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How to navigate mental hunger during eating disorder recovery
by Kate Sweeney
Sometimes, the only way forward is through.
What do I do if I’m waking up at 2am thinking about food?
What if I just ate and I want more food?
I am cooking for everyone else and spend hours per day looking at recipes. What is going on with me?
If you have these questions, then you may be experiencing mental hunger.
Mental hunger can be very challenging to handle because it can cause a lot of distress, mostly to our eating disorder parts and the parts of us fearful of being out of control or gaining weight or eating “unhealthy”.
It also takes a ton of time and energy, as we focus so much on food.
This distress can then activate ED and make it hard to eat adequately and/or regularly meet nutritional needs during recovery.
Unfortunately, ignoring mental hunger or dealing with it through more rules and less food intake can further exacerbate suffering.
What is mental hunger?
Mental hunger is the cognitive and psychological experience of wanting food, maybe even craving it, even in the absence of physical hunger signs.
Mental hunger is experienced in different ways.
Some examples of mental hunger include:
Waking up in the middle of the night thinking about food
Waking up in the morning and the first thought being about food
Reading recipes throughout the day for no real reason
Watching others making food online
Cooking and baking and not eating the food, serving it to others or ‘saving’ it for later
Studying food or cooking for a living (yes, I’d go so far as to say this could be mental hunger for some)
Planning out meals and snacks with laser thin precision based on ED rules
Thinking about food most of the day, and finding it hard to focus on much else
Fantisizing about a food or food group
Extreme desire not to waste food
Watching influencers online talk about their ‘day of eating’
Getting angry if someone eats off your plate
Going to restaurants to order food and look at it
Mental hunger is physical hunger.
When we are undernourished, struggling in the binge-restrict cycle, chewing/spitting or purging, physical and mental hunger are one and the same.
However, mental hunger feels and looks a lot different than physical hunger.
Why does mental hunger replace physical hunger?
We know hormones (i.e. complex changes in the hunger hormone ghrelin during anorexia nervosa), metabolic changes, psychological factors, medications, movement changes and more can affect physical hunger during recovery.
For the vast majority of people who struggle with any eating disorder that involves restriction, they will have a change in physical appetite.
This can lead to a complete lack of appetite or a very erratic appetite, as the body slows down to account for not knowing if/when food is available.
By slowing down, I mean that our bodies start to go into hibernation. Our gastrointestinal system slows, we have hormone levels shifts which result in low testosterone levels for men and no period for women, we struggle with slowed cognition, our heart beat slows as muscle is lost from the heart and more.
This is a normal adaptation to undernourishment.
Our bodies still want to survive, and along with brain changes that occur during restrictive eating, people start to experience the phenomenon of mental hunger.
Learning from the Minnesota Starvation Study
Perhaps the best evidence for the effect of undernourishment on mental hunger is from the Minnesota Starvation Study of 1950 by Dr Ancel Keys.
In 1950, Dr Keys recruited 36 young, healthy men for the year-long experiment. The study design was as follows:
12 week control period
24 weeks semi-starvation, defined as <½ of the men’s total normal caloric intake. This amounted to 2 meals per day, 1570 calories per day
12 weeks rehabilitation with adequate caloric intake
Some participants went on to further weeks of unrestricted intake, in which they increased caloric intake on their own to over 7,000 calories per day
Mental hunger was one of the study’s findings. In fact:
Participants became more preoccupied with food. They talked about it more, read about food and dreamt about food.
They watched movies involving food often.
Participants became obsessed with cookbooks and collected recipes.
3 participants even changed their occupations to being chefs
Some participants developed eating disorders.
All of these signs of mental hunger continued even after the 12 week rehabilitation phase.
How do I respond to mental hunger?
In recovery, honoring mental hunger is as important as responding to physical hunger.
Responding to mental hunger supports re-regulation of hunger and fullness cues and helps the body and mind heal from under-nutrition and food insecurity.
As scary as it is to lean into mental hunger, it is what is needed.
Tearing off the band aid and letting go.
This may mean:
Increasing your meal plan
Eating ‘off’ of the meal plan you may have or getting rid of the meal plan altogether!
Eating at odd hours like the middle of the night
Cooking food and eating it, alone and with others
Committing to one recipe instead of sitting in indecision
Going to a cafe to have a snack versus eating a safe food at home
Letting your team know about the mental hunger and addressing it
I must add here that many clinicians themselves hold fat phobia and thus, are afraid of mental hunger as well or try to reduce it by ‘filling up’ at meals with fiber, protein and fat. Some clinicians even indicate that eating more than on the meal plan may be binge eating - IT’S NOT!
Unrestricted eating is completely normal in recovery.
Even if you have a GI condition as well as an ED, there are ways to reduce restriction and open up your options, responding to mental hunger.
Some tips for managing mental hunger:
Consider your goals for recovery and your reasons for nourishment.
Are you willing to make the trade off of distress with eating when mentally hungry for the ability to meet your goals, be fully yourself and be less in the prison of the ED?
Use mindfulness techniques like meditation, movement, journaling, breathing, Dropping Anchor and more to practice sitting with emotion.
Eat with your supports.
Use distraction when eating like watching a movie, listening to music and more.
Keep food by your bedside if you wake up hungry, so you can eat and go back to sleep.
Include ‘fear’ foods regularly.
Go out to eat to practice letting go of rules around portions or ingredients.
Be curious and notice how you feel after eating more adequately or having a fear food. Notice your thoughts, energy levels, etc. This will help you build trust in your body and not let the ED run the show.
Lean on your treatment team, especially your dietitian. Talk about how the mental hunger feels for you and get more tools on how to move through it.
Re-writing the story
Most often, our eating disorder places unhelpful meanings on mental hunger.
Mental hunger becomes ‘bad’ and our thoughts shift to eating as ‘giving in’ and ‘weakness’. The fear of weight gain or being out of control and binge eating or just plain ‘eating at the wrong time’ come up.
However, mental hunger is telling us that:
We have unmet energy needs
We need to eat to restore balance and trust in our bodies, to get regular physical hunger signals again.
We need less restrictive rules around eating and need to rebuild our relationship with food.
In rewriting the ED story, you can realize mental hunger is:
A sign our bodies are trying to communicate with us
A sign that our bodies ARE working
A powerful way of keeping our bodies alive
So, what if, while you sit with the ED thoughts of the mental hunger being ‘bad’, we also had the following thoughts:
‘My mental hunger is a sign I need more nourishment. I am willing to eat more because it is in line with my goal of recovery. If I feel distress, I can use my tools and skills (calling a friend, going for a walk, etc) and I can also tolerate it.
In my experience working with clients, eating in response to mental hunger (and not compensating later!!!) actually decreases disordered thoughts and the feelings that come along with them.
It seems odd, right? But, in fact, when the body and brain are nourished, we think less about food.
This doesn’t mean you can’t still be interested in food, find satisfaction from it and even, be a ‘foodie’.
It means that food won’t own you. Your ED won’t be living rent free in your brain.
Closing Thoughts
Mental hunger is complicated and scary for those of you going through recovery. It is also a sign that our body is communicating for us, working and doing what is needed!
Your body is amazing.
Writing a different story about mental hunger is about opening up versus closing down, letting go of rules versus making more, and of building trust with your body versus fighting it.
Eating in response to mental hunger is hard and yet, a powerful way to continue moving forward in your recovery.
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