Weight loss increases hunger: a major obstacle for maintenance

weight-lossWe  know about the issue of slowed metabolism after weight loss due to the lean muscle mass loss that goes along with fat loss. This is one reason why higher protein/low carb diets work better than low fat diets; because muscle mass is maintained better. Well, new information from Diabetes in Control backs up what some of us know intuitively or may have experienced personally….

Losing Weight Increases Hunger

The study showed that for every kg of weight they lost, patients consumed an extra 100 calories a day — more than three times what they would need to maintain the lower weight.

This out-of-proportion increase in appetite when patients lost a small amount of weight may explain why maintaining long-term reduced body weight is so difficult.

A validated mathematical method was used to calculate energy intake changes during a 52-week placebo-controlled trial in 153 patients treated with canagliflozin, a sodium glucose co-transporter inhibitor that increases urinary glucose excretion, thereby resulting in weight loss without patients being directly aware of the energy deficit. The relationship between the body weight time course and the calculated energy intake changes was analyzed using principles from engineering control theory.

Previous studies show that metabolism slows when patients lose weight; however, these results suggest that proportional increases in appetite likely play an even more important role in weight plateaus and weight regain.

Knowing that patients with type 2 diabetes who receive the sodium-glucose cotransporter 2 (SGLT-2) inhibitor canagliflozin (Invokana) as part of a glucose-lowering strategy excrete a fixed amount of glucose in the urine (which causes weight loss), they used a mathematical model to calculate energy-intake changes during a 52-week placebo-controlled trial of the drug, in which 153 patients received 300-mg/day canagliflozin and 89 patients received placebo.  Using this approach meant that the participants who received canagliflozin consistently excreted 90-g/day glucose but were not aware of the energy deficit.

Previously, the researchers had validated a mathematical model to calculate the expected changes in caloric intake corresponding to changes in body weight (Am J Clin Nutr. 2015;102:353-358). They input the current study data into this model.

At study end, the patients who had received placebo had lost less than 1 kg and those who had received canagliflozin had lost about 4 kg. The weight loss with canagliflozin was less than predicted, due to the patients’ increased appetite. On average, patients who received canagliflozin ate about 100 kcal/day more per kg of weight lost — an amount more than threefold larger than the corresponding energy-expenditure adaptations.

“Our results provide the first quantification of the energy-intake feedback-control system in free-living humans,” the researchers write.

They add that in the absence of “ongoing efforts to restrain food intake following weight loss, feedback control of energy intake will result in eating above baseline levels with an accompanying acceleration of weight regain.”

The findings suggest that “a relatively modest increased appetite might explain a lot of the difficulty that people are having in both losing the weight and maintaining that weight loss over time. From the results it was concluded that, while energy expenditure adaptations have often been considered the main reason for slowing of weight loss and subsequent regain, feedback control of energy intake plays an even larger role and helps explain why long-term maintenance of a reduced body weight is so difficult.

The findings suggest that an increased appetite is an even stronger driver of weight regain than slowed metabolism. “The message to clinicians is to not only push physical activity as a way to counter weight regain but also use medications that impact appetite.”

In summary, the researchers conclude the few individuals who successfully maintain weight loss over the long term do so by heroic and vigilant efforts to maintain behavior changes in the face of increased appetite along with persistent suppression of energy expenditure in an omnipresent obesogenic environment. Permanently subverting or countering this feedback control system poses a major challenge for the development of effective obesity therapies.

Practice Pearls:

  • Findings suggest that an increased appetite is an even stronger driver of weight regain than slowed metabolism.
  • Appetite increased by ∼100 kcal/day above baseline per kilogram of lost weight.
  • The message to clinicians is to not only push physical activity as a way to counter weight regain, but also use medications that impact appetite.

Obesity. 2016;24:2289-2295. Abstract

Anger and exercise CAN trigger heart attacks

running

Can Anger and Exercise Trigger a Myocardial Infarction?

Diabetes in Control October 29th 2016

An International study explores the role of physical exertion, anger, and emotional upset in triggering acute myocardial infarction.

In the INTERHEART study, researchers explored the triggering association of acute physical activity and anger or emotional upset with a myocardial infarction (AMI) to quantify the importance of these potential triggers in a large, international population.

