Let’s Talk About Diet and Hunger

Let's take a crack at one of the biggest problems of our time: how to lose weight without even trying. We decided to conduct an experiment, and boy were we ready for it. Fast forward eight months later, and we're 50 pounds lighter. Something worked, and it wasn't the typical approach. We're psychologists, not doctors, and we had a hunch that weight regulation was more a psychological issue than a physiological one.

If shedding pounds were as simple as burning more calories than we consume, we'd all be our ideal weight. We've heard the advice to "eat less" a million times, but somehow it's not that easy, and the United States keeps getting heavier. It's time to shake things up and take a fresh perspective.

Hunger is more than just a rumble in our stomachs. It's a motivated state of mind that psychologists have been studying for over a century. While we all experience hunger before meals and fullness after eating, it's always present, always humming in the background, even if we're not aware of it. Hunger is more like a mood that can influence our decision-making, priorities, and emotions, and even profoundly alter our sensory perceptions.

Imagine looking at a tiny hamburger before dinner and thinking, "Why do they have to make them so small? I'll have to eat three to feel satisfied." That's the hunger mood at work, making food appear smaller than it actually is. On the other hand, if you're full, that same hamburger would look like a monster. It's not just about the food; the hunger mood can also distort our body image. When we're hungry, we might feel thinner, and the diet seems more effective, making us more likely to indulge. But when we're satiated, we might feel like a beached whale.

The hunger mood can even warp our memory. Imagine keeping a food log to track what we eat. Can we trust it? Not really. We might misjudge portion sizes and forget what we've eaten depending on our hunger state. One study found that most people consume the majority of their calories through snacks between meals, but when asked, they deny it. They're surprised to learn just how much they snack.

The hunger mood is a tricky beast because it operates outside our conscious awareness. It's no wonder that obesity is such a pervasive problem.

The Hunger Mood

A part of our brain regulates the hunger mood called the hypothalamus, which is responsible for controlling our basic motivated states, including hunger. It detects various factors such as fat, protein, glucose levels, blood pressure, and temperature by tasting the blood. Along with these factors, sensory signals such as the smell, taste, and sight of food, fullness in the gut, and surrounding circumstances also play a role in hunger regulation. Our neural circuits develop habits based on this data, leading to hunger at certain times of the day, and feeling full at the end of a meal. However, psychological fullness is a feeling of sufficiency that comes from a more complex computation rather than just having a full stomach.

If you try to cut back on calories, your hunger mood is likely to rise, causing you to eat bigger meals and more snacks for the next few days. People often judge how much they've eaten by how full they feel afterward, but since that feeling of fullness is partly psychological, a heightened hunger mood can lead to overeating and feeling less full. This can make you think you're making progress, but your weight may not respond as you expect due to the warping effect of your hunger mood.

The standard advice of exercising to lose weight might not always work as intended. After a workout, you may feel so spent that you burn fewer calories for the rest of the day than on a regular day. Moreover, exercising can increase your hunger, leading you to overeat or snack on unhealthy options.

Trying all the standard diets out there might work for a short period, but most people eventually fall off the wagon and gain back more weight than before. The idea of willpower is often associated with weight loss, but cognitive control is much more complex and limited in its ability. Willpower is essentially pitting long-term rewards against short-term rewards, which can lead to falling off the wagon and causing more damage than can be undone by getting back on again. Additionally, most of the psychological complexity involved in weight loss operates under the surface of our consciousness, making it challenging to realize how much we're sabotaging our own efforts.

Traditional Weight Loss Fails

The traditional approach to weight loss focusing on calorie intake and exercise is failing, as evidenced by the rising obesity epidemic affecting more than two-thirds of the US population. The mainstream medical perspective ignores the role of psychology in hunger regulation and treats it as an inconvenience in studies. This approach overlooks the fact that the obesity epidemic is not a matter of calories or willpower but rather a problem with poisoning the normal regulatory system that evolved over millions of years to be effective.

