Obesity and addiction

[Susan]

Great thread! Great to read your experiences.
I've lost a signigificant amount of weight and went from obese to the upper end of "normal" BMI over the last few years.

The strange thing about it is that it was and still is so easy on the one hand and so hard on the other:
"All I had to do" is make healthy choices and be active. Eating 3 to 4 meals a day, not eating sweets, picking up cycling, running, HIIT.
And the weight came off.

I still have to think about my food choices every day, every meal. I enjoy being active, and I am very active, but it doesn't regulate my appetite. I am always hungry. I could always eat more. If I have open access to food I shouldn't eat, it will end in a binge. In fact, sometimes I can't avoid binging, so eat unreasonable amounts of vegetables and salad so that the binge won't affect my weight. I have to be alert when I go shopping, because what I have at home, I WILL eat. If I am not at home where I have control over my food choices, I often can't stop eating when I should or eating the wrong things.

The strange thing is that the same people who judged me because of my weight before, mostly family members, keep forcing food at me now, even though they know how I struggled. They often say "now that you have lost all that weight, it won't hurt" or "you can eat what you want because you are so active" - which just isn't true. People often don't want to hear the truth (especially people who struggle with their weight themselves often just want to hear about an easy fix). I have learned to throw out food that I shouldn't eat and to get back on the wagon if I fell off.
But like Limewave, I constantly feel just one step away from regaining my weight.

I think it is clearly an addiction. It was significantly easier to stop smoking than to eat right. It's like being addicted to heroine, just that unlike with heroine, you can't just stop eating. You have to constantly keep the balance between nourishing your body and hurting yourself with food.
Food is so much more complicated than just eating when you are hungry. There are so many occasions where it is a social norm to eat and to eat certain things, to a degree that it can be an insult not to eat.
I think to people who don't have the problem, my struggles to manage foodintake will sound obsessive and unhealthy. And while I am fully aware that my relatioship with food is unhealthy, I have to manage it somehow, and obviously much more restrictive than people with a normal relationship with food.

[lph]

I was thinking that one of the most interesting points in this discussion is how not only obese people have a difficult relationship with food. Normal-weight people can be obsessed with food too, and I don't mean this in a judgemental way, just that for some people more than others it is necessary to pay extreme attention to what they eat and how they eat, to maintain a healthy weight. Obesity just makes it more visible to others.

It's not that I'm incapable of binging, and I do need to keep up certain good habits to eat well over time, but once I have those habits I do "just... eat". If I eat something out of the norm like a very rich restaurant meal it usually affects my appetite, I might feel queasy or not want to eat for a long time, it doesn't trigger a desire for a lot more of the same type of food and I don't need to actively choose to eat less the following day. But this is very closely tied to activity and exercise for me.

I wish there was a lot more research done on appetite. Hunger is a very strong feeling, and almost impossible to ignore. Now that most of us have unlimited access to food we need to know a lot more about how to balance our natural desire to eat while it's there with the more subtle signals of "enough".

[goldfinch]

I wish there was a lot more research done on appetite. Hunger is a very strong feeling, and almost impossible to ignore. Now that most of us have unlimited access to food we need to know a lot more about how to balance our natural desire to eat while it's there with the more subtle signals of "enough".

There is quite a bit of research. As a formerly obese person I especially was interested in how hormones which regulate appetite go way out of whack when you lose weight, with not enough of the hormone which suppresses appetite and too much of the hormone which increases appetite. Then there is the effect of behavior conditioning on appetite. If you eat in certain circumstances when that circumstance occurs you might feel hungry. Food and the triggers that stimulate you to eat both elevate dopamine levels in the reward areas of the brain. If you have reduced dopaminergic activity in the brain you may overeat to compensate. A genetic deficiency in this brain chemical may very well drive you to addictive behavior from overeating to drug addiction and even gambling. Interestingly, this is often reversed in gastric bypass patients. Bypass is a far more effective way to lose weight and keep it off than a diet, as drastic as it is.

Certain types of food can drive the appetite up, specifically, sweets and starches. Insulin is important in regulation of appetite.

We know a lot about appetite, we just don't know enough about how to deal with it. Right now, bypass may be the best bet for the obese, risks and all. There are some promising avenues of research that might lead to better solutions. Yes, there even may be a pill someday. There are some things one can experiment with to see if it helps, such as:

--knowing the triggers which stimulate you to eat and break that connection.
--find new sources of pleasure and reward. Exercise may fall in this category. Good social networks of like minded people certainly are sources of pleasure and reward.
--eat more protein, less carbs
--High dose fish oil? Maybe increases dopamine and dopamine receptors

My hunch for me is that I am dopamine deficient. I struggle with controlling eating. I also struggle with controlling my shopping. I have to have a rigid set of rules about my shopping. For example, I keep a separate credit card for shopping and pay that card from a separate bank account. I fund that account twice a year in a pre-determined amount. That is all I can spend on pleasure shopping.

[Catrin]

Goldfinch - interesting comment about the dopomine...back when I was still on anti-depressants (stopped in 2000), the only medication that actually worked for me worked focused on dopomine (not the more usual serotonin). I still deal with major spending issues - though I had it under control until I discovered biking

At this point controlling eating is much less challenging - as long as I track everything, I am lost if I stop that - I think it helps provide accountability. As a single woman who lives alone that really helps. It also helps knowing how much it cost me to go from size 23 to size 6 in clothing - and I can't afford to go the other direction. I got rid of ALL of my "big" clothing.

At least the spending is now under control - there isn't much left free to spend I like your solution and may adopt it.

[lph]

There is quite a bit of research. As a formerly obese person I especially was interested in how hormones which regulate appetite go way out of whack when you lose weight, with not enough of the hormone which suppresses appetite and too much of the hormone which increases appetite. Then there is the effect of behavior conditioning on appetite.

I should have written "I wish I knew more about research on appetite". And now I do Very interesting stuff, goldfinch. Especially the gastric bypass bit (that was the surgery term I was looking for), and the effect on appetite. A bit scary too. Surgery is a drastic measure and has it's own dangers.

[SadieKate]

I was thinking that one of the most interesting points in this discussion is how not only obese people have a difficult relationship with food. Normal-weight people can be obsessed with food too, and I don't mean this in a judgemental way, just that for some people more than others it is necessary to pay extreme attention to what they eat and how they eat, to maintain a healthy weight. Obesity just makes it more visible to others.

This is exactly what I was talking about. You just can't know what other's internal struggles are. And this goes for any goal each of us might have.