Healthy Eating & Eating Disorders - Anorexia, Bulimia, Binging | Episode 36

Huberman Lab

Podcast Notes Key Takeaways Food and eating are highly individualized – no one can tell you exactly when and what you should be eating in a single protocol because we just don’t have the biomarkersSince we can’t truly define healthy eating, it’s important to understand unhealthy eating and unhealthy relationships with foodAnorexia, bulimia, and binge eating are all distortions in relationship to food where reward and habit are disrupted beyond controlAnorexia overrides all homeostatic processes driving people towards food and weight sustaining nourishmentAnorexia has a biological underpinning: anorexics feel good by approaching foods that are low fat, low calorie and are rewarded more than if eating in a healthier way to support the weightCreating awareness about what the habits are and train brain switch about what should be rewarding (not starving) and shutting down reward (starving) is the key treatment in anorexiaAnorexia is more habit-based while binge eating and bulimia cause food to be hyper attractive (like driving a car with no breaks)Bulimia and binge eating are marked by hyper impulsivity and lack of top-down processing (if this then that thinking) and inhibitory controlWhile pharmaceuticals are not helpful for the treatment of anorexia, drugs that increase serotonin are beneficial for bulimia and binge eating in combination with cognitive behavioral therapy

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In this episode, I discuss what drives hunger and satiety, and the role our brain, stomach, fat and hormones play in regulating hunger and turning off the desire to eat more. I also address how protein is assimilated better early in the day than it is later in the day, and why those using intermittent fasting might want to shift their feeding window to earlier in the day.

 

Then I delve into the topic of disorders of eating: Anorexia Nervosa, where people starve themselves and Bulimia Nervosa where people binge and purge their food. I discuss some common myths about Anorexia such as the role of media images increasing the rates of anorexia and the myth of the "perfectionist" anorexic. I also review the symptoms, and the brain and chemical systems disrupted in this condition. I explain how anorexics become hyperaware of the fat content of foods and develop reflexive habits of fat-hyperawareness. Then I discuss the most effective treatments ranging from family-based models to those that target the habitual nature of low-fat/calorie food choices. I also discuss new more experimental clinical trials on MDMA, Psilocybin and Ibogaine for Anorexia, and both their promise and risks

 

I review the latest work on binge eating disorder and brain stimulation, drug treatments and thyroid disruption in Bulimia and why the treatments for Bulimia are so similar to those for ADHD. Finally, I discuss "cheat days," body dysmorphia and the growing list of novel forms of eating disorders start to finish. As always, science and science-based tools are discussed.

 

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Links:

Ingesting Protein in the Morning Supports Muscle Maintenance & Growth: https://bit.ly/3DPlms7  Studies Using Virtual Reality to Explore Eating & Hunger & Body Image: https://bit.ly/3BGaDya  https://bit.ly/2WWGRq8 

 

Timestamps:

00:00:00 Introduction: Fasting, & Defining Healthy Eating 00:08:55 Morning Protein Is Important  00:22:04 Sponsors 00:26:29 Defining & Diagnosing Eating Disorders 00:29:00 Anorexia Nervosa (Overview & Myths) 00:33:44 Bulimia (Overview & Myths) 00:37:35 Binge Eating Disorders, EDNOS, OSFEDS, Pica 00:39:44 What is Hunger? What is Satiety? 00:42:00 Neuronal & Hormonal “Accelerators & Brakes” on Eating 00:46:17 Fat, Leptin & Fertility & Metabolic Dysfunctions in Obesity 00:50:30 Why We Overeat 00:55:30 Homeostasis & Reward Systems/Decisions  00:59:58 Anorexia 01:04:28 The Cholesterol Paradox 01:06:13 Psychological vs. Biological/Genetic Factors in Anorexia 01:09:44 Chemical Imbalances, Serotonergic Treatments 01:12:56 Altered Habits & Rewards in Anorexia: Hyperacuity for Fat Content 01:18:28 Brain Areas for Reward Based Decision Making vs. Habits 01:24:06 Habit-Reward Circuits Are Flipped in Anorexics: Reward for Deprivation 01:28:30 How Do You Break a Habit?  01:33:23 Family Based Models, Cognitive Behavioral Therapy 01:35:39 MDMA, Psilocybin, Clinical Trials, Ibogaine  01:40:35 Anabolic vs. Catabolic Exercise, Spontaneous Movements, NEAT 01:43:23 Distorted Self Image in Anorexia  01:47:54 Bulimia & Binge-Eating, “Cheat Days”, Thyroid Hormone 01:53:05 Inhibitory Control, Impulsivity, Adderall, Wellbutrin 01:58:00 Direct Brain Stimulation: Nucleus Accumbens 02:04:28 Anorexia/Reward. vs Bulimia/Binging   02:05:45 Healthy Eating Revisited 02:10:55 Synthesis, Body Dysmorphias 02:14:15 Support: Podcast, & Research Studies

 

Please note that The Huberman Lab Podcast is distinct from Dr. Huberman's teaching and research roles at Stanford University School of Medicine. The information provided in this show is not medical advice, nor should it be taken or applied as a replacement for medical advice. The Huberman Lab Podcast, its employees, guests and affiliates assume no liability for the application of the information discussed.

 

Title Card Photo Credit: Mike Blabac - https://www.blabacphoto.com