Stephanie Fein MD [00:00:01]:
Hello, fabulous Dr. Stephanie Fein here with weight loss for fertility. And if you are listening to this when it comes out, it is December. OMG December. And the holidays are in full swing. So I'm sure parties, we just had Thanksgiving, all that. I have lots of holiday themed episodes and I'm going to put the links to them in the show notes. So this will not be a holiday themed one because I just have a whole bunch of them.
Stephanie Fein MD [00:00:28]:
And so I'm going to direct you to those. Again, they'll be hooked up, but let me tell you a little briefly about them. Episodes 4 through 7, episodes 57 through 59 and episodes 110 and 112. And that covers family feelings, travel, baking, planning, food pushers, putting it all into perspective, all holiday related. So go have fun. Go have a listen on your maybe on your drive to your family or as you're cooking or any anything like that. They're always really good refreshers. Today I'm covering a topic I have not explicitly covered before and I want there to be a standalone episode for this.
Stephanie Fein MD [00:01:12]:
So that's why we're doing it. And it was inspired by a new client. Sweet, sweet new client. And if you'd like to be a new client, I'd love to have you go to my website, Stephanie Fine MD Fine as f e I n stephaniefinemd.com and click on the Lose Weight with me button and it will connect us so we can start. So this fabulous new client. The first thing I do, one of the first things I do is introduce the hunger scale. It's my very favorite tool and it's one of the concepts that's first on the list. And again, I have a lot of episodes about this.
Stephanie Fein MD [00:01:50]:
We just recently had a Hunger Scale Handbook series and that is something to look for. It's in the 140s. I think that you'll find it. It's called the Hunger Scale Handbook series. But very briefly, the hunger scale goes from negative five to positive five. Negative five is completely empty, no food. And positive five is Thanksgiving Day stuffed. And that is where you have to lay down.
Stephanie Fein MD [00:02:19]:
You're so uncomfortable, you have to unbutton your pants. And so we don't want to to be on either end. And the numbers we want to hover between are negative 2 and positive 2. Negative 2 is just hungry and positive 2 is satisfied, not full. And that is the hunger scale. And for each person, if I'm working individually with you, we go into the specifics for you and your life and getting support like that can be really helpful. And so I was talking with this new person and it was just reminding me when we're newly introduced to it, there is so much there. It takes a minute to find what our sensations are.
Stephanie Fein MD [00:03:00]:
We're not used to tuning in. And as babies, we are very connected to them. Our body indicates we can't even control it. As babies, we start rooting. That's like turning our heads and looking for the nipple or milk. One of the late stages, like it's probably like a negative 4 or negative 5 is the crying. And in fact, if babies are so upset and crying at that point from hunger, you actually have to calm them down. It's hard for them to eat.
Stephanie Fein MD [00:03:32]:
That really is the same as us. We may not cry, but we can get very agitated and we lose our ability to be calm in eating. And so anyway, when we're babies, we are very connected to this. And as we enter the culture, as we're socialized, a lot of times that can be trained out of us particularly. And it's for good reason, right, if like dinner time is a certain time, if you're not hungry. Oh, because this is when the food's on the table. It really. I completely can understand how this happens.
Stephanie Fein MD [00:04:08]:
And we are captive as children and we are dependent on people, and so their desires can matter for us anyway. There's many reasons how also girls in school, middle school, we may have demands on us and want to lose weight and look a certain way. And then we start doing sort of crazy diets. There's so many reasons why we lose our ability to know what our hunger feels like in our body and our satisfaction. So today I want to talk about the hunger cues that we can experience that are really subtle, because we may know the really obvious ones. We may not, by the way, but sometimes those are easier to identify, but the subtle ones are more challenging. And so I want this to be a guide so that we can start to be like, oh, I didn't realize, maybe that's my hunger. Because remember, the main reason we use the hunger scale and we want to know when we're hungry is because if we get over hungry, too hungry, negative 3, negative 4, negative 5, we will overeat and it will feel very out of our control.
Stephanie Fein MD [00:05:16]:
And we often blame ourselves for that. But the truth is it's a physiological response. And to help ourselves with that is we start to show ourselves that we eat when we're hungry. And then it's easier to stop when we're satisfied, not full. So the extreme Hunger signals or cues are the first list I'm going to talk about. And that's negative four or negative five. Okay. And here are some common ones.
