Hunger vs Satiety (Eat to satiety?)

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the-hunger

#1

Let’s start with a name drop to establish credibility. Just listened to Dr. Ben Bikman (again)

The discussion went to the topic of hunger satiety signals.

The observation was made that when people break a fast they can then suddenly feel insatiably hungry.

This interesting podcast discussion gives a little noogie to the concept of eat to satiety advice.

How can someone “eat to satiety”, when eating seems to be driving the hunger?

Thankfully the doctors describe that the sensation is only transitory and lasts for about an hour. But many of us know we can do a lot of damage to dietary good intentions in an hour of insatiable hunger.

The mechanistic hypothesis is a temporal gap, a timing issue, between the effects of insulin that drives hunger and the effects of the satiety hormones and the hormones that negatively feedback on insulin response. And underlying all that is the aim to mediate and minimise the insulin response when feeding, so as not to experience the hunger induced.

Other options were to eat and then do something else (like go on the ketogenic Forums) for an hour and let the hunger pass.

Something to think about when we advise newbies to “eat to satiety” when they are feeling they could eat until Saturday.

a hard poke or grind with the knuckles, especially on a person’s head


Can we please stop repeating the “You have to eat at a deficit to lose weight on KETO” lie?
(PSackmann) #2

I can only give my n=1 on the subject of satiety. And I do consider I may be a unicorn in this. When breaking a fast, even if it’s a OMAD day, I do get that ravenous hunger after the first bite, but it doesn’t take an hour for satiety signals to kick in. Maybe it has to do with my thinking about eating before I eat, if you give credence to the theory that thinking of food begins the insulin release? Or the fact that I’m conscious of needing to intake a large number of calories in one go on OMAD or after a short fast and therefore plan a nutrient dense meal, with enough fat to override the temporal gap? Whatever the underlying mechanism, for me the hunger signals don’t last an hour.


#3

I’m sure it’s not a theory. The doctors discuss it as part of the analysis. Yes, thinking about food will start insulin release in anticipation. And that will eat up some of the hunger time. As will eating a meal over a 20 minute duration. So the remaining half hour may be the struggle time until the hormone signals sort themselves out.


#4

From another thread.


(Anne Brodie) #5

Oh my goodness. I have been keto for 21 months now, the last six months or so of that on maintenance. Not a newbie to keto but still learning techniques to best handle maintenance and I’ve only recently experienced this reaction (the ravenous feeling after starting my OMAD in the evening). I’ve tried having a few bites and then pausing a while before having the rest, but with varying success. It is SO helpful and timely to hear others discuss this. And I’m going to try thinking about the meal approximately an hour before and see how that goes.


(Erin Macfarland ) #6

I find discussions like this (meaning the one on the podcast) to be incredibly frustrating and probably confusing as hell for people just starting out. Here is why-
I’ve been keto/lchf for almost 6 years. So there’s been a TON of new research and n=1 experiences shared in that time amongst this community. The advice used to be to “fill up on fat” in all circumstances. Protein was still considered something to limit. I’ll try to keep this all brief so I don’t run on…lol…while I’ve been eating this way I’ve been lean, active and insulin sensitive. I found my way to keto when researching ways to mitigate my family history of diabetes and my genetic testing results showing my very elevated risk of developing it.
Anyway…I was doing everything “right,” as far as macros and moderating protein. But I am mostly lean body mass and like I said, very active. I’d eat a small amount of protein and plenty of fat but still be RAVENOUS. So rather than having more ribeye or other fatty meat I’d go to town on fat bombs, Mac nuts, I’m sure most people here have done this…I’d end feeling slightly queasy but still not actually satiated. I avoided “overdoing” protein for a long time because everyone seemed to believe it would stimulate insulin too much. After a few years I found Amber Ohearn, Ted Naiman, and the still-fringe carnivore peeps. I decided to try eating that way and see if it made improvements in my satiety. Overall strictly eating carnivore wasn’t for me, but…I continued to base my meals around lots of fatty meat and adding veggies or a little dairy or eggs as desired. And that gnawing, post meal hunger I’d struggled with forever pretty much stopped. Protein seemed to really make those hunger signals quiet down. I describe all this to make the point that hunger, and satiety, are dynamic and depend upon a LOT of variables. And, despite what “experts” might advise or tell us, sometimes these things are out of our control- in the sense of if our bodies are genuinely hungry, there is very little we can do to mitigate that. We can wait and distract ourselves, or up our protein or take a walk. And sometimes that works and the hunger passes. However, there are times when it is nearly impossible to “trick” our bodies into not being hungry. There are factors that will absolutely mess with hunger/satiety hormones: state of metabolic heath (insulin sensitivity), sleep quality and quantity, activity levels, stress…when these are compromised it’s incredibly difficult to fight those hunger signals. I know for myself when I don’t sleep well, I’m more active than usual, or the intensity of my training increases, I don’t get enough sleep…I’m absolutely a bottomless pit.
However, one thing i don’t feel is being addressed regarding this issue on the podcast is that even if you have a day here and there where you “overeat” and can’t fight the hunger, THINGS BALANCE OUT!! It bugs me when well respected figures in this community, that generally don’t subscribe to the CICO model of weight gain, imply that if you don’t strong arm the hunger beast, you’ll gain a ton of weight and that you should implement restriction and it won’t have any downstream consequences…baloney…every time I think I’ve outsmarted my hunger and managed to stop eating even though I am actually still hungry, it will come back to bite me in the ass. The next day, I’m lethargic, distracted by thinking about eating, and when I do eat I eat more than I probably would have had I just ate to satiety the previous day. And yes, I understand that there are many people that have messed up satiety signals due to metabolic diseases like diabetes and insulin resistance. However, I think it’s irresponsible to suggest that people should categorically implement strategies to stop themselves from eating more when they’re hungry. Just like fasting isn’t the answer for everyone, even people who have plenty of fat stores, trying to purposefully keep from eating when your body keeps saying it needs fuel can cause more harm than good. And I’m talking about doing that on a regular basis. Yes I understand letting yourself be peckish on occasion. But I think this issue is more complicated and nuanced than the episode suggests…I’ll get off my soapbox now :joy:


