Unexplained Hunger and Weight Fluctuations: A Guide

Physical discomfort?

Hello doctor, I have been eating three meals a day regularly, but recently I often feel hungry two to three hours after eating.
I'm not sure if it's true hunger or if my gastrointestinal system is uncomfortable.
My weight has also been unstable, sometimes reaching over 38 kg and other times dropping to below 37 kg.
Last Friday, I measured my fasting blood sugar at 73 and my total cholesterol at 198.
Is that too high for my age? My liver function is normal.
What can I do to improve this situation?

Lan, 10~19 year old female. Ask Date: 2017/04/24

Dr. Chen Taicheng reply Family Medicine

Hello, if you often feel hungry, it's important to ensure that you are meeting your daily caloric intake.
In nutrition, the commonly used unit of energy is the kilocalorie (kcal), often mistakenly referred to as "calories." Nutrients that provide energy, such as carbohydrates, fats, and proteins, provide 4, 9, and 4 kilocalories per gram, respectively, which you can calculate yourself.
For your daily caloric needs, please refer to http://ppt.cc/0AJzF.
Given your lighter weight, you may need to consume about 35 kilocalories per kilogram.
The normal cholesterol level is below 200, but it should also be assessed in conjunction with other lipid values.
Depending on your age, blood lipids and glucose are usually within normal ranges.
Sometimes feeling hungry may be related to gastrointestinal discomfort, including gastritis or peptic ulcers (for example, duodenal ulcers can cause pain when fasting).
If you continue to experience stomach discomfort, please consult a gastroenterologist or a family medicine physician for further evaluation.
Please ensure that your daily nutritional caloric intake is sufficient.
Minor fluctuations in weight are generally normal, but if you experience continuous weight loss, it should be monitored.
The most common causes of weight loss are gastrointestinal issues, including gastritis, peptic ulcers, dyspepsia, or malabsorption due to insufficient digestive enzymes from the pancreas.
Other potential causes include endocrine issues (such as hyperthyroidism, hyperglycemia, or hypercalcemia), as well as problems related to the heart, lungs, liver, kidneys, chronic infections, or inflammation, which can also lead to weight loss.
You may want to seek further evaluation from a family medicine physician or an endocrinologist.
Wishing you good health, Dr.
Chen Tai-Cheng from Taoyuan Hospital Family Medicine Department is concerned about you.

Reply Date: 2017/04/24

More Info

Understanding unexplained hunger and weight fluctuations can be quite perplexing, especially when you feel like you are eating normally but still experience these issues. Let's break down the potential causes and solutions based on your symptoms and health metrics.

Possible Causes of Unexplained Hunger
1. Hormonal Fluctuations: Hormones play a significant role in regulating hunger and satiety. For instance, ghrelin is known as the "hunger hormone," and its levels can fluctuate due to stress, sleep patterns, or changes in diet. If you are experiencing stress or changes in your routine, this could lead to increased hunger.

2. Blood Sugar Levels: Your fasting blood sugar of 73 mg/dL is within the normal range, but fluctuations in blood sugar can lead to feelings of hunger. If you consume meals high in refined carbohydrates or sugars, you may experience a spike in blood sugar followed by a rapid drop, leading to increased hunger shortly after eating.

3. Gastrointestinal Issues: Sometimes, feelings of hunger can be confused with gastrointestinal discomfort. Conditions like gastritis, acid reflux, or even food intolerances can cause discomfort that might be misinterpreted as hunger.
4. Psychological Factors: Emotional eating is another common reason for increased hunger. Stress, anxiety, or even boredom can lead to eating when you are not physically hungry.

Weight Fluctuations
Weight fluctuations can be caused by various factors, including:
1. Water Retention: Changes in diet, particularly sodium intake, can lead to water retention, causing temporary weight gain.
2. Muscle Gain vs. Fat Loss: If you are engaging in physical activity, especially strength training, you might gain muscle while losing fat, which can lead to fluctuations on the scale.

3. Dietary Changes: Any recent changes in your diet can also affect your weight. If you have increased your caloric intake or changed the types of foods you eat, this could lead to fluctuations.

Recommendations for Improvement
1. Balanced Diet: Ensure that your meals are balanced with adequate protein, healthy fats, and complex carbohydrates. This can help stabilize blood sugar levels and keep you feeling full longer. Incorporate whole grains, lean proteins, and plenty of fruits and vegetables.

2. Regular Meal Timing: Eating at regular intervals can help regulate hunger hormones and prevent extreme fluctuations in hunger. Consider having smaller, more frequent meals throughout the day.

3. Hydration: Sometimes, feelings of hunger can be mistaken for thirst. Ensure you are drinking enough water throughout the day.

4. Monitor Stress and Sleep: Both stress and lack of sleep can affect hunger hormones. Engage in stress-reducing activities such as yoga, meditation, or regular physical activity. Aim for 7-9 hours of quality sleep per night.

5. Consult a Healthcare Professional: Given your cholesterol level of 198 mg/dL, which is borderline high for your age, it may be beneficial to consult with a healthcare provider or a registered dietitian. They can help you assess your overall health, dietary habits, and any underlying issues that may be contributing to your symptoms.

6. Keep a Food Diary: Tracking what you eat and how you feel can help identify patterns related to your hunger and weight fluctuations. This can provide valuable insights into your eating habits and help you make necessary adjustments.

Conclusion
Unexplained hunger and weight fluctuations can stem from a variety of factors, including hormonal changes, dietary habits, and psychological influences. By focusing on a balanced diet, regular meal timing, hydration, and stress management, you can work towards stabilizing your hunger and weight. If symptoms persist, seeking professional guidance is advisable to rule out any underlying health issues.

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