Hunger (Revisited)

You can't talk about your relationship with food and weight without addressing hunger, and it's a topic I've broached on more than one occasion in the past. For those who have not seen those posts (or have forgotten them), it's my feeling that humans were meant to deal with a little hunger and that part of modern living is that we've made it so easy to eat anytime, anyplace, and anywhere that we've increasingly lost the ability to tolerate even mild hunger. I feel that there is a "sweet spot" on hunger at which we are uncomfortable but not in actual deep discomfort and that is the time at which we should eat.

I've done hunger conditioning to help extend my ability to endure hunger, and, as I've said before, my goal is to not starve myself until I want to gnaw off an appendage, but simply to put up with feeling hungry for a little while. Ultimately, the goal is to eat when I feel concretely hungry rather than vaguely and mildly so. At best, I can tolerate (grudgingly and with difficulty) a rumbling stomach for a few hours before eating. At worst, I never even get past the "I'm a bit peckish, what's to nosh?" stage. More often than not, I'm landing on the latter and only doing the former when forced by circumstances. I don't see this as a failing, but it is something to keep in mind. The way in which I trained myself to deal with hunger is like a muscle. I haven't flexed it as much recently as I did initially, and it has grown weaker. My hunger tolerance was once stronger than it is now.

One of the things which continues to be a challenge for me is choosing to deal with hunger prophylactically. That is, I don't eat because I'm hungry, but I eat because I anticipate that I will be hungry later during a time when I have no access to food or no ability to eat (such as when I'm working). This relates to fear of hunger as I've written about before and a desire to deal with all stress in the most expeditious manner.

The discomfort for me as a lifelong fat person is acute when I feel hungry. To some extent, that has changed, but I still don't bear it as well as someone like my husband who has been thin or only moderately overweight for most of his life. He can delay his responses because the pain he suffers is less because his biochemical processes aren't screaming as loudly at him to eat. Despite weighing in the 170's-180's now, I'm hardly having skinny person reactions to food. I still have a fat person's response though not as strongly as I once did. I don't get headaches anymore or feel as weak as I did initially when hungry. I also don't have the same energy crashes, but my stomach still sends potent "pain" signals.

The reason I'm revisiting this topic isn't that I have been allowing my hunger tolerance to atrophy (though I have, to a small extent, and I feel it sometimes at work between lunch and dinner). I'm talking about it again because of a study I read about which suggests that there may be health benefits in eating only when hungry. This study, at least to me, also suggests that modern lifestyles with ready access to food may be a large contributor to insulin resistance and Type 2 diabetes. If waiting to eat until hungry improves blood glucose numbers, then perhaps a lifelong ability to eat before one has actually become hungry is a piece of the higher incidence of diabetes puzzle.

I want to restate, quite emphatically, because so often people misinterpret the words of others, that I'm in no way advocating waiting until one is famished to eat. I do believe that waiting until one is feeling the actual discomfort of hunger is not a bad idea. Frankly, I think that waiting until you are ravaged by hunger to eat is an invitation to binge eat. Even now, I struggle when I come home from work and am very, very hungry (due to unavoidable delays based on a schedule I have zero input into) not to eat and eat and eat. It seems to take longer to gain satiety when I'm super hungry than when I'm modestly so. However, I do think that a little hunger is good, and the aforementioned study might go a tiny distance toward supporting that on a scientific level. I'm going to go back to making efforts to "stretch" my hunger tolerance, not just because of this study, but simply because I know it can be done and that it'll make my situation at work easier in the long run.

Scientific evidence that life isn't fair

There is a fascinating BBC documentary about weight and the ways in which we are not all treated equally when it comes to maintaining, losing and gaining weight. The full documentary can be viewed here and I strongly recommend watching it. It is in 10-minute segments. Each subsequent segment will automatically load at the end of the previous one.

