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Think of the most interesting man you know. Now imagine what he would be like had he grown up in a tarpaper shack without indoor plumbing, joined a monastery, had an extensive career as a female model, actress, author and screen writer, then traded in his weave and acrylic nails for a Ph.D. in neuroscience. If you have been able to conjure up that image, turn it up to 11... and let's do it!!

Thursday, April 7, 2011

You Can Never Get Enough of Something That is Almost Satisfying

If you know anything about me at all--you know saying that I've had some unusual experiences is an understatement to say the very least.   However, the circumstances surrounding a recent experience surprised even me.   Now I've struggled with my weight all of my life, well not all of my life, but every since I learned to feed myself.  I'm not talking about wanting to get rid of a pesky 20 pounds... My top weight was a 1000 pounds.   Now I'm half that and headed in the right direction.   So if ANYone in this world wants to find some permanent solutions to extreme disordered eating its me.   

Recently I discovered a key part of the puzzle.  Quick background... lately I've been doing Weight Watcher's Plus Online... and it has been working great for me---down 98 pounds in two months.   Now for most people that would be really exciting... but for someone like myself, who has lost 600 pounds and gained 300 back... i don't get excited when I drop a chin or two.   I'm playing for keeps this time.   The reason this WW online is exciting is because its not a diet... I can eat anything... I just have to stay within the point range.  So it becomes a game... if I want this.. I can have it... I just have to factor it into my food plan... so it's all good.   That's what a normal person does.  They have a large meal, then they have a couple  of lighter meals.   Normies, as I call people without eating disorders have a built in mechanism that manages this for them.   People like me, clearly don't.   

What's most exciting about this 98 pound reduction is that I had barbecued ribs, chocolate cake, fried chicken, pancakes, and bacon EVERY day.    That's fabulous because I am at the age, not to mention health status, where I can no longer die unexpectedly--so suffering, deprivation, and grief is out--its nothing but joy and happiness from here on out.   I'm not willing to give up ANYTHING but grief, and self-inflicted punishment.   For the first time in my life I am having fun reducing.   I'm eating everything and anything---and spending time with my boys too--Johnny, Jack, Jim, Jose and Old Grand Dad.   And the weight is coming off quicker than a wide receiver out on the cross.   

So the other day, I saw there was a sale of bologna--and its beauty on a budget with me--besides food taste better when its inexpensive.   So I was ready to have myself a big bologna sandwich.  Well my husband had bought some HORRIBLE dry, health bread, undoubtedly made by drunk Icelandic lesbians.   Anyway, bottom line the sandwich was horrible because of the bread.... so I had another one because I wasn't satisfied.   The next day I woke up, and I wanted another bologna sandwich. That's when I realized that the problem was the bread.   It ruined the sandwich, which made it less satisfying.   Of course I wanted another one---why?  You can NEVER get enough of something that is only partially fulfilling.  That is why the key to dieting is TO not do it.   Eat well, and eat with awareness.  Have whatever you want, when you want, but be aware of what you are having and have well structured plan that takes the uncertainty out of your food plan.  When the boundaries are clear, the freedom is limitless.   Now let's look at this from a neuroscience perspective. 

The Brain, Hunger, and Appetite”
Have you ever been stuffed and still had an appetite for something? For example, you may have just finished a big meal, and still you have to have dessert. You feel this way even though you know you don’t need it, you don’t want it, and yet you have to have it to feel satisfied. 

Most Americans would agree Thanksgiving is not Thanksgiving without a roasted turkey. No matter how exquisite a Thanksgiving meal was, if there was no roasted turkey, they wouldn’t feel satisfied. Why is that? It’s because satiation is not just about satisfying hunger. It’s also about satisfying appetite. 

Hunger is not the same as appetite. Hunger is a signal from your body telling you that it wants food. Appetite is a perception saying you want something, not necessarily food. Appetite is influenced by many sources, including emotion/mood, availability of food, environment/surroundings, and associations. Humans often mistake appetite for hunger, and respond by eating.

