The Flavor-Calorie Theory

In March I did a quick video introducing Seth Roberts, a Berkeley psychologist, and his interesting theory known as the flavor-calorie association theory of body weight set point regulation. I also mentioned Roberts’s pioneering work in 180 Degree Metabolism – in the lengthy discussion about the going theories on what causes leptin resistance and a rise in set point.



I am still incredibly captivated by this theory, and really struggle to find loopholes and flaws in it. It’s come to the forefront recently as I have experienced a tremendous anorectic (hunger-suppressing) effect from eating a high-starch/low-fat diet, which contains much lower flavor intensity (it’s bland as hell) and much lower calorie density (8 pounds of potatoes contain the same amount of calories as 1 pound of butter, for example) – both prominent factors in the creation of flavor-calorie associations that increase hunger and lower metabolism. These, of course, are telltale signs of an increase in bodyweight set point. I, on the other hand, have experienced a big decrease in appetite and a rise in metabolism – down 5 pounds in the first 27 days of July.

For more on increasing metabolism, please read this FREE 180DegreeHealth EBOOK.

Here are the prime factors in the flavor-calorie theory, which explains numerous diets all under one umbrella…

1.) Calorie density – the more calorie-dense a food is, the more it triggers an activation of reward centers in the brain and a mysterious rise in weight set point.

2.) Absorption rate – the faster a food is absorbed, the stronger the flavor-calorie association and the larger the rise in the activation of reward centers in the brain and a rise in set point that occurs when these pleasure centers are tickled.

3.) Flavor-intensity – the more highly-flavored the food is, the more it raises set point

4.) Food familiarity – the more you eat ditto foods with a strong flavor-calorie association (like, say, Cool Ranch Doritos), the more you start to prefer those foods, the stronger the flavor-calorie association becomes, and the more fattening those foods become.

5.) Liquid vs. Solid – Liquids, in general, promote stronger flavor-calorie associations and are more fattening than solid foods – raising the set point.

There is ample evidence supporting all of these arms of the flavor-calorie association hypothesis. Of course, what I just described is the food produced by food companies – packaged/processed foods, fast food, and other restaurant food. This is something that anyone with personal experience and the eyes to see can observe. Most don’t develop severe weight problems eating homemade, solid, unsweetened, unrefined food with a low calorie density and no added flavor enhancers. Most who do develop weight problems do so by repeatedly eating specific foods that are scientifically-designed to outcompete other foods in activating reward centers in your brain and creating strong flavor-calorie associations that make plain food increasingly unpalatable and undesirable.

Food companies have this down to a science – serving up food that is designed to be masticated and absorbed more quickly, enhanced with MSG and other flavor enhancers, and washed down with a highly-sweetened beverage in liquid form, sometimes sweetened with Aspartame or other highly-sweetened substance that causes a stronger flavor-calorie association and an increase in bodyweight set point.

The reasons why I find this theory to be so compelling:

1) Humans are the only creatures that have the intelligence to specifically manipulate their food in such a way (combining certain ingredients, cooking, adding spices, chemical flavor enhancers). The only creatures that eat food that comes in such a package are humans and their pets, the only creatures on earth that suffer from obesity (and giant squirrels and chipmunks that are fed this food by humans).

2) In simple laboratory studies, feeding a highly-sweetened substance like Saccharin, an artificial sweetener with no calories, increases food consumption and body weight.  According to Roberts's theory, you would also see artificially-sweetened beverages consumed by themselves as opposed to with a big calorie load in a mixed meal NOT be fattening or induce greater calorie consumption, which may indeed be true. 

3) In simple laboratory studies, feeding more liquid calories and fewer solid food calories increases calorie consumption and body weight. For example, feeding sucrose in granulated form is not fattening. Feeding sucrose as part of a liquid solution is very fattening.

4) High-fructose corn syrup, which is a liquid and is also sweeter than sucrose due to its higher concentration of fructose, is markedly more fattening than white sugar.

5) The strongest association between obesity and food is the association between obesity and soft drinks, highly-sweetened, rapidly-absorbed, liquid food that tastes exactly the same every time you drink it.