The studies conducted and discussed in the documentary validate a lot of the notions that overweight people have about the difficulties they face and the fact that there are people who are "naturally thin" who do not face those difficulties and are either genetically gifted or lack genetic handicaps when it comes to weight. Here are some of the conclusions one can make based on the results of the studies:

• Some people can eat a tremendous amount of food and not gain weight commensurate with the number of calories consumed.
• It is physiologically impossible for some people to become obese regardless of how much they eat. 
• Fat children will gain weight much more easily as adults than children who were thin. Regardless of their lifestyle habits as adults, they will always put on weight more readily than people who enter adulthood thin. 
• The tendency to continue to eat attractive foods despite being full manifests in young childhood indicating that self-control is a matter of early disposition than an exercise of conscious will.
• Some people can eat a tremendous amount of food and gain muscle instead of fat even though they are not exercising.
• There is a genetic marker for people who are likely to gain weight because they are not signaled to stop eating when their stomachs are full.
• Some people do not have to "exercise willpower" to stop them from eating appealing food. Their bodies signal them such that they have absolutely no inclination to eat once they are sated regardless of the food options.
• It is difficult to escape your body's high "set point" for weight unless you are willing to live in a constant state of hunger.
• Naturally thin people sometimes experience a metabolic boost even when sedentary which helps them maintain their weight without increased activity or later adjustments to diet.
• There may be an actual viral component to the "obesity epidemic" that explains why more people are fatter than ever before.

I found this documentary immensely valuable because it lays to rest a lot of the questions about "blame" and weight. Essentially, the thin arguing that the fat need to exercise "willpower" looks a bit more absurd after seeing these studies. Essentially, people who are effortlessly thin are asserting that we should have to do something that they themselves rarely or never have to do. They may assume they have "willpower", but the truth is that their mettle in regards to food is not being tested. It is essentially someone in a sports car zooming up to the top of the hill and berating us for not being able to get to the top of that same hill on foot while pushing a huge boulder. It's easy for them, but they seem not to consider that it's far harder for us and neither their ease nor our difficulty is under conscious control.

Seeing this documentary did not do anything to dissuade me from the choices I'm currently making, nor does it inspire a sense of hopelessness in me. Indeed, it makes the challenges clearer and the path I have to pursue easier to visualize. The difficulties I have encountered are in line with the study results, and knowing the fact that my difficulties are unique to overweight people (rather than something that thin people overcome and fat people fail at) increases my patience and tolerance of any perceived "failure". In essence, I think that knowing the hurdles improves the chances of coming up with coping strategies to get over them rather than making the "race" appear impossible to complete.

I'm also mindful of the short-term nature of the studies and am still left pondering whether or not one can slowly curb natural biological tendencies in the long run. It is still my hope that I can "re-program" my body to adapt to a lower weight and reset it's weight set point in the very long term. That is not to say that I ever expect to be skinny or very thin, but I do hope to force my body to adapt to a comfortable, healthy, lower weight than it may naturally gravitate toward. I also have a reinforced desire to use psychological conditioning methods in order to cope with the challenges of being what I now conclude is the tendency to be naturally overweight.

Stand Up

There have been a few interesting articles recently about weight loss and standing vs. sitting. The articles claim that you will burn up to 60 calories more per hour if you stand rather than sit and that it is desk work and computers that are making us overweight rather than what we eat.

Frankly, though I'd like to be encouraged by this, I'm skeptical and believe this is another in a long line of studies advocating that we wouldn't be fat with small changes in our lifestyle. The main reason I'm doubtful is that there are a lot of waitresses and nurses who are overweight, and they are in jobs where they do nothing but stand most of the day.

On a personal level, I also doubt this because I am not a "sitter". I have a lot of problems sitting for long periods of time and often get up and walk around to do things while working. I rarely sit for a long time in front of the computer screen or television. Certainly I don't sit for more than 40 minutes at a time without getting up and doing something else. Yet, I still manage to be pretty damn fat.