Hunger is one of the body’s most vital signals, because without it we would starve to death. Thus, the hunger signal is a good thing. However, humans can often misinterpret and confuse signals such as hunger and appetite, which are two very different signals, from very different places in the body. For example, you feel something is off, so you interpret that as hunger, but you could be thirsty, or perhaps you’re just bored and paying too much attention to your body. Maybe you feel uneasy in your stomach. It is actually stress, but you mistake it for hunger. 
Some European scientists researching the difference between hunger and appetite had subjects fast for 12 hours before entering the fMRI scanner. Then they showed them images of food, interspersed with non-food images. While viewing the images, subjects were instructed to rate the strength of their appetite. Over the short experiment the body's level of hunger did not change, but perception of appetite fluctuated when subjects were viewing, or not viewing food. 

The researchers then looked to see which brain areas correlated with the subjects' appetite ratings. They found two areas in particular: the insula, and the putamen. The insula is responsible for bodily sensation, particularly of the digestive system. Increased appetite does not mean you're getting hungrier, but it can mean you're getting more aware of how hungry you are. Putamen sounds like an obscure Egyptian pharaoh, but it is actually a part of the basal ganglia, which is in the motor system. In the European study, activity in the putamen suggests that the greater your appetite, the more likely you are to go do something about it. Understanding that there are many things that contribute to the perception of appetite is essential to curbing cravings, and in turn essential to controlling the behaviors associated with those cravings.

Satisfying cravings activates the reward system. More importantly, humans are reward whores. Food and sex are primary examples of this. Eating sustains the individual and breeding sustains the species. This is why food and sex are rewarding. If food wasn’t rewarding and sex didn’t feel good, then humans wouldn’t eat or breed. Our ancient ancestors would have dropped dead of starvation while playing some fun cave game. Of course, the ancients wouldn’t have been our ancestors because they would not have bred, since there would be no reward motivating them to couple. Who could blame them? Sex is messy at best when the feel good is taken out of the mix. Likewise, securing, preparing, and eating food would be an unnecessary tedium if it did not culminate in the rewards that come from eating a satisfying meal.

Human evolution, like the brain, does what it needs to do to promote its agenda. That is why evolution made food rewarding. It is more complex than you might imagine, and much deeper ingrained in who we are than you may think. 

Another example of evolution promoting its agenda is the advent of color vision. During the Pliocene Epoch, between 5 and 2 million years ago, our simian ancestors were colorblind, and primarily ate insects. In their defense, insects were meatier back then. Still, when our simian ancestors evolved from being insect eaters to fruit eaters, color vision was necessary to help determine if the fruit was ripe. This necessity, according to neuro-evolutionists, altered the retina to effect dichromatic vision in the ancients. A fruit is ripe, according to humans, when it has the maximum nutritional value. Our primary sensory mechanisms innately know this. How do they know? They know because the fruit looks, smells, tastes, and feels ripe. This wisdom is the result of millions of trial-and-error encounters with eating fruit passed on over generations. What we learned from these various encounters with fruit over time is stored at a cellular level—that is how we “innately know” when fruit is ripe, and most rewarding to eat. 

Like reward in general, the rewarding aspects of food are controlled by the dopamine system in the brain. When you eat food, your brain releases dopamine. In a sense you get addicted to that dopamine. But it doesn’t just stop there. The brain is always learning. One of the learning strategies of the brain is to associate a specific reward with whatever came before it. All the steps that lead to the big reward of eating become rewarding in their own right. Seeing and smelling food are almost always precursors to eating food, so these rewarding aspects of eating are easily transferable. The brain sees the food, which is slightly rewarding, and anticipates the bigger reward that will come from eating it, so it engages in behavior that will lead to that reward (i.e. eating). None of this is consciously controlled. It is part of the basal ganglia system that controls habit formation. 

