As I discussed in my most recent post, Principles of Intuitive Eating: Reject the Diet Mentality, we live in a culture that promotes dieting and disordered eating. If you missed out on this post, I strongly suggest going back and reading it before digging into this principle of IE! The diet mentality discourages us from tapping into our instincts + eating when we are hungry. If we aren’t intentionally rejecting the diet mentality, something as simple as honoring our hunger, can become extremely complicated.
Founders of Intuitive Eating, Evelyn Tribole and Elyse Resch accurately state, “A dieting body is a starving body.”¹
Starving bodies often either (1) experience extreme hunger, which drives them to overeat or binge-eat, and/or (2) they begin to lose touch with their hunger and satiety cues altogether. Many individuals who diet or have a history of disordered eating experience both of these symptoms.
One of the most compelling illustrations of the effects of restrictive dieting and weight loss on human behavior is The Minnesota Starvation Study.
During World War II, Dr. Ancel Keys conducted a study on the physiological and psychological effects of starvation at The University of Minnesota. The objective of this study was to learn more about how to re-feed starving bodies, specifically those who suffered from war-time hunger and famine.
The study consisted of 36 men who were conscientious objectors of the war. These men were some of the most physically AND psychologically healthy men to be found….. No pre-existing anxiety or depression. No high blood pressure or insulin resistance. Nothing. These men were the “perfect” picture of physical and psychological health.
So what were these men asked to do? How did Ancel Keys study starvation in men who were seemingly healthy?
He severely slashed their caloric intake and took away their food. In essence, Ancel Keys induced semi-starvation in all 36 participants. During the first 3 months of the study, Keys allowed the participants to eat as they normally would, with no calorie or food restrictions on the table.¹ The group average was well over ~3,000 calories per day.
In the next 6 months of the study, aka the semi-starvation period, the participants’ calories were approximately cut in half, averaging just over ~1,500 calories per day.²
As a part of the experiment, the men were required to lose ~25% of their former weight.²
Following the 6 months of semi-starvation and weight loss, there was a 3 month period of nutrition rehabilitation, where the participants were gradually refed. 4 of the men were withdrawn either during or at the end of the semi starvation phase, leaving 32 men left to study during this phase.
The results of the study are eye-opening at best, and alarming at worst, as they are eerily similar to the symptoms of chronic dieters and individuals with restrictive eating disorders. As a whole, the men experienced severe physical, psychological, and social consequences as a result of calorie restriction. In many cases, these consequences persisted beyond the nutrition rehabilitation phase (much like those who are recovering from eating disorders/disordered eating).
Here are the results of the study:1,2
-Participants experienced a drastic increase in their preoccupation with food. Many of the men found it difficult to concentrate in their usual activities of daily living because of intrusive thoughts related to food and eating.
-The basil metabolic rate of each participant, on average, decreased ~40%. Heart rate, body temperature, and respiration rate also decreased. During the refeeding process, participant’s metabolisms sped back up, with those consuming the most calories returning to the highest metabolisms.
-Food became a prime topic of conversation, along with reading, and daydreaming about food. Cookbooks and menus became of increasing interest to many of the men who previously had no interest in those things. 3 of the men actually became chefs!
-Participants ranged from taking an abnormally long time to consume meals (>2 hours), to ravenously consuming meals within a few minutes.
-Several of the men reported binge-eating episodes, followed by self-loathing, disgust, and severe emotional upset.
-The group found it most difficult to stop eating on the weekends, with their daily caloric intake almost tripping from their pre-diet totals.
-One man began eating out of a trash can, as if he was unsure if/when he would have safe access to food. Another stole penny candy and broke down at a grocery store, consuming several cookies, a sack of popcorn, and two bananas.
-Physical changes included gastrointestinal distress, decreased need for sleep, dizziness, headaches, hypersensitivity to light and noise, reduced strength, hair loss, and cold intolerance.
-Almost 20% of participants exhibited a sharp decline in psychological functioning. Depression, mood swings, irritability, apathy, and anger outburst were common post-starvation. One man reported that he had “never been more depressed in his entire life”.
