Intuitive Eaters Should Depend on Brain and Stomach

How hunger influences eating.

Posted Apr 23, 2019

Eating what and when you feeling like eating is one of the attractive aspects of intuitive eating, a program that contradicts traditional instructions about food choices, calorie content, timing of meals and snacks, and portion size. The concept is simple: Pay attention to hunger signals from your stomach, i.e., such as actually feeling hungry, and then eat. Consume what you want and of course, try to make healthy choices, but if you want to eat something that is not particularly nutritious, that is fine, too. Don’t let guilt motivate your decision to eat or not to eat a particular food, and just as important, don’t let emotions affect your eating.

According to Laura Hartung, a registered dietician in the Boston area and one of the proponents of this eating method, you should make sure that your hunger, and not your emotions, is what's driving you to eat. Indeed, she claims that if you ignore your emotions, you will learn to, ”Choose foods that make you feel energetic and good.” Apparently we shouldn’t be eating out of a need to feel better; i.e. less unhappy, but if we choose the right foods, we will feel better or “good,” in her words.

The intuitive approach makes sense. If we eat only when we are hungry and just as important, stop when we are full, we would or should lose weight and never be vulnerable to overeating. This approach eliminates following instructions in a weight-loss program or eating only pre-packaged calorie-controlled meals or drinks. Indeed we revert, in a sense, to eating as infants do, i.e., responding to signals generated by our bodies to drink to replenish water loss, and to eat to restore calorie loss. And as we become sensitive to these signals, we may even choose foods based on our bodies’ particular needs. For example, when protein or vitamin requirements increase after an infectious illness, we may experience a specific hunger for eggs or oranges. Whether or not the approach will produce significant weight loss is still being investigated. An early report suggests that is does not.

But the intuitive eating approach disregards, or perhaps is not aware of, the relationship between nutrient intake, the brain, performance and mood. The brain, not the stomach, both influences and is influenced by what we eat. Alcohol is a familiar example. Many people feel different after drinking alcohol, either energized, voluble, hypomanic, less stressed, depressed, angry, tired or sleepy. For some, the need to drink is generated by the brain in order to bring about these behavioral states. Should alcohol be eliminated from the diets of intuitive eaters, because drinking is not generated by hunger?

High-fat foods like cheese, sausage, biscuits, ice cream, and cheesecake, so tempting to those freed from the restrictions of calorie counting, are appealing to intuitive eaters. But they may not realize how eating these and other high-fat foods may affect their performance and mood. According to a study by a group of Australian researchers, consuming large amounts of fat at a meal increases daytime sleepiness. The report cited other studies linking sleepiness after the consumption of a high-fat, low-carbohydrate meal.

Shouldn’t intuitive eaters be aware that their food choices might influence their ability to carry out a job requiring alertness and attentiveness? 

Intuitive eating’s emphasis on attending only to hunger signals emanating from an empty stomach ignores the possibility that signals from the brain may also be directing the individual’s food choices. Women who experience the mood and appetite changes of premenstrual syndrome ("PMS") have well-established cravings for carbohydrates, especially sweet carbohydrates. Hunger for these foods does not originate in the stomach, but in the brain due to alterations in serotonin activity. Consuming carbohydrate-rich foods has a well-documented positive effect on the mood and cognitive changes of PMS; women who instinctively (intuitively?) choose carbohydrate foods are responding to brain, rather than stomach, “hunger.”

However, if the premenstrual woman does respond to these brain-based hunger signals, she is not following the objectives of the intuitive eating program, because her food choices are related to her premenstrual mood, not hunger.

Intuitive eating also overlooks the hungers produced by antidepressants, mood stabilizers and anti-psychotic drugs. The urge to eat often occurs even when the stomach is still filled with food, because the drugs seem to weaken satiety signals from the brain. Some patients feel the need to eat another meal an hour or so after completing a previous one.  This side effect of their medication is not related to stomach hunger, and thus eating intuitively is unlikely to help these patients counteract the effect of their drugs on their food intake.

That said, intuitive eating is liberating for so many struggling with excess weight. It tells us to stop paying attention to claims about what foods to eat or avoid, to view foods as not only nourishing, but also a source of enjoyment and to stop mentally calculating calories and their impact on our weight tomorrow.  It brings us all a little closer to the way we should be viewing food.

References

"Assessing the effectiveness of intuitive eating for weight loss - pilot study,” Anglin, JC, Nutr Health. 2012 Apr; 21:107

 Cao Y, Wittert G, Taylor A, et al., “Associations between Macronutrient Intake and Obstructive Sleep Apnoea as Well as Self-Reported Sleep Symptoms: Results from a Cohort of Community Dwelling Australian Men,” Nutrients 2016, 8(4), 207

Wurtman J, Brzezinski, A, Wurtman R, “Effect of nutrient intake on premenstrual depression,” Am J Ob Gn l989 161:1228

Sayegh R, Schiff I, Wurtman J, et al, “The effect of a carbohydrate-rich beverage on mood, appetite and cognitive function in women with premenstrual syndrome,” Obstet Gynecol. 1995 86:520