INTERHEART was a case-control study of first AMI completed in 262 centers across 52 countries. In this analysis, they included only cases of AMI and used a case-crossover approach to estimate odds ratios for AMI occurring within 1 hour of triggers.

Trained study staff performed a standardized physical examination on participants and administered a structured questionnaire. Participants with AMI (cases) were asked the questions, “Were you engaged in heavy physical exertion?” and “Were you angry or emotionally upset?” in the 1 hour before the onset of symptoms and during the same hour on the previous day.

Control participants were asked, “During the last 24 hours, were you engaged in heavy physical exertion?” and “During the last 24 hours, were you angry or emotionally upset?”

Data were also collected on age, ethnicity, diet, physical activity, tobacco use, education, employment, psychosocial factors, and cardiovascular risk factors. Anthropometric measurements (height, weight, waist, and hip circumference) were measured in a standardized manner.

Medical history (diabetes mellitus, hypertension, angina, stroke, other vascular disease, and depression) and baseline medications were self-reported. Smoking was categorized as never smoking, former smoking, or current smoking. Obesity was defined as body mass index of ≥30 kg/m2.

Countries were grouped into 10 geographical regions: Western Europe, Central and Eastern Europe, Middle East and Egypt, Africa, South Asia, China and Hong Kong, Southeast Asia and Japan, Australia and New Zealand, South America and Mexico, and North America.

Physical activity was categorized as mainly sedentary, mild exercise, or moderate/strenuous activity. Stress was categorized as none or some periods of stress versus several periods or permanent stress. Education was categorized as none, 1 to 8 years, 9 to 12 years, trade school, or college/university.

Of 12,461 cases of AMI, 13.6% (n=1650) engaged in physical activity and 14.4% (n=1752) were angry or emotionally upset in the case period (1 hour before symptom onset).

Physical activity in the case period was associated with increased odds of AMI (odds ratio, 2.31; 99% confidence interval [CI], 1.96–2.72) with a population-attributable risk of 7.7%.

Anger or emotional upset in the case period was associated with increased odds of AMI (odds ratio, 2.44; 99% CI, 2.06–2.89) with a population-attributable risk of 8.5% (99% CI, 7.0–9.6).

There was no effect on modification by geographical region, prior cardiovascular disease, cardiovascular risk factor burden, cardiovascular prevention medications, or time of day or day of onset of AMI. Both physical activity and anger or emotional upset in the case period were associated with a further increase in the odds of AMI.

From the results, it was reported that physical exertion and anger or emotional upset are common in the 1 hour before the onset of symptoms of AMI and that either exposure may act as an external trigger for AMI in all age groups. We report no differences by geographical region, previous cardiovascular disease, cardiovascular prevention medications, cardiovascular risk factors, and INTERHEART risk score.

 

Circulation. http://circ.ahajournals.org/lookup/suppl/doi:10.1161/CIRCULATIONAHA.116.023142/-/DC1 and http://dx.doi.org/10.1161/CIRCULATIONAHA.116.023142. 2016;134:1059-1067   

Margaret Coles: Invite this Physiotherapist into your home

At  www.movingtherapy.co.uk. you can find Margaret Cole’s free educational resource to help your health and well being.

home-physio

Margaret worked as a community physiotherapist and when she retired she decided to put her knowledge and experience to good use. She produced videos covering a lot of different situations that you can face regarding your physical and mental states and has put them on the site. She also gives advice on how to lose weight.   People from all over the world have visited the site since 2011.

NHSinform Scotland and her local authority also promote the site.

 

 

Anna: Let’s talk about depression

Diabetes and Depression |

Diabetes and Depression

What a combo.  As if having diabetes wasn’t enough, out comes depression to make it complete.  Or was it the other way around?  This is reminiscent of an old chicken and egg dilemma. Remember, which came first?

Chicken hatches out of egg

People with diabetes (PWD) are more likely to have major depression compared to those who don’t have it.  Diabetes is a chronic condition that requires attention on a daily basis.  This can feel overwhelming at times and can take a toll on both physical and emotional health.

Diabetes affects emotions and emotions can affect BG level.  It isn’t clear whether depression somehow triggers diabetes or if having diabetes leads to being depressed.  In either case, there is obviously a connection.

