Constant Hunger - Help!!!

[Reesie]

Salutations friends. I have been dealing with a very real issue to me for just about a year now that has ravaged my quality of life.

Starting in July 2018 I began watching what I ate through a food diary and calorie counting, supplemented with just about daily walking on the treadmill to stimulate some extra calorie burn - I simply wanted to shrink down as a lady, not become buff.

My starting weight was 209.2lbs and as of today hovers ~135lbs. The past three months my weight has plateaued, but my body fat % has been decreasing, not a result I can complain about. Total losses being 74lbs and 18.1% body fat.

As of November 2018, I noticed I was hungry all the time. I had just come off of keto following some trauma, and had been severely cutting back my calories. I'd figured I went into starvation mode with malnutrition so I began eating to sustain my weight - more exercise, more calories + calories to sustain, vice versa.

The amount of low-calorie food increased in volume in my attempts to sate my hunger. I could eat a big bowl of oatmeal, a bowl of soup, two PBJs and still be ravenous. I can physically fill my stomach to the point of vomiting and my body still tells me I am hungry, and I need food.

Reading up on things I could do to try helping, I began seeking more nutritionally valuable and fibrous foods. Higher protein and fiber intake, and more vegetables for fibrous material, which has helped a slight. I have begun taking Caralluma Fimbriata extract, a cactus extract used to treat people who lack the "I'm full" mechanism entirely, and Wellbutrin, to help suppress it further.

These things have helped grant me back my ability to focus on things, but my satiation/satisfaction is impossible to reach. The quality of my life is decreasing. Essentially my only motivations are to distract myself until I can eat again (I now eat 5 small meals throughout the day). I am constantly uncomfortable.

What the heck is going on?? I know some people have significant weight loss and have no issues. I have also read up that is it not unheard of for hunger to increase with weight loss, less leptin to counter the ghrelin your body produces, believing you're starving, as fat cells never technically go away. The studies I have read up on this state the participants dealt with increased hunger for the 2+ years they followed them, which they concluded that it would never go away, but I like to believe my body will adjust, as it needs time to adjust to my new weight.

Perhaps it makes a difference, but I have always had a hormonal balance issue with estrogen and testosterone. I am a female, but at the age of 13 (6 years ago) I tested with 58% testosterone in my body, and I know has increased since my weight loss. Maybe this has something to do with it?? I don't know.

Any feedback or suggestions would make my day lovely. Sorry for such the extensive message, but I wanted to leave no variables to question.

Thankyou 🙂

[VLLyles]

Are you taking any supplements?  If not get with your doctor to make sure all vitamin and mineral levels are normal.  Since I crave sweets I am missing out on getting enough magnesium.  

[Dominique]

Here are some numbers I’ve seen recommended for sustainable and lasting weight loss: 1%, 10%, 3 months.

• lose no more than 1% of your body weight per week
• lose no more than 10% of your starting weight before switching to a maintenance phase
• lose for no more than 3 months before switching to a maintenance phase

You started at 209 lbs in July 2018 and are now (14 months later) 135 lbs. You reached that weight three months ago, which means you lost 74 lbs (35% of your starting weight) in 11 months (44 weeks). In other words, you far exceeded two of the three mentioned limits. What you observe (constant hunger) is an expected consequence of having lost so much for so long. What is done is done, so you should now think of a damage control strategy. You basically need to rebuild your metabolism back to its normal level. This is done by sending clear signals to your body there’s food around, so it no longer needs to remain in "starvation mode". This means you should be ready to accept regaining some of the weight you lost. If you keep pushing, you will only make things worse. Sometimes one step back, two steps forward is the best approach. 

[MadisonToler]

you mentioned going off keto due to trauma. your body could be trying to cope with that same trauma by emotional eating, which will cause you to THINK you're hungry but never feel full. maybe try talking with a therapist or professional? could be something else completely different, but it's just a possible cause i didn't see anyone else bring up.

[DocA]

My guess is you may have an undiagnosed metabolic combination or that and or a condition that a gastroenterologist said can happen when smaller framed people inherit the same size intestinal tract as a larger /male ancestor like DAD. Then there the other 30 variables, so I recommed one of the non-profit renound hospitals that assemble a team of specialists :Mas General, Cleveland Clinic, Menninger,  Mount Sinai, they will assemble a team under one leading specialist, he/she will start you and in several days, assemble their findings a diagnosis with recommendations. If you do this out side of this kind of structure, you could line up an outpatient fragmented mess taking well over a year ending up with Wild **ahem** Guesses. You likely have a rare metabolism, or genetic event that requires you to break all the usual fitness rules. See TED talks on the abdomin is our second brain. Top researchers give those talks. I hope this opens a door for you.

