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Several practical, therapeutic tools and resources can help patients get more in sync or accepting of food and their bodies when in treatment for an eating disorder. Some, like the hunger scale or hunger-fullness rating system, can also be useful well into recovery, helping to keep you in touch and in sync with your natural hunger cues.
The hunger scale—sometimes called the hunger fullness scale or hunger satiety scale—is used in many intuitive eating practices. There are different versions of the scale, but generally, it involves a "rating" of hunger levels between 1-10, with one representing ravenous and 10 meaning full to the point of feeling sick.
The overall hope of using a tool like the hunger scale is to help people get in better touch with their own hunger and fullness cues, to feel content after they eat, and to eat more intuitively, giving their body what it needs, when it needs it, without passing judgment or criticism.
The first idea clarifies often fuzzy feelings, making them easier to discuss and understand. The second idea opposes the strict rules about when and how much to eat that are usually involved with diets.
Any strict rules around eating can be dangerous, especially as they fail to consider some factors that can significantly affect your daily nutrition needs, including how much sleep you get, your activity level, and hormone fluctuations.1
These kinds of food rules also often lead people to ignore the first few "levels" of hunger and only eat once they're very low on the hunger scale, which can increase the drive to overeat. Repeating this behavior can desensitize someone to subtler hunger cues and "teach" them to only eat once they feel very hungry and only stop eating once they feel very full.1
Even though it is intended to help clarify feelings around hunger, the hunger and fullness scale is subjective, so people can have challenges and frustrations when using it.
Some people may fixate on determining the exact number they are on the scale, which misses the larger spirit of the tool.1 The scale is meant not as a hard definition but more as a loose guide to help you understand, relatively, how hungry or full you feel. This helps you be more aware of what you’re eating and when which can lead to a more intuitive eating practice.
The scale can also promote the false dichotomy of "hunger" and "satiety" as the only two options, or the idea that you need to eat when you're hungry and stop when you're full. There are nearly endless variables in life that work against these simplified ideas. If someone focuses too much on how the scale should dictate their behavior, they may feel like "failures" if they eat past fullness, which can lead to the same type of guilt and shame connected to the toxic diet cycle and many eating disorders.3
The best way to think of the hunger scale is as a guide to help you gain perspective and make the most informed choices for yourself at any moment.
Depending on the particulars of someone's situation, the hunger fullness scale can also be helpful in treating an eating disorder.
The scale works best when it's used to help someone become attuned to their body cues, specifically hunger and fullness. It is one way to deprogram harmful beliefs and artificial rules around when and what to eat after someone subjects themselves to unrealistic body, appearance, and food standards.
Studies show that intuitive eating can lower the odds of engaging in disordered eating behaviors and increase body positivity.4 Both of these are essential aspects of eating disorder recovery.
Still, the scale is only recommended in some cases. Particularly when someone has engaged in heavily restrictive dieting, their body's cues can "adjust," making them less likely to feel or recognize feelings of hunger or overly sensitive to feelings of fullness.5 In these situations, other treatments and tools might be more helpful in repairing someone's relationship with food and eating.
Everyone is different, so it's important to listen to the advice of your treatment team on how best to use the hunger scale in your recovery journey.
The hunger and fullness scale can be applied in many ways, depending on your specific treatment regimen, medical history, and current stage of recovery.
If you enjoy food journaling, you may incorporate the scale into your daily log, dictating where you were on the hunger scale when you started and stopped eating. You can also use the scale periodically throughout the day to check in with yourself and see when you're feeling ready for a snack or a meal. This can also help you assess whether you're genuinely feeling hungry or reacting to outside factors, like stress or boredom.1
Generally, the hunger scale is good to use when eating a meal or snack. You can check in at the start to help you understand how hungry you were when you started eating and use it as you eat to help you stop before you feel uncomfortably full. Printing out the chart below can be a helpful way to remember the scale and the types of portions you may want to see on your plate.
Recommendations vary, but some nutritionists say it's good to start eating when you're feeling around a 3 or 4 and stop eating when you're feeling around a 7.1 But many variables can change these recommendations. The scale will register and feel different for everyone. The most important thing is learning to listen more closely to your body and its unique signals for hunger and satiety.
At Within Health, our team of multidisciplinary experts uses a wide range of tools and treatments to help each client get the exact type of help they need. In some cases, this includes working with the hunger satiety scale.
If your treatment team thinks this tool may be helpful for you, you'll speak with them to learn more about the nuances of the scale and work out the most appropriate way to use it in your recovery routine.
You can also access the scale through our app and track your feelings to help you stay on top of your body's hunger cues. You can also start building a log to help you recognize and adjust for specific patterns.
Your treatment team will work with you more to ensure you use the hunger scale to the safest extent possible and continue offering support throughout your recovery journey.
Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.
Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.
The hunger scale—sometimes referred to as the hunger fullness scale, hunger and fullness scale, or hunger satiety scale—is a tool used in eating disorder treatment and recovery. It describes a range of hunger and fullness on a scale of one to 10 to help users better explain or understand how they're feeling.
Hunger and satiety—or the feeling of fullness—are two key aspects of ensuring the body has an appropriate amount of energy. These feelings are controlled by a part of the brain called the hypothalamus.6
Hormones play a significant role in hunger and satiety. Hormones signal to the brain and body that it's time to start or stop eating. The hormone ghrelin is credited mainly for feelings of hunger, while leptin is a primary driver of feelings of satiety.6
Hormones also play a significant role in hunger cues in women, depending on where they are in their menstrual cycle.
Satiety is a word describing the feeling of fullness. Rather than meaning overly full, it usually indicates that someone is full just to the point of feeling satisfied.
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