The mere sound of the word DEPRESSION is reminiscent of a low mood, feeling worthless, having low energy, feeling sad and whatnot.  The blues.

9-sept-depression-cloud-pixabay

While everyone can occasionally get sad, clinical depression is far more than that.  Oftentimes it’s a lifelong challenge.  It can affect people of any age or gender or life situation; depression doesn’t discriminate.

Depression can affect our lives in so many ways.  It can range from work issues to relationships to drug & alcohol use or suicidal thoughts.

When you feel low and down in the dumps, a feeling of despair follows.  You might start thinking that no one can help you since they can’t change the circumstances.  Well, and you’re wrong.  What can be changed is the way you look at the events surrounding your depression; a different angle, so to speak.  I know this for a fact; been there, done that, right around the time of my divorce.  But I finally bounced back although this took quite some time.

The symptoms of depression can include feeling sad or unhappy especially in the morning; at times, irritable and angry.  Frustrated, having low energy, loss of interest in activity that you usually enjoy.  This can affect your sleeping pattern; you might feel anxious and restless.  You may experience guilty feelings and can’t concentrate.  Your eating pattern can change as well; you can eat much less or more than you usually do; you may develop unusual cravings.

5 Causes of Depression |

1.   Depression can be genetic, although the exact gene causing it is presently unknown. If you have a family member with depression, you’re more likely to experience it, too.  This however might be hard to tell as clinical depression was formally recognized in the U.S. around 1970s.  Prior to that, it was known as melancholy, therefore undiagnosed.  It could have been misdiagnosed for a multitude of other reasons, especially in the old days.

2.   Depression can be triggered by imbalance of certain neurotransmitters in the brain.  Why this is happening, remains a mystery and is not fully understood.  Antidepressant medications work to balance these neurotransmitters, mainly serotonin.

3.   Hormonal changes certainly play a role in developing depression.  Generally, depression is more common in women than in men, due to the changes in hormone levels throughout a woman’s life.  Pregnancy, giving birth or experiencing a miscarriage, PMS, menopause are just a few examples.  Thyroid problems can cause hormonal fluctuations as well because thyroid is an endocrine gland.

4.   Enter the change of seasons.  Seasonal Affective Disorder or SAD is a form of depression that can happen as daylight hours get shorter as the winter approaches.  Around this time of the year, some people experience feelings of tiredness, lethargy and loss of interest in everyday tasks.  This condition usually goes away once the days get longer.

5.   Then there is a situational depression that can happen due to a change in life circumstances or struggle.   Such as for example, losing a loved one, getting fired from work, financial troubles or other serious changes.  PTSD or post-traumatic stress disorders is often diagnosed in soldiers returning from war.  However, it can also happen as a result of a childhood trauma, abuse or assault, a car accident, or being diagnosed with a life-threatening condition.  Some sources classify these as anxiety disorders.

The treatment of depression is a long and bumpy road.  It may include medications, psychotherapy, or both.  It can go by trial and error and takes time to find a working combination of these.  Exercises can definitely help but oftentimes it’s easier said than done.  When you’re feeling sad, worthless and having low energy, exercises can seem next to impossible.  Perhaps you can start out slowly.  Try to stay busy with something you enjoy doing … if you draw a blank, turn to chores.  Generally, anything that helps to take your mind of whatever bothers you.  If you feel like writing, keeping a diary might help; blogging is even better.  You can find plenty of understanding folks here on WordPress.

Eric Barker: Meditation for the distracted

meditation.jpg

Welcome to the Barking Up The Wrong Tree weekly update for September 4th, 2016.

Neuroscience Of Meditation: How To Make Your Mind Awesome

Click here to read the post on the blog or keep scrolling to read in-email.

So is meditation just another fad that pops up from time to time like bell-bottom jeans? Nope. Research shows it really helps you be healthier, happier and even improves your relationships.

