Stephanie Fein MD [00:00:00]:
Hello, fabulous Dr. Stephanie Fein here with Weight Loss for Fertility and welcome to the Hunger Scale Handbook series. Over the next seven weeks, you're getting a deep dive into the nitty gritty of the number one tool for sustainable weight loss, and that's the Hunger Scale. In this compilation of past episodes, you'll be reminded of the how, why and exactly what of this versatile tool that'll have you connecting to your body and hunger the way you did when you were a baby, when you had no food issues, getting back to your factory settings before diet, culture, well meaning parents and social media had you doubting yourself, starving yourself and getting in the habit of overeating in direct response. The hunger scale is the best place to start to lose weight permanently and safely when you're trying to get pregnant. It can be used now and even in pregnancy and beyond. I'll be referring to this series for years to come. Listen, practice and refine over the next weeks.
Stephanie Fein MD [00:01:08]:
Feel free to ask me any questions that arise. I'm always looking for ways to communicate the nuances of the hunger scale better and better. There is so much to glean from this valuable tool. Find me on instagram @Stephanie Fein MD DM me or contact me on my website, stephaniefeinmd.com and now, the Hunger Scale Handbook Series.
Stephanie Fein MD [00:01:33]:
Week four, the extremes.
Stephanie Fein MD [00:01:36]:
Negative five and positive five.
Stephanie Fein MD [00:01:40]:
Hello fabulous. I am so happy to be with you today on this episode of the Weight Loss Fertility Podcast, we are doing a hunger scale spotlight. We've done these before. They're so useful. I love using this time to focus in on what we can learn from each number on the hunger scale. You know, I love a hunger scale. The hunger scale is amazing. It's so helpful in general and then each number can help us with something.
Stephanie Fein MD [00:02:10]:
So the hunger scale was first introduced in episode two. So if you want to dive into that, that's episode two. And then the first spotlight hunger scale Spotlight was episode 21. And there I talked about negative one. There's so much to learn there, so go listen to that one if you haven't already. And then the next one was episode 34 and that one focused on positive three, which is a great one to revisit. And that's often how we learn our positive 2 by recognizing our positive 3. So we'll link all that up in the show notes for you to have easy access.
Stephanie Fein MD [00:02:46]:
Today I wanted to spotlight the extremes. So the extremes are negative 5, which I define as empty, and positive 5, which I think of as Thanksgiving stuffed. So as a reminder, we aim to eat at negative two, which is just hungry. And we stop at positive two, which is satisfied or enough, you know, somewhere in the middle. So what is the utility of the extremes? That's what we're going to talk about. So first, utility. First thing I wanted to say is that it's part of a definition, right? It's the boundaries. So we need to be somewhat familiar with them, if not in.
Stephanie Fein MD [00:03:31]:
In real life, in. In our bodies, but in theory, right? So you may never have been completely empty of food, but you've been very hungry at some point in your life, likely. And so you can have that as your gauge. You make your own hunger scale, right? There's the numbers, but your feeling at each number is unique to you. Boy, I wish I could tell people how exactly it feels for each number. That would make my life so much easier. But actually, I don't really want to be able to do that because it's so important that you figure that out for yourself. It's really vital that you figure out a way to get in touch with yourself enough that you know what each number is for you.
Stephanie Fein MD [00:04:24]:
Now, that doesn't necessarily happen overnight. This is the practice, and that's why the extremes can be really important, theoretically that we know the boundaries of this scale. Now, we don't need to test this out. So you don't need to not eat for days and days just to see what empty feels like. Like I said, you've had your own experience. You can use that experience. Same thing is, we don't need to know how much food we could possibly fit in. We don't need to do that.
Stephanie Fein MD [00:04:55]:
We can use our experience of being very, very full. That's why I say Thanksgiving full. You may have had that experience on Thanksgiving or Christmas or, you know, where there's a big meal. There's also, and we'll touch on this a little bit like binges sometimes. And binge, just in the regular dictionary is excessive indulgence. Colloquially, we can use that word to mean we eat a lot of food. And certainly there is a binge eating disorder that has a definition in the dsm. And that's not what I'm talking about right now.
Stephanie Fein MD [00:05:35]:
So I just want us to. We can't talk about positive five without thinking about a binge, like eating a lot and just for us to have in our minds. So we know that the diagnostic criteria includes recurrent episodes of binge eating. And it's in a discrete period of time. It's larger than what most people would eat in a similar period of Time. And there's a sense of lack of control over that. Okay, so we may identify with that, but it also includes associated with three or more of the following, eating much more rapidly than normal, eating until feeling uncomfortably full, eating large amounts of food when not physically hungry, eating alone because of the feeling of embarrassment about how much you're eating, or feeling disgusted with oneself, depressed or very guilty afterwards. If you have three out of them, you're meeting the criteria.
