Why Feeling Full Matters for Weight Loss

One of the most common things that I hear from patients trying to lose weight is I'm hungry all the time. And this actually makes sense. Many weight loss efforts focus on eating less, but very little attention gets paid to helping patients stay satisfied. So they spend their day fighting hunger, thinking about food, and wondering why their plan isn't working. Welcome back to the Exam Room Nutrition Podcast. I'm your host, Colleen Sloan. I'm a physician assistant and registered dietitian, and today we're kicking off a special four-part series called Avocados in Practice. Thank you to Avocados Loved One Today for sponsoring this series as we explore emerging nutrition research and practical nutrition strategies clinicians can use with patients. In today's episode, we're talking about satiety, satisfaction, and weight management. We'll discuss why satiety matters, whether foods higher in fat can fit into a weight management plan, and how to think about nutrient density and satisfaction when counseling patients, including some of our patients who are taking GLP1 medications. Joining me today is Patricia Bannon, registered dietitian, nationally recognized communicator, and healthy cooking expert. Patricia has shared evidence-based nutrition advice across major media outlets and is known for translating nutrition science into practical strategies people can use. Patricia, thank you so much for being here today. Hey, Colleen, it is so great to be here. I'm a fan of your podcast. So great to be on. Thank you so much. Yeah, so I'm sure you hear this from some of your patients, but one thing that we hear all the time is I'm trying to lose weight, but I am hungry all the time. So I'm curious, why do so many weight loss efforts leave people feeling deprived and thinking about food constantly?

Yes, well, weight loss is hard enough, but when you're feeling hungry all the time, it is absolutely not sustainable. So there's several reasons for that. One can be that the calories were cut too aggressively. Another can be you just feel deprived, right? You've lost the enjoyment because you've cut out too many of your favorite foods. And then the third could be key nutrients are missing, those key nutrients that add satiety, the feeling of fullness, mainly protein, healthy fats, and fiber. And the interesting thing is we're finding people on GLP1s are one of the best things for them is their reduced food noise, right? That constant preoccupation with food and with feeling hungry. And they're often more in tune with those hunger and fullness cues. So that's great. But whether you have a patient on GLP1s or not, that meal composition still matters, right? The goal isn't just eat less. The goal is to find meals, balance meals that support fullness, nourishment, and enjoyment. And that's where avocados can really fit in nicely here with weight management because they provide a combination of fiber and healthy unsaturated fats. These are the two nutrients that can slow digestion and support longer-lasting fullness while providing those important nutrients. So one-third of a medium avocado has three grams of fiber, and also, you know, that creamy texture, it's gonna make those smaller meals more satisfying. The other thing you can do is often pair avocado with other foods that have fiber as well as protein. So, for example, it could be eggs and whole grain toast with avocado, it could be beans and vegetables and avocado to create more of a balanced filling meal.

You know, talking about calories and weight management, there's like an interesting debate that goes on on social media, and that's whether calories matter or not. And so I would love to kind of pick your brain a little bit when we're communicating this with our patients. Should we be focusing on satiety and satisfaction or really just focusing on simply a calorie restriction? And then along those lines, are there certain foods that actually do help to support fullness if we are on that weight loss journey? Yeah, great question.

So calories matter, but it's only a small part of the bigger picture. Satiety and satisfaction are essential in terms of sustainability and in terms of quality of life. And as we just talked about, so you're not feeling hungry all the time. So clinicians can encourage meals that combine protein, fiber, and healthy fats because these nutrients are going to promote satiety by slowing digestion and increasing appetite hormones. So signals that tell the body when we're full. So a study that's really interesting on avocados and satiety, this was supported by the Avocado Nutrition Center. It's a clinical trial of 31 adults with overweight or obesity and elevated fasting glucose and insulin. And they added half or a whole avocado to breakfast. And what they found was reduced hunger, enhanced meal satisfaction, and raised levels of PYY and naturally occurring GLP1. Those are two hormones that signal fullness to the brain. So this might be related to the combination of the fiber and the healthy fats that help slow digestion and support satiety. Of course, this can't be generalized through a larger population, but it's really adding to the evidence of avocados supporting weight management and in this case, satiety, that feeling of fullness.

So something that comes up a lot when I talk about avocados with my patients who are trying to lose weight is they're worried because they've been traditionally told that avocados have too much fat, which means they have too many calories, right? And so they're kind of leery of eating avocados on a weight management program. So has that concern actually ever been studied?