Stephanie Fein MD [00:05:47]:
I am sure there are people who experience other ones and I would love to hear from you, I would love to know what you would add to these lists. But here's what I got for the extreme hunger, dizziness, weakness, feeling shaky, grumpy, so that's irritable on steroids, a headache or a painful empty stomach like symptoms in your stomach area, abdomen. There could be other parts of this like blacking out, fainting. There certainly are lots of extreme things, but this is the general area and we don't want to get there. That's our goal is that these are the late stage symptoms and we want to catch our hunger earlier, specifically at negative two when we can. And so now I'm going to talk about the signs and cues that can be for. And these are different for everybody. Everyone has a different combination or a different.
Stephanie Fein MD [00:06:53]:
It depends on your own physiology. So these can be subtle at negative 1, negative 2 or negative 3. And they could be degrees or you could have some symptoms or cues at one level and not at the others. Okay, here is the list. You have a decrease in energy. So it's a subtle shift from having energy when you're feeling nourished. And then you have a decrease of a lull. Feeling tired, thinking about food.
Stephanie Fein MD [00:07:34]:
Now that's really an important one because we start to think that we're craving or there's something wrong with us. But that could be the indication that you are starting to get hungry or in fact you're hungry. Thinking more about food, particularly if you're like working, you're doing your thing that has nothing to do with food. And then you start thinking about food. That could be your negative 2 signal to go along with that increased appetite or cravings for certain foods. If all of a sudden you're thinking that you have an appetite, which is a slightly different word than hunger, but if that speaks to you, then we're going to use that for your individual hunger cue. And cravings for certain foods might be, and I've absolutely seen this where someone all of a sudden they start wanting like a ding dong and they're like, oh, that's my sign, or they want something salty and that's their sign. Moving on with the list.
Stephanie Fein MD [00:08:37]:
Difficulty concentrating where you were doing fine and all of a sudden it's more difficult, fuzzy thinking, more confusion in things that aren't necessarily confusing to you. Normally you can Start to get a slight headache, like a change in how your head feels, maybe tiny bit of lightheadedness. So in the extreme hunger, we can have pronounced lightheadedness, but here, there might be just a moment of it. Irritability is another one. A change in your mood where you were fine, and now you're sad. You were fine, and now you're annoyed. And nothing actually happened to make it that way. Something did happen.
Stephanie Fein MD [00:09:26]:
Your blood sugar went lower, and your body physiologically needs fuel. That's what happened. And it's telling you in a way of changing your mood. And then there's a growling stomach. That could be. Not everyone gets a growling stomach. That's the stereotypical hunger cue. But not everyone gets that at all, ever or not every time.
Stephanie Fein MD [00:09:54]:
So that was the list of. Of the more subtle signs that you may be hungry. And looking for them is gonna be really important when you're establishing your own hunger scale. And that's what this sweet new client reminded me of, that it does not have to be the shaky piece. Often, that is, we know for sure we're hungry when we're shaking, opening the refrigerator, or pulling out a fork, that's too late. But we certainly can use that as the extreme. And then we can work backwards from there. What was I feeling 30 minutes before that? What was I feeling 60 minutes before that? That's how we can start to get there.
Stephanie Fein MD [00:10:42]:
But we're so used to feeling tired in the day. And sometimes what we'll do is we'll just grab. We'll think, oh, that's my sign to grab coffee. But really, it's your sign that you're hungry or that you're getting hungry. And in 15 minutes, you'll need food. Now, if we have coffee instead, we're masking the hunger scale, the hunger signals, because caffeine is a appetite suppressant. So that's something really interesting to notice. When you're starting to figure out your hunger scale, you might want to delay your coffee or play with the timing of your coffee so you can really see when you get hungry.
Stephanie Fein MD [00:11:26]:
And it might be these more subtle signals. I think of them as the brain ones. The difficulty concentrating, confusion, mood changes, thinking about food. These are things we might not associate with hunger, but they are the signal for hunger. Now, the things that are not hunger are emotions. Emotions are not hunger. And it's important to know the difference. This is one of the reasons I love hunger scale.
