Do you question why you feel hungry all the time?  Check out our audio transcript to learn more.

Why do I feel hungry all the time?

Dawn (00:00):

Hello and welcome to the Gastric Health Show. My name is Dawn Boxell, a Registered Dietitian. And this week’s topic is Why do I feel hungry all the time? And we are going to dig into this kind of complex topic of hunger and hopefully give you some deeper understanding of why maybe you have dysregulated hunger cues. I think that’s kind of the big picture that I want you to understand is that hunger is normal and everyone should have hunger. So it’s not bad to feel hungry, but it’s not uncommon. Or it can be kind of an understanding of why some people experience dysregulated hunger. But essentially it’s important to learn from this cue. This cue of hunger is your body’s way of saying, Hey, I need fuel. And whether it’s accurate or just confused by hormones or genes or other biological or even psychological causes, it’s still your body’s communication system to you to say, Hey, I need something.

What is physical hunger?

(01:30):

So this is where I want to challenge you and I want you to really evaluate as we go through this. I always like to present it in the way that if your hunger is dysregulated, it could be because something in your life is out of balance and that’s what you have to focus to correct. And this could be a wide variety of causes, and that’s what we’re going to dig into. What is physical hunger? And really physical hunger is just an actual cue that your body is sending when it genuinely needs food. It is hungry for a reason because it needs the fuel source to keep your brain thinking, your lungs expanding, your food digesting, and just everything flowing like it’s supposed to. It’s very smart. Your body is very smart. And when your stomach stretches or expands, it begins the communication between that gut and brain for satiation and hunger hormones to be released.

what is psychological hunger?

(02:53):

So you can think of the ghrelin and the leptin in this case, but additionally, your blood sugar, it kind of plays a role in prompting those hunger cues as well. Now, what is psychological hunger? And this is not triggered by really a physical need, but it’s more of an emotional, environmental or stressful trigger that really prompted you to go digging in the pantry. So this type of hunger really is complex and it does have deep roots in some instances. But I also want you to know that this type of hunger is not abnormal. So it’s not bad if you have psychological hunger or what you may think of it as like a head hunger. It’s not bad to have that. It’s normal for human beings to experience this and learning these cues and the differences is where there’s power to be found. And in reality in some studies, it did show that 38 to 75% of adults admit to having psychological hunger.

Why Do You Feel Hungry?

(04:14):

So again, you should never feel shame or guilt for having hunger. And I will say with all of the GLP-1 medications, this has been brought to the forefront to my attention at least, that I feel like people are confused, that you shouldn’t be hungry and hunger is bad and it really isn’t. And I want you to understand that it’s good to have hunger cues and it’s good to learn from them and expand in that understanding on what you should do. If your hunger cues seem dysregulated and inappropriate for maybe you just had a meal recently, then it’s time to explore maybe what’s driving that, what’s triggered you to want to go back to the kitchen after you just ate a full meal an hour ago. So let’s dig into these together and hopefully this will help you get a bigger understanding. So some biological causes of hunger.

Biological causes of hunger 

(05:35):

1. Genetics. 2. Blood sugar and insulin dysregulation. 3. Gut dysbiosis. 4. Stress or cortisol imbalances. And 5. Hormones. So let’s dig into genetics. So there are certain genes that affect the way that your body regulates appetite and your metabolism. And I did do a post on this, and you can check this out on our website @ gastrichealth.com, and it is titled, and you can just search it in the search bar. Does hunger mean my bariatric surgery is broken? And I did go into some of these things that we’re talking about today, but I expanded on it in this topic today so you’re getting a little more, but I dug into a lot of the genes and stuff there as well in a different light. So feel free to check that out as well. But again, genetics play a role biologically in driving hunger cues as well.

Blood Sugar/Insulin Dysregulation:

(06:43):

So if you have some genes that are turned on and are really driving this appetite hunger dysregulation, then we have to kind of go upstream and turn it off and block it so that you are not struggling with dysregulated hunger. So the next one is blood sugar and insulin dysregulation. And I would say to me this is foundation one, you have to get your blood sugar and your insulin within normal reference ranges. You can’t have pre-diabetic numbers and insulin resistant numbers and not feel hunger all the time, and especially even cravings. I’m not really going to mix those in, but really they are connected. You will have more cravings and increased appetite and hunger regulation with dysregulated blood sugar and insulin levels. So you have to get those imbalance first, and that’s where learning how to eat, how to package your meals, the timing of your meals, all of that matters in making your appetite and hunger cues in balance.