I think part of the issue which is not being thoroughly explained or discussed in recent studies is the fact that people rarely just stand. It is likely that those who burn 60 calories more per hour are moving around as well. I'll grant that standing almost certainly burns more calories that sitting (because holding yourself upright requires more muscle control), but I think there is more to this than the current studies claim. Chances are this is yet another example of oversimplification of the test parameters in order to make the variables measurable and have scientific validity, while having little in the way of real life applicability.

The bottom line though is that I don't think that the main issue that we should be dealing with is how to not sit all day because I see that as unavoidable in the modern world, but rather at what level we need to eat and exercise to compensate for the fact that our lives are so much more sedentary now. I think if employers are to play a role in making America healthier, we also have to consider the fact that they often want office workers essentially chained to the desk as much as possible and even count things like trips to the bathroom when the better thing to do would be to give people little exercise breaks every few hours so that they could walk around or stretch.

Of course, people are always looking for simple solutions, and I'm guessing this one might spawn a bunch of offices without chairs and with standing desks. I've noticed that most data is used to make workers more uncomfortable rather than to employ a more complex, but possibly successful solution (like company-sponsored gyms or movement breaks during the day).

Exercise, Good or Bad

Lately, there has been a lot of conflicting information about exercise and weight loss and control. For a few years, word was that walking for a half hour a day was good enough for you. Now, we're reading that it's not enough to actually lose weight, but it is good for your heart. Additionally, I've been reading lately that exercise simply is not useful at all when you want to lose weight because people who exercise just end up eating more.

The results of these studies are not only disheartening, but misleading. One of the problems with all surveys, studies, and tests is that they take a complex problem and oversimplify it so that they can get scientifically valid results. That is, they look at a limited number of factors and tend to watch behavior only over the short term (less than 2 years, in many cases). What is more, most researchers have a hypothesis before constructing their study and either consciously or unconsciously create conditions that will validate their theories.

If you scrutinize the information that is coming out carefully, you'll see that the interpretation is always spelled out in a particular way. One of the studies noted that certain types of exercise increased muscle mass and muscle burned about 40 more calories per day than fat and all it would take to mitigate any of the gains from having more muscle would be to eat one pat of butter more per day. While this is certainly so, the interpretation completely ignores the fact that you are burning more calories for the duration of the exercise (often around 100 calories or more) and that you are almost certainly suppressing your appetite for the time after exercising and possibly boosting your overall metabolism. In other words, exercising daily, even modestly, has the potential to burn around 150 calories a day or more from combined effects of aerobic activity and increased muscle mass. Even if you eat at a maintenance level (around 2000 calories for an average person), daily exercise should help you lose around a pound a month (possibly more).

Why do the study results focus only on increased muscle mass and calories burned at rest? Why do they assume that anyone who is trying to lose weight would simply decide to eat more just because their exercising happened to work up an appetite? My personal exercise habit is to get the exercise in a few hours after a meal and then rest and pretty much recover from the appetite suppression effects in about the right time for lunch or a planned snack. I don't eat more because I exercise even if I want to, and honestly, I don't find myself being greatly hungrier than usual because I exercise. I'm hungry and fighting it all of the time anyway so there's really not much of a difference.

I have to wonder what motivates this sort of reporting. Is it simply that the winds of information have been blowing one way for awhile so there's nothing new to say and they figure they might as well have them blow another way for a bit? Is it that they see the obesity problem getting worse so they assume they must create a reason?

I don't know why such discouraging news is being reported, and I do know that weight loss is actually more complex than "eat less, exercise more", but I do know that eating less and exercising more will eventually work for most people if they can hold the line against their biological and psychological impulses (which is no small task). My guess is that these studies are likely pointing to the fact that it is much harder to do these things than expected and that people who try to exercise to lose weight end up eating more without realizing it or believe their exercise is burning more calories so they can justify a little indulgence.

The answer would seem to be not to say that exercise doesn't help people lose weight, but rather to educate people about the effects such that they are more cautious about how much they are eating. Essentially, people need to know that exercise when you want to reduce your weight doesn't buy you much of anything in terms of being able to eat more.