Food: The Good, the Bad, and the Stressful!

If you’ve dealt with someone who has intellectual disability or delay, you’ve probably had issues with their eating- eating too much, too little, and of course limited foods.

Did you know most people with intellectual disability have trouble telling when they’re hungry or full? It’s up to us to help them understand that their body needs food like a car needs fuel, when it’s on empty.

But how much do we ourselves understand about eating and hunger? Let’s ask ourselves some questions:

The Big Question-

How many bites does it take for you to go from hungry to satisfied? Your autistic child may not be able to feel hungry or full, but what if we could give them a number to follow?

If you are like most people, you have no idea how many bites a meal should take. Through countless years of being told to clean our plates and sit and eat whether we were hungry or not, most of us consider food to be a routine rather than a time to refuel.

Have you ever eaten something because you didn’t want it to go to waste- so instead it goes to waist? I know I have. “Clean the leftovers out of the fridge before they go bad!” Waste or waist? Maybe we need to rethink this.

Habits and emotions have replaced our natural need for and enjoyment of food. And this has been passed on to our children for generation after generation.

So let’s learn how to listen to our bodies, so we can help our loved ones do the same.

The TABLE Test

One of the best tactics for curbing emotional eating is to use the TABLE questions. Ask yourself when you are thinking of eating:

Am I

T– Tired?

A – Angry?

B – Bored?

L – Lonely?

E – Entertained?

These are common signals we confuse with hunger. I’m tired-I need energy-I eat. I’m angry-I need to calm down-I eat. Most of us mistake these signals. Your special needs loved one may be doing the same. Boredom is often a case for a wander through the fridge, as well as snacking in front of a favorite video. As a caregiver, help your loved one find the real fix for what’s ailing them. Giving them food, even if it’s expedient, isn’t always the best habit, for us or for them.

Different Hungers

Learning to differentiate between physical and emotional hunger takes practice. It takes a real investigator to differentiate it for someone with an intellectual disability. For instance, here are five important distinctions to help you decide whether you’re experiencing emotional or physical hunger. Almost none of these will apply to someone with cognitive delay:

Emotional hunger comes on suddenly; physical hunger occurs gradually.
When eating to fill an emotional need or void, you may crave a specific food, such as ice cream, and only that food will meet your need. When you eat to fill a physical need, you’re more open to a variety of options.
Emotional hunger feels like it needs to be satisfied instantly with the food that you’re craving, whereas physical hunger can wait.
You may continue to eat well beyond the point of physical fullness when using food to address an emotional need. For physical hunger, you’re much more likely to stop when full.
Emotional eating is significantly more likely to result in feelings of guilt than eating to satisfy physical hunger.

Do you see the problem with this list? Although it’s very well defined for the typical person, it uses concepts like time, the understanding of craving rather than food limitations, and guilt towards overeating which many with cognitive delay cannot conceptualize.

The Big Answer-

So how many bites does it take to go from hungry to satiated? On average between 10 and 15 at each meal. 5-7 for a snack. Shocking, right? Give it a try. Eat 15 forkfuls of your dinner and then step away from your plate for about half an hour. How is your energy level? How about in one hour?

What does hunger feel like?

Have you been eating on emotion or routine for so long that you wonder if you remember what being hungry feels like? You’re not alone. There’s more than one Google search for that.

Hunger signs vary in intensity from feeling empty or having a growling in the belly, to tiredness, headaches and even feeling weak or shaky. If you are unfamiliar with those feelings before eating, it probably means you are giving your body food before it gets hungry.

Our need to eat should be similar to our need to empty our bowels. A signal sent to our brain that says-it’s time.

And as we mentioned before, people with intellectual disability may not have the same signals. Crankiness, vocalizing loudly, acting out, difficulty to settle to tasks and meltdowns can be the sign you’re looking for. And yes, these can be signs of other things, or nothing at all. But if it’s near a mealtime, give food a try.

What does full feel like?

Most of us know what over-full feels like. It makes us tired, glues us to our chair, and occasionally is accompanied by feelings of regret or even guilt.

There are two ways our body says that’s enough

The Twenty Minute signal- Your gut hormones register the nutrient content of what you’ve eaten and when they decide that’s the right amount the signal is sent to your brain-“ that’s all we need”>>>>>>>> Brain replies>>>>>>>>>> “stop eating, you’re full”. This process takes about 20 minutes round trip. The problem is, you can overfill quite a bit before that 20 minute trip is finished.
The Stomach Stretch signal- The nerves in your stomach begin to send out subtle signals as you eat. This will continue as each mouthful reaches your stomach and it stretches a bit more. As you become full, the empty feeling of hunger will be replaced with a gentle pressure. As soon as you feel the pressure in your stomach, stop eating. You should still feel light and energetic with this gentle pressure; if the fullness is uncomfortable, you overate.

For most of us, it will take real concentration to learn to feel these stomach signals. Until we learn it, we can use the 15-20 bites per meal average to keep us eating reasonable portions.

Retraining ourselves to listen to our bodies may be uncomfortable at first. But just like anything worthwhile the benefits are far greater than the inconveniences.

Here’s one great benefit. Did you know that gut-cleaning and cell repair happen when your body takes a break after digesting food? So when your stomach takes a break, it really gets to work! Stopping when you’re full adds this little health gem to your system.

Helping Your Loved Ones

So now that you have a handle on healthy eating, let’s summarize the ways we can help our intellectually disabled loved one with knowing when they’re full and hungry.

For the over eater:

Offer foods like frozen peas or corn or cherries as between meal snacks that will take a while to eat but not be processed
Plate their meals with what will work out as 10 bites and save 5 bites for when they ask for seconds or come back for a snack in a half hour.
Redirect to chew toys so they can have the feeling of chewing without actually eating
Turn snacks into exercise rewards- Dance to that half hour music video and then we’ll have a snack
Replace one fruit with a vegetable each week until they are having more veggies than fruit.
Replace fruit juices and cokes with a small amount of fruit and veg combo juice added to sparkling water to make bubbly juice
Start to watch for the true hunger signs rather than the bored eating or entertained eating and redirect when it isn’t really hunger. Distract. Go for a walk or to the park. Get as far from the kitchen as possible.

For the under eater:

Play the name game- Eat one bite for each letter in your name. Or eat one bite for each letter in the city you live in. Or eat one bite for each number on the clock. Or one bite for each of the Avengers they can name. Or one bite for each of the red Legos on the table. Use their favorite thing to encourage them to eat.
Smoothies with lots of fruits and veg which can be made into popsicles or drunk through a straw. Save a Slurpee cup from 7-eleven to put smoothies in.
Video pause and go game- Video plays when they eat, but if they stop and turn away it pauses. You control with a remote but they control with their fork.
Hide foods in their favorites- add pureed carrots to Ketchup a little at a time, add cooked cauliflower to mac n cheese, hide a variety of veg in spaghetti sauce
For those who like to drink from straws or sippie cups, let them sip soups or meal replacement smoothies.
For ice crunchers, make your ice out of healthy fruit and veg juices or smoothies, even frozen broth.
Does your child only eat crackers or chips? Create healthy crackers with your food processor and a dehydrator.

Above all, whether you are trying to change your food pattern or help someone with theirs, have patience. You started your food path when you were born and it’s been a lifelong habit. Breaking habits and making habits take time. Especially for those with intellectual challenges.