Always hungry

August 6, 2012 3:00 PM

Sick and tired of being hungry, and would love to hear from anyone who has had this same struggle and eventually figured out what was going on / what to do about it. (Anonymous b/c of medical information given inside.)

Can't remember when it started, but for at least the past several years I've been hungry almost all the time. This is whether I'm dieting or not, working out or not, etc. When I diet, I count calories, but feel like I am always getting plenty of calories (at least 1500 calories daily--for a female weighing 160 pounds) and enough fiber/protein/fat/bulk etc.

(Really don't want suggestions to eat a handful of nuts, drink lots of water, etc. as I'm already doing these things or have done them without it solving the problem. I'm planning to finally consult a nutritionist but I believe they'll be pretty pleased with what I'm doing already.)

More info: I have the energy for 4-5 hard workouts a week. I'm sleeping well, though of course should try to get a bit more (8 or 9 hours instead of 7--I am much happier with a generous helping of sleep). At 165 pounds I'm slightly overweight but not significantly overweight (I'm 5'6 and muscular).

This certainly got worse (i.e. the hunger pangs escalated) when I went on an SSRI--for anxiety not depression--about a year and a half ago, with the happy bonus--sarcasm--of gaining 23 pounds within the span of a few months while I was eating-when-hungry but not counting/restricting calories. Since then I've been counting calories to try to get to the weight I'd really like to be at--140 or 145--while I still have a twenty-something's metabolism, but am finding it extremely difficult and unpleasant because of the hunger. The feelings of hunger that are uncomfortable some days and almost painful--certainly distracting--other days (occasionally bringing me to the point of tears).

[In case I sound crazy for dieting under these circumstances, it is worth pointing out that I find the difference between feeling hungry on 1550 calories is not that far off from feeling hungry on 1750 calories or even the hunger I felt consuming 2300 calories (estimated retroactively) during my adjustment to the new SSRI. Painfully hungry is painfully hungry, and I'd much rather feel good about my body and in control of my weight gain/loss while being hungry than not.]

As I've said, I'm planning on finally breaking down and consulting a nutritionist to see if they have any suggestions, but would love to hear from anyone that has had similar struggles which they felt were for inexplicable reasons until they finally figured it out. Thanks!

posted by anonymous to health & fitness (20 answers total)

Can you switch to another SSRI? Unrelenting hunger pains would certainly fall under unacceptable side effects to me.
posted by fshgrl at 3:03 PM on August 6, 2012 [1 favorite]

YMMV, but I only realized in my mid-late 20s that what I'd often thought were hunger pangs was actually heartburn.
posted by needs more cowbell at 3:11 PM on August 6, 2012 [5 favorites]

I'm 120 lbs, don't work out, and I need 1700 calories to maintain my weight instead of getting too bony.
posted by availablelight at 3:14 PM on August 6, 2012 [1 favorite]

1500 calories a day does not match with 4-5 hard workouts a week for the vast majority of people.

It is impossible to retroactively calculate your calorie intake. You have got to start weighing your food before and after you eat to get a much better idea of what you are actually consuming. Also, keep track of what your workouts consist of. "4 miles of 7 minute miles" looks very different than "hard workout."

That said, are you still taking the SSRI? If so, has the prescribing doctor or your General Practitioner/Family Doctor had anything to say about this? If you are not still taking it, please see your doctor to discuss this. Changes in appetite are not to be taken lightly and may have actual significant (fixable!) medical causes.
posted by bilabial at 3:16 PM on August 6, 2012 [3 favorites]

Have you tried cutting out sugar and refined carbohydrates from your diet? It was like magic to me when I did that -- how the constant hunger I thought was just part of me almost completely disappeared. Minus the roller coast swings of blood glucose I had previously, it was much easier to get to a normal BMI, as well.
posted by peacheater at 3:19 PM on August 6, 2012 [1 favorite]

This would be an unacceptable side effect for me, no matter how effective the medication was otherwise.

