Stephanie Fein MD [00:00:01]:
Hello, fabulous. Dr. Stephanie Fein here with weight loss for fertility. And we're back. So happy to talk to you. We love, I should say I love. And hopefully you are now a fan of the hunger scale as a major tool to help us stop overeating. There are a million benefits.
Stephanie Fein MD [00:00:25]:
I have so many podcasts about hunger scale, and this will relate. Almost all the things I talk about will relate to the hunger scale because hunger is the most important indicator for eating. And that's an important point, because it's not celebrating or coffee break or any other reason we have a reservation. None of those are the best reasons to eat. The best reason to eat is hunger. And when we teach ourselves that we're aligning ourselves with how our body works and all the hunger hormones, it's always so interesting to me when I think of the GLP1s. The new medications for weight have impact on the hormones, but we can do that by listening to our bodies, by understanding how it works, the hormone signals become stronger. So it's like doing a GLP one, except we're doing it naturally.
Stephanie Fein MD [00:01:25]:
It's not exactly the same, but I'm always reminded of that when we're talking about hormones. We have the hormones. We can alter how they affect us by tuning into them. Okay, that's my little spiel about hunger scale. I really, really love it. But it can be tricky when we're first starting out, especially when we're not used to using our internal cues as telling us when eat and when to stop. We often don't trust ourselves because we can find ourselves overeating. There are so many reasons for overeating, and often, especially in diet culture, we'll end up blaming ourselves around that.
Stephanie Fein MD [00:02:03]:
Everyone benefits when we blame ourselves because then no one else has culpability whatsoever. And while I'm a huge proponent of personal responsibility, I do not think it serves us to blame ourselves, especially in a punishing way when there's lots of factors involved. So I do like the idea, however, of starting to learn our cues and get in touch with how our body works around food. And when we're starting, we're learning to use the hunger scale. And actually, now that I'm thinking about it, I'm going to tell you the scale, which is negative 5, is out of fuel, like fainting. And positive 5 is extraordinarily, uncomfortably, painfully full. And we have all the numbers in between. We here learn to eat at minus two, which is just hungry.
Stephanie Fein MD [00:03:02]:
It's not very hungry. It's just hungry. And we stop eating at positive two, which is satisfied, not full. So if we're eating, if we eat to full, full is I'd say three very fulls, four and very, very full is five. If we are used to eating till three or four, that's a good piece of information. And we can start stopping at positive 2 instead of positive 3 or 4. One of the main ways that we lose weight with the hunger scale is that we notice when we're overeating and we change that behavior. And one of the things people find very often, a lot of my clients find is that they are over hungry, so they're waiting too long to eat.
Stephanie Fein MD [00:03:50]:
It's so common. I think a bit of it is that we from diet mentality, we think being hungry is good. It means we've now sort of tricked ourselves into, oh, now we're going to have fewer calories because I didn't eat when I was hungry. It just does not work that way and in fact backfires because if we get over hungry, we overeat. So if we get to negative 3, we will eat to positive 3. If we get to negative 4, we will eat to positive 4. On autopilot, it will feel like a bottomless pit. If you've ever felt that way, it's likely partly because of this over hungry piece.
Stephanie Fein MD [00:04:29]:
I cannot tell you exactly which hormone it is, but I'm convinced it's a hormone that has us sort of desperately eating when we get desperately hungry. So we avoid that around here and we eat when we're just hungry. We stop when we're satisfied, not full. And that way we're not overeating so good. So we have to discover our numbers. That's the beginning part of how we lose weight at weight loss for fertility with the hunger scale. And I was speaking to a client who was having a hard time with sort of the breakfast lunch time. And she wouldn't be hungry for breakfast, which of course, if you're not hungry, we don't eat.
Stephanie Fein MD [00:05:11]:
But then she'd find herself over hungry for lunch. So what was going on? We investigated and that is what inspired today's episode. A very common reason why it might be hard to determine hunger in the morning is coffee. It turns out while my client wasn't having breakfast in the morning, she was having coffee. And that can impact our hunger scale. So we're going to talk about it today. Caffeine is an appetite suppressant. It has lots of effects.
Stephanie Fein MD [00:05:46]:
You know, some good for you, some can be in high doses, can be bad for you. And there's a Whole bunch of things. And today is not going to be about that. I'm not making a recommendation one way or the other. But I'm just here to tell you about caffeine as an appetite suppressant. So that's what we're going to be focusing on, that aspect of it here. You can have this, that effect with, you know, full with espresso you could have. Some people can have it with decaf or even tea, soda.
Stephanie Fein MD [00:06:17]:
So there are fast and slow metabolizers of caffeine. And if you are a slow metabolizer, you can get jittery, it's uncomfortable and it lasts a long time. If you're a fast metabolizer, then the effect goes away quickly and you may not ever get jittery. You just sort of feel awake. That's why there's some people who can have it, you know, at night and still go to sleep, no problem. So we all have different ways that our body reacts, including how much we're taking in and what our body does with it. And that's really important to know because we have to take that into account when we're working with the hunger scale. So if caffeine masks hunger, then when it wears off, you're left feeling over hungry because it's the hunger, the need for fuel is still going on in your body.