The failure of traditional weight loss methods often leads to demoralization and depression, causing people to spiral into comfort eating, self-medication, addiction, and losing all motivation to lose weight. The chance of recovery for obese individuals is less than one in 100, and the prevailing medical theory that weight is a matter of calorie control suggests that their problem is weak character. This false and harmful message is damaging to mental health and ignores the psychological complexity of weight loss.

The hunger and satiety system is a sophisticated and intricately calibrated system that should work in the background without any conscious effort. However, for more than two-thirds of the population, this system is not functioning correctly, leading to the obesity epidemic. The focus on calories and willpower ignores the role of psychology in hunger regulation, which is crucial to addressing the problem of weight loss. Therefore, it is essential to consider an alternative approach that takes into account the complexity of this system to solve the problem of obesity.

My Own Experiments

For a year, I conducted an experiment on myself using an event-related design. I ate the same meal every day to establish a baseline, measuring my weight, waistline, and keeping notes on anything relevant. Then, I made a single change to a single meal and monitored its effect over several days until my measurements returned to baseline. I repeated this process with different meal changes and observed the pattern that emerged. While I didn't expect to discover anything new, the goal was to see which of the conflicting diet advice out there matched my own personal data.

What I found most intriguing was not the effect on my weight, but rather the impact of certain meals on my hunger levels. When my hunger mood was up, even if I didn't feel hungry, I would find myself at the lunch deli earlier than usual, and I wouldn't feel as satiated after eating. Conversely, when my hunger mood was down, I would get caught up in my work and delay lunch by an hour. This pattern was undeniable, even if at times it seemed like there might be another reason for it.

I discovered three habits that consistently increased my hunger: the super-high death-carb diet, the low-fat craze, and calorie counting. The typical American diet is heavy in carbs, from breakfast cereals to fast-food burgers with buns, sugary beverages and desserts, and carb-heavy dinners. Even supposed "healthy" options like deli sandwiches or sushi have a high carb content. The low-carb movement, popularized by Robert Atkins, suggests that by cutting carbs, the body switches from glucose to ketones as its main energy transporter, leading to fat burning and reduced insulin levels. However, recent studies have shown mixed results on its impact on weight loss.

The low-fat craze, which warned against eating butter, eggs, and whole milk, has also been shown to increase hunger. Fat helps reduce hunger, and its removal from diets can lead to an increase in hunger over time. Finally, chronic dieting and calorie counting can also disrupt hunger regulation, leading to a vicious cycle of willpower and failure.

During my own year-long self-experimentation, I used an event-related design to monitor the effects of different diets on my body. I ate the same thing every day to establish a baseline and made small changes to one meal at a time to observe their impact over several days. Through this process, I discovered that some foods and dietary habits had a greater effect on my level of hunger than on my weight or waistline.

I found that a high-carbohydrate diet increased my hunger, while a low-carb diet reduced it. This suggests that a low-carb diet doesn't necessarily lead to weight loss through increased energy utilization, but rather by reducing the amount one eats. On the other hand, a diet high in carbohydrates can lead to overeating and an insatiable hunger, particularly in extremely obese individuals.

The low-fat craze, which was prevalent during my upbringing, also contributes to increased hunger. While dietary fat may have some negative effects, numerous studies have shown that it actually reduces hunger. Removing fat from one's diet can result in a gradual increase in hunger, as the hypothalamus learns to associate fat intake with satiety over time.

Finally, the chronic diet of calorie counting and constant monitoring of food intake can also contribute to increased hunger. By micromanaging one's hunger control mechanism, the natural balance is disrupted, leading to a vicious cycle of exerting willpower and ultimately failing.

Overall, the scientific literature and my own observations suggest that a diet high in carbohydrates, low in fat, and focused on calorie counting can all contribute to increased hunger. Small changes to one's diet can have a noticeable impact on hunger levels, emphasizing the importance of finding a diet that works for each individual.

William H. McDaniel, MD

Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School.

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