Failing that, it is possible that you'd find a higher fat diet more satiating.
posted by Sidhedevil at 3:20 PM on August 6, 2012

Have you had your thyroid checked?
posted by KathrynT at 3:22 PM on August 6, 2012 [1 favorite]

By "almost all" the time, do you mean even after you eat? Or do you get hungry at some point after meals? Because if the former, you should see a doctor and find out what's causing it. You should probably see one if it's the latter, too. Because it could be a physical problem like thyroid or some gastro issue. Sure, it could be a side effect of your meds, but you said it started before the meds, yes?

Don't see a nutritionist to work on the side effects -- see a doctor to work on the root of the problem.
posted by clone boulevard at 3:24 PM on August 6, 2012 [3 favorites]

I think it has less to do with how much/how many calories you eat, and more with what you are actually eating.

I'm similar with always being hungry, and the constant hunger pangs went pretty much away when I started adding fiber into my diet - mostly in the form of lentils. I started having them almost every day and my constant hunger went away, as well as a lot of my cravings for sweets and junk.

Lentils can be delicious. I usually saute onions/garlic/other veggies, then add the lentils and cook in either water or chicken broth. Then add parm or goat cheese(makes them creamy) or something and it's really satisfying.

I take snacks such as roasted chick peas to work and they are actually filling. I laugh at people who tell me to eat a handful of nuts because I could eat 12 handfuls and would probably still be hungry.
posted by fromageball at 3:53 PM on August 6, 2012 [3 favorites]

Failing that, it is possible that you'd find a higher fat diet more satiating.

I got diagnosed with gallstones just last week and had to cut all fat, every gram, out of my diet immediately to minimize the risk of an attack. And even though my appetite has been way way down for weeks as a result of the stones, since I removed all fat I am RAVENOUS.
posted by L'Estrange Fruit at 4:20 PM on August 6, 2012

You're on an SSRI already but I found that Xanax and similar drugs worked way better for my anxiety that combined with life changes and therapy led to me not being anxious and.... wow.

Turns out that that sensation that felt like hunger or nausea etc was just the anxiety. I lost 35 pounds without making any other changes. Don't underestimate the degree to which anxiety can have physical symptoms.
posted by French Fry at 4:20 PM on August 6, 2012 [3 favorites]

The best way I found to control hunger was to go on a low carb diet. After 3 weeks of South Beach I just didn't experience hunger the way I did before.
posted by bq at 5:31 PM on August 6, 2012 [1 favorite]

Go see a doctor. Constant hunger is one of the symptoms of (untreated) diabetes; as others have mentioned, it could also be thyroid-related. It's possible it's nothing, but better to rule those possibilities out sooner rather than later.
posted by asterix at 6:47 PM on August 6, 2012 [1 favorite]

How much stress do you have in your life? What is your job like? Increased levels of cortisol can make you fucking ravenous, and if you're operating with a high background level of stress, this could do it.

I'm also concerned by the fact that your hunger pangs are so painful that they bring you to tears. Is it possible that you're misinterpreting bonafide abdominal pain as just a 'severe' hunger pang? If I were you I would consult a gastroenterologist about that -- and don't frame it as a "hunger pang," simply call it what it is without trying to assign a cause: pain in your abdomen that you feel daily and that is sometimes so severe that it brings you to tears, and that seems to be reduced with eating.
posted by telegraph at 7:14 PM on August 6, 2012 [3 favorites]

Caffeine helps me control hunger to some extent, and it's actually pretty good for you. Otherwise, I'd try other anti-anxiety meds/anti-depressants. My best treatment for a panic attack is a cold, wet washcloth on my face. It sounds like you're actually coping very well; good luck.
posted by theora55 at 7:48 PM on August 6, 2012

Eating something unpleasant and pungent often has the ability to put me off my appetite. Perhaps try a couple of bites of a strong cheese that you are not fond of, that generally works for me.
posted by msali at 8:46 PM on August 6, 2012

