Hunger Regulation

The desire to regulate hunger has resulted in a wide variety of approaches
and techniques, including professional diet centers, programs, and clinics;
self-help books and magazines; diet clubs and support groups; self-help
classes; and “diet doctors.” Many people have benefited from psychotherapy
in an effort to understand and control their hunger regulation mechanisms.
Group therapy is one of the most successful forms of psychotherapy for food
abusers. Types of group therapy vary greatly and include leaderless support
groups, nonprofessional self-help groups such as Overeaters Anonymous,
and groups led by professional therapists.

Advantages of group support for hunger regulation include the realization
that one is not alone. An often-heard expression in group therapy is “I
always thought I was the only person who ever felt this way.” Other advantages
include group support for risk taking, feedback from different perspectives,
and a group laboratory for experimenting with new social behaviors.
Witnessing others struggling to resolve life issues can provide powerful
motivation to change. Self-help and therapy groups also offer friendship
and acceptance. Creative arts therapies are other forms of psychotherapy
used by persons seeking to understand and control their hunger regulation
mechanisms. Creative therapy may involve art, music, dance, poetry,
dreams, and other creative processes. These are experiential activities, and
the process is sometimes nonverbal.
A more common experience for those who have faced the issue of hunger
regulation is dieting. Despite the high failure rate of diets and weightloss
programs, the “diet mentality” is often associated with hunger regulation.
Robert Schwartz studied the elements of the diet mentality, which is
based on the assumption that being fat is bad and being thin is good.
Dieting often sets up a vicious cycle of failure, which deflates self-esteem,
thus contributing to shame and guilt, and leads to another diet. The diet
mentality is self-defeating. Another key element to the diet mentality is the
mechanism of self-deprivation that comes from not being allowed to indulge in certain foods and the accompanying social restrictions and isolation
that dieting creates. Dieting treats the symptom rather than the cause of
overeating.
Numerous approaches to hunger regulation share a condemnation of
the diet mentality. Overcoming overeating; understanding, controlling, and
recovering from addictive eating; and being “thin-within” are approaches
based on addressing hunger regulation from a psychological perspective
rather than a physiological one. These approaches share an emphasis on the
emotional and feeling components of hunger regulation. They encourage
the development of skills to differentiate between stomach hunger and
mind hunger—that is, between hunger and appetite—and thereby to learn
to recognize satiety as well as the reasons for hunger.

Behavior modification consists of a variety of techniques that attempt to
apply the findings and methods of experimental psychology to human behavior.
Interest in applying behavioral modification to hunger regulation
developed as a result of the research on external cues and environmental
factors that control the food intake of individuals. By emphasizing specific
training in “stimulus control,” behavior modification helps the individual to
manage the environmental determinants of eating.

The first step in most behavior modification programs is to help the patient
identify and monitor activities that are contributing to the specific behavior.
In the case of an individual who overeats, this could involve identifying
such behaviors as frequent eating of sweets, late evening snacking,
eating huge meals, or eating in response to social demands. Because most
people have more than one stimulus for eating behavior, the individual then
observes situational stimuli: those that arise from the environment in which
eating usually takes place. Once the stimuli are identified, new behaviors
can be substituted—in effect, behavior can be modified.