[SunsetRunner]

Some random thoughts:

You said you came off of Keto-did you go to low fat? 

I highly recommend cronometer.com to track food because it gives you nutrient detail down to the micro level-this would show if you are lacking in a vitamin and or a mineral-these deficits could cause the hunger pangs you describe-your body seems to be crying out for something.

It might be that you need to eat foods that aren't low calorie but eat them in moderation. 

Have you had a physical any time recently?  An overactive thyroid can cause overactive hunger.

That's all I have-good luck and if you find a solution, please post it!

[Reesie]

@ Dominque Many thanks for the extensive response! Your suggestions are routes I may seriously consider, along with some of the others I have received.

You mentioned I may need to rebuild my metabolism, done by sending signals to my body there's food around and no longer needs to starve.

To do this, I presume I would need to increase my daily intake of calories? Of nutritious food, of course.

If I am successfully able to do this, and can stabilize things but still want to **ahem** off that slight regain, would that be possible in following the limits you provided/stated?

Thank you! ☺

[Dominique]

Yes, in order to restore metabolism, you need to reintroduce calories (preferably from quality sources, of course). You may regain a few pounds, but if you do so slowly, the gain should be limited. Besides, you have lost so much from your starting point you can afford to regain a little bit. Sometimes, one step back, two steps forward is the best approach. You don’t have to stay in maintenance forever: once you’ve stabilized things and no longer have unbearable cravings, you can start an active weightloss phase again. I suggest you have a look at the Losing All Your Weight At Once video by Dr. Mike Israetel, who’s one of my favourite resources for all things nutrition, weightloss and training. The 1%, 10% and 3 months "rules" are from him, and he also provides advice on how long maintenance phases should be. In the video, you’ll also recognize many of the symptoms you’ve experienced (e.g. hunger / cravings).

[Reesie]

That video was incredibly informative!! Wowee
So, maybe some silly questions, but I want to clarify
-Will I want to regain that weight in fat or muscle? I presume fat
-What would a healthy/steady increase of calories look like? I see often a
200cal increase to slowly add on one pound at a time

-How would I know when I no longer need to continue increasing calories, or start/stop maintenance?

I may also have to tailor how I track my activity. I've been using Fitbit
with MyFitnessPal. I'd set my daily caloric intake to default at my BMR,
but to import any exercise from Fitbit. Ergo, on days I wasn't doing much
anything I wouldn't be consuming enough to gain any weight (and likely in a
slight deficit), and days I was more active I was eating what was imported
to "maintain."

My game plan in that aspect may be to slap that 200cal onto that BMR and
continue that routine, but I imagine you have input as to what I should do
instead - maybe more than 200, maybe just go for a flat calorie rate
despite how active I am, etc.

Many many thanks for all the input you've already given me!! I feel a sense
of hope I'd lost

[Dominique]

Regarding gaining/losing fat/muscle: the optimal environment for losing fat is a caloric deficit, while the optimal environment for gaining muscle is a caloric surplus. This means doing both at the same time is very hard, especially if you’re relatively lean to begin with. What happens in practice is people lose both fat mass and lean mass while in a caloric deficit, and also gain both fat and lean mass when in a caloric surplus. The more aggressive the deficit is, the more lean mass you will lose. Likewise, the more aggressive the surplus is, the more fat you will gain. This makes the case for losing/gaining weight at a moderate pace.

As to how much you should eat / how many calories should you add: you should experiment and see what happens on the scale. Ideally, you would weigh daily and use weekly averages (so as to eliminate the impact of normal daily fluctuations). If you see your weight is increasing too fast, reduce calories a little bit. If you see you’re no longer gaining anymore, it’s time to add calories. 200 calories sound like a good increment to me.

You should set yourself a target weight, accept the fact that it’s higher than your current weight (I know it can be hard for women) and try to get there as slowly and steadily as possible. Once you’re there, you should be able to lose fat again, but a lot more easily and without the adverse effects (unbearable hunger/cravings) you’re currently experiencing.

[mnashp]

I suffered extreme hunger coming off of keto due to health concerns with blood pressure and cholesterol. I was never hungry on keto, but as soon as i added whole grains, i clocked it to about 20-30 minutes before the pangs set in. Then, experimenting, I would eat protein and not feel hungry for an hour.

so i learned to juggle the calories and macros and timing and reduced the RATE at which i ate my carbs, to avoid spiking insulin any more than necessary. I slowed WAY DOWN and capped with protein (teaspoon of peanut butter with glass of skim milk works great).

hope that helps!