Stephanie Fein MD [00:07:06]:
It's just that the drug of caffeine is masking it and we want to avoid that instant or quick feeling of over hungry. And preferably we want to do that without taking away your coffee. Now if you don't care about your coffee in the morning, yes, I recommend not having it. I mean, if you're like, I could take it or leave it, leave it. Great. Especially when you're learning about your hunger skill. But if you're one of those people who's like, you could take it out of my cold dead hand, then I will not be taking it out and you stick with it. But we're going to talk about how to handle that.
Stephanie Fein MD [00:07:50]:
Most people don't drink it. For the appetite suppressant Beson, it's for one of the other effects that can caffeine has on arousal, basically. And like many drugs, because caffeine is for sure a drug, there is a bit of tolerance effect. So we can get to the point that we need the drug just to feel normal in the morning. So you feel draggy, you have your coffee, you feel normal. And that is dependence. So that's what happens with all like illicit drugs that you end up at first like heroin Feels amazing, but then you're just taking it so you can feel normal and not terrible. And on a mini version, that's the same thing that's happening with caffeine.
Stephanie Fein MD [00:08:38]:
To stop yourself from feeling exhausted. You have the caffeine just to feel normal. And being dependent is not particularly a problem, but there will likely be some measure of withdrawal if there's a dependence on it. If you stop abruptly. And for caffeine, that's usually like a headache of some sort, some sluggishness, some fatigue. It goes away after days or weeks, depending on how you metabolize, how long you've been doing it, you know, all that sort of stuff. There's no need to stop it unless you're told to do so by your re because your reproductive endocrinologist may have ways of thinking about it, what they like. So I would highly recommend doing what they say.
Stephanie Fein MD [00:09:18]:
And if they do want you to stop, then you may just have a headache. You may not. You may, if you're a fast metabolizer, maybe no problem whatsoever. And the RAs also have different recommendations. Sometimes some want none, some are fine with one, some you can have up to two cups. It depends. So just definitely do what they're saying. But I.
Stephanie Fein MD [00:09:39]:
But if you're continuing to have it, we want to talk and figure out how to use the hunger scale in the face of coffee. So in terms of weight loss, we want to mitigate the negative effects. And the only real negative effect is that it can lead you to be unknowingly over hungry. And if we get over hungry, let's say later in the morning, we may find ourselves wanting a big breakfast. This is the problem with over hunger. It can be very, very sneaky because what can happen is all of a sudden you have a major craving for a lot of food or food right now. Over hunger can be physically uncomfortable, but it can also show up more subtly, like potentially as a result of the delayed perception, it can feel like a craving. So let's say you have coffee in the morning, you.
Stephanie Fein MD [00:10:33]:
You weren't hungry for breakfast, but all of a sudden you have a very big craving for pancakes or a sweet or something like that. Part of that could be habit, but part of it could be that your body is over hungry and wants quick fuel. And when it wants quick fuel, it thinks of sugar and flour first, and then it compels you to get that. It wants you to get that. It influences you. The way it influences you is that it has you thinking about it. Thinking is a craving. That is what A craving is.
Stephanie Fein MD [00:11:07]:
It's just thoughts, but they're thoughts that are born in your brain. I know that that's how all thoughts are, are born. But it's created by your brain to get you to have fuel. And if you're over hungry, more likely than not, that fuel, that craving will be for sugar and flourish. And if it is, or even if it isn't, you still will be over hungry. Meaning you'll need more food than you normally would have if you had eaten when you weren't over hungry, but just, just hungry. So one of the ways that I know I'm getting hungry or over hungry is that I want things I normally don't crave. Like, I will notice that I want like a breakfast of pancakes.
Stephanie Fein MD [00:11:56]:
That's not what I normally have. And I don't normally want that. If I want that, I just plan for it that there's no problem having pancakes for breakfast. But if I wasn't planning it and all of a sudden my brain's offering it as a great, you know, option, I know I'm over hungry. When we have the craving. The problem with having the craving is that it's hard to resist. We're put now in a position of having to sort of argue with ourselves. And that's never a great position to be in.
Stephanie Fein MD [00:12:26]:
And we think we have to use willpower. But the easier sort of better way to deal with it is if we ate at negative two, we could have skipped the whole craving part. It's an important point that cravings can be over hunger and they are hard to manage if they are started. It can be done. You can see past episodes on urges. I talked about urges before. We can. There is a skill in learning how to deal with urges, but it's so much easier if we just avoid the whole craving in the first place.
Stephanie Fein MD [00:12:58]:
And we can do that if we don't let ourselves get over hungry. And a place that it may be a sticky point for you is if you're noticing it's in the morning after your coffee has worn off. Now this is a, this is a bit of a tangent, but I wanted to talk about it here. Because of coffee, if you're fasting, which is not something I recommend here in terms of forcing yourself to fast or to not eat, even in the face of hunger, I do not recommend that. But I did want you to know that only black coffee counts for fasting, meaning if you have anything in your coffee, then it will stop your fast. So if you have coffee at six in the morning and Then you don't. You're trying to fast till noon. You've stopped your fast at 6 in the morning.