From The Mindful Brain:

The MBSR program brought the ancient practice of mindfulness to individuals with a wide range of chronic medical conditions from back pain to psoriasis. Kabat-Zinn and colleagues, including his collaborator Richard Davidson at the University of Wisconsin in Madison, were ultimately able to demonstrate that MBSR training could help reduce subjective states of suffering and improve immune function, accelerate rates of healing, and nurture interpersonal relationships and an overall sense of well-being (Davidson et al., 2003).
And it’s not some magical mumbo-jumbo at odds with the science of psychology. In fact, it is psychology. William James, one of the fathers of modern psych, once said this…

From Thoughts Without A Thinker:

While lecturing at Harvard in the early 1900s, James suddenly stopped when he recognized a visiting Buddhist monk from Sri Lanka in his audience. “Take my chair,” he is reported to have said. “You are better equipped to lecture on psychology than I. This is the psychology everybody will be studying twenty-five years from now.”
Last week I posted about the neuroscience of mindfulness. Long story short (and grossly oversimplified): the right side of your brain sees things literally. The left side interprets the data and makes it into stories.

But Lefty screws up sometimes. His stories aren’t always accurate. As the old saying goes, “the map is not the territory.” When you listen too much to Lefty’s stories and not enough to the raw data from the right brain, you can experience a lot of negative emotions. A big chunk of mindfulness is keeping Lefty under control. (For the full story, click here.)

But where does meditation fit into all this? What does sitting cross-legged and focusing on your breath have to do with Lefty, the brain and eternal happiness?

And how the heck do you meditate properly? Maybe you’ve tried it and only ended up taking an unexpected nap, or getting horribly bored, or feeling like your brain is noisier than the front row of a death metal concert.

Let’s look at the science and cut out the magic and flowery language. We’ll hit the subject with Occam’s Chainsaw and get down to brass tacks about what meditation really is, why it works, and how to do it right.

Time to put your thinking cap on…

What The Heck Is Meditation?

A good quick way to see it from a neuroscience perspective is as “attention training.” (You know, attention. That thing none of us have anymore.)

But what the heck does attention have to do with happiness, stress relief and all the other wonderful things meditation is supposed to bring you?

Paul Dolan teaches at the London School of Economics and was a visiting scholar at Princeton where he worked with Nobel-Prize winner Daniel Kahneman. Dolan says this:

Your happiness is determined by how you allocate your attention. What you attend to drives your behavior and it determines your happiness. Attention is the glue that holds your life together… The scarcity of attentional resources means that you must consider how you can make and facilitate better decisions about what to pay attention to and in what ways.
And Harvard professor Daniel Gilbert, author of Stumbling on Happiness, did research showing that “a wandering mind is not a happy mind.” We want to focus on what the right side of the brain is giving us and get free from Lefty’s endless commentary.

When Lefty gets going with his ruminating, he’s much more likely to end up feeding you negative stories than positive ones. You’re happier when your attention is more focused on the concrete info your right brain is feeding you: the “here and now.” That’s all that “being in the moment” stuff you hear about.

So improving your attention is like dog obedience training for Lefty. When you can keep your attention on the right brain data and learn to disengage from Lefty’s running commentary you stress less, worry less and get less angry.

Is meditation powerful enough to overcome that often critical, cranky voice in your head? Yeah. It was even able to improve attention skills in people with ADD.

From The Mindful Brain:

At the UCLA Mindful Awareness Research Center, we recently conducted an eight-week pilot study that demonstrated that teaching meditation to people, including adults and adolescents with genetically loaded conditions like attention-deficit/hyperactivity disorder, could markedly reduce their level of distraction and impulsivity.
(To learn the four rituals neuroscience says will make you happy, click here.)

Okay, so meditation helps you focus on good things and let go of the bad, which can help you be happier and less stressed. Makes sense. So how do you do it right?

How To Meditate

Focus your attention on your breath going in and out. Your mind will wander. Gently return your attention to your breath. Repeat. Repeat. Repeat…

That’s it. Really. That’s all you have to do. Here’s how fancy neuroscience explains what’s going on…

From The Mindful Brain:

If in mindfulness practice our mind is filled with word-based left-sided chatter at that moment, we could propose that there is a fundamental neural competition between right (body sense) and left (word-thoughts) for the limited resources of attentional focus at that moment. Shifting within mindful awareness to a focus on the body may involve a functional shift away from linguistic conceptual facts toward the nonverbal imagery and somatic sensations of the right hemisphere.
Translation: the more you pay attention to the concrete info your right brain is giving you about your breathing, the less attention you have for Lefty’s interpretations, evaluations and stories.

