{Intuitive Eating with a Chronic Condition} Principles #2 & #5: Honour Your Hunger & Feel Your Fullness

This is the second in a series of posts on adapting intuitive eating for a chronic condition. I would like to acknowledge that I personally don’t have a chronic condition, and am open to learning from the lived experiences of those who do. Please leave your feedback by commenting below, or by sending me a private message.
Other posts in this series include:

Principle #1: Reject the Diet Mentality
Principle #3: Make Peace with Food
Principle #4: Challenge the Food Police
Principle #6: Discover the Satisfaction Factor
Principle #7: Honour Your Feelings Without Food
Principle #8: Respect Your Body
Principles #9 & #10: Exercise – Feel the Difference & Honour Your Health with Gentle Nutrition

Intuitive eating is often described as “eating according to your hunger and fullness cues”. Though this is correct for the most part, if you don’t also do the work to reject the diet mentality and incorporate the other intuitive eating principles, this can quickly become the “Hunger-Fullness Diet“: “Eat only when you’re hungry.” “Stop eating when you feel full.”

In reality, it’s not uncommon or “wrong” for an intuitive eater to eat when they’re not hungry—perhaps they’re “pre-emptively” eating because they know that food won’t be available at the time that they would be hungry. Perhaps they’re eating socially, whether it’s a celebration or just to be polite.

Similarly, it’s not uncommon or “wrong” to eat past the point of fullness. The difference between that and a “binge” is that the latter feels emotionally distressing; overeating may lead to discomfort, and it may even feel mindless or out-of-control, but an intuitive eater simply notes that it happened, perhaps approaches the reason with curiosity, and moves on.

As you can see, the nuances of “Honour Your Hunger” and “Feel Your Fullness” are already complex, and can be even more complicating when a person’s chronic condition and/or its treatments affect their natural hunger and fullness cues.

When Your Hunger/Fullness Gauge is “Broken”

Many conditions, medications and treatments can mess with a person’s appetite. You may feel hungry all the time, full all the time, or fill up after only a few bites of food. In fact, many who don’t have a chronic illness experience this, and I have written briefly on this topic before.

In these cases, if you only ate according to your hunger/fullness cues, you may not meet your nutritional needs. This is where “nutritional rehab” comes in.

Nutritional rehabilitation, also called “structured eating”, “scheduled eating” or “mechanical eating”, is just as it sounds—eating in a structured way that overrides your hunger/fullness cues, with a goal of meeting your nutrient needs. Evelyn Tribole, one of the co-authors of Intuitive Eating (Amazon Associate link), describes this like a cast for a broken arm; similar to how a cast temporarily restricts movement in order to support proper healing, structured eating is meant to be temporary until you are able to rely more on your hunger and fullness cues. I will note that because structured eating often incorporates many “healthy” eating behaviours, such as eating at regular intervals and including a variety of foods throughout the day, eating intuitively might sometimes look similar to the rehab phase.

The concept of nutritional rehab was written with the eating disorder patient in mind. Restriction can suppress a person’s hunger cues, and the thought is that structured eating can help bring these cues back “online”. However, there are some situations where your hunger and fullness cues may never become fully “reliable” in terms of helping you meet your nutrient needs. If that’s the case, you may always need to engage in some structured eating to make sure your needs are met.

Relearning Your Cues

Just because you are engaging in structured eating doesn’t mean you can’t “honour your hunger” or “feel your fullness”. Often when a chronic condition or treatment affects a person’s hunger and fullness cues, it doesn’t turn them off, it just makes them different. While we typically associate feelings of hunger and fullness with our stomach, each person’s cues are different. Some people might start getting headaches, feel tired, get shaky, or notice that their mood changes when they’re hungry. Others might notice that they start losing interest in food, or that it doesn’t taste the same when they are full. Some of my bariatric surgery patients shared that they started hiccuping or sneezing when they were getting full!

“Often when a chronic condition or treatment affects a person’s hunger/fullness cues, it doesn’t turn them off, it just makes them different.”

I often use the Hunger/Fullness Scale as a tool to help people tune into their individual cues. Find out more about my process here.

Get Support

While the idea of eating according to your appetite may seem simple, there are many layers of nuance, especially when nutrition rehabilitation is involved. If you are struggling with a “broken” hunger/fullness gauge for whatever reason, I strongly encourage you to seek out a certified Intuitive Eating counselor or Health At Every Size®-informed dietitian. (I take clients locally and online too!)

Do you rely on your hunger and fullness cues most of the time, or do you need some structured eating for support? Please share your experiences, thoughts and questions in the comments below.