There are many reasons that people eat a lot. But one important reason is hunger.
Hunger is, of course, subjective, so I have no way of telling what you mean when you say you’re hungry, and vice versa. Thin people tend to assume that everyone feels hunger the same way that they do, but it’s not true. Some people have a ravenous appetite even after a big meal, and scientists aren’t sure yet what causes that appetite.
One possibility is hormones. A few people in the world have been found who have no leptin, and they have ravenous appetites. Leptin-deficient children eat constantly. But when you give them leptin, their appetites return to normal and they lose weight. The hormone ghrelin goes up before meals and makes you hungry.
Another possibility is signals in the brain, especially a part of the brain called the hypothalamus. The hormones probably work there.
Now scientists are studying whether they can stimulate the brain in a way that would help people lose weight.
In this study of three patients who failed to keep weight off after gastric bypass surgery, the researchers implanted deep-brain stimulation electrodes that gave mild electric impulses to the lateral hypothalamic area. They tested various sites in the lateral hypothalmus and chose for each patient the area that produced the greatest increase in metabolic rate.
It is well known that when you lose weight by dieting, your metabolic rate goes down. You get more efficient in digesting your food so you have to eat less and less if you want to continue losing weight, or even maintaining your weight loss. So if we could normalize metabolic rate, the weight loss could continue at a good rate until we reached goal weight.
This study was designed primarily to test the safety and efficacy of the procedure. And it did result in weight loss. However, this procedure is not yet ready for prime time. The study was to see if it was worthwhile continuing such research with more patients.
One patient saw a 9 percent increase in resting metabolic weight and reduced his weight by 16.4 percent after 9 months. A second lost 12.3 percent of her weight after 11 months. The third patient lost only 0.9 percent of her weight after 16 months, but she said this was the first time in her life that she didn’t have constant hunger, and her binge eating behavior was reduced to normal.
It’s interesting that despite the woman’s decrease in hunger, she lost very little weight.
This study illustrates the complexity of weight loss. Hunger is important. Metabolic rate is important. Hormones are important. Habit is important. Social cues are important. Type of diet is important. In each of us, the various factors may have a different effect.
This means that there is no one diet that is perfect for everyone, even no diet that is perfect for everyone with diabetes, and anyone who claims that there is can’t be trusted.
I’m in the camp that believes that a low-carb diet is the “default diet,” meaning you start there. But if that diet doesn’t work for you, then there’s no reason not to try something else. Just give the low-carb diet a chance, because it takes a few weeks, sometimes even more, for your body to adapt if you’ve been eating a lot of carbohydrates.
Then you might want to try even less carbohydrate, or slightly more carbohydrate. Or you might want to try the other extreme, a low-fat diet with a lot of carbohydrate.
Whichever dietary approach you try, it’s good to eat whole foods, not convenience foods. And it’s good to fill up on low-carb, low-calorie vegetables like broccoli, cauliflower, spinach, lettuce, and the like.
Scientists are slowly homing in on what really causes hunger and weight gain, and studies like this make it clear that lifelong obesity is not usually a moral issue involving self-control. It’s a biological issue involving hormones and brain signaling, both of which can be out of kilter in some people.
Let’s hope they figure it out soon.
Published On: June 30, 2013