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 @StephanieFeinMD DM me or contact me on my website, stephaniefeinmd.com and now, the Hunger Scale Handbook Series. Week six, negative four. Hello. Fabulous. It's been a while since we spoke directly about the hunger scale, but I came across an interesting issue with a new client and I knew I had to discuss with you.
Stephanie Fein MD [00:01:49]:
So today, today is a hunger scale spotlight and we're discussing negative four. Now, I look back and I did a whole bunch of hunger scale spotlights, but never negative 4. So here we are today. So excited about this. Okay, first, to set the scene, for those of you who are new around here, I'm going to go over the hunger scale in general. So the hunger scale, as I define it is from minus 5 to positive 5. Negative 5 is so hungry, you're like passing out. Totally empty.
Stephanie Fein MD [00:02:26]:
Positive five is extraordinarily full. You have to lie down, you have to undo your pants. Very physically uncomfortable. Okay? Those are the two extremes. We never want to be there if we can help it. The place that we do want to be is we want to eat at all. Negative two, which is just hungry. And we stop at positive two, which is satisfied, not full.
Stephanie Fein MD [00:02:56]:
You'll hear me say that a lot. Satisfied, not full. We eat at minus two. We stop at two. Satisfied, not full. Now, when people are starting with this, people have different issues. And one of the wonderful things about hunger scale is that you can see what the issues are. Some of us wait too long to eat and we have problems eating at minus 2, and some of us have problems stopping at positive 2.
Stephanie Fein MD [00:03:24]:
Some of us have both varying degrees. But this is the beauty of the hunger scale when we start to check in. And of course, the hunger scale is so important because we're shifting an external reason for eating to an internal reason for eating. The beauty of that is that we're always with ourselves so we can always attend to our body's needs, which is really what food is supposed to be doing. That's what food is for. It's for fueling us, attending to our needs. So this scale also includes minus 1, minus 3, minus 4 and minus 5, because we talked about minus 2. And of course, positive 1, positive 3, positive 4 and positive 5.
Stephanie Fein MD [00:04:09]:
So positive 3 is full, positive 4 is very full. And positive 5, as we discussed, is extraordinarily full. Positive 1 is just starting to feel like food has landed. I will say that 0 is completely neutral, minus 1 is starting to get hungry, minus 2 is just hungry, minus 3 is very hungry, minus 4 is very hungry and minus 5 is very hungry. Those are the levels that I want you to think about. And today what we're talking about is -4. And it's ideally a place we never get to, right? Because if we're always eating at minus two and stopping at positive two, we never have to deal with threes, fours and fives. And certainly once we are working with the hunger scale, we very rarely get to those points because we're discovering.
Stephanie Fein MD [00:05:11]:
But someone new, someone who hasn't been exposed to the hunger scale, we start to see our patterns. What usually happens is you're running late, you miss breakfast, then you have a meeting. Now it's three o' clock before you look up and you're starving. That's typical. So minus four is over hunger. If you're at minus four, you are over hungry. And if we wait to eat at a minus four, we will always overeat. This is the important thing to know about -4 is there's always an equal and opposite reaction, meaning if we are at a minus four, if we're that hungry, we will very often, most often eat to a positive 4.
Stephanie Fein MD [00:06:03]:
And it's very challenging to stop at a positive 2. And in fact, this is what we're going to talk about today. So over hunger, we don't think in black and white here and all or nothing here, but always leads to overeating. Maybe not always, but A lot of the time, most of the time, which is why we want to avoid it. Negative four is over hunger. It will lead to overeating, often till positive four. And there's different ways that it leads to overeating. And that's what we're going to talk about.
Stephanie Fein MD [00:06:38]:
So most of us, when we're at minus 4, eat to somewhere around positive 4, as I suggested. Something happens hormonally. This is really important. Something happens hormonally when we get over hungry because we've ignored signals at minus one. We haven't ignored that, but we've clocked it at minus two and we've ignored minus three, and now we're at minus four. So we have now ignored a whole bunch of signals. So things are happening in our body and something happens hormonally that has us disconnect from the usual satiety cues and we don't feel satisfied even with our usual size meal. This is a really important point.
