From Mechanical to Intuitive Eating: Hunger Cues
A couple of weeks ago, I wrote about Mechanical Eating in Eating Disorder Recovery, which is a vital and foundational stage of nutrition for eating disorder recovery where you:
establish a regular pattern of eating
learn to show up to balanced plates and consume adequate serving sizes at each meal and snack
and consume your meals and snacks at regular and planned intervals of time
In the big picture, once physical stability and a certain amount of recovery has been acquired, the goal for many is to begin to work gently on eating more intuitively, which begins with getting familiar with your body and its cues.
This exploration and reconnection is so important, as, when you have an eating disorder, you become very disconnected from your body’s hunger and fullness cues, as well as what your body is asking for and why. As such, you will need to learn to get out of your head and back into your body as part of the recovery process, in the later stages of the work.
One of my favorite tools for this is The Hunger Scale.
The Hunger Scale:
What is the hunger scale?
The hunger scale is a scale from 1-10, highlighting the various stages of hunger and fullness, with simple explanations to help connect you to what they may feel like. The extremes of starving and stuffed are at either end of the scale and these are usually what people are most familiar with as the sensations are the loudest. As you move to the middle of the scale you, will find the more subtle hunger and fullness cues that you can become disconnected from and have trouble noticing when you have an eating disorder or are in eating disorder recovery.
It is a tool to help bring awareness and connection to your hunger and fullness cues and begin to identify when it is time to eat and when you have had enough, which is a foundational skill to becoming a more intuitive eater (to honor your body and its cues).
This is completely different from the “should” voice (or the eating disorder voice) which may have told you in the past about when and what you should or should not eat. Instead, it is a way for you to begin to bring awareness to your personal eating patterns and your drives to eat, and help you learn to honor them.
This is not a tool to use forever, but rather a helpful way to bridge the gap between mechanical eating that is externally guided, to intuitive eating that is internally guided.
How do you use the hunger scale?
There is no right or wrong way to use the hunger scale, however, I suggest using it with some frequency and consistency when you are just beginning with the work of re-learning your body’s hunger and fullness cues, and learning to trust them.
I would recommend that for at least 1 week, you have a goal of using the hunger scale before and after most (or many) meals and snacks, with the intention of getting curious with yourself and using if from the lense of self exploration. This is NOT a diet tool, or an effort to change your eating, but rather a tool to bring more awareness to yourself and your patterns.
At the end of the week, here are some journal prompts to further your exploration:
Before your meals, did you find you were truly hungry (physical sensation) or more often just mentally ready and wanting to eat?
After your meals, did you find that you were:
a) Not physically full but rather feeling like you “should” be done with the meal or “that it should be enough”.
b) Just starting to feel full but could definitely eat more still.
c) Comfortably full.
d) Over-full/ feeling physically uncomfortable.
Did you find that you were easily able to notice the more subtle sensations in your body of hungry and full vs starving and stuffed, or was this quite challenging to tune into?
How do you get familiar with what hunger and fullness feel like in your body?
As you are spending some time using the hunger scale and checking in with your hunger and fullness cues before and after meals, the hope is that you will become more aware of your patterns and more comfortable (or used to) checking in with your body and where it is at. If it is full and satisfied, or wanting more food, or craving something specific. And it is also important to note that it is very common, and incredibly normal, for this to feel uncomfortable.
Take as much time as you need on the step above (checking in with the hunger scale before and after meals), and when you are ready, the next step is to get clear on what hunger and fullness feels like in your body and where you feel it!
Here are some journal prompts to explore your physical sensations of hunger and fullness:
What does hunger feel like in your body? How do you know when you are hungry based on physical vs mental cues?
For example, perhaps you feel the physical sensation of hunger lower in your abdomen? Or higher up? Does it stay in one place or does the sensation radiate up and down? Does your stomach make any noise? Etc.
What does fullness feel like in your body? How do you know you are full based on physical vs mental cues?
For example maybe you feel it higher up than your hunger cue, or perhaps you feel a sensation in your throat, or perhaps a gentle heaviness compared to hunger, etc.
How do these physiological cues of hunger and fullness differ from your mental cues?
For example, maybe your mind tells you you're hungry for lunch because it's noon, but your body isn’t hungry yet. Or maybe you always feel you are done with the meal after one serving because you have been told never to get seconds, but learn from your hunger cues that you need more.
When should you not use the hunger scale?
The hunger scale is not appropriate in the early stages of eating disorder recovery, when someone is refeeding, needing to physically stabilize and is still regularly engaging in eating disorder symptoms (such as purging, restricting, chewing and spitting, etc.).
In these early stages, mechanical eating is essential. There is no rush to begin to learn to eat more intuitively, and I always say that the slower you go, the faster you get there. Take your time refeeding safely (with the help of a care team), becoming physically and medically stable, creating space from your eating disorder symptoms, and having enough nourishment that it becomes easier to show up to the cognitive and emotional work of recovery.
In time, readiness, and much more stability, the time for this work of beginning to relearn your body’s cues with the intention of honoring them fully and with clarity, will come.
I will also note that the readiness for this work of learning to eat more intuitively is usually much sooner in binge eating disorder recovery, compared to with anorexia or bulimia recovery. Recovery is individualized and your treatment team (or us if you are in our youth recovery program) will always recommend to you (and help guide you) when it is time to begin this work.
Types of hunger:
Beyond learning your hunger and fullness cues, meaning what they feel like in your body and where you feel them, it can also be helpful to bring awareness to the 7 types of hunger (yes, 7!!). This can be especially helpful if you struggle from binge eating disorder.
Again, it is so important to note that this is not a diet tool. Knowing that there are various types of hunger does not mean that you should never eat unless you have “stomach hunger” or “cellular hunger”. It is so normal to eat and enjoy your food for other reasons as well. Such as having cake in celebration, or eating something just because it looks so tasty regardless of how hungry you are, or because you are enjoying a meal with family and friends.
My hope is that in learning about the types of hunger, you can have more language around your experiences with food, and bring more awareness to them. For example, sometimes you may be wanting food to cope with an emotion. Perhaps you are feeling burnt out and exhausted and this is triggering you to binge eat. In these moments, having awareness of your “heart hunger” can help you understand what you are needing and help you to add in other tools to support you in what you are experiencing and needing emotionally.
Another wonderful way to use your knowledge of the types of hunger, is to explore preparing your meals in a way that appeals to your senses. Such as presenting and plating your food in a way that appeals to you visually and using spices or herbs that smell delicious to you. The more you appeal to your senses in a meal, the more enjoyable and satisfying it will be, which will increase meal satisfaction and reduce the urge to binge beyond that meal. It is also an act of care and worthiness towards self and food.
Eating disorder recovery is truly an act of “knowing thyself” and learning more about your hunger and your body's cues is a great way to connect to this. These tools can help you bridge the gap between wanting to be more connected to your body and more intuitive with your choices, and not yet feeling clear on those cues or how to honor them. Nothing is intended to be used rigidly and instead is a method of open exploration and self learning.
As always, if you are looking for more support in any phase of your recovery, please reach out! We offer free calls and are always happy to connect.