You’re building yourself a knob that turns down the volume on Lefty’s criticisms and ramblings.

But the process is slow. Lefty will start talking again and you need to keep returning to the breath. Over and over and over. Sound like a waste of time? Nope. Here’s that father of modern psychology again, William James…

From The Principles of Psychology:

The faculty of voluntarily bringing back a wandering attention over and over again is the very root of judgment, character and will… An education which should improve this faculty would be the education par excellence.
(To learn about the neuroscience of mindfulness, click here.)

Simple, right? Actually, I’m hesitant to call meditation “simple.” It is simple, as in “not complex.” Those instructions would fit on an index card with room for your grocery list.

But that doesn’t mean meditation is easy… You know why?

Lefty Fights Back

You try to focus on your breath and banish Lefty but he keeps storming back into the room banging a tympani drum and clashing cymbals together. He won’t shut up.

Even without any input except breathing he still keeps finding things to talk about. And he jumps from one idea to the next. You try to dismiss him but it’s like mental whack-a-mole.

This is where most people give up. Don’t. Your head is not broken and you’re not clinically insane. Buddhists have known about this problem for over a thousand years. They call it “monkey mind.”

From Thoughts Without A Thinker:

Like the undeveloped mind, the metaphorical monkey is always in motion, jumping from one attempt at self-satisfaction to another, from one thought to another. “Monkey mind” is something that people who begin to meditate have an immediate understanding of as they begin to tune into the restless nature of their own psyches, to the incessant and mostly unproductive chatter of their thoughts.
Lefty is like a puppy locked in the house by himself, tearing up the furniture until you come home from work and pay attention to him. But there’s actually a valuable lesson here…

Lefty’s ideas seem so important. But then he’s on to talking about something else. And that seems so important. But then that idea flits away and it’s replaced by another one. And then that idea evaporates and is replaced…

Remember, Lefty isn’t you. He’s merely part of you, doing his job. Your heart beats, and Lefty generates thoughts. But those thoughts — which seem so important in the moment — drift away if you don’t entertain them.

And when it comes to the bad thoughts you have, and the bad feelings those generate, this is crucial and wonderful. You can just let them slide away.

But you’re tempted to take Lefty’s hand and go down the rabbit hole wondering if you should stop meditating because maybe you left the stove on, or if now wouldn’t be a great time to watch TV or finally debate the meaning of life…

Don’t. Turn your attention back to the breath.

And Lefty will say things that worry you or make you sad. And he knows just what will get under your skin. After all, he’s in your head. He’ll play “Lefty’s Greatest Hits” which never fail to get you all worked up. Don’t take the bait.

Your normal reaction is to grab your phone, check Instagram, check email, turn on the TV or do anything to distract yourself.

But that’s how you got into this problem in the first place. You need to sit here where it’s all quiet and build that attention muscle. No Instagram. Return your attention to your breath. Again and again, despite Lefty’s wailing.

Now you can’t shove Lefty away. He’s like the world’s worst internet troll — but with psychic powers. If you engage him, you just make it worse. Thoughts don’t float away if you wrestle with them. It’s like that finger trap puzzle you played with as a kid. The more you struggle to get out of it, the tighter it gets.

Just gently turn your attention back to the breath. Yes: over and over. Build that muscle.

Or maybe Lefty isn’t fighting you at all. Maybe you’re just skull-crushingly bored by this whole meditation thing. But the truth is, you’re not bored…

Lefty is. He’s tricked you again. The voice saying, “God, this sucks. Let’s watch TV.”? That’s not you. That’s him.

What is it when you call something boring? Is it concrete data from the right brain? No. It’s an evaluation. That’s Lefty talking.

Writer and neuroscience PhD Sam Harris explains that boredom is just a lack of attention.

From Waking Up: A Guide to Spirituality Without Religion:

One of the first things one learns in practicing meditation is that nothing is intrinsically boring— indeed, boredom is simply a lack of attention.
When Lefty says he’s bored that means you need more meditation — not less. Train that attention span and shut Lefty up.

(To learn what Harvard research says will make you successful and happy, click here.)