Stephanie Fein MD [00:07:24]:
If we get over hungry, our hunger scale is whacked. At that point, it is off. It does not work normally. What I mean is, per usual, I do not know the cascade of hormones exactly, but imagine that it's leptin, ghrelin, it's all the usual players and maybe some we don't even know about, but they react, they go offline, they act in a different way. When we are over hungry, we can't rely on them so much. And so we're over hungry. We eat and eat and eat. We are triggered.
Stephanie Fein MD [00:08:09]:
Our brain wants us to eat more. The theory being that it gets worried that we're going to be in starvation mode and it sees food, it's so thrilled that it wants to shovel it down. I call this the bottomless pit. It really feels like that. It feels like you could eat and eat and eat and eat and never feel satisfied. This is the derangement of the hormones that I'm talking about. They go offline, they stop working in their usual way, and you feel like a bottomless pit. So we usually just eat more, right? We eat until we're thinking, oh, I'm still hungry, I'm feeling still hungry, so I'm gonna keep eating.
Stephanie Fein MD [00:08:46]:
And we eat until we do feel the physical feeling of satiety and then we stop. But that often happens when we're overfull. We feel overfull at that point, like we felt like a bottomless pit. We ate and ate and ate. But a couple minutes later and we discover, oh, my gosh, I really overate. This is much More than positive two. We think we're eating to a positive two, but it's so much more food than normally would satisfy us. And this is actually the important point.
Stephanie Fein MD [00:09:21]:
So the traditional problem with negative four is that we're over hungry. We feel like a bottomless pit. We keep eating, and when we finally feel satisfied, it turns out we ate too much food. It's like a trick. It's like a mask. The body says, oh, you're still hungry even though you really have had enough food. But it's again, I'm going to say, it's worried that you're going to starve. And so it's so happy to see food, it wants you to eat it all up.
Stephanie Fein MD [00:09:53]:
So that's one way we overeat at negative 4. Related, but slightly different is what my new client did. And I hadn't run into this before. This is why it was so interesting, was that she stopped at the usual amount of food. So it was a set amount of food that she normally eats. She ate that. But of course, what she noticed is that she was not at a positive two. She was maybe at a zero or maybe a plus one on the hunger scale.
Stephanie Fein MD [00:10:22]:
And then what do you do? And she's just starting with this hunger scale. So it's confusing. It was an interesting thing to notice because do you stop eating because you're at a zero? You're not at a positive two. And so what happened was she did stop eating because she had the amount of food that she normally has, but she was still hungry. And so very soon after, she needed a snack and at that point wasn't prepared for needing a snack. So eating not great snacks, that's the problem we get into is that we haven't planned for it and we end up eating things that aren't the best or that we wouldn't have eaten. And remember again, this is because our hormones are deranged. And when we ignore our hunger cues and we can't count on our usual body signals for hunger and enoughness, and so then we're.
Stephanie Fein MD [00:11:12]:
It's confusing. This is why it's so important to stick to the hunger scale. And what I mean by that is eating at negative two, stopping at positive two. Because when we get too hungry, we get into this difficult space where we're chasing hunger. And that is a very uncomfortable, physically uncomfortable, emotionally like mentally uncomfortable place to be. Why am I hungry? I ate so much food. Why am I eating so much food? Why am I hungry? Then our brain, this would always happen to me. It would Feel like I'll always be this hungry.
Stephanie Fein MD [00:11:49]:
I will always be a bottomless pit. Our brain is so tricky and it does those sorts of things. So the thing that is so important about the hunger scale is really to be able to eat at negative 2 so that you can stop at positive 2, so that when you stop at positive 2, that's a amount of food that works for your body, that fuels it, but does not overfeed it. So. So there is not extra calories there that your body did not need. We're eating more than our body needs. If we wait till -4 and overeat, and we are likely to overeat because our signals are not working the way they usually do because we've ignored the signals. So we don't want to be at negative four, how do we prevent that? How do we not eat at -4? The first week or so that you're noticing this, you will see a pattern.