Gut Dysbiosis

(08:06):

And I would say maybe not in balance, but in a way that seems appropriate so you don’t feel like, Hey, I just had a full meal, I need to eat in an hour. No, when we get those imbalance, you can go a normal four to five hours without having these cues to have to eat. 3. The gut dysbiosis. So we know that certain gut bacteria play a role in driving hunger for certain foods. Low diversity makes you more susceptible to bacterial messaging. So what does low diversity mean? So diversity is the different varieties of bacteria are living in your gut. And what we know is that obesity in general always presents, and this has been study after study after study, this is not something new. Low diversity. So you have very few species and strains of bacteria and that is correlated to that bacteria having more control of the communication and messaging.

Fiber filled carbohydrates

(09:25):

And this is where things can get hung up and really get you in a bad place where you feel like you have no willpower and you are relying on willpower is really a better way to think of it. So you want a high diverse range of bacterial species and strains in your gut. That is the ultimate goal. And if you follow me long enough, you probably know this answer, but you need fiber filled carbohydrates to accomplish this. So that is one piece of it because that’s what’s going to grow it. So probiotics with some prebiotics, but those fiber filled carbohydrates are going to give you the prebiotics and then also fermented foods. Those will also provide some good beneficial bacteria that will add. And actually when you combine those altogether, that’s when you get the magic. That’s when you can increase that short chain fatty acid production.

Hunger dysregulation

(10:31):

That’s when you’re providing that or setting that right environment in your gut so that you can have a healthy gut microbiome and you can have normal hunger cues. If this is what’s driving it, and I want to preface it, I guess I should have said this first, but it’s probably not just one thing. Driving hunger dysregulation for most people, it’s probably a combination of some of these or probably two or three or one or two of these is really contributing to this dysregulated hunger. So that’s where start with the lowest hanging fruit. Start with the one that makes the most sense to you that you feel like, Hey, I’m ready to tackle this. I feel like I can do something about this. I want to work on my gut. Or I’m ready to work on my blood sugar and my insulin. I’m ready to make those changes and strategize and plan and act on it.

Environment for disease

(11:38):

So whichever one makes the most sense, that’s where you start. But it’s likely going to take a combination of one or more of these to correct to get your hunger in the right place. So some other things about gut dysbiosis. So we know that the more opportunistic bacteria that are in your gut or think of those as the bad guys that it creates the environment for disease. We want more commensals, more good guys in your gut or just a balance of good and bad. All of us will have opportunistic and commensals. We need the good and the bad guys and they live harmoniously in our gut. So we don’t want to wipe out all the bad guys. You need some of them to create balance and you don’t want to have way too many of the good guys that creates imbalance as well.

Harmonious balance

(12:36):

So it’s all about finding this harmonious balance with all of them living together. But some things about certain species and strains of bacteria that drive hunger for certain foods. So we know that bacteroidetes prefer certain types of fat. We know that Prevotella grows better in a carbohydrate source. We know that bifidobacterium outcompete others in the presence of dietary fiber. And then lactobacillus and bifidobacterium grow from foods rich in polyphenols. So again, this is giving us guidance. This is giving us the ability to shift the microbiome. So if you have gut dysbiosis where it’s you don’t have enough good bacteria or you have too much bad bacteria or you have an imbalance of bacteria in the wrong location or all of those or a combination of those, then that could be why you have hunger dysregulation and it seems out of place and you feel hungry all the time.

Hunger Hormones (Ghrelin, GLP-1, GIP)

(13:52):

So this is where we work on improving your gut health and really just shifting that environment and get it to a better place. Okay, the next one is the stress and cortisol. In the short term, excess stress hormones can actually lower or suppress appetite, but it’s when it becomes chronic is when that shifts and triggers an increase in your appetite. So that’s where learning how to manage your stress and keeping your cortisol level in check and making sure that it’s not elevated chronically, that you’re not in that sympathetic state or fight or flight state all the time, which is causing that dysregulated hunger. The next one are hormones. So think about ghrelin. You can think about leptin, GLP-1, GIP. Ghrelin is your hunger hormone. And whereas the GLP-1 and GIP and leptin are more satiation hormones and these hormones when they are out of balance is when you can have dysregulated hunger.