6) Lab animals that are fed “chow,” which, because it is more palatable than fat, carbohydrate, and protein separated into different bowls, causes the lab animals to become fatter and maintain a higher weight set point than controls. When the controls are switched to chow, they do not gain weight, suggesting that flavor-calorie associations that affect bodyweight set point occur in youth to a greater degree than adulthood (perhaps a reason why Granny can eat all kinds of things without getting fat that make YOU blow up like a balloon).

7) Feeding humans less calorie-dense foods, such as a diet high in fiber and water content from fruit, vegetables, and unrefined starches causes a massive decrease in calorie consumption – up to an instant 40% decrease with no decrease in satiation reported (from Burkitt et. al.’s Western Disease).

8) Diets that are sweetened vs. diets that are unsweetened are much more fattening and promote greater calorie intake.

9) Refined carbohydrates, which are more calorie-dense and more rapidly absorbed tend to increase calorie intake and body fat, whereas unrefined carbohydrate diets have the opposite effect.

10) Low-carbohydrate diets are comprised of foods that are not particularly palatable, and typically decrease appetite and body weight.

11) Low-carb diets that contain artificial sweeteners often negate the hunger-suppression and weight loss effect of a low-carb diet. Even Atkins reported this, and advised those who weren’t losing weight to make sure they excluded aspartame from their diets.

12) Displacing more homecooked food, which generally has low flavor-intensity, natural flavor variability, slow absorption, and less calorie-density with packaged, processed, refined, rapidly-absorbed, chemical flavor-enhanced ditto foods and restaurant foods parallels a huge rise in obesity. It’s reported that calorie intake per capita has increased 20% in the United States since the early 70’s.

13) Obesity was unheard of in all places in which unrefined carbohydrates were ingested as opposed to refined carbohydrates.

14) There are strong associations between obesity and the flavor enhancer MSG.

I could go on for a while here, but that is a good starting point. Ideally we would all be able to raise body temperature without any increase in body weight. Instead, this could be achieved by lowering body weight set point. Of course, lowering the weight set point is easier said than done, and is, as I discussed in my conversation with Sean Croxton last night, perhaps the most important secret yet to be revealed.

But I do find this theory to be solid and applicable. Those attempting to lose weight may find much better success…

- eating almost exclusively homecooked whole foods

-cooking differently each time or with the addition of different spice combinations to reduce flavor-calorie associations

-eating lots of food that is not calorie dense – like root vegetables and vegetables

-avoiding all liquid calories

-eating foods that require lots of chewing

-keeping fat intake reasonable (which decreases flavor-calorie associations), and being wary about foods with strong flavor-calorie associations where fat and carbohydrate are conjoined and in ditto form – pizza, ice cream, fast food, chips, cookies, etc.

-keeping sweets to a minimum, especially when combined with a calorie-dense meal. Fruit, which has a very low-calorie density, eaten by itself, does NOT form strong flavor-calorie associations. When consumed with a high-calorie load after a mixed meal, I find fruit to be very fattening, and juices even more so, which would be expected if Roberts’s theory is accurate.

-not seasoning foods too heavily

For more on Seth’s theory, read the Shangri-La Diet or Seth’s free report here:

http://sethroberts.net/about/whatmakesfoodfattening.pdf

180 on Underground Wellness

Hola amigos!  Tonight I will appearing on Underground Wellness on Blogtalk radio.  This is quite the happenin' show, with a large audience who the host, Sean Croxton takes callers from n' everything. 

The show goes from 5pm Pacific time to roughly 6:30.  It sounds like we'll probably cover some of the central 180 topics and have a fun conversation.  I'm appearing on the show thanks to several 180 fans hounding Sean about getting me on the show - so thanks.  I owe ya. 

Anyway, I invite you to call in and add to the conversation.  I'd love to speak with some of the faithful live on the phone as well, so don't hesitate.  I'd be honored to be called a douche, ripped a new one, or hear about some of the benefits you've derived from your 180 adventures.  It's all fair game. 

The show is hosted at the following url:  http://www.blogtalkradio.com/undergroundwellness/2010/07/29/180-degree-health

Mr. Croxton and I actually share quite a bit in common.  When I saw my first UG Wellness video on youtube about a year ago I couldn't believe my ears.  He was actually using the same line of argument in defense of dietary fat that I had used in an article called "Fatzilla."  Anyway, this was my introduction to Sean - a likeable guy that is destined for great success  as a health advisor and "edutainer"...