Whether he’s banging pots and pans or trying to trick you into thinking “you” are bored, Lefty won’t shut up. How do you get him to pipe down?

The answer is quite fun. Because we’re going to get Lefty to work against himself…

Don’t Fight. Label.

Ronald Siegel, professor of psychology at Harvard Medical School, writes this about the brain: “What we resist persists.” Arguing with Lefty just keeps him talking. You cannot “force” him to shut up.

So what’s the answer? Acknowledge Lefty. And, for a second, step away from focusing on the concrete and “label” what he is saying:

Lefty: “We keep meditating and we might be late for dinner. Better stop now.”

You:Worrying.” (returns to focusing on the breath)

Lefty: “I wonder if we got any new emails…”

You:Thinking.” (returns to focusing on the breath)

This uses Lefty against Lefty. When you use the left brain to put a label on its own concerns, it’s like writing something down on a to-do list. Now you can dismiss it because it’s been noted for later.

From a neuroscience perspective, it dampens Lefty’s yapping and frees you to return your attention to your breath.

Via The Upward Spiral:

…in one fMRI study, appropriately titled “Putting Feelings into Words” participants viewed pictures of people with emotional facial expressions. Predictably, each participant’s amygdala activated to the emotions in the picture. But when they were asked to name the emotion, the ventrolateral prefrontal cortex activated and reduced the emotional amygdala reactivity. In other words, consciously recognizing the emotions reduced their impact.
In fact, labeling affects the brain so powerfully it works with other people too. Labeling emotions is one of the primary tools used by FBI hostage negotiators to get bad guys to calm down.

(To learn how meditation can make you 10% happier, click here.)

Okay, so you know how to meditate and how to overcome the biggest problem people face when doing it — Lefty’s protests. But how does meditation lead to mindfulness?

Meditation Skills + Life = Mindfulness

Daniel Siegel of UCLA’s School of Medicine says that when you practice meditation consistently it actually becomes a personality trait.

You gradually start to take that attention-focusing and Lefty-labeling and apply it during your day-to-day life.

From The Mindful Brain:

Mindful awareness over time may become a way of being or a trait of the individual, not just a practice initiating a temporary state of mind with certain approaches such as meditation, yoga, or centering prayer. We would see this movement from states to traits in the form of more long-term capabilities of the individual. From the research perspective, such a transition would be seen as a shift from being effortful and in awareness to effortless and at times perhaps not initiated with awareness.
But you can accelerate this process if you actively to try to perform it. If you’re frustrated in traffic, you can focus your attention on the beautiful, sunny day outside.

When Lefty cries, “Why does this always happen to us!” you can label his statement as “frustrated.” That’ll cool down your amygdala and put your prefrontal cortex back in charge.

You can return your attention to the sunny day around you and let his complaints slide away as they always do — if you don’t turn them into a finger trap.

Lefty gets quieter and quieter. You focus more on the good things in the world around you.

And this is how you become mindful.

(To learn more about how to practice mindfulness from the top experts in the field, click here.)

Okay, newbie meditator, we’ve learned a lot. Let’s round it up and see how mindfulness can lead to the most powerful form of happiness…

Sum Up

Here’s how to meditate:

  • Get comfortable. But not so comfortable you’re gonna fall asleep. This ain’t naptime.
  • Focus on your breath. You can think “in” as your breath goes in and “out” as your breath goes out if it helps you focus.
  • Label Lefty. When Lefty brings the circus to town in your head, use a word to label his chatter and dampen it.
  • Return to the breath. Over and over. Consistency is more important than duration. Doing 2 minutes every day beats an hour once a month.

What makes us happier than almost anything else? The research is pretty clear: relationships.

But winning the war with Lefty is so internal, right? It’s all about you. (And him, I guess… But he is you… So it’s still about you.) Does that mean meditation and mindfulness are hopelessly selfish and self-absorbed?

Nope. What’s one of the biggest complaints we hear from those we love — especially in the age of smartphones? “You don’t pay enough attention to me.”

And here’s where that meditation-honed attention muscle pays off. You can give them the focus they deserve. When you don’t have to spend most of the day hearing that chatterbox in your head, you can truly listen to the people you care about.

Daniel Siegel explains that those attention skills can powerfully improve relationships with those you love by an increased ability to empathize.

