Tuesday, November 19, 2019

Retrospective #276: “Why do I eat…even when I’m not hungry?”

“Why do I eat, even when I’m not hungry?” I’ve been asking myself this recently. It is also a question that arises in the HBO Documentary series, “The Weight of the Nation,” that I reviewed in Retrospective #275. It is in Part 4, “Challenges,” that dips briefly into science. The answer is hinted at by Rudolph Leibel, MD, Co-Director of the New York Obesity Research Center, Columbia University Medical Center. “Evolution happens slowly. DNA changes slowly.”
I have asked myself, “Why do I eat…,” many times. I think all of us who are prone to overeat have asked it. At the beginning of Part 1, “Consequences” in “Weight of the Nation,” an obese man says, “You try [to eat less] …and you lose hope.” Another says, “I know I should eat the right things. I’m gonna try.” Then in Part 2, despair returns: Another obese man says, “What can I do? I love good food. I love cheeseburgers. Sure, I know what to do; I just can’t do it.”
Commenting on Retrospective #268, “Help with Cravings,” – a serious student of the science of overeating – said to me, “So, you do not experience cravings? If you do not have them, you are lucky. I have had periods without cravings, and periods with cravings. They are a non-rational desire for something, or an insatiable appetite, even on NO carb. This suggests that there is some unknown biological cause, but nobody knows the cause of cravings.”
I posited the idea, suggested by among others the Jaminets in “The Perfect Health Diet,” that we may eat UNTIL our body is satisfied that it has all the essential nutrients it needs (including for example the fatty acids n3 and n6 and certain essential amino acids from protein. Lacking them, we eat more nutritionally poor and non-essential foods (carbs) to the point of obesity.” This specialized craving hypothesis has a certain appeal to me, but it’s only part of a complex answer. As Francis Collins, Director, National Institutes of Health, says in Part 2, “It’s a challenge for sure!”
For me, the bottom line is to acknowledge that MY BODY is in charge of my well being. That’s hard for me to admit; I do not lack for hubris. But in my own “conscious” self-interest, that is what I must conclude if I am to figure out how “I” can help “it” (my body) maintain homeostasis. Think about all the “insults” I throw at my body every day (eating choices and other behaviors that I do or do not do, like physical activity) that challenge my whole-body condition. If “evolution happens slowly,” and “DNA changes slowly,” my body must suffer from such unremitting “insults”.
But without knowing this “unknown biological cause” of craving – what I will call our “biological imperative,” I attempted almost 10 years ago (2010) to address the subject of why I eat, even when I’m not hungry, in a long thread (200 posts, 4000 hits) I started at Dr. Bernstein’s Diabetes Forum  (registration required), called, “Impulse Control and Metacognition.” My idea was to be “conscious of the “cue,” the impulse to eat when I’m not hungry, and then deal with that impulse by another means, e.g. by distraction (reading, writing a column, yard work, etc.).
Right at the start, the Forum’s Global Moderator commented, “Isn’t it likely the problem is actually physiological rather than psychological?” (Georgette was always so gentle with me; Bernstein was a “safe” place to be if you were interested in getting answers from very knowledgeable people about Type 2 diabetes. Anyway, I replied (this WAS 10 years ago): “I am not pursuing this aspect of it, however, because I know of nothing I can do to manage or control the hormone(s) in question. It is, after all, an autonomic function of homeostasis, the body's self-regulatory system.”
In the matter of hormonal regulation, I am today a lot wiser than I was 10 years ago. I still hold, however, that 99% of our body’s activity is autonomic and totally out of my “conscious control. I have a broken glucose metabolism – I have Insulin Resistance and fewer operative beta cells in my pancreas – ergo, I am Carbohydrate Intolerant. All I can do is “listen” to my body very carefully and do what I think is the right thing to minimize the “insults.” That means I need I watch my carbohydrate intake very carefully to keep my serum insulin level low. I use the scale and my glucose meter daily (for a fasting reading), and I use my triennial doctor’s visits for blood tests (HbA1c, CBC, lipid panel, electrolytes, hs-CRP (for chronic systemic inflammation), and other lab tests.). I figure that if I take care of my body, my body will take care of me. After all, except for my “conscious” self, it’s 99% of me. It’s simple self-interest.

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