Stephanie Fein MD [00:12:50]:
It will be pretty obvious. You'll be like, oh, yeah, that's a negative four. Oh, I'm doing the thing where I'm skipping the meals. And so this is where your planning comes in. The planning, the food week comes into play. We're looking at our schedules and we're seeing where we're going to make food, where we're going to order food, where we're going to get out food, and then we plan accordingly. Remember, we're looking for patterns when we start this. And if it happens, a one off, which of course can happen, Right.
Stephanie Fein MD [00:13:19]:
You just notice that for the next time, like the next time you go to the airport and there are flight delays, so that next time you're like, oh, I remember there were flight delays and I got stuck, so I'm going to bring this snack. Or your boss pulled you into a meeting that you weren't expecting and then you didn't have time to eat. That's. If that's a one off, that's not a problem. You just plan for the next time. But if it's happening to you every day, every week, that's when we have to start looking at it and decide how we're going to handle that situation. So starting to use the hunger scale and finding these patterns and then doing what you need to do so that it doesn't happen, that's how we lose weight in a way that does not have deprivation, restriction, guilt. We just notice that we have to work with our body, not against it.
Stephanie Fein MD [00:14:09]:
The last piece of this that I want you to see is that overeating, once we hit negative 4 is not a character flaw. It's biology. Okay? This is such a very important point. It's not your fault. I'm putting that in air quotes. You are in fact hungrier because you've skipped meals. You're feeling the sensation of hunger very strongly. If you wait till minus four, just sets you up to overeat.
Stephanie Fein MD [00:14:41]:
Biologically, there is something that happens with the hormones. Even if we can't know what it is, this is a reliable thing that happens, that if we ignore the signals and we let it go too long, we absolutely will overeat. The worst part of it is that we end up thinking we have bad willpower or that we can't eat like other people. We blame ourselves. When we don't know what's going on, we automatically blame ourselves. And that's one of the worst parts of diet culture is this idea that we internalize the blame and think there's just something wrong with us, when really we were just unaware of how the body and hunger work together and how sensitive the system is. When we know this, we don't have to judge ourselves and think we're terrible and can't do anything. We just have to get on board with listening to our bodies.
Stephanie Fein MD [00:15:40]:
And our culture is so happy to have us not listen to our bodies, especially workers. We don't want workers to pee or eat or take a break in any way. So as a society, we're so happy to have us ignore these sorts of things. But that's not functional. And those of us who are overweight see that on our bodies that we can't get too hungry because we will overeat. So the hunger scale is a very useful tool for guilt free restriction, free deprivation, free weight loss. And my fave part is that it's sustainable through IVF cycles and pregnancy and beyond. The hunger scale is such a beautiful way to lose weight forever.
Stephanie Fein MD [00:16:28]:
We spent time looking at the problems with waiting until negative four to eat, specifically that it sets you up to overeat. And the worst part is that we think we have a problem with ourselves. We blame ourselves when really it's just that we're unaware of how our body and hunger work together and how sensitive the system is. It is delicate. So we want to eat at minus 2 because we start getting hormonal imbalance, hunger hormone imbalance. If we wait too long when we eat, when we're hungry at minus two and stop when we're satisfied, not full at positive two, we feel well and our system works the way we want it to. It has us feeling physically comfortable and eventually emotionally comfortable too, because we start to see that eating at negative 2 to positive 2 is what our body needs and we can eat whatever we want in that amount. No bad foods.
Stephanie Fein MD [00:17:34]:
If you want help with this, I am here for you. Lose weight with me. This is how we do it. Without blame, without guilt. Just working with your body and getting in line with it so that you can go through anything, including pregnancy, and feel fantastic at a weight you're happy with. So lose weight with me. Go to my Instagram @StephanieFeinMD or my website stephaniefeinmd.com or weightlossforfertility.com either one will get you there. I am sending you so much love.
Stephanie Fein MD [00:18:09]:
Until next week.