It has been studied. And one of my best friends who just went and she had high cholesterol levels and is trying to lose weight. We were talking about foods she could add. I mentioned avocados, and she's like, Yeah, but I'm gonna gain weight. And I was prepping for our episode, and I was like, oh, I have a study that addresses just that thing. So this is a study on avocados and weight loss. It's called HAT, which stands for the Habitual Diet and Avocado Trial. This is the most extensive clinical trial on avocados to date. It includes just over 1,000 adults with elevated waist circumference. And in the HAT study, they found that daily consumption of avocados did not add to weight gain. So participants in the study, they ate one avocado a day for six months, and they did not experience an increase in visceral fat or secondary measures of body weight compared to the control group, despite the extra calories. And I think that's where it really gets interesting because when you take a deeper look at the dietary data, you find that that avocado, which was a large avocado, added 281 calories. However, the participants' daily calorie intake was only 159 calories higher. So this shows that 43% of the avocados calories were offset by eating less elsewhere without them even thinking about it. And that's the part I love from a behavior change standpoint. And even though they were eating more calories, it didn't affect their overall weight. So the greater fullness or meal satisfaction may have played a role here. So I really think as clinicians, the conversation needs to shift from how many calories are in this food or meal to also asking what does this meal contribute, right? In terms of satisfaction and fullness. And that's where those avocados really provide the fiber, the healthy fats, and several other vitamins and minerals.

Yeah, that's why that debate of like, do calories in, calories out really doesn't really matter on social media is tricky because nutrition is nuanced, right? And it doesn't, it doesn't paint that overall picture. We have to actually look at nutrient density and the quality of that food that we're discussing. So that brings me to my next point, and that's talking about protein. This macronutrient tends to dominate the conversation around weight loss, especially for patients who are on GLP1 medications. But we know protein is important. However, when patients are eating less overall, is there anything else we should be talking about in terms of overall diet quality?

Yes. So protein, protein, protein. It's all the craze right now. And it is important. It's important for satiety, it's important for preserving lean mass, especially when patients are eating less and losing weight. Um, but it's only a small part of the picture, right? Yes, you just said, it's nuanced. And actually, most Americans are getting enough protein, especially during this protein craze, right? So the interesting thing is that 95% of Americans don't eat enough fiber. And most Americans eat too much saturated fat and not enough unsaturated fat, those healthy fats. So I think clinicians should consider these nutrients fiber and healthy fats when they're talking to their patients trying to lose weight, as well as other vitamins and minerals like potassium, vitamin D, and calcium. So one-third of a medium avocado provides three grams of fiber along with six grams of healthy unsaturated fat. And it's also adding that creamy texture, which again adds to that satisfaction.

You know, my listeners are clinicians and you've sold us, you've told us the science. We all believe that, you know, avocados are really, really beneficial, but my listeners are educating real patients sitting in front of them. And so they need some practical advice and strategies that they can suggest to their patients. So I'm curious if you have any examples of some easy swaps or how they can suggest their patients use avocado.

Yeah. So this is this is where it really matters, right? Like the science is important to tell us what we need to suggest, but how do we make it realistic for the patients that we're seeing? So, how do we get it on the plate? How do we get them to enjoy it? Swapping it. Swap is a great idea. You know, mashed avocado in sandwiches, dressings, dips, baked goods is great. I really think they're wonderful in baked goods because you can actually swap them one for one. So mashed avocado in place of the same amount of saturated fat in that baked goods. So, for example, in muffins. And because they're higher in water content, you're gonna get really moist baked goods, which is fantastic, right? That's what we want. You can also top it. You can top whole grain toast with an egg and avocado and blending it in. That works great too. Smoothies, uh, you can do it in maybe overnight oats and pairing it. Again, I mentioned this earlier, but pairing it with other fiber foods and protein foods for a more balanced meal that's gonna feel satisfying.

That's really important. We can't just tell our patients you need to eat more fiber and unsaturated fats. Let's give them some really practical strategies and some suggestions that is realistic and doable into their daily life. So, Patricia, thank you so much. This has been such a helpful conversation. Thanks for joining me today. And thank you to Avocados Love One Today for sponsoring this series. I'll link the research and resources we talked about today in the show notes. And be sure to come back tomorrow when we're talking about what to eat when cholesterol is high and why what we add to the plate matters just as much as what we take away. We'll see you tomorrow.