Learn to increase that GLP-1 naturally by your food choices

(15:15):

So that’s where if you feel hungry all the time, that’s where if you learn to increase that GLP-1 naturally by your food choices. And I have a whole YouTube, podcast and blog post on GLP-1s, increasing GLP-1s naturally, and I just spoke on this at the Bariatric Symposium, and really increasing this hormone can help balance out your hunger hormones in a way that can be sustainable. So again, feel free to check those out on our website at gastric health to get those details of that information on GLP-1s. But it’s important to understand that I think it’s the combination of these five things, the genetics, your blood sugar, insulin dysregulation, gut dysbiosis stress or cortisol imbalances, and then hormones. What about these are driving those desires or need to eat more than is appropriate? Again, remember, that is not bad to have hunger and you should honor your hunger.

Psychological Causes of Hunger

(16:35):

You should eat when you feel hungry, but when your hunger is inappropriate and that you need to eat so frequently and that you never feel satisfied, look at these biological causes and decide, is this part of the puzzle? Is this what I need to focus on to get this imbalance or get this in a more acceptable state that I don’t think about food all the time? Next is psychological causes of hunger. And so this area is complicated and really can get deep and it’s really multifactorial and can really, I want to say, go into a place that you might find that you need a lot of head work, mindset talk, maybe even some therapy to really get into what is driving this piece for you. So four causes of psychological hunger, one, hedonic hunger, two, unprocessed trauma. Three, you’re stuck in fight, flight or freeze.

Hedonic Hunger

(17:54):

Four, you have a poor relationship with food. So let’s go to the hedonic hunger. And this is considered, you can think of this as like head hunger, but essentially you are eating for pleasure, not for a physical reason. It’s more there’s a connection and you need this. You can even think of a dopamine boost or something in that area because you are seeking pleasure. So maybe there’s negative things going on or there’s a trigger that has occurred that stimulated this and that is why you are desiring to eat a certain food. But hedonic hunger is linked to food addiction and obesity. And one study found after bariatric surgery, and this was a small study with 120 participants and they did a very low calorie diet or bariatric surgery and both experienced a 10 to 15% weight loss and a reduction in head hunger. But they found that the bariatric surgery results in greater changes in head hunger and food rewards than the very low calorie diet did, which totally makes sense if you have a smaller stomach, it’s a lot easier to manage the hunger between meals compared to somebody consuming 800 calories, 500 to 800 calories a day to get in that very low calorie range to maintain that and not feel hunger.

Bariatric surgery and Hedonic hunger

(19:43):

So to me, that makes sense. So again, it just shows the benefits of bariatric surgery when you really do struggle with appetite and hunger dysregulation, causes of hedonic hunger, sleep disturbances, genetics or your hungry genes and obesity, and first off sleep disturbances. Insufficient and poor quality sleep disrupt your hunger regulating hormones. This is where getting a good night’s sleep is so important and why we find that paying attention to sleep matters when it comes to hunger. And we know that a lack of sleep increases your ghrelin and decreases your leptin. A 2018 study showed a lack of sleep, increase your desire for high fat, sweet food and changed behavior towards sweet and savory. A 2019 study show having a reduced sleep by 33% had increased hunger, tiredness, sleepiness, portion sizes, and food reward. So everyone has had a bad night of sleep and definitely can impact you when they go night after night after night. Another 2018 study found increasing total sleep by 21 to 177 minutes, decreased your overall appetite, desire for sweet and salty and desire for dairy-free, sugar-free food. So this is the flip of that showing that just increasing your sleep by 21 minutes per night can have a beneficial effect on your appetite and hunger regulation. So that’s why it’s important to prioritize getting a good night’s sleep and just really focusing on how can I improve my sleep in every way so that each night I am just getting good deep quality sleep.

Genetics (Hungry Genes)

(22:15):

Okay, so let’s go into genetics, the hungry genes. And I will tell you, this really blew my mind when I started learning about genetics and the whole connection with your appetite and hunger regulation and how this truly does influence your ability to have hunger, how you experience fullness and hunger. It’s genetically driven. So some of us have more of those genes that set us up for having stronger hunger cues just in general. So that would be, think of those individuals who have battled their weight their whole life and likely have some of these hungry genes that really make it difficult to control hunger. Not impossible, because I will tell you there are things that you can do to get this gene back in place and get you to where hunger and appetite is in a good solid place, that it’s not dysregulate, it’s not in a place that you really struggle.

