Stephanie Fein MD [00:00:00]:
Hello, fabulous. Dr. Stephanie Fein with Weight Loss for Fertility. And I don't know if I told you this, but I'm writing a book, Weight Loss for Fertility. It's a catchy title, but it's what I do. I'm putting all my ideas and methods into one place. I'm excited for it to come out. It's going to take a little while.
Stephanie Fein MD [00:00:18]:
I promise to keep you updated. I'm writing three to five hours a week because slow and steady wins the race. And this morning I was working on one of the hunger scale chapters and I hit on this idea of satiation versus satiety. Now, these terms are from the obesity, medicine and nutrition literature, and they serve a particular purpose, and I wanted to share it with you. Now, it's not that we're necessarily going to use these words all the time now, but it's a useful concept to talk about. Satiation and satiety are really part of a continuum and they even have similar mechanisms in the body. But the distinction is valuable for us, especially for those of us who use the hunger scale, which should be all of us. Right? So we're going to talk about it, the concepts.
Stephanie Fein MD [00:01:15]:
Let me define the terms first. Okay. Satiation is what happens during the meal. It's the process of becoming full, the gradual buildup of signals that eventually makes you put your fork down. Satiation, that's what ends the meal. And for us, we talk about that as positive too, on the hunger scale. So satiation is when we stop eating, when we notice our satisfaction, when. And for us, we've defined that as positive, too.
Stephanie Fein MD [00:01:48]:
Satiation is positive, too. Satiety is what happens after the meal, basically immediately after. This is why it's a continuum, because satiation is the beginning of satiety really is what ultimately we're talking about. But now we're going to define satiety, which is the thing that happens after the meal. It's the state of being full. It's the state of being satisfied. And it keeps you from wanting to eat again for the next several hours. Satiety is what keeps the meal over.
Stephanie Fein MD [00:02:23]:
So satiation is the off switch. And satiety is what keeps the off switch off until it's time for the next meal when you're at negative two again. So in terms of the hunger scale, satiation is the feeling you have at positive two. And satiety is the feeling you have from that positive two back to negative two, the average of that being zero. Right. Not hungry. It also satiety could be seen as the time it takes you to go from positive 2 to negative 2. The hunger scale primarily trains satiation.
Stephanie Fein MD [00:03:02]:
That's the main part of the hunger scale. When we use the hunger scale, we're looking to eat at negative two, right? But a big part of it is retraining our brain to stop at positive two, which is satiation. Say that four times fastest. So we're stopping at the right moment during the meal. That's the positive two. And when you eat what you eat, protein, fiber, good quality, whole foods, that largely governs the satiety. How long we stay comfortable between meals, both matter. And they can be learned and fine tuned independently.
Stephanie Fein MD [00:03:47]:
And so we do that. Satiation plus two. We fine tune it and learn about it by being aware of the cues in our body around hunger and satisfaction. And we tune in to our body during meals before, during and after satiety. We learn and fine tune by listening to our body and how it feels after the foods we choose to eat. What is our body telling us in the time between the end of one meal and the beginning of the next? Tuning into satiation. Remember, that's our positive two is what establishes the end of an eating episode. That's what they call it in literature, eating episode, which of course is a meal.
Stephanie Fein MD [00:04:37]:
And therefore it determines meal size. So when we eat at negative two and we stop at positive two, that's a meal size. And that's an appropriate meal size for our body. And that's what our body needs. We may have been used to eating from negative 4 to positive 4. And that could have been your meal size. But that's a meal size that's too big for our body. Our body doesn't need that much food.
Stephanie Fein MD [00:05:03]:
We are eating from negative 2 to positive 2. So we are defining satiation as positive 2. And when we do that, we're determining our meal size. Satiety, however, determines our eating frequency. So the longer we're satisfied between meals, the fewer meals we have. Now, that's not our goal. Our goal is not to have one meal. Our goal is to have the amount of meals that make sense for our body.
Stephanie Fein MD [00:05:34]:
And often that's between two and four. But satiety will determine that. So satiation determines the meal size and satiety determines the eating frequency. That concept is important and interesting to us and has everything to do with the hunger scale. These two concepts, these two ideas are useful because they have different sensations in the body. And as I just explained, they have different modes, right? So one talks about the meal size or 1 indicates the meal size determines the meal size, the other one determines the eating frequency. The other. These are just useful concepts when we're talking about the hunger scale and eating.
Stephanie Fein MD [00:06:17]:
And when we want to understand them in our body, we need to look for the sensations of them in our body. How do they feel in our body? Feeling our positive too, which today we're calling satiation. It's going to be fun. Feeling our positive too depends on subtle cues. They're not hit you over the head cues, they are distinct and they're there. But we do have to be aware of them. We have to be mindful when we're eating. And it makes sense because our hunger inhibiting hormones, many of which are made in the gut in response to exposure to food.
Stephanie Fein MD [00:06:59]:
So once you eat, that's when we make them. We make the hunger inhibiting hormones. They take a minute because first they have to be triggered by food in the gut. And then they're created and then they're sent to the brain. This happens relatively quickly, it happens within minutes, but it doesn't happen instantaneously. So the hormones have to be triggered, created and then sent to the brain via the bloodstream and also nerve endings. But when this happens, the real peak of these hunger inhibiting hormones is 30 to 60 minutes after ingesting food. Now we do not eat for 60 minutes, right? So 30 to 60 minutes, when these hunger inhibiting hormones reach their peak, that's when you're going to feel the not hungry feeling in the hours between.
