Sunday, May 20, 2012

Constant Craving

About five years ago, tired of my continual struggle to lose weight and, more frustratingly, maintain my weight loss, I screwed up my courage and asked my doctor about prescribing an appetite suppressant. He brushed me off with a comment that those medications were really meant for people with more serious weight problems than my own and concluded, "You'd have to take the pills for the rest of your life."

I already had an antidepressant on my "take for the rest of your life" list, and didn't want to add more, so I left it at that.

A couple of years later, the same doctor diagnosed me with diabetes and prescribed the first of five medications I now take for diabetes (and potential complications) every single day.

I call that a failure in preventive medicine.

Later, another doctor recommended the Appetite Awareness Workbook. While the book did not help me lose weight, it did help me understand what I was struggling with.

Hunger and appetite are NOT the same thing. People who do not struggle with an overactive appetite may not realize the distinction. Wikipedia sums it up nicely:
Hunger is a sensation experienced when one feels the physiological need to eat food. . .  Appetite is another sensation experienced with eating, however, it differs from hunger; it is the desire to eat food without a physiological need. 
I know people who really don't "feel like eating,"  even when they are hungry - until you place something appetizing in front of them. My husband and sons are among them.

I, on the other hand, rarely felt actual hunger pangs because, in response to my constant craving for food, I ate about every two hours.

And I can finish a multi-course, festive dinner and, half an hour later, find myself rummaging through the cupboard for a little smackerel of something, as Winnie-the-Pooh would say. (He shares my overactive appetite.) I can be moaning with nausea and STILL want to eat something!

It is. Whacked. Up.

But something happened recently that has pulled the reins on this out-of-control horse.

I mentioned earlier that I'd noted a connection between eating a high-carbohydrate breakfast and then feeling "hungry" all day. I misused the word; I was really talking about  appetite.

Well, I've recently -- finally! -- started on medication for my diabetes. It will likely come as no surprise to you that my appetite has diminished, especially after the doctor prescribed a recently approved injectable medication when the first medication still didn't get my blood sugar low enough. One of the so-called side effects of this new medication is appetite suppression and consequent weight loss. (Yippee!)

As my blood sugar has stabilized my appetite has decreased and my "willpower" has increased. I've had no qualms about leaving a plate half-finished, no tendency to make forays through the kitchen every half hour.

I'm going to go on a bit of a tangent here, but there is a point to it, so bear with me.

In Psych 101, our professor cautioned against flawed statistical correlations. He used a rape and ice cream example. "Suppose," he said, "statistics showed that there was an increase in stranger rapes in the summer, when there was also an increase in ice cream sales. It would be flawed to say that ice cream causes rape or that committing rape makes rapists hungry for ice cream. Researchers would look for a third, independent variable such as mild weather." It was such a ludicrous example that it stuck with me.

So here's where I come back to talking about appetite.

Suppose the correlation is not between obesity and diabetes but between appetite and both obesity and diabetes. Helping people suppress their appetites would no longer be considered a frivolous or vain concern, but would be considered a step in preventing diabetes.

What about you? What are your hunger-appetite correlations?


  1. I think a lot about appetite and stress. I have no appetite and am unaware of hunger when I am stressed (is it any wonder that I was having a hard time breaking 100 pounds when my marriage broke up?), whereas others have appetite but not hunger when they're stressed.

    The frustrating thing about weight loss is that you can't make what worked for you work for everyone. Or I'd be a millionaire. And I'm not.

  2. Amen.

    Only twice in my life have I lost weight without making a conscious effort to exercise or diet. In one case, I was just really busy and enjoying being so, and in the other I was profoundly depressed in response to a personal crisis.

    Otherwise: I eat through anything.

  3. Interesting post, and good point. I'm in the stress eater category, and am also quite capable of eating long after I'm full.

    As for the eating every two hours, that actually makes some sense, physiologically. It takes 2-3 hours to digest food, and so the blood sugar levels can dip and thus send you foraging again. My trainer figured out that I'm like that (even though I didn't know it), and so has me eating mini meals (lean protein, veg & fruit) every couple of hours. When I follow that, I'm not hungry and (when not suffering from appetite related sugar cravings), I also lose weight.

    Wondering if non diabetics can benefit from those shots, too!!


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