Enjoy the show! 

Joel Marion

Joel Marion is a likeable dude. What I like about Joel is that he understands and can relate to the common person. While the fringes of alternative nutrition blogs like this one attract a certain nutrition and health geekazoid crowd, Marion’s target audience are people like him – people that live in the real world, socialize in the real world, and do dearly love slamming pepperoni pizzas and Double Stuff Oreos – on occasion.

The question is, can you lose weight doing that intelligently, and can you actually improve your health in the process? I believe you can, and that Joel Marion has captured what could very well be the most important concept when it comes to losing weight intelligently – the “cheat” day.

Bodybuilders have been practicing “cheat days” for ages, but Marion has put the cheat day into context of the discovery of the hormone leptin – the master regulator of energy balance in the human body.

In his book, Cheat to Lose (interesting, but probably not enough to impress anyone here), he points out what is the dieter’s dilemma. That is that calorie restriction in some shape, form, or fashion is required to lose body fat. You have to eat less than you burn, burn more than you eat via exercise, etc. to lose fat. And when you do that, your metabolism slows down, your appetite goes up, you lose muscle mass, and the body does anything and everything it can to protect itself from further weight losses.

While my emphasis is, and will continue to be finding how to make that happen automatically within the body instead of relying solely on behavioral changes – the reality is unchanged. You must burn more fat than you store to lose fat, and this, in general, necessitates at least a slight deficit in calories ingested vs. calories burned through total metabolic and physical activity.

What I’m more interested in, is whether one could do any type of dieting that they want to create a calorie deficit and get away with it (metabolically-speaking) by doing an aggressive “cheat day” once every seven days. Marion certainly thinks so, and I’d like to believe him.

The premise of Marion’s program, both his old program and his new, even more radical approach, is that leptin levels are not solely linked to body fat levels but to calorie intake also.

I would agree with this. While leptin levels tend to rise as body fat rises (increased metabolism, decreased appetite, inhibited fat storage) and fall as body fat falls (decreased metabolism, increased appetite, inhibited fat burning), the peaks and valleys in leptin are way out of proportion to body fat when it comes to altering calorie intakes.

For example, an often cited quote by Russ Farris that I often throw out, is that during an overfeeding study leptin levels increased by 68% during the study, while body fat levels didn’t even come close to increasing by 68% (it was probably more like a 10% increase).

Likewise, Marion repeatedly refers to a study in which calories were restricted in dieters, and by the end of just 1 week, leptin levels fell by 50% despite a drop in body fat by only a few pounds.

This is precisely why trying to cut calories – and even perhaps the act of cutting calories automatically (which often happens with a new exercise regimen, on a low-carb diet, uber low-fat diet, or a whole foods diet), works short-term, but continued over several weeks and months often stalls and results in accompanying health problems (no matter how “clean” or nutritious your food may have been).

This is exactly why a smarter and more sophisticated approach is needed, and, in the context of leptin, Marion has created just that. The good news is this… (p. 21)

“…while leptin levels drop around 50 percent after one week of dieting, it only takes one DAY of overfeeding or ‘cheating’ to bring levels back up to baseline. So the solution to our dilemma and the very premise of this diet is: CHEAT... It all makes perfect physiological and psychological sense. By periodically cheating on your diet, you circumvent the negative physiological side effects of calorie restriction. Each week you start fresh with baseline levels of leptin and a hormonal environment primed for burning fat, not muscle. The metabolic crash that occurs with prolonged dieting is no longer an issue, so keeping lost weight lost as you enter the maintenance phase of the diet won’t be a problem.”

What does this mean in the context of 180 and what is the answer that I lean (no pun intended) towards giving to people asking me what I personally recommend for losing pure body fat with no lean losses these days?

It means this…

1) For restoring a severely damaged metabolism, it requires prolonged rest and overfeeding – a calorie surplus, as outlined in the FREE EBOOK available HERE. Fortunately, given the new insights covered in the MNP post, there now appears to be a way to minimize fat gain and maximize muscle gain and increased body heat and metabolism while overfeeding – maximizing starch intake and minimizing fat intake (easier said than done as many have crippling problems with hypoglycemia and impaired glucose metabolism that must be overcome first, which may mean eating more fat and gaining more fat before body composition is addressed).