Stephanie Fein MD [00:07:53]:
So that's satiety, right? When you're not feeling hungry, you're just going on with your day. You're not thinking about food, you're just doing what you need to do because you fueled yourself. And that's because the hunger inhibiting hormone reached their peak. It's very easy not to feel hungry. That peak feeling feels different in the body than the positive two feeling. That indicates you're done with a meal. Do you know what I mean by that? That's an important point. When all the hunger inhibiting hormones are on board at their peak, you're not even thinking about food, you're not hungry.
Stephanie Fein MD [00:08:31]:
Nothing doesn't occur to you, nothing. But when they start, because the positive too, the satiation is the beginning of the satiety process. And so we're looking for signs that the process has begun. The beginning of that process is what we're looking for. So signs. And that will be our positive two. Now that's just an important idea. So this idea that there's two different Feelings.
Stephanie Fein MD [00:09:03]:
One is the I'm just not feeling hungry, not even thinking about food. That's when the hunger inhibiting hormones are at their peak. But we want to stop eating at positive two, which is when they're just beginning and there are signs that's happening, you'll know what those are for yourself. But that's what we're looking for. Now the thing about it, and you may have heard about this before, is that there's a lag time, right? Because as I mentioned, it takes minutes to create the hormones and then send them in the bloodstream. So there can be a lag time between eating the food and the hormones reaching your brain. And in that lag time, we can continue eating. And only 15 minutes later do we discover that we overdid it.
Stephanie Fein MD [00:09:46]:
I'm sure that's happened to all of us where we're like, oh no, I feel fine, I'm still hungry. And you're eating. And then 15 minutes later you're like, oh my goodness. That is important to clock, to notice. It's all part of the discovery process. We're getting to know our body and its signs and sensations because we don't want to eat our meal. And then 15 minutes later feel like we're at a positive 3 or positive 4. We want to feel like we're at a positive 2 at the peak.
Stephanie Fein MD [00:10:19]:
And so that will mean that we're looking for maybe even more subtle signs or different signs about when we want to stop eating. We don't want to be hungry, but we don't want to be at positive 3:15 minutes later. This is where we play with how much food, what type of food, all that stuff. This is what requires the practice. And once you get it, you're golden. Cause you know how much food, what it feels like is a meal for yourself that gets you at satisfied, not full. As we're doing that, we're also learning what foods fuel our body the longest, how long they last. The satiety part of this equation, the kinds of foods we eat will impact this state, the satiety state, because whole foods, proteins, high fiber foods, and when I say high fiber foods, I'm really thinking about vegetables.
Stephanie Fein MD [00:11:24]:
Those things take longer to digest and therefore stay longer in the system. And that prolongs the signals that inhibit hunger. The hormones keep being processed, being created and sent into the bloodstream. Processed foods, on the other hand, are often easily digested and move much quicker through the system, leaving us hungry sooner. There are other factors doing that. I'm not talking about insulin Right now, but there's that part too. So there's a lot of things that processed foods bypass, or yeah, I would call them bypassing in terms of that they digest really quickly. And so the hunger inhibiting hormones act differently.
Stephanie Fein MD [00:12:09]:
But also glucose and insulin are spiked because of how quickly and easily digestible the processed foods are. They really do act different in our body and we can feel it if we're paying attention. Again, this does not mean you can never have processed foods. It doesn't. It means finding the right combination in a meal for you and your body and how that works for the day. That's what we're looking for. So these two words, satiation and satiety, offer us another way of looking at the hunger scale and our eating, at looking at feeling done versus staying done. And that concept is important because we have, even though it's a continuum, we have two different ways of handling it, of noticing it.
Stephanie Fein MD [00:13:02]:
One is noticing the beginning of the process are positive too. And the other one is choosing foods that work best in our body, that last the longest so that we have satiation and satiety working for us, impacting the hunger inhibiting hormones both in the bloodstream and in our nervous system. It's so interesting because there really is science behind it and we can feel that go on in our body again. That's what the newest weight loss medications have taken advantage of. Those are hunger inhibiting hormones and we have them naturally. So if we're tuning in, we can feel them and then they can help us make the decision to stop eating. When we pay attention, when we're connecting to the sensations in our body, we strengthen those connections and it gets easier and easier to hear them and be able to stop at them. We can do that naturally, just with our brains, with practice.
Stephanie Fein MD [00:14:13]:
And making that connection inside it is so worth it because then you have this skill forever and it becomes second nature. And that's always what I'm looking for. Not only weight loss now, but sustainable weight loss forever. So as a recap, satiation is the feeling that has us stopping eating at a meal sized portion. It's our positive two on the hunger scale. Satiety is the peak feeling of no longer hungry. And the length of time it lasts depends on the foods we eat and the way our body handles those foods. Generally, whole foods, proteins, higher fiber foods, rich nutrient foods, will keep us satisfied longer.
Stephanie Fein MD [00:14:58]:
Being able to recognize our satisfaction signals are positive too. Usually the beginning of the hunger inhibiting hormone dump means overeating is a thing of the past. And sustainable weight loss is inevitable. That's always what I'm going for. If you have any questions about this or anything else, or if you want some help with weight loss and getting our brain to be able to do this for itself, for the body, I am here for it. You can find me @StephanieFeinMD on Instagram or LinkedIn or just go to my website StephanieFeinMD.com and click the lose weight with me button and we will be connected. I am sending you so much love until next week.