Sleep Disturbances

(23:39):

So we really have to focus on all those biological pieces and making sure that we’re getting all of that dialed in and just optimized. Same with the sleep. We have to get those pieces working for you so that you can keep those genes silence or kept in a place that you are not bothered by it. So let’s talk briefly about some of these genes. MC4R have weaker satiety signals and increased calorie intake. The FTO gene have a decreased responsiveness to satiety. The APOA2 have increased ghrelin and food intake. The FAAH have an increased reward with sugar, and TAS2R38 has an aversion to bitter food. So you will likely lean more towards those sweeter things because you don’t enjoy or you really have an aversion or a negative correlation with bitter foods.

Obesity

(24:59):

And SLC2A2 have increased sugar intake, and then the DRD2, which is your dopamine receptors, they have increased binge eating and then the CLOCK genes changes in your eating behavior, especially if you don’t get adequate sleep. So again, all of these hungry genes or genes that really influence food intake can really drive one to have dysregulated hunger and really feel hungry all the time. So again, don’t get confused in that, oh, I’ve just been given awful genes and I have nothing I can do about it. No, I know I say this anytime I talk about genes, but your genes only load the gun. Methylation pulls off the safety and your epigenetics or your diet and your lifestyle pull the trigger. So it just means that there are ways to change this. We have the ability to shift these hungry genes to a place that is more sustainable, that will benefit your health and keep you healthier longer because they’re going to be in check.

Dysregulate and out of balance

(26:20):

They’re not going to be dysregulate and out of balance in a way that you can’t make it from meal to meal without starving. Okay, so then obesity and having the disease of obesity additionally adds to this hunger dysregulation because our fat cells are their own endocrine system and that can influence your appetite. One study found that the genes ANKK1 and DRD2, which we just talked about, the DRD2, the dopamine receptor genes. These two SNPs contribute to obesity, overweight and hedonic hunger in women. So again, it’s just showing you that, hey, maybe you were given some crappy genes. Maybe your genes are stacked against you, but I promise you there are things that you can do to put the odds in your favor that you’ll have better appetite and hunger control without feeling like you’re going to pull your hair out and that you have to be hungry, that you have to have this hunger… deal with this hunger all the time.

Unprocessed Trauma

(27:36):

No, there are things we can do. We go back up to those biological things and some of these that are driven by poor sleep and we work on them. We really work on that genetic signaling and really putting the odds in your favor to have more control in your hunger. Then we kind of go, so these four things of psychological causes of hunger. Number two is unprocessed trauma. And this is something that if you have never read the book, The Body Keeps the Score. I would highly encourage you to listen to it if you or read it. I listened to it on Audible. It is a very long book. I think it’s like 17 hours on Audible or maybe even more, but I’m pretty sure it was like 16, 17 hours on Audible. But oh my gosh, I was glued. I just couldn’t stop listening to the book and I was just like, this makes so much sense.

Stress management

(28:41):

So unprocessed trauma is something that you have to explore. If this hunger is dysregulate and we’re checking the boxes, we’re getting your blood sugar imbalance, we’re fixing your gut imbalances, insulin is not out of whack and we’re getting your stress, we’re managing it better, your sleep is better. We’re getting all of these things working for you, but you are still struggling. Then this is when you have to enlist a therapist. This is when you need to get into counseling and dig into maybe what is keeping me stuck in this from my past. So again, unprocessed trauma is something that can be a contributor to dysregulated hunger. The third one is stuck in fight, flight or freeze. Again, that goes back to stress management, maybe some unprocessed trauma, lifestyle behavior routines. You maybe say yes when you should be saying no or you’re just, this is season of life is just full of events, life events.

Stuck in Fight, Flight, Freeze

(30:07):

So if you’re stuck in that, that could be why. So the last thing you need if you are stuck in fight, flight or freeze is to one, really be focusing on the biological piece. I would really be focusing on the psychological pieces and working with a good therapist. So that you can work through this piece of it. And the fourth one is a poor relationship with food. That comes with that fear and guilt that drive this. And when you really are afraid to eat and you really are. You think that it’s a badge of honor to have excessive hunger all the time and restricting the food more and just white knuckle it out as the way to do it. I think it’s time to look through a different lens when it comes to food and working with a therapist, working with a dietitian, and really challenging this piece, move through this negative food piece where you’re feeling fear and guilt for consuming certain foods and shame.