2) Once metabolism is restored, body fat can be lost any way you desire.  There is probably no "better" or "best" way to do it.  For me, that means cutting way down on fats (most days). I feel great doing it, and it happens to be the perfect counter to some imbalances I developed on a prolonged low-carb, high-protein, high-fat diet. It is very satiating, makes fat storage virtually impossible, and I enjoy being able to lose fat eating up to 10 pounds of food a day. But any method theoretically could be used – such as carb cycling, intermittent fasting, eating very small portions of all your favorite foods, or exercising your brains out.

3) To keep from developing health problems doing these practices, and to also limit the amount of weight you need to lose to look lean and attractive (by protecting lean body mass), overfeeding once every 7 days is absolutely mandatory. High-glycemic carbs like grains, corn, potatoes, etc. raise leptin the most. In addition, the higher the starch to fat ratio while overfeeding, the greater the ratio between muscle gained to fat gained during the overfeeding day. The main objective, however, is overfeeding. If you cannot do it with low-fat rice, oats, potatoes, pasta, bread, etc. (at least 1,000 calories above your maintenance calorie levels for the day), then you should be eating pizza, cheesecake, and whatever you are most likely to be able to overfeed on just as Martin Berkhan practices.

4) For greater muscle gains, overfeeding on high-starch, low-fat more than one day per week should be very effective. For each day with a 1,000 calorie surplus, assuming you maintain an 8:1 ratio of starch to fat by percentage of calories, you should be able to add at least .5 pounds of lean body mass with no fat gain at all. Resistance exercise also helps, but is not mandatory for lean mass gains – even for middle-aged women.

5) Once your metabolism is great, your health is good, and your body composition is good – it’s time to switch to a satisfying, nutritious, well-rounded maintenance diet consisting of anything you want to eat as long as most of your diet is wholesome, and you can eat to appetite without fat gain, health problems, or a decrease in body temperature. The “high-everything-diet” would be great – a mixed diet with all the fats, protein, and carbohydrates you care to eat. This can include sugar, alcohol, caffeine, or whatever you want to try to get away with. The healthier you are, the more dietary liberty you will have to relax and enjoy along with the rest of society.

But the basic message of Joel Marion is very simple and potentially one of the greatest “tricks” for losing body fat known. The basic concept is that you cannot lose weight 7 days per week. If you do, you will run into a brick wall because of low-calorie intake’s effect on leptin. To sidestep that problem, you overeat – really overeat, one day per week. The more starch-centered this overfeeding is, the more you will raise insulin, and the more you raise insulin the more you raise leptin back to baseline, which negates the negative impact of low-calorie intakes all week long – not to mention gives you pronounced muscle growth.

Note, for fat loss, the “cheat” day concept only works if you lose 1-2 pounds of bodyfat during the week prior to the cheat day. This cannot really be monitored with a scale, as 2-pound weight loss doesn’t mean a 2-pound fat loss, so you will have to judge it based on how your clothes fit, muscle definition changes, appearance, etc. With the lean body mass gains that can come with it, the scale becomes even more useless, so don’t use it. You will know within a month whether you are getting leaner or not.

P.S. – The 180 Kitchen revision is still not quite wrapped up, and I’ve got a busy week this week so you may not see it released until next weekend.

P.S.S. – I will be appearing on the Underground Wellness Blogtalk radio show with Sean Croxton this Wednesday evening at around 6pm Pacific time if you’d like to listen. Should be a good one.

Reactive Hypoglycemia

In the last post on Anorexia, I promised to discuss what I believe to be a very common problem for any long-term dieter – particularly one that has taken their metabolism down to the extremes seen among underweight anorexics. This is what is deemed “reactive hypoglycemia.”


The telltale sign of reactive hypoglycemia, without using a glucose meter, is tremendous hunger and shakiness within an hour or two of eating a meal. A glucose meter provides more hard evidence of the condition, and typically shows a high fasting blood sugar level that plummets after ingesting food.

The basics of reactive hypoglycemia, which are experienced most commonly by people who have lost a lot of weight and have entered into a functional state of starvation (whether going from 400 to 250 pounds on a low-carb or calorie-restricted diet, or going from 120 to 80 pounds via eating disorders seems to be somewhat inconsequential).