Stephanie Fein MD [00:06:32]:
There's marked distress regarding binge eating. And that eating occurs on average at least once a week for three months. So that's the bigger definition of binge eating disorder. It's chronic and compulsive eating. And if this sounds like something you're doing or feeling, then I highly recommend getting professional help with this. A therapist there places to find eating disorder specialists. And that might be something that would be really helpful. We're not talking about that particular, certainly not the eating disorder.
Stephanie Fein MD [00:07:12]:
We are talking about the extremes, which of course, then this is why I went over this, right? We can start to think about that. And when we eat, eat a lot of food, it will be physically uncomfortable. And sometimes we may call it a binge, and that's okay. But I want to separate that out from a binge eating disorder, because that's really important. If you identify with binge eating disorder, I want you to seek support for that. And here we talk about weight loss and there can be some confusion right, about where we land. That's why I talked about the criteria. If that applies, please get support.
Stephanie Fein MD [00:07:57]:
But if not, if you just notice that sometimes you can eat till very full, that's something that's important information for us here in weight loss. Okay? So the main thing is, if you're thinking that you're having a binge eating disorder, then get support. And if you're thinking, I have binged, or maybe in the past I had that, not now. We're just using this spotlight to notice when we've gone too close to the edges. So that's actually my second point. So the first point about looking at the extremes is the definitions. So we know that there are boundaries, and when we know where the edges are, we can find our way. It's like in a map.
Stephanie Fein MD [00:08:46]:
You know, you can see the whole map and now you know where you're going. And the next thing that's important about extremes is knowing where to avoid. So we're talking about weight loss. And in order to lose weight, we don't want to be regularly at the edges. Now, the reason we don't want to be. We certainly know it's very intuitive about why we don't want to be at the very, very, very, very full. That's too much food for our bodies. But it may not be as intuitive about why we don't want to get very, very, very hungry.
Stephanie Fein MD [00:09:22]:
Because a lot of us think, oh, if I want to lose weight, I stop eating. That's the answer. It's not the answer, by the way. And getting empty is a problem because you will have an equal reaction to overeating. If you get to negative 5, you will very likely eat to positive 5. That's the issue with the extremes. You end up going from one extreme to the other, and that's actually chemical and biological. Your hormones will be really wanting you to eat a lot of food, and you will eat it rapidly.
Stephanie Fein MD [00:10:01]:
So it seems like in diet culture, the way that we lose weight is we stop eating, we don't eat, we restrict ourselves, we deprive ourselves. But that leads to what we see most of the time is yo, yo dieting, having times of not eating and then having times of eating too much. So we really need to look at both sides of this, the negative five and the positive five. And we're now just talking about knowing the places to avoid, remember? So we're avoiding positive five, but we're also avoiding negative five. Okay, So I think of these boundaries, the edges, as like bumpers in the bowling alley. I don't know if you've ever seen. If you ever go bowling with kids or just beginners, you can put blocks or bumpers in the gutters. You put them in the gutters, and then that way the ball never goes in the gutter.
Stephanie Fein MD [00:11:02]:
It just sort of bounces down and it will hopefully hit at least one of the pins. So that's what we're doing here by having boundaries so that we're. We work our way from the edges, if that's where we're starting into the middle. And so we know now where to avoid. We avoid the edges, so we're happy to have the extreme. So we know where to avoid. We have our boundaries, we know where they are. And now we know where to avoid for weight loss.
Stephanie Fein MD [00:11:31]:
So once we know we want to avoid the extremes, we can identify when we have hit them. When we sort of gone astray from what we're wanting to do, we've wandered off course. Because we have these boundaries, we know these numbers, we can identify when we've gone off. And that's really important because before we are using a Hunger scale. We may just feel like that's normal. I'm supposed to eat until I'm very uncomfortable. We really do get in that habit. And so by using the hunger scale and knowing that, we can identify, oh, I am changing my behavior, and I don't want to be uncomfortable anymore.
Stephanie Fein MD [00:12:14]:
I've gone into this discomfort, and now I'm remembering that this is too far. So what can I do for it to be different next time? Now, here's a really important note about this. One is what we don't want to do here is beat ourselves up. So let's say we're trying to lose weight. We're using the hunger scale. We notice we keep going to the higher ends, plus four, plus five. And that awareness in and of itself is amazing. So we don't need to beat ourselves up about it.
Stephanie Fein MD [00:12:50]:
What we do is we see it, we identify it, we say, oh, my goodness, look, I've done that again. What was going on here? What caused this? Now, a quick hint is, notice how hungry you got. Remember, that's the other end of the extreme. If you got really hungry, then it's very, very easy to overeat. If you weren't paying attention and noticing these extremes, you may not notice that, because then the answer isn't, you know, force yourself not to eat so much at that meal, but make sure you get to eat something before you're too hu. That's a completely different answer to the issue. And you wouldn't know it if you weren't identifying where you are now. Remember, this is where the compassion comes in.
