Refeeding: A Treatment for Obesity?
“I’m hungry all the time. I think about food all the time.” I was lamenting to Mike, my husband, about why it’s so hard for me to follow my program for more than an hour or so.
“That’s because there is something the matter with your brain. For whatever reason, it tells you that you’re hungry all the time.” He was trying to help me, but his words were anything but consoling. “You’re like an anorexic, except backwards.”
How many times had I wished I could be anorexic? How many times had I wished I could be free of this desire to eat all the time?
Mike continued talking, “What would you do if you WERE anorexic?” I cried and laughed at the same time. “I’d be so damn happy and not eat for a year. I’d finally be skinny.”
He nodded and asked, “And then after you were skinny, what would you do? If you didn’t eat, you’d die, so what would you do?”
I knew EXACTLY what the treatment for anorexics was: refeeding. Food is introduced in small quantities at regular intervals. They have to eat when the timer goes off, even though it’s the last thing they want to do. I explained it to Mike and he nodded knowingly, “That’s EXACTLY what you need to do. You have the SAME problem as an anorexic. You need to eat a small meal every couple of hours whether you feel hungry or not. You need to NOT eat in between times. Your hunger mechanism is just as broken. You can’t trust it. You just need to set a schedule and eat when the schedule tells you to.”
When I was eating healthy and at my lowest weight, that is EXACTLY what I did. The memory of it flashed in my mind and I remembered my Palm Treo phone’s alarms going off at break time so I would remember to eat a snack. I used to tell the woman in the desk across from me that I needed an alarm because I would forget to eat. That was half the truth. The whole truth was that I needed to eat a snack at 10 am because otherwise I’d eat an entire day’s worth of calories at lunch, fueled by my unchecked hunger.
I immediately pulled out my phone and set alarms for breakfast, snacks, and lunch (my family reminds me that I need to eat dinner). The next morning, the alarm went off, reminding me to eat breakfast. I had just finished my first cup of coffee and I didn’t really feel like eating. I realized that I was wrong. I’m NOT hungry ALL the time. I’m not thinking about food all the time. Only when I let myself get too hungry, so I ate my breakfast as planned.
After my morning walk, I felt like stepping into the kitchen and eating something, but I remembered that I needed to wait until my snack time. I glanced at my watch and it was only an hour away. I can wait an hour. And the alarm surprised me in the middle of my work. I was no longer hungry, but it was time to eat a banana. I could do that. I ate my banana, refilled my glass of water and went back to work.
About an hour later, I got up to go to the restroom and I immediately wanted to eat again. My lunch time alarm hadn’t gone off, however, so I decided to wait. By the time my lunch alarm DID go off, I was knee-deep in work. No longer hungry, I snoozed the alarm once and then after it went off, begrudgingly microwaved my meal. This idea that I was hungry ALL the time was dissolving. As long as I fed myself good food every few hours, I forgot all about eating.
I did want to eat about a half hour before my afternoon snack time, but I waited. I had a lull in work and I was bored, not hungry. After months of not being able to follow my plan for more than an hour each morning, I finally have a tiny modicum of success. It appears that refeeding works for anorexics and binge eaters alike.
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