In this well-hidden Jimmy Moore podcast, a former colleague of Dr. Atkins, Keith Berkowitz (yeah, that slightly creepy looking dude up above - I don't think he has a twin brother), describes how, in those who have lost a lot of weight, he keeps repeatedly seeing the strange phenomenon known as reactive hypoglycemia in his patients.

CLICK HERE TO LISTEN

Traditionally, it is well known that eating a diet with a pretty high ratio of dietary protein to carbohydrate helps to medicate this problem. The high ratio helps to trigger glucagon release, which triggers the release of stored carbohydrate – keeping blood sugar levels more stable. One of the first to publish a book exclusively on hypoglycemia was Broda Barnes, who published Hope for Hypoglycemia: It’s Not Your Mind, It’s Your Liver with his wife Charlotte in 1978 – the year the world began (at around midnight between February 6th and 7th according to my mom).  More on Broda Barnes in this FREE EBOOK.

In the book, Barnes reveals some tremendous insights. The first is that he was able to give “hope” to hypoglycemics by supplementing desiccated thyroid extract in sufficient doses to raise basal body temperature to 97.8 to 98.2 degrees F (armpit temp). This appeared to completely eradicate the condition for many patients, allowing them to eat foods they never thought they’d ever be able to eat again, like chocolate cake, without having extreme hypoglycemic reactions (like that noted by Ailu in the comments in the last post, who has literally passed out after eating pancakes by themselves for breakfast).

This makes perfect sense when you consider that, when dropping well below the body weight set point, humans have been repeatedly shown to have huge drops in body temperature/metabolism – well beyond what can explained by the change in body mass. In fact, this quote by Robert Pool, author of what I consider to be perhaps the best book written on the puzzling illness of obesity in reference to Rudy Leibel’s work, says it all:

“Leibel found that the non-obese group, which consisted of 12 men and 14 women who weighed an average of 138 pounds, needed an average of 2,280 calories per day to maintain weight. By contrast, the obese group, an identical number of men and women who weighed an average of 335 pounds, needed 3,651 calories a day. This wasn’t surprising – the obese subjects weighed nearly two and half times as much as the control group, so it seemed reasonable that they might need an extra 1,400 calories a day to maintain that weight. What was surprising, though, was the comparison after the weight loss. After the 26 obese patients had lost an average of 115 pounds apiece, they weighed an average of 220, and at this reduced weight their bodies demanded just 2,171 calories a day. In other words, these reduced-obese patients, who still weighed an average of 80 pounds apiece more than the lean subjects, had to eat 100 calories a day less to maintain their weight.”

Might I also mention that these reduced obese subjects, when eating the 2,171 calories required to maintain their new weight, ALL experienced ravenous and gnawing hunger which persisted until every ounce of weight they had lost was regained.

Anyway, the point is that whether fat or thin, the starvation reaction of the body is the starvation reaction of the body – whether you weigh 220 or 60 pounds. And the result is often the same when it comes to reactive hypoglycemia, which very commonly affects the hypometabolic, and is a huge barrier for the anorexic and reduced obese alike when it comes to reintroducing carbohydrates into their diet. Because when they do – crash and burn. Not only that, but it re-awakens a beastly and outrageous hunger that is the worst nightmare of both Anorexics and obese alike. Fear of weight gain and out-of-control eating set in quickly.

So, what the hell do you eat if you are trying to overcome hypoglycemia? That’s a good question, because the standard high-protein, low-carbohydrate diet given to hypoglycemics since forever to control and medicate the condition, also happens to lower metabolism according to Dr. Barnes, who knew a thing or two about it…

“…it has been clearly established that a high protein diet lowers the metabolic rate, [therefore] symptoms of hypothyroidism will be aggravated… Hypoglycemia may be controlled on the high protein diet, but the other symptoms of thyroid deficiency which usually accompany hypoglycemia are aggravated.”

I agree, and it makes sense on some level that protein would lower metabolism. For starters, protein, calorie for calorie, is more satiating. Therefore, you eat less food – not good for the metabolism of someone in a functional state of starvation. Secondly, consuming EXCESS protein beyond what your body uses (and your body uses very little for muscle-building if you are not eating very many carbohydrates – the Taxi for getting dietary protein into muscle cells), forces the excess protein to be burned as energy (protein oxidation). Uh oh, you need a rise in adrenal hormones like cortisol to use protein as fuel, which are antagonistic to the thyroid, increase insulin resistance, etc.