From The Mindful Brain:

Our relationships with others are also improved perhaps because the ability to perceive the nonverbal emotional signals from others may be enhanced and our ability to sense the internal worlds of others may be augmented… In these ways we come to compassionately experience others’ feelings and empathize with them as we understand another person’s point of view.
Spend a little time focusing on your breath every day and you can replace Lefty’s voice with the voice of those you love.

Remember: every time you hit a share button an angel gets its wings. (Or, um, something like that.) Thank you!

 

Email Extras

Findings from around the internet…

+ What’s the best way to take truly restful breaks during the day? Click here. (Written by the very smart Christian Jarrett.)

+ How can your choice of office furniture make you smarter? Click here.

+ Which over-the-counter painkiller works the best? Click here.

+ Miss last week’s post? You definitely need to read “Lefty Part 1.” Here you go: Neuroscience Of Mindfulness: How To Make Your Mind Happy.

+ What’s the best way to motivate people at work? Click here. (Written by that great reader of research Melissa Dahl.)

+ You made it to the end of the email. (I appreciate you waiting to meditate until *after* you finished the email.) Okay, Crackerjack time. Ever hear a song or read something that just “gets you.” It says how you feel better than you could say it yourself? Oh yeah. That feeling. Well, I felt like that yesterday when I read a great comic by the enviably talented (and funny) Matthew Inman. Oh, and it’s about happiness, passion, and doing what you love. Click here.

 

Thanks for reading!
Eric
PS: If a friend forwarded this to you, you can sign up to get the weekly email yourself here.

 

When you are a food addict, what can you do to re-claim your body?

Susan Pierce Thompson PhD is a neuroscientist who used to be pretty hefty in her teens and twenties till she went on a 12 step programme along the lines of alcoholics anonymous but dealing with the issue of food addiction.  She has stayed very slim for the last 12 years and reckons she knows what keeps us from losing weight and keeping it off long term. Indeed she teaches about this subject at university and has recently started online classes with team support to help the food addicts get “happy, thin and free”. She calls her programme Bright Line Eating.

The basics of this is that the “everything in moderation” mantra does not work with the seriously addicted food addict. Flour, sugar and anything that even tastes sweet gets the heave-ho permanently. Could you do this? Of course you could, if you want to get thin and stay thin. But Susan recognises that breaking your intentions happens and that the most important thing is to resume your plan immediately rather than beat yourself up about it, or use a minor deviation as an excuse to binge with a vow to start on Monday again.

Rats as well as humans seem to fall into three groups. The ones who seem able to resist temptation without a problem, the ones who can resist it for a while but then will give in, particularly if under some sort of stress, and the highly addicted who just can’t leave sugar, sweet stuff, refined flour products and white potatoes in all their forms alone. Susan says that modern foods and patterns of eating have hijacked the brain and sap willpower, induce cravings and set up feelings of hunger. Indeed she has found that rats rate sugar water as more pleasurable than cocaine even when they had been made into serious cocaine addicts by researchers.

The taste of anything sweet seems to be a problem. Saccharine, and all artificial sweeteners have the ability to induce cravings, even stevia. Although fat and salt make food more palatable, and humans eat more of it when laced with butter, cream, olive oil and salt for instance, they don’t set up the same addiction circuits. It is the flour/sugar items such as chocolate, ice cream and pizza that are the top addictive foods for most westernised humans, with potatoes and potato products coming in fourth.

When you get a craving for something, parts of your brain are being affected by chemicals that you have no control over. Cravings and hunger are controlled by the hypothalamus. This is your body’s thermostat that controls all sorts of complex processes through the release of hormones.

Your willpower centre is in the anterior cingulate cortex and behaviour is controlled here. The problem is that behaviour gets more difficult to control if you have to withstand temptation for just 15 minutes. It gets even harder to control behaviour when the blood sugar is low or you are already tired, have already had your temptation tested, are feeling emotional or have been focussing on tasks. Susan calls this the “willpower gap”. You know what you are meant to do but you just can’t seem to help yourself from doing something else. Like opening that packet of biscuits.