Diet Culture Beliefs

(31:38):

So I do want to say something when it comes to this because. I will say there are times when certain diets are necessary in an easy example for me is a celiac patient. If I have somebody who has celiac’s disease, they can’t have gluten. I mean one milli bowl of gluten. So one crumb of gluten can really impact their ability to manage their disease. So there’s a time and a place for certain diets. And the goal for all dietitians, we want you to be able to eat a wide variety of foods and not be stuck in a restrictive state. No dietitian wants that for you, but you have to layer in that there are some people. They really can’t have certain foods for the rest of their lives, and that’s okay. But that doesn’t mean that just because you can’t have that food that it doesn’t mean. You can’t have some other foods that are just like that, that doesn’t contain maybe that one ingredient that gluten.

Poor Relationship with Food

(33:00):

So you think of food allergies, you think of celiac disease, inflammatory bowel disease. I have other patients that there are times. When we’re in healing that we can’t have certain foods and it’s for a season. Same thing with people who struggle with some of the FODMAPs. There is a period of time where you really can’t have certain foods at very high amounts. So again, it’s a fine line that you work through. But your ultimate goal is you shouldn’t feel shame or guilt or fear for eating food. Food is fuel. No matter if it’s good or bad food. It still provides fuel and it still provides some type of nourishing property. Whether it’s maybe the best for you or not. Again, it’s finding a way to really not look at the food as or demonize one food or one food group. I think we could easily talk about carbohydrates here.

Before it used to be fats, now it’s carbohydrates

(34:15):

Before it used to be fats, now it’s carbohydrates. And you just have to learn that there’s no one magic diet that’s going to work for everyone. This is where personalized nutrition, which is going to be the future. And it is going to be where we can dial this in more to your genes and. Really help support you at a genetic level that can really help support getting a good variety of foods without the fear or guilt of having them. So again, I think you just have to evaluate, Hey, why am I experiencing hunger? Why am I removing this food? And now I’m hungry because I don’t have any carbohydrates and I am working out all the time? And guess what? Your body needs carbohydrates. If you’re working out, you need carbohydrates. You can choose fiber filled carbohydrates to get your optimal results. But again, I think it’s that relationship with food that gets messy and. Gets people in a place that they think. I shouldn’t and I couldn’t have these things.

Complex combination of biological and psychological.

(35:34):

When in reality you can. You just have to determine what makes sense for your body and run with it. So that’s where you really, just working with somebody can help if they’re train in… especially a dietitian. I would say really a register dietitian is your best bet because. That’s where you’re going to get the best guidance in improving that relationship with food. As well as providing you what your body needs without being restrictive and crazy about food choices. So let’s wrap this up. Hunger really is a complex combination of biological and psychological driven causes. And this is why it’s important to work with a license healthcare professional. That is train in really helping you peel back the different layers that maybe are contributing to this dysregulate hunger. And I would love to work with anyone who is really struggling with their hunger. I love to do the genetic test and work with you through this.

Conclusion

(36:49):

I know that not everyone can do this. But I will tell you, even without having a genetic test. Sometimes we can make some really good educated guesses and. Assume that some of the genes that you do have are turned on. We can work through changing that. So if you feel like that’s you, that, hey, my hunger is dysregulated. I’m hungry all the time. No matter what I do, I try to do what they say online, and I’m confused. I just don’t know what to do. And that’s where I’d love for you to reach out. I’d love to help you, and. I’d love to help give you good solid evidence-backed guidance to help support you in a way. That can help turn this around and get your hunger in a place that is appropriate. You have appropriate hunger cues and you feel balanced and satisfied in life. Because you’re not jumping from diet to diet. You have some food freedom, and you have no shame or guilt around your food choices. And you really do enjoy the food that you eat. You get to enjoy it with the people that you love. So I hope this topic has given you some insight because. I really want you, if you, one, are hungry all the time, start working through these biological. And psychological causes and see if you can’t get things to turn around. And I think you’ll find a different.

(38:36):

Once you get that in a different place, you’ll be surprised how quickly that you can feel that fullness from just eating the foods that you enjoy. So I hope this helps you guys. Have a great week and we’ll see you next time. Bye-bye.

Listen, Learn, Enjoy…

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