Constant hunger is a common side effect of some SSRIs. In my experience, the only thing that worked was changing medications.
posted by lab.beetle at 9:39 PM on August 6, 2012

Before seeing a nutritionist you should really discuss these issues with a doctor and get a full blood workup. Hunger to the point of tears sounds a bit beyond the need to merely tinker with your diet, though I definitely think 1500 calories for someone of your size and activity level is pretty low (for reference, I weigh 130 and am moderately active and feel just about right - and maintain my weight - with about 1700 calories a day. Every body is different and there is no magic number of calories that everyone of your height and weight "should" eat).

I would gently suggest perhaps holding off on being so gung-ho about the weight loss until you figure out what's going on and then get the go-ahead from a doctor. You sound like a very healthy person from your activity level; why not keep up the exercise but ease up a bit on your dietary restrictions for now? It sounds like your body is under a lot of stress right now and that could at least give your body a chance to recoup a bit.

When you get hungry, do you feel like you're crashing? I am hypoglycemic and I feel totally ravenous not long after eating a carb-heavy meal. This is usually accompanied with shakiness and irritability. Do you experience any of those symptoms? Or is the hunger more constant? It sounds like you try to eat a balanced diet, so perhaps this isn't the answer, but I thought I'd throw it out there.

One other thought that popped up: I read recently (I think here on the green) that people with undiagnosed Celiac disease often feel hungry because the disease prevents the absorption of vitamins & minerals and such. That's probably another long shot since it's a pretty rare disease, but maybe one to have on your radar.

Please keep us updated, and good luck.
posted by imalaowai at 12:08 AM on August 7, 2012 [1 favorite]

nthing seeing a doctor for blood-work, etc.

Your SSRi can be a culpret (I've made my peace with the one I take for anxiety.) But it shouldn't be a constant thing. Sometimes you have to fiddle with the Rx until you get one you can work with.

I also think that you're not taking in enough calories. If you're eating a well balanced diet, with lots of veggies, fruit, lean protien and whole grains (and milk if you're into it) (in whatever proportions make sense) then hunger should be temporary, and should stop when you eat. If you're still ravenous after meals, there's a problem.
posted by Ruthless Bunny at 9:41 AM on August 7, 2012

I would definitely go in and get yourself checked out by a doctor if you are having actual hunger pains on a 1500 calorie a day diet! Not that 1500 calories is a lot, because it isn't. But from a purely physiological perspective it is certainly enough to sustain a person indefinitely; if you were subsisting on just, say, 1000 calories, hunger pains would be a lot more understandable!

There are the usual Mefites coming in to say, "Well, I need this many calories!" but you know your body best, and it doesn't sound like you are starving yourself. In fact, you seem to have really good dietary habits overall.

Normally, I would think something was up with your thyroid because of that rapid weight gain you had. But you have plenty of energy for a hard workout 4-5 times a week, which means you are not suffering the debilitating fatigue of a defective thyroid.

If you had other gastric problems along with your stomach pain (constant constipation/diarrhea), I'd figure you were a candidate for Celiac's or Crohn's or another food allergy/sensitivity. You don't mention any, is that a possibility?

I'm also wondering if this pain is from hunger or something else. You're a woman, and I'm pretty sure you would have mentioned if your cycle was connected to shifts in these feelings of hunger. But in case it didn't occur to you, anything from PID and endometriosis to a torqued ovary could cause serious stomach pain.

Like you, I'm leaning to the anti-anxiety SSRI being the main culprit, though. Lexapro, I know, has been linked to stomach pain, as has Celexa. The good thing is that not all SSRIs will make you gain weight, and some even help you lose weight, so if concern about your weight is holding you back from changing, maybe knowing you could have a much easier time on another SSRI will reassure you?

So, again, I'd go to the doctor to check it out, because that pain, in the absence of any other symptoms, sure seems wrong, and not something you should have to live with!
posted by misha at 6:25 PM on August 7, 2012