And lastly, protein requires more energy to digest, which is one reason nearly all diet authors advocate big protein intakes. It causes a greater heat production (thermogenesis from food digestion) than any other type of food – grounds for saying it “raises your metabolism!” Well yes, it “burns more calories” and causes a postprandial rise in body heat, but when this causes your body’s resting energy expenditure to decline, then it’s actually counterproductive, not productive.

Anyway, what to do?

I think what Riles and JT proposed in the last comments section was very sound. Instead of jumping straight into a very high-carbohydrate intake to heal metabolism, build lean tissue, and feel better fast – it might be best to slowly transition into it.

For starters, matching starch and protein intake on a gram for gram basis is a good start. Tha boyz recommended 1 gram per pound of lean body mass of each – with a little fat to satisfy the appetite at first. Slowly, you begin increasing the ratio of carbohydrate to protein in the diet (by increasing carbs and slowly reducing protein – as well as fat) until you’ve reached what is more or less the preferred macronutrient ratio for high-body temperature, low cortisol, great muscle building, good physical performance, and great difficulty in gaining body fat – even when overfeeding and not exercising. That is at least a 5 to 1 ratio of carbohydrate to protein upon close scrutiny, with fat well under 20% of total ingested calories.

Another approach would be to eat high-fat/low-carb with the RIGHT amount of protein (1 gram per kg of body weight) and slowly displace an increasing amount of fat with carbohydrate. Not sure which route would make for an easier transition, but I would think trying to increase carb intake while fat intake is very high would be tough, and increase the likelihood of gaining weight.

For more on the importance of body temperature and how it can be brought up through dietary measures, read THIS FREE EBOOK.

Of course, supplementing with thyroid extract is a very viable option during the transition period as well.

“To date, when the symptoms of hypothyroidism are relieved, hypoglycemia, like the others, disappears.”

-Broda Barnes

I should also mention that reactive hypoglycemia appears to be caused by secreting WAY too much insulin in response to ingested food.  I believe this to be an aggressive attempt by the body to store food into cells - part of the programmed famine response of the human body. 

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Anorexia Rehab

Over the weekend I was asked a question about anorexia, and since my thoughts and feelings about the disease are so vast, I saved my reply to this anonymous poster for its very own blog post (note, that is NOT a photo of the person who wrote the following)…

“I have had anorexia for 6-7 years now and I need and want out. I have gone from ‘conventional’ treatment where people shove ice cream and subs in your face to LC because it helped me mentally calm down and distress, then to VLC and then ZC then back up the ladder to VLC and LC now. I eat a shitload of protein and fat and slowly and upping my carbs. My blood sugar is shot. My adrenals are shit. My cortisol is well, shit as well. I have some incredible hypoglycemia problems. Like another person who commented on your blog, ANY form of exercise sends my blood sugar through the roof. My waking blood sugar is over 100 and stays there until I eat and usually post meal is anywhere from 60-90. I played around with Martin’s intermittent fasting because, yeah I am a dumbass. I am starting your book now, thank you.


I guess my question is this… you have read Ancel Keys ENTIRE starvation study and experiment. Well, I am like the prime candidate for overcoming what those people went through and getting my body out of starvation. Any steps, help, ideas are more than welcome.”

To begin with, anorexia is a lot more complex than most people give it credit for. It’s also a lot more dangerous and debilitating than many give it credit for as well. In the words of Furious Pete, former anorexic that nearly died from it – “it’s a bitch of an illness.”



Most assume that anorexia is purely psychological, stemming from body image issues and a desire to appear like supermodels or something like that. While this mentality can certainly instigate undereating and lead to the powerful physical and psychological addiction that best describes anorexia, once the disease has set in, to say that it is purely psychological is a huge error.

I liken anorexia to addiction. From what I suspect, most cases of anorexia begin with a desire to lose weight. When someone loses weight as we have been discussing at length over the past month, this is accompanied by a large rise in catecholamines – the adrenal hormones that break down both fat and muscle tissue to be used as fuel. This breaking down of body tissues is referred to as “catabolism.” Catabolism… catecholamines. Coincidence?

