes it challenging for you to eat an adequate amount of food, re-incorporate distractions until you are able to make peace with food.
Summary
Relearning fullness is a critical step for intuitive eating. While restoring fullness cues can take time, your role is to consistently eat meals and snacks and explore your hunger and fullness roadmap. When you feel your fullness cues respond with kindness to allow your cues to normalize over time.
If you’re finding you need more help in challenging the Food Police, please contact me for individual nutrition counseling.
Resources:
Intuitive Eating: A Revolutionary Program That Works
Intuitive Eating Workbook: 10 Principles for Nourishing a Healthy Relationship with Food
Today's Dietitian. Appetite Hormones: https://www.todaysdietitian.com/newarchives/070115p26.shtml