Ask a Doctor: Between Cravings, Food Focus and a Disrupted Sense of Hunger and Fullness

“Why do I often think about nothing but food?” During the day you’re disciplined and eat according to “plan”, and in the evening on the sofa your hunger – or simply your appetite – practically screams at you, so that you can’t think of anything else. How often do I come across this scenario in the Cycle Clarity Call? Well, often enough that I’m now not only writing these lines, but have also recorded a podcast with a doctor about it.

Dr. Melanie Maurer is a doctor and psychiatrist and has already been a guest expert in my Food Freedom Academy. Together we answered your most frequent questions: she from a medical and psychotherapeutic perspective, I from the perspective of nutrition counselling and my own recovery.

In this article you’ll learn why hunger and fullness can disappear after a long period of undernourishment, where evening cravings come from and what really helps. Whether exercise is allowed in period recovery, you can read in the article Ask a Doctor: Is Exercise Allowed in Period Recovery?.

No hunger, no fullness: how does the feeling come back?

After a longer period of undernourishment, the body switches into a kind of emergency mode. Hunger that goes unanswered anyway is turned down, the stomach gets used to smaller amounts, and the hormones that regulate hunger and fullness fall out of balance.

One of them is leptin. It’s produced in fat cells and tells the brain how well the energy reserves are filled. If leptin levels drop sharply, which inevitably happens with undernourishment, the brain reads this as a threat to survival, with consequences for fullness and the cycle. Melanie knows this from her own experience: after a competition diet her period stayed away for a long time, and when she was examined, her leptin was barely detectable.

The way back leads through regularity: eat enough and regularly, even without feeling hungry. I like to speak of strategic intuition, meaning first a fixed structure of breakfast, lunch and dinner, with snacks in between depending on your situation. I support my women with this very individually in my 1:1 coaching. It works like your inner clock after a long-haul flight: with fixed mealtimes it gradually adjusts to the new time zone, until hunger shows up at lunchtime by itself.

And in case you need to hear this right now: fats don’t make you fat. You can gain from too much of anything, but especially for the female hormone system fats are indispensable: they are building blocks for hormones and make a meal keep you full for a long time. Carbohydrates are the main source of energy – and not only for your brain. Protein serves as building material.

Evening cravings: what can I do?

First it’s worth looking at the whole day. Do you eat breakfast? Does your morning start with coffee instead of a meal? Are you saving up food during the day to keep the evening as a reward? Then evening cravings aren’t a weakness of character, but your body’s logical response.

If your intake during the day is fine and you still reach for the crisps on the sofa, an honest question helps: am I really eating enough nutrient-dense foods? Is it hunger, boredom, loneliness or habit? If hunger isn’t the problem, food isn’t the solution. But if you can’t think of any reason other than wanting chocolate, then eat the chocolate.

Otherwise you eat an apple first, then a banana, then muesli, and in the end the chocolate anyway, without the actual need being met. That’s why unconditional permission and food neutrality are so effective: chocolate is then no longer a cheat-day reward, just chocolate, the way broccoli is just broccoli.

Many women with evening binges eat on the sofa in front of the TV and barely notice what they’re eating. A deliberate setting helps: prepare something good in the evening, sit down with it at the dining table and have the sweet part right there too. Afterwards you get up, the meal is finished, and only then do you move to the sofa.

The familiar routine of sofa + TV + chocolate-crisps-pizza-ice-cream binge and a guilty conscience has become a kind of switch-off ritual for you. Pushing back against it now and deciding to undo these connections in your brain, to literally reprogramme it and create new routines, takes strength.

I eat well and enough, so why do I still have cravings?

Often the answer is quickly found: being underweight or undernourished. On closer inspection the total amount is often less than thought, or important nutrients are missing.

If you really do eat regularly, balanced and enough, are at a normal weight and still have cravings, it’s worth getting checked by a doctor. The women I support have me at their side for this, because I know exactly which hormone and lab values we should look at when and how to interpret them. Because: the reference range is not the optimal range when it comes to blood values. I also analyse their everyday life and a special food diary, so that we can see crystal clear which stumbling blocks my client has overlooked so far.

Melanie adds from a psychotherapeutic point of view: how are you actually doing in your life? Are you content, stressed, lonely? Which need are you meeting with food? For many it’s the hug from the inside, the feeling of not having to think about anything for a moment.

Cravings are rarely a question of discipline; usually they are a message: either your body needs more nourishment, or a need for rest, closeness or a break is falling short. You don’t have to figure out alone which one it is for you.