Along with the rise in catecholamines comes a rise in neurotransmitters dopamine and beta-endorphin. These are energizing. Pain goes away. A state of subtle euphoria sets in, and we get a little “high” from it. We are talking about opiate substances here, and they are very addictive – as addictive if not more addictive than actual opiate drugs. Dopamine… dope. Coincidence?

Anything that causes a big rise in catecholamines typically triggers a rise in beta endorphin and dopamine. That’s why you hear so much “buzz” from those who practice intermittent fasting for example, on how good they feel, how much energy they have, how clear and focused their thinking is, etc. They are getting a natural high, just like vigorous exercisers get. Very low carbohydrate eating often has the same impact, and while an anorexic can self-medicate by keeping carbs low enough to trigger dopamine and beta endorphin release, it is counterproductive to recovery for reasons explained below.

The problem is when a person with susceptible physiology meets activities and substances that spike these neurotransmitters to great highs. This is what makes the difference between a person that gets addicted and one that does not. What is susceptible physiology? Susceptible physiology is someone who naturally produces LOW amounts of these neurotransmitters for whatever reason – typically poor nutritional history on behalf of themselves and their parents I suspect, as nutrition needs to be excellent in order to have sound production of these neurochemicals (naturally weak adrenals may in part be responsible as well – and there’s no doubt that adrenal stressors heighten a person’s susceptibility to addiction).

When levels are naturally low, substances or activities that spike these neurotransmitters are particularly alluring. That’s because a person that naturally has low levels of these neurotransmitters correspondingly has a lot of receptor sites wide open to capture this small amount of dopamine and beta endorphin. Anything that causes a surge of these chemicals causes quite a thrill ride.

At the same time, spiking these neurotransmitters results in what is called “downregulation” in which some of those wide open receptor sites close down. This is precisely what makes anything that spikes feel good brain chemicals habit forming and addictive. With a low production of dopamine and lots of wide open receptor sites, life feels good, balanced, stable, and normal. But with a low dopamine production and closed receptor sites life feels slow, sluggish, depressing, painful, and so on – the opposite of a dopamine high.

Once dopamine has been spiked enough, and enough receptor sites shut down – even if dopamine production is still the exact same as it was to begin with, the person feels nothing but withdrawals and has the experience of insufficient dopamine, beta endorphin, or whatever. They need increasingly larger spikes of these neurotransmitters just to feel normal, much less good, just like any true long-term drug addict or alcoholic.

This is exactly the pathology of anorexia. A susceptible person starves him or herself. When that happens, beta endorphin and dopamine levels rise – making the person feel VERY good at first. If a person manages to fight their hunger signals hard enough, and long enough with a large motivating factor such as body image issues to override natural physical feedback…

Then receptor sites start to shut down. Undereating, at this point, then becomes self-perpetuating and the normal hunger feedback loop is broken. Resuming eating once again induces instant withdrawals for which abstaining from eating is the medicine. Undereating, from a functional standpoint, becomes a drug to get a dopamine and beta endorphin feel-good fix. Without it, a person feels miserable physically, and depressed, lethargic, and dark psychologically. At this point, anorexia is not something that can be cured with a Club sandwich any more than a heroin addiction can be cured with a Club sandwich.

Before I go indefinitely on this addiction/anorexia tangent, let me get into specifics in terms of the questions that were asked in the email I received above…

Recovering from anorexia is like recovering from serious drug addiction and should not be underestimated. Any person suffering from anorexia, if he or she has any hopes of recovery, must first be able to grasp what addiction is, how it operates, and what MUST be done to recover.

From this vantage point, the psychological pre-requisite for recovery can hopefully be mustered. That psychological pre-requisite is one of understanding how the body and mind work, and grasping fully why eating makes you feel shitty and depressed with an uncontrollable urge to stop eating.

I imagine a typical anorexic seeking recovery is at odds with themselves, frustrated as to why they can’t just eat when they know they need to, and confused at all the terrible physical and emotional trauma they experience when eating. To get to the other side, it really takes full recognition of the problem, how to fix it, and a whole lotta self compassion. Otherwise you’ll just beat yourself up for not eating instead of realizing exactly why you don’t want to, taking it easy on yourself because of it, and taking the proper steps knowing fully that it is going to be a major hellish battle that every cell in your body will try to resist.