Stephanie Fein MD [00:13:52]:
So I just want you to know that piece of information. And remember, I do not recommend fasting in the face of hunger. It's not sustainable in pregnancy or during lactation. There's just no reason for it. We want to be learning how to eat when we're hungry, stop when we're satisfied. So whenever you're hungry, I recommend eating. But I wanted to point out that we naturally fast when we sleep. We're not eating when we sleep.
Stephanie Fein MD [00:14:21]:
So if we're using the hunger scale, we usually do get a good number of fasting hours in. It's often 12 hours, easily, effortlessly. Because if we're eating dinner, let's say at 7, when we're just hungry, we stop when we're satisfied. Your hunger likely won't be there until seven the next morning. So the hunger scale helps us with the benefits of fasting. Meaning the benefits of fasting are that you have a long period where there's no sugar or insulin. It's really the insulin benefit we get. If there's no spike in insulin.
Stephanie Fein MD [00:14:57]:
We have a long rest without insulin. That is what benefits us. Because when insulin's on board, we, we're storing fat. When there's no insulin around, we're not storing fat, we're using fat. So it's nice to have a long period of time. But we can do that naturally. We can use the hormones. We can basically sort of train our hormones.
Stephanie Fein MD [00:15:17]:
And I don't mean train like they're not used to that. I'm saying we're really training ourselves. Our body can do that easily. We're training ourselves to follow our body, to be guided by our body. That's what we do with the hunger scale. So just know that about your coffee, that if you're having black coffee, it will elongate, it will extend a fast. But if you have anything in your coffee, it's not. So it's important then.
Stephanie Fein MD [00:15:46]:
So what do we do now? Now that we know this information, it's important to learn how it affects your own body. If you don't drink coffee in the morning and this is not an issue, then this is just good information that you could use at your next coffee, coffee date or party, you know, cocktail party. But if you do have coffee and you've noticed that this is an issue in the morning, then learning how the coffee affects you is really important. And that just means paying attention. You can always write down your Hunger levels, the hunger number, your hunger scale, and you can see what's going on. Is there a pattern when what do you notice that sort of thing? Logging always helps with that sort of thing. But if you're noticing that you get over hungry in the morning or for lunch, then your coffee and caffeine and appetite suppressant effects can be the reason. So the way we deal with it is we plan for it.
Stephanie Fein MD [00:16:43]:
Okay. So we first of all know that it's a possibility and we experiment with the timing of eating something. So what we don't want to do is eat when we're over hungry. So now we have to figure out a time to eat sooner. So is it just that we have hunger signals that are different than hunger signals off caffeine? That would be good to know. Maybe. We normally have stomach grumbling when we're just hungry, but when we have caffeine on board, it's our, we're distractable. So maybe it's a more subtle hunger cue.
Stephanie Fein MD [00:17:19]:
That's fine. And we want to discover that for our morning because we always want to eat before we're over hungry. And so you'll have to find that when that is for yourself, you'll notice a different negative, two different symptoms of your hunger, potentially on caffeine. And then when we do eat, when we're just hungry, we won't have cravings for, you know, sugar and flour. We eat something with protein. Protein is so helpful. It stays with us longer. So it, it helps us not be hungry faster.
Stephanie Fein MD [00:18:00]:
Right? It helps us, it stays in our stomach longer. Again, this is another effect of the GLP1s. It's, we have, our stomach is slower to empty. That's what happens with protein. So we can do this without medications. These are the techniques that work for that medication, and they work without the medication. And if we eat protein, we're more likely to stay fuller longer. So we can have something planned that has protein for our breakfast.
Stephanie Fein MD [00:18:32]:
So we have our coffee and then we plan what our breakfast is going to be. And we eat that breakfast when we're at negative two, which may look different with caffeine. Okay. And then we're only eating to positive two and it's easier to do when we eat at minus two to stop at positive two. We don't have to use, you know, crazy amounts of willpower or any. It's not a problem. And that's really good to know. And that's what the rest of the day looks like too.
Stephanie Fein MD [00:19:00]:
Eating when we're hungry, easily stopping when we're satisfied. So coffee is fine to have. Depending on what your ARI says, be aware of the effect it might have on your appetite. Learn the altered hunger signals and then eat before you're over hungry, preferably with protein. And that will help you not overeat and lose weight. And in the process you're connecting more with your body. You're learning how to treat yourself kindly. Find your desires, your likes, your dislikes, and you always have the guide in you.
Stephanie Fein MD [00:19:48]:
The hunger scale Getting to know yourself always pays off, not only in weight loss, but in the rest of life too. We always lose weight when we stop overeating and the hunger scale is a magnificent tool to help you do that. Lose weight with me. If you want sustainable weight loss and a kinder relationship with yourself and food in the process, then give me a ring. And what I mean by that is I can go to my website, weight lossforfertility.com or stephaniefinemd.com to get started right now. There I am sending you so much love. Enjoy your coffee and have an easier day with not overeating. This is how you do it.
Stephanie Fein MD [00:20:36]:
Sending you love.
