Hunger is not the only physiological signal managing our food intake. There are several factors that decide when it is time to eat and when it is time to stop eating. As recovering morbidly obese people it is important to try and understand the signals our body sends in order to lose weight and not become morbidly obese again. After all, ignoring the signals contributed to our obesity in the first place.
The following definitions are from Understanding Nutrition (10th Editon) by Ellie Whitney and Sharon Rady Rolfes, pages 252-256:
Hunger: the painful sensation caused by a lack of food that initiates food-seeking behavior.
Hypothalamus (high-po-THAL-ah-mus): a brain center that controls activities such as maintenance of water balance, regulation of body temperature, and control of appetite.
Appetite: the integrated response to the sight, smell, thought, or taste of food that initiates or delays eating.
Satiation (say-she-AY-shun): the feeling of satisfaction and fullness that occurs during a meal and halts eating. Satiation determines how much food is consumed during a meal.
Satiety (sah-TIE-eh-tee): the feeling of satisfaction that occurs after a meal and inhibits eating until the next meal. Satiety determines how much time passes between meals.
There are three types of influences that trigger hunger. The most reliable are the physiological influences such as an empty stomach, gastric contractions, and the absence of nutrients in the small intestine, GI hormones and endorphins. Sensory influences such as the thought, sight, smell and taste of food will trigger hunger. And finally, perhaps the influence we know best, cognitive. That is the presence of others, special occasions, perception of hunger (head hunger), the time of day or the presence of food or free food. In other words, external cues.
But as we all know, there are mental and external cues that can lead to hunger, appetite and even satiety. According to Understanding Nutrition, “Eating can be triggered by signals other than hunger, even when the body does not need food. Some people experience food cravings when they are bored or anxious. In fact, they may eat in response to any kind of stress, negative or positive. These cognitive influences can easily lead to weight gain.”
As we go forward with our post-surgical weight loss living it is important to pay attention to the feelings of satiation and satiety as much as we pay attention to hunger and appetite. The small stomach works well (when used correctly) to signal a feeling of satiation and indicate it is time to stop eating. This leads to satiety, which is like a pink sticky note that reminds us to not start eating again.
Develop a new awareness and listen to your body. Finally, just as hunger is not an emergency, it is also not a failure. If you feel hunger during the 5 Day Pouch Test then take one of the steps above to ignore it. And if you are still hungry then eat something from the approved list of foods for the day. Associating hunger with feelings of failure often leads to destructive eating and inappropriate food choices. The 5DPT is a powerful tool and a great step toward building a better relationship with food and your weight loss surgery.