Do you start planning what you’re having for dinner before you finish your lunch and constantly make sure you carry snacks around in your bag at all times? Are you hungry all the time and wonder why? You’re not alone—this is a pretty common feeling.
It makes sense in the context of being part of a medical condition or the side effect of a medication, but for a lot of people, that’s not the case. They’re just hungry. ALL. THE. TIME.
Turns out, this is one of those tricky areas where there are so many potential reasons why, but to help break it down, we spoke with a leading gastroenterologist about why this happens.
To start with, it’s important to remember that “hunger is one of our few innate biological responses,” Dr. Ketan Shah, a gastroenterologist at Saddleback Memorial Medical Center in Laguna Hills, California, tells SheKnows. In this case, it’s a response to your body being deprived of calories.
Shah explains that when we humans were in an evolutionary state of being hunter-gatherers, we relied on hunger to provide us with the signals we needed to keep ourselves alive. But unless you count hunting through the produce section to find the nicest apples or gathering coupons to save on frozen pizzas, lots of us aren’t in that place anymore.
The availability of food is no longer an issue for most people. Not only that, but high-calorie foods—like the American diet—are in abundance, which has resulted in obesity becoming an epidemic in staggering numbers: 32 percent of American adults are overweight and another 38 percent are obese, according to Shah.
“This makes me question the applicability of hunger as an innate biological response in 2017,” he says. “Let’s delve deeper into the physiologic mechanisms behind hunger to better understand the paradox that has developed.”
OK, let’s break it down:
Ghrelin is a hormone produced by the stomach, which increases during periods of fasting and decreases after eating — especially when carbs are involved, Shah says. It stimulates food intake in the brain and secretion of growth hormone. Ghrelin levels are relatively high in lean individuals and low in obese individuals.
Conversely, leptin is a hormone synthesized by fat tissue that sends signals to our brains to down-regulate appetite and up-regulate anorexigenic hormones according to Shah. Unlike ghrelin, leptin levels are high in obese individuals, but interestingly, leptin resistance develops in obese individuals. Also, genetic defects in leptin and leptin receptors have been found in children with early onset obesity.
One explanation for binge-eating
There is increasing evidence that eating food rich in sugar and fat — especially during a binge — triggers a dopamine reward system in your brain similar to what happens in drug addiction, Shah explains. If this happens a lot, it could result in your hunger hormones getting out of whack.
“Even more interesting is that in patients who undergo weight-loss surgery, hunger-associated hormones like ghrelin are independently reduced, which partially explain the long-term results of these procedures,” he notes. “In short, binge-eating of highly palatable foods has disrupted our innate hunger response, resulting in a sensation of hunger even when our body physiologically does not need any more calories.”
When to see a doctor
Yes, hormones have a lot to do with hunger levels, but a chronic hunger state has also been associated with adverse physiologic and psychological changes, termed “semistarvation neurosis” as well, Shah explains.
Also, being hungry all the time can occasionally be a sign of an undiagnosed medical condition (but, Shah stresses, only in a small minority of cases). It can suggest a hypermetabolic state like hyperthyroidism or pregnancy, inadequate intake or malabsorption of nutrients leading to hypoglycemia or specific nutrient or vitamin/mineral deficiencies, hormonal changes or simply the body’s normal response to exercising more than usual.
Shah recommends seeing your doctor if you are losing weight or having difficulty maintaining or gaining weight despite an adequate intake in calories. Another recommendation: Don’t forget your roots.
“A good balance can be achieved by remembering that we were designed to be hunter-gatherers who eat smaller, more frequent meals consisting of natural foods low in calories and absent in processed ingredients,” he adds.