To recover, I believe that there is no way around achieving “upregulation” in which the receptor sites for beta endorphin and dopamine open back up again – allowing you to feel normal with your naturally low production of those neurotransmitters instead of experiencing too little and having an unquenchable thirst for anything and everything that spikes it.

A very low carbohydrate diet, in the short-term, could very well make for a substitute for anorexia, as could very strenuous exercise, as could various psyche meds and stimulants. However, that is ultimately trading one form of addiction for another, and is not genuine recovery. However, it can make for a great stepping stone.

But ultimately upregulation must occur. For this to happen, it is essential to focus on doing everything possible to keep beta endorphin and dopamine levels as low as possible. This, ladies and gents, is brutal for someone with downregulated receptor sites for these chemicals. The withdrawals can be major.

For someone seeking to keep these levels as low as possible, major tactics include:

1) Eating frequent, starch-based, whole food meals at above-maintenance calorie levels. The food should actually be somewhat bland, in whole food format, with some, but not too much added fat or protein (protein raises adrenal hormones and associated neurotransmitters, and really good food, especially sweets mixed with fat, triggers a big release of opiates that you are looking to avoid). A non-vegetarian macrobiotic-ish diet would actually be decent for recovery. This will also help in fixing reactive hypoglycemia, which I would guess nearly all anorexics suffer from to some degree (although it too will exacerbate hypoglycemic symptoms in the short-term).
2) Sleep a lot, including regular naps.
3) Perform various relaxation techniques, from gentle yoga and breathing exercises to meditation.
4) Avoid stress as much as possible.
5) Avoid strenuous exercise.
6) Avoid stimulants.
7) Avoid drugs – recreational and psychoactive.
8) Avoid sweets.
9) Avoid anything overly pleasurable. The more miserable you are, the faster you are upregulating.

This is obviously a lot to ask for, and would require tremendous support from family members, loved ones, and potentially demand professional assistance like that required for a drug addict attempting rehabilitation. Unfortunately, I’d venture to guess that most professional eating disorder rehab joints, just like most drug rehab joints, provide many forms of self-medication from candy to cigarettes that lessen withdrawals and limit true fundamental healing of the core problem.

Once you have upregulated, be very cautious about meal-skipping, drugs, stimulants, stress, and other adrenal stressors that can cause a relapse, as your sensitivity to such things is greatly heightened in an upregulated state.

Bulimia shares a similar pathology. Know how miserable you feel right before puking and how euphoric and instantly healed you feel immediately after vomiting? That’s some endorphins for you. Addictive as hell if you do it enough to start shutting down your receptor sites.

For more specific lifestyle and dietary recommendations geared for overcoming addiction and more by lowering adrenal hormone activity via overfeeding, over-relaxing, and oversleeping, READ THIS FREE eBOOK.

More on reactive hypoglycemia in a blog post this Thursday – something many chronic dieters, hypometabolics, and adrenal gland punishers experience given sufficient time.

GI Cancer Prevention

Gastrointestinal cancer is a broad term that refers to cancer affecting an organ in the gastrointestinal tract, including:

• Esophageal cancer
• Stomach cancer
• Gallbladder cancer
• Liver cancer
• Pancreatic cancer
• Colon cancer
• Rectal cancer
• Anal cancer

Though not preventable, there are some simple ways to reduce the risk of GI cancer:

• Do not smoke. Smoking increases the risk of GI cancer and other types of cancer.
• Eat a healthy, well-balanced diet─ rich in fruits and vegetables and low in sodium and fat.
• Get the recommended colon cancer screening beginning at age 50 and continuing at the recommended intervals.

Penn Medicine offers a multidisciplinary approach to the evaluation and treatment of patients diagnosed with GI cancer. Penn gastroenterologists work in collaboration with the Abramson Cancer Center of the University of Pennsylvania to offer patients the best treatment while preserving quality of life. To make an appointment or schedule a screening with a Penn gastroenterologist, call 800-789-PENN (7366) or log on to PennMedicine.org.

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GI Cancer

Look Your Best with Help from Penn Medicine's Skin Care Program

Skin is the largest organ of the human body. Penn Medicine's Skin Care Program offers an integrated approach to skin wellness and care by using the latest treatments, enhancements and restoration. All services are provided by certified medical aestheticians. Summer specials on select products are available.

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