-Although previously outgoing and lively, most of the participants became withdrawn and isolated.
-Sex drive was drastically reduced in participants. Many of the men found it hard to date, reporting that it took too much effort to hold another woman’s hand.
-Many of the men reported severe hunger, even after large meals. Many of the men reports feelings of nausea, some reported vomiting. There were multiple reports of eating until feeling uncomfortably full, yet also feeling hungry. Hunger was insatiable for many of the men for months after regular access to food was granted.
-After ~5-8 months of refeeding, the majority of the men reported some level of normal eating patterns and the return of regular hunger and fullness cues. However, some continued to experience extreme hunger. One study participant went on to consume ~25% more than he did pre-starvation, and when he tried to reduce this amount, he reported that he became so hungry he could not stand it. It’s almost as if his body was saying, “Heck no, we aren’t doing this restriction thing again.”
What can we learn from the Minnesota Starvation Study?
Not honoring your hunger has very serious consequences.
It makes so much sense if you feel totally disconnected from your hunger and fullness cues + a little crazy around food if you’ve been restricting it. It may feel like you can’t trust your body, like you can’t trust yourself. Learning to honor your hunger is a crucial building block in re-esablishing trust with your body.
The first step to honoring your hunger is to start listening for it. Any or all of these symptoms can indicate that a person is experiencing hunger:¹
-Gnawing in the stomach
-Uncomfortable stomach pain
-Weakness / Fatigue
But what if you don’t experience any of these things? Or, what if you feel so bogged down by external rules and regulations that you constantly feel hungry and never truly satisfied?
Great question. When a person is disconnected w/hunger and fullness cues, it can be extremely helpful stick with a more structured routine until the hunger and fullness cues come back.
When my clients have a history of chronic dieting or disordered eating, as a general rule of thumb, I recommend eating every 3-5 hours, with 3 well-rounded meals (includes protein, fat, carbohydrates, fruit or veggie, and dairy/calcium source) and at least 2 snacks per day, with each snack having at least 2-3 different food groups in it.
This loose guide should be the bare minimum of what you’re getting in each day.
If you’re still hungry while following this guide that’s okay. Reminder, it’s the minimum! What I provided above is super simplistic and doesn’t go into much detail in terms of portion sizes, etc for a reason. It’s too difficult to provide a recommendation for what every single person reading this post bc everyone’s individual needs are different based on age, gender, activity level, etc. If you’re confused on what you should be eating + how much you should be eating, I strongly suggest working with a HAES dietitian who has experience with disordered eating / eating disorders to give you a more individualized meal plan.
Incorporating some routine and structure into your day can help a lot if you’re trying to better connect with your hunger and fullness cues. It’s also lot easier to listen to your cues when you aren’t ravenously hunger approaching a meal.
Once you’re at the point where you are able to recognize your hunger cues, you have to start responding to them. For many people, this can be the toughest part. We’ve been taught that our appetites and hunger are something to fear, something to be ashamed of, rather than an important component of our humanity.
When we are thirsty, we drink. When have to empty our bladder, we use the restroom. When we are tired, we sleep. Why is hunger any different?
But we’ve been conditioned to believe that, and it takes time and practice to unlearn those messages.
It can be so scary to start honoring your hunger. I totally get it…AND, I believe you can do it.
You’ve got this.
Cheers to honoring your hunger today!
P.S. The journey to recovering from disordered eating, chronic dieting, or an eating disorder can be extremely difficult and lonely! I would encourage you to enlist support from family, friends, online peers, and mental health professionals if you are able to do so.
Ready to start your intuitive eating journey? Check out these fabulous resources:
- Tribole E, Resch E. Principle 2: Honor Your Hunger. In: Intuitive Eating: A Revolutionary Program That Works. New York, NY: St. Martin’s Press; 2012:59-73.
- Garner D. The Effects of Starvation on Behavior: Implications for Dieting and Eating Disorders. Healthy Weight Journal. 1998:68-72.