(Bacon is a many-splendoured thing) #7

Apart from the fact, of course, that re-feeding after a fast is a very different context from adapting to a ketogenic diet from the standard dietary pattern

Refeeding after fasting

While we fast, our insulin/glucagon ratio remains low, because of the need for gluconeogenesis. Hence the metabolic situation is dominated by catabolism, and insulin remains low, as it must, so that the twin processes of gluconeogenesis and ketogenesis may proceed unhindered. The serum insulin is low in both the keto-adapted and carb-burners when they fast, because of the absence of dietary carbohydrate.

After an extended fast, such as after weeks without food in a lifeboat or months on starvation in a concentration camp, the risk of killing survivors by giving them food is very real. It is called “re-feeding” syndrome and is the result of one’s electrolytes’ getting severely out of balance, resulting in an abnormally low serum potassium (hypokalemia). If not handled correctly, hypokalemia can kill a patient, even when the doctor is aware of the problem and is proceeding cautiously.

Re-feeding syndrome can also be a problem when ending even a much shorter fast, which is a good reason not to give in to hunger when breaking a fast.

Switching from the standard American diet to a well-formulated ketogenic diet.

In the context of someone who has not been fasting, but who is now making a dietary change, the situation is completely different. There has been food intake all along, and electrolytes are highly likely to be in balance or close to it. This means that any imbalance resulting from the removal of restrictions on excreting sodium when we switch to keto is likely to manifest itself, at worst, as the “keto flu,”—which is easily remedied by eating a bit more salt. The more profound electrolyte imbalance of prolonged fasting is not going to apply in this situation, so advising eating to satiety carries with it no risk.

Under the SAD, the main reason for hunger is not lack of food intake (especially not in the case of anyone eating the recommended six meals a day plus snacks), but rather inhibition of certain hormonal pathways by excessive serum insulin. These pathways are cleared as soon as insulin drops sufficiently low, which happens fairly quickly after the restriction of dietary carbohydrate. Exactly how quickly and how low the insulin will drop will most likely depend on the person’s degree of insulin resistance, or so I would imagine.

We know the twin processes of gluconeogenesis and ketogenesis are started up in the liver shortly after excess serum glucose and excess stored glycogen are used up, because without them, the brain and the the erythrocytes will soon starve from lack of fuel. But although we generally talk as though these processes are stimulated by a drop in insulin level, they are actually initiated by a rise in serum glucagon, with insulin acting primarily as the brake to keep the processes from running away with themselves. it is the insulin/glucagon ratio which is the controlling factor, not the absolute level of either hormone. When the ratio is low, bodily processs are primarily catabolic, when high, primarily anabolic.

Eventually, however, the serum insulin level drops low enough for the hunger and satiety hormones to begin to resume their proper roles in regulating appetite. At that point, there is no reason not to rely on hunger and satiation as guides to food intake.

My experience was that it took 2 to 2-1/2 weeks of ketogenic eating before my appetite hormones re-regulated themselves. Up to that point, I was still thinking in terms of my old carb-loaded habits when judging food portions, and my appetite was still quite strong, though more easily satisfied by the quantities of fat I was eating. But one day, out of nowhere, I stopped being hungry in the middle of a meal and was forced to stop eating. I simply wanted no more food, which was weird for someone accustomed to eating to the literal bursting point while still wanting more. From that day forward, I have rarely wanted more than two meals a day, if that.

We strongly advise newcomers to eat to satiety for two reasons: first, to help overcome the deeply ingrained fear of caloric abundance; and second, to avoid the metabolic effects of restricting calories. I suppose a third reason would be to get people in the habit of trusting their bodies again. One of the most deleterious effects of our current approach to diet and nutrition (to my mind, at any rate) is the pernicious habit of thinking that our bodies are evil and must be held in check at all times.

This Puritan way of thinking—mind good, body bad—is an old Christian heresy brought into nutritional thinking by way of the Seventh-Day Adventist Church and their advocacy of veganism. The reality, however, is that eating to satiety is the best possible way of preventing gluttony, because the body is always fed the right amount—not too little, not too much—and this renders bingeing and purging completely unnecessary punishments that we can stop inflicting on ourselves. Granted, people accustomed to over-riding their bodies’ signals may have to work to re-learn what satiety feels like, but it is a fairly strong signal, one hard to ignore once one knows what it feels like.

TL/DR

At any rate, we tell people not to gorge after a fast, because it is dangerous, whereas telling newbies to trust their bodies and eat to satiety brings benefits and no known risks.


#8

My experience as well.

Which takes us to cravings Amy Berger has a good solution. If a person has mixed hunger signalling manifest as feelings, the question to ask is “Can I eat a [keto meal. e.g. pork chops, eggs etc] right now?” If the answer is no, then that is a momentary craving. If the answer is yes, then that is hunger and it is time to eat.