Generally speaking, the average American eats 3 meals a day, sometimes snacking in between meals. But how do we know when it's time to eat? Does someone tell us? Do we just innately know? Well, in a perfect world we would feel physical hunger, respond to that hunger by eating, eat until we feel satisfied and then stop eating. But for most of us, our desire to consume food is driven by much more than physical hunger and fullness. It's driven by a combination of both internal and external cues. If a person is not utilizing a strong self awareness as to why he or she is eating it could let to overeating or undereating if these cues are being ignored. Lets take a look at the difference between internal and external hunger and fullness cues.
Internal hunger cues include the physical feeling of hunger. This could manifest as a stomach pain or cramping and/or an audible "growl" when hungry or slight stomach distention or feeling bloated when full. When hungry, it could also be a physical feeling of tiredness or lightheadedness from a lack of energy. These internal cues are driven by hormones and nerve signals released in the body in response to a lack of or replenished energy as it applies to hunger and fullness, respectively. It's these types of cues you want your clients and patients to be aware of and listen to when deciding when and how much to eat.
External cues are more prevalent and tend to be the cues the public rely on when deciding when and what to eat. External cues can include the actual site of food, it's presentation, the knowledge of what time of day it is and certain environment factors (aroma, lighting, etc.). Some people may not physically be hungry, be see food offered during a work meeting and eat simply because it is there. Also, someone may be physically full but still see more food on their plate so they continue eating.
I believe a powerful tool in helping people establish balanced eating habits and practice effective weight management is first recognizing there innate INTERNAL hunger and fullness cues. Here are some ways you can implement this tool in your practice as a dietitian.
1) Add this question to your initial assessment form. You could ask, "When deciding when and what to eat, do you find you listen to your body's hunger and fullness cues or respond more to the environment/presence of food?" You will find, more often than not, that people say they respond to their environment more than their physical bodies.
2) Educate the client/patient on the difference between internal and external cues
3) Challenge them to complete a "Self Awareness Log" for a week that requires them to identify and write down which cue they responded to when deciding when to eat, what to eat and when to stop eating.
I hope you have enjoyed this blog post and find it applicable to your daily work! Happy practicing, dietitians!