Your brainstem is where leptin is active. Your brainstem is the most primitive part of the brain and the most basic functions that keep you alive such as breathing reside here.  The trouble is that insulin resistance leads to leptin resistance, and although your brain stem may be flooded with leptin, telling you that you are full, the leptin resistance means that the message doesn’t get through, and your brain stem thinks you are starving. Mindless eating ensues just as mindless breathing continues.

A major step in resolving this impasse is that insulin levels need to be lowered. And what raises insulin the most? Yes, sugar and starch.  This is why a low carb diet, as we describe in our book, can help you lose weight and get your appetite under control. It is all down to physiology.

Susan goes a bit further than we do, however, in that all sweet stuff, with the exception of sweet fruit, is banned. Also all flour products are completely banned. This is because those people who have very serious food issues are more susceptible to dopamine, the reward hormone.

Dopamine is active in the nucleus accumbens. It goes up in response not only to food stimuli but also to sex stimuli for example. Indeed Susan describes sugar as the pornography equivalent of sex. I have to agree with her here.

In large magazine shops you often see rows of women’s magazines on one side and men’s magazines on the other.  The men’s magazines seem to be mainly all about becoming more competent in something eg music, muscle building, computer know-how, with some soft pornography thrown in. Women’s magazines have “how to be more nurturing” magazines with pets, home decorating and crafts taking about a quarter of the space. The rest seems evenly split between “how to make lovely food” often featuring beautifully iced sponge cakes with lashings of cream on the one hand, and “how to get thin from not eating beautifully ices sponge cakes with lashings of cream on them”. I’ve often thought of food articles and particularly photographs as being porn for women.

So, back to dopamine. What a great hormone. You have lots of it and you feel like you rule the world. The downside is that your reward feeling gets worn down by the never ending waves of  dopamine and you tend to need a bigger fix for the same wonderful feelings over time. Also if dopamine becomes depleted you can feel pretty unhappy and also can need another fix to bring it up.  This is a reason why Zyban, the anti-smoking drug can induce suicidal depression.

Zyban, also known as varenicicline,  makes the craving for cigarettes stop by blocking dopamine. When you smoke, you don’t get the hit. Instead you think, “This fag is lousy, why the hell am I smoking it?” This makes it somewhat easier to break the smoking habit. The downside is that you can feel lousy about everything. And sometimes the effect is unpredictably tragic.

Despite the common belief  that we are in control of our behaviour rather than our brain chemicals, Susan is so convinced of the chemical superiority over willpower, that she builds methods of how to resist the hijack into her diet plan.

Dr Thompson knows that a chemically affected brain really has the belief that the body is starving and that flour and sugar are even more powerfully addictive than heroin or cocaine for about a third of the population. She knows you can’t reason with your brain stem. Instead it reasons with you.

That little voice says, “I deserve that”. “It’s only one time”. “It’s only a little bit.”  As more and more exceptions to our dietary plan creep in, we watch ourselves breaking rules, and the belief that we are incapable and lacking in some way, especially compared to thin people, reduces our feelings of competency. Our self-esteem goes down the plug hole. As I have said before, a prominent bariatric surgeon told me that the drop out rate with bariatric patients was particularly high because of the very low self- esteem that this group of people have.

Susan says that very clear boundaries are necessary to get back on track. A lot of planning, daily preparation, long term habit change and support is necessary to overcome addictive eating. Emergency action plans and support are needed for the inevitable breaks in willpower.  But, she says that dopamine receptors recover in time and that as insulin resistance disappears, the insatiable hunger goes with it. She says that reliance on willpower is the single biggest mistake dieters make. Instead you need a whole system to deal with false hunger, addiction and social pressures to eat flour and sugar.

Restorative behaviours such as meditation are important. So is getting out in nature. Anything other than food that boosts your willpower battery is good. Exercise is not part of the plan for most people because it can be a step too far when good eating habits are in the process of being embedded. She thinks exercise can be too much a sap on a person’s willpower unless it is already an entrenched habit.

The path to being slim and healthy is not easy so a different way of looking at the problem is welcome. In particular simple calorie measuring is no good for some people if sugar and flour are part of the calories. Also low carbing may not be extreme enough for some people and cutting out all sweeteners and sugar rather than keeping to small amounts of sugar and starch may be necessary.

Based on an online webinar by Susan Pierce Thompson PhD. October 14 2015.