You can override habits by using the prefrontal cortex, and making other plans. Unfortunately the prefrontal cortex is easily distracted (hey what’s that over there), by stress, or sadness, and it stops paying attention to what the basal ganglia is making you do. 
Also the limbic areas of the brain, where emotions are regulated, can, will, and always do, take the cortex off-line when we have an emotional flare up. That’s why people do things like scream, throw cocktails in people’s faces etc, when they are emotionally upset—their cortex has been taken off line and they are reacting from “survive now, ask questions later” part of the brain. 

We may sometimes overeat because we are low on dopamine, and the brain, needing more dopamine, makes us do something that it knows will give us a kick of dopamine (i.e. eating). Unfortunately dopamine release eventually habituates, and you stop releasing the same amount of dopamine for the same stimulus (eating). Suddenly you’re eating just to break even on dopamine. Your body doesn’t release a lot of dopamine when you overeat, but if you don’t overeat then your dopamine levels will drop further. This can cause compulsive eating: eating not for pleasure and nutrition, but eating just to avoid a decrease in dopamine.

Food is rewarding in several ways. There is the utilitarian reward of staving off starvation. That is, there was something wrong before (your body needed food), and now it is gone. There is also the conscious hedonic, sensory pleasure we get from eating food such as the deep tartness of balsamic vinegar, the sweetness of a ripe tomato, the juiciness of perfectly grilled steak. To fully experience this requires being conscious of what we are eating. When we eat distracted, or worse yet, eat terrible tasting food that we don’t even want to be conscious of, we miss out on the conscious pleasure of eating. When we eat just out of habit, or as a compulsion, we often miss out on greater satisfaction. That’s the bad news. 

Here’s the good news: sensory deprivation. When one of our primary senses is disabled the others heighten to compensate. So the take home message for compulsive overeaters is simple, and ironically opposite of what most dieticians and weight-loss experts would have you do. There is a reason why nutritionists have had over a 100 years to solve the weight crisis, and not only have they not solved the problem, they have watched it worsen. The reason is diets and dieting take the enjoyment out of eating. That is the worst thing you can do to a person who is predisposed towards deriving joy from food. 

What compulsive overeaters have to do is turn the eating experience up to 11. How? Remember Pavlovian conditioning, i.e., the precursory events that humans associate with eating. It is like a seduction of self. Set the mood. Never eat and multitask. Turn off the television, the telephone, step away from the computer. Don’t feed yourself like you’re a stray dog—presentation is everything. Make yourself a nice, pretty meal, arranged fancifully on a plate. It doesn’t have to be elaborate. It can be a tuna fish sandwich, just make it a fabulous tuna fish sandwich. Now here’s the clincher. When you take that first bite, close your eyes and savor what you eat. Your experience will be sensational because when you close your eyes your other senses heighten to compensate for the absence of vision. The more time you spend eating, the more heightened they become. Because dopamine encodes in the brain on the anticipation of reward, the pretty food, on a fancy plate will start the dopamine flowing. When you close your eyes to eat it, it will be a greater reward than anticipated, because your taste buds will be heightened to compensate for your eyes being closed. Also, being fully focused on eating and not distracted by the TV, telephone, or Internet, enhances the eating experience. Thus, your dopamine will go through the roof. 

But you said, ‘dopamine habituates’, what about that? It does, but each food carries with it, its own individual reward expectation. For example what you expect from a well barbecued spare rib, and a piece of blueberry pie are two very different things. So yeah, if you eat blueberry pie every day it’ll get boring. That’s why we save turkeys for the holidays, to make them special. Turkey’s aren’t all that. Try replacing chicken in your diet with turkey, and see how fast you get over turkey. Compared to chicken, it’s a boring bird. But on Thanksgiving, you don’t want chicken, and you don’t want duck, you want a big turkey on the table with its legs sticking up. So eat a variety of food, and good food, and foods that you love. If you are truly present for the consumption of your food, you will walk away satisfied, and you won’t eat too much. Your neuropeptides will tell your nucleus accumbens when you’ve had enough. They won’t let you overeat, because you will satisfy your hunger and your appetite…

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