Stephanie Fein MD [00:11:59]:
When we're getting used to tuning in and listening to our body, we will start to notice Our emotions, too. Because emotions have sensations in your body, they're different sensations than the physiologic hunger. And it's important to be able to learn how to discern between the two. That may not be something you can do right away, but when we keep checking in, we will start to notice the difference. One is physiologic hunger, meaning we need fuel. And that's why the brain ones, to me make a lot of sense. And one is a feeling, and the sensation often is different. So it's less like fuzzy in the head and more like tingling in my chest or a knot in my throat or a pit of my stomach, that kind of thing.
Stephanie Fein MD [00:12:53]:
Those are sensations. And we do need to learn the difference between those and physiologic hunger. The other thing that's not hunger is when we want to eat, when we desire to eat, when it's just our brain wanting to eat. And this is where the hunger scale really shines. Because the difference between our brain wanting to eat and our body needing to eat is very different. And learning the difference is key. And one of the ways we can learn the difference is we decide we want to eat. We think we want to eat, but because it's noon, because I walked by the office kitchen and the donuts were out, and now I want a donut, or I see other people eating, and that means I want to eat now, too.
Stephanie Fein MD [00:13:44]:
But wanting to eat and being hungry are different things. And learning the difference is really important. When we're just starting out, we're learning. We're just finding what our hunger, what are the numbers are. We're playing with that. We're learning about that. With each meal, we're getting new information. And what's so valuable about the hunger scale is that it's flexible, right? Because around here, we care about permanent weight loss that can be maintained easily over your lifetime.
Stephanie Fein MD [00:14:23]:
And if that's what we're going for, then we need a tool that's really flexible, and that's what the hunger scale is. So there will be an evolution of your understanding of the hunger scale for yourself. And also because your body will give off different signals at different times and things like times of the month in your period, you will have different hunger signals. When you're sick, you will have different hunger signals when you're stressed. If you change jobs around the holidays, it may feel different in winter, it may feel different than it does in the summer. So always checking in and being open to what your body is telling you is going to be very important. The really wonderful thing that I love about the hunger scale, as you can tell, there's lots of things I love about the hunger scale, but this one can be used in pregnancy. There is nothing dangerous about it for baby or you.
Stephanie Fein MD [00:15:25]:
And your hunger signals will change. I'm working with someone right now. She's in her third trimester and her hunger just changed. She's saying she's hungry all the time, which actually makes so much sense because she can only fit a little bit in. So she is having to eat more often, smaller amounts, because she hits positive two pretty quickly. And so protein ends up being really important. And every time she's hungry, she eats. And that's how that works.
Stephanie Fein MD [00:15:54]:
We go with the hunger scale. When your body is physically hungry, we feed it and then we stop when we're satisfied, not full. And it can be used during pregnancy, it can be used in lactation, it can be used in perimenopause, like literally every time of your life. And that is something I love very much about the hunger scale. A tool you can have forever. The other wonderful thing is that we're always aware of the changes and if not for every day, when we check in for each meal, but at the week mark, because you have something handy called the food date each week. And the food date is a time set aside each week that you check in with how the week went. So there's never more than seven days where you're completely checked out of this.
Stephanie Fein MD [00:16:53]:
And that is such an important piece. So you will be aware of the evolution of your hunger scale because you will be checking in each week when those things go together, the hunger scale and the food date, there is only maintenance, there is only ease with your food, no matter what is going on. So to wrap up as you start to use the hunger scale, be on the lookout for signs of hunger that may not be stereotypical, especially the subtle mood thinking changes that can indicate needing fuel. And that's what hunger is. It's your body's need for fuel. The cues may change at different times of the month, different times of the year, like the seasons, with treatments. Once pregnant, lactating, change in job, home, stress level, all these things can change your hunger signals. And it's a good idea to check in on them.
Stephanie Fein MD [00:17:51]:
If you hit a plateau with your weight loss, particularly the plus two. Satisfied, not full. If you're noticing that your plus two is changing, that you're actually ending up eating a little more, that may be part of the reason for the plateau. And we keep checking in on the hunger cues and if they're changing during maintenance because you have the food date. And that's the perfect time to check in on things like the hunger scale. I'd love to hear about your cues. What surprised you when you started tuning in? I would love to know. Reach out to me on instagram @stephaniefeinmd F E I N.
Stephanie Fein MD [00:18:32]:
Or use the contact me page on my website, stephaniefeinmd.com. I am sending you so much love until next week.