Stephanie Fein MD [00:13:43]:
This is where it's so important to not do it the way we've done it before, which is often beating ourselves over the head. It does not work. I was going to say, if it worked, I'd let you do it, but I actually never would because there's never a reason to make us feel bad. Nothing good comes from making ourselves feel worse, from judging ourselves, from treating ourselves poorly. Nothing. So this is one of those areas that can be one where, oh, why am I doing this again? What we're doing is we're getting curious and having compassion about being able to identify when we've overeaten or when we've let ourselves get too hungry, which, as I've said, leads to overeating. They're completely connected, these extremes. Okay? So it's part of the process.
Stephanie Fein MD [00:14:34]:
To change a habit is to find the edges. See, when you've gotten there, get curious about it and change something for the future. That's how we Learn. It's not perfect, it's a little messy, but ultimately it works so beautifully because you keep going down the road and you don't go backwards. You just keep going down the road. You learn more and more and more and you change your habit again and again and practice, and the practice leads to new habits. And we can do that so much better when we're compassionate with ourselves as we're going through this learning process with the hunger scale. Okay, last thing that the extremes can really help us with.
Stephanie Fein MD [00:15:18]:
And these sort of go in order, right? Because once you're identifying that you've gone astray, you can can pinpoint the problem. So is it that you get too hungry? Often we'll think, I ate too much yesterday, so I'm not going to eat anything today. And then of course, you get to the middle of the day and you're so hungry. If you notice that pattern, that's fantastic. Now we know the pattern and it's. Once we see it, we can do something about it. So we can see going to these extremes on a daily basis, not, you know, sort of punishing ourselves to not eating all day. And then we can't sustain it.
Stephanie Fein MD [00:16:01]:
And then we end up eating and usually sort of the floodgates open and we end up eating a lot. And we actually can. Then it's a cycle, right? Because then if we eat a lot and then we're going to do it again the next day, like, well, then I can't eat the next day. And then of course, we end up eating the next day. It's a vicious cycle that's so harmful not only to our bodies, because our bodies need fuel, especially when it's hungry. When it's hungry, it's telling you it needs fuel. And then overeating gives the body it's too much work. The body does it, but it wasn't designed to handle it that way.
Stephanie Fein MD [00:16:36]:
So that cycle is a problem that we can solve by noticing it and using the hunger scale. The other way that we do this is with yo yo dieting in general, right? So that one day is like a microcosm, right? You're not eating and then you're so hungry that you just eat so much. It's the same with yo yo dieting, right? You restrict, restrict, restrict. And then you end up eating everything in sight so you lose weight and then you gain it back. And we can do that cycle each month, every year. As I said, it's a pattern that's so uncomfortable and it's physically uncomfortable, both because you get so hungry and then so full. But it's psychologically uncomfortable because we do end up beating ourselves up over that. There's no compassion.
Stephanie Fein MD [00:17:31]:
There's only judgment, harsh judgment, and it's wearing on us. So when we're looking at these extremes, we're using the hunger scale, and we're grateful for the fact that there are boundaries. We can see where they are. We can know if we're trying to lose weight, that we want to avoid them. And then we can tell when we've hit one of them because of how it feels, because we're paying attention to the hunger scale. We're knowing, oh, this is too hungry for me. Oh, this is too full for me. And then we can define the issue or the problem that we need to work on because we've noticed and we're seeing what's happening.
Stephanie Fein MD [00:18:13]:
It gives us some place to start. And again, always with compassion. Right? That's how we do things around here. So the extremes are important to look at. It's important to have them in your brain about what it feels like for you, where you want to go and where you don't. And what's interesting, too, is as you lose weight and as you use the hunger scale, your boundaries actually get smaller. Like, your tolerance of being very hungry is smaller. You don't have a tolerance for being very, very hungry anymore.
Stephanie Fein MD [00:18:48]:
And you don't have a tolerance for being very, very, very full anymore. What I mean is your positive 5 happens sooner once you've been using and practicing the hunger scale. It's really amazing, like, where you used to be able. I can remember times when I would eat so much more than I can eat now. And of course, physically, I could still eat it, but I wouldn't be able to tolerate the discomfort anymore, whereas it was very regular for me before. So this using the extremes and then watching them sort of shrink over time is so valuable. There you have it. Hunger scale.
Stephanie Fein MD [00:19:35]:
Spotlight the extremes. I highly recommend using the hunger scale. It's so valuable, and if you have any questions about it at all, I would love to hear from you. There's two ways you can DM me @StephanieFeinMD on Instagram, or you can go to my website, stephaniefeinmd, and you can contact me there. I would love to hear from you. Any questions you have, I'm happy to answer. And I'm just sending you so, so much love.
