Tag Archives: leptin

Why Am I So Hungry When I am Morbidly Obese?

overeating morbidly obese

“Why am I so hungry when I am morbidly obese?”. This is one of the most commonly asked questions from my obese patients. They often come to me feeling like a failure because they can’t follow the weight loss advice of their physician to “just eat less food”. This is extremely difficult to do when you are always hungry. What could possibly be creating these feelings of hunger?

There are primarily two hormones that tell us when we are hungry and when we are full; ghrelin and leptin. Leptin is produced by fat cells; it turns on the signal that tells us we are full and turns off the signal that tells us we are hungry. Ghrelin is produced by stomach cells; it turns off the signal that tells us we are full and turns on the signal that tells us we are hungry.

Obese individuals typically have high levels of leptin and low levels of ghrelin. Over time this leads to a firm of insensitivity to leptin and hypersensitivity to ghrelin.

So what does this mean? The brain is almost constantly receiving a signal that the body is hungry and rarely receiving a signal that body is satisfied. If you are overweight and are experiencing constant feelings of hunger, even after you have recently eaten, I encourage you to talk to your physician about having your serum leptin levels and serum ghrelin levels checked.

So what can be done to correct this imbalance? There are many sources that list a variety of supplements that can be used to balance out leptin and ghrelin levels. however, this approach treats the symptoms rather than the cause; an imbalance in these two hormones suggests that there is malfunction going on within other parts of the body. Supplements may help these two hormone levels fall or rise into a “normal” range for a short period of time, but if you aren’t treating the root cause it is likely that eventually you will need to take higher and higher dosages in order to keep them in a “normal” range. The cause of this malfunction within the body will vary from person to person, it could be anything from a parasite infection to leaky gut. We’ll be talk about parasite infections and leaky gut in an upcoming blog post. So stay tuned!

Dr. J. Renae Norton is a clinical psychologist, specializing in the outpatient treatment of obesity and eating disorders such as anorexia, bulimia, bulimarexia, and binge eating disorder (BED) and the Director of The Norton Center for Eating Disorders and Obesity in Cincinnati, Ohio. She is the Director of The Norton Center for Eating Disorders and Obesity in Cincinnati, Ohio.

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Medical Advice Disclaimer: The information included on this site is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan. Reading the information on this website does not create a physician-patient relationship.

© 2013, Dr J Renae Norton. This information is intellectual property of Dr J Renae Norton. Reproduction and distribution for educational purposes is permissible. Please credit ‘© 2013, Dr J Renae Norton. http://edpro.wpengine.com’

Food Pollution: Eating Disorders and Obesity

photo used under a creative commons license

 In this week’s episode we discussed the effects of Food Pollution on Eating Disorders and Obesity.

Listen to internet radio with Eating Disorder Pro on Blog Talk Radio

In this episode we covered:

5:25 – The Systems Involved in Regulation of Appetite, Fat Storage, Weight Loss, Weight Gain, and Food Addiction
6:10 – What is Leptin?
6:24 – White Adipose Tissue (WAT) and Triglycerides
9:07 – The Effects of Food Pollution on the Weight Management System
10:57 – The Starvation Hormone – Leptin
11:40 – What drives Leptin Levels?
12:56 – Leptin Resistance
13:50 – Caller Question – How can I find out what my leptin levels are?
17:00 – Leptin Resistance
19:00 – The Effects of Food Additives and GMOs on Leptin
20:28 – Leptin and Anorexia
21:22 – The Effects of Anorexia and Obesity on the Endocrine System
22:46 – Cortisol
24:02 – Leptin and Anorexia
25:14 – Ghrelin: The Hunger Hormone
27:45 – Anorexia and Ghrelin – The Effects of High Ghrelin Levels on Treatment
30:44 – Bulimia and Ghrelin
32:10 – Obesity and Ghrelin
32:40 – Neuropeptide YY (PYY)
34:10 –  Obesity and PYY
35:37 – PYY and Mood
35:55 – Regulating PYY through Diet and Exercise
38:55 – How to Regulate Leptin Levels

Links We Discussed
Leptin
Ghrelin
Peptide YY

Show Summary

The Weight Management System

In order to understand the role that food additives, genetically engineered organisms (GE’s), sweeteners, and neurotoxins play in the current epidemic of obesity and ED’s we must first understand the systems involved in appetite/hunger, fat storage, weight loss/gain and food addictions. There are three primary hormones involved in appetite/hunger regulation: Leptin, Ghrelin, Peptide YY.

Leptin

Leptin, which is a peptide hormone, was discovered by scientists in 1994. It is found in gastric tissue and placenta but is most abundant in white adipose tissue (WAT) otherwise known as body fat. WAT is composed mainly of adipocytes (fat cells) that store energy in the form of triglycerides during times of nutritional abundance. During times of nutritional deprivation, fat cells release the triglycerides (fat) into the blood stream to provide energy for the body. If there is too much fat in the form of triglycerides, it is stored in different places, such as the hips or belly, in case it is needed later. It also accumulates in the arteries, causing coronary artery disease.

In general, the amount of WAT, or body fat, is determined by the balance between energy intake and energy output. While it is partly influenced by genetic factors, it is driven primarily by environmental factors, such as the amount and/or type of food eaten.

It is damaged by food additives that are neurotoxic or addictive and by environmental carcinogens and obesegens.
Under normal conditions, this system is carefully regulated so that WAT mass remains constant and close to a well defined ‘set point’ for each individual. The set point, which is designed to keep the body at a healthy weight, is part of a feedback loop that maintain homeostasis.

Disruptions of this steady state that are caused by damage to the systems involved, can lead to chronic decreases or increases in the quantity of WAT mass. Decreased amounts of WAT are associated with periods of dieting, malnutrition, as in the case of ED’s, Anorexia. During these periods, the healthy body sends a message to the brain to increase food intake and decrease energy output. Increased amounts of WAT are present with obesity. Under these conditions, leptin sends a message to the brain to inhibit food intake and increase energy expenditure. In this sense, leptin acts as a long-term regulator of optimal body weight. It has been dubbed the “starvation hormone” because it’s primary function is to keep us from eating too little or exerting too much, and thus avoid starving to death.

Leptin levels are driven by the amount of adipose tissue one has under normal conditions. While the system works well to keep weight at optimal levels, it becomes less and less effective the more (or in the case of Anorexia, the less) adipose tissue there is. In the case of excess weight, the farther one is from the optimum, or set point, the stronger the signal to decrease food intake and increase energy output.

However, there appears to be a threshold for leptin levels, such that when they get too high or remain too high for too long, the brain no longer registers or recognizes them. This is called Leptin resistance, and it’s very much like insulin resistance. When this happens, the brain no longer senses changes in leptin levels. Instead, it perceives, that the body is in a state of starvation.

As a result, the individual experiences the need to increase food intake and decrease energy expenditure, regardless of how much excess fat they actually have on board. This causes more weight gain, and more adipose tissue, which results in more Leptin resistance, which in turn results in more weight gain. This is an example of a classic vicious cycle.

In the case of Anorexia, leptin levels are too low, due to the lack of WAT or fat cells, so that the individual is leptin deficient. The message from the brain is the same as it was for the obese patient that was leptin resistant, eat more, exert less, but for a different reason. In this case, the individual actually is starving to death. Unfortunately, in the case of the Anorexic individual, whose fear of gaining weight is overwhelming, the response to feeling hungry is to eat even less, causing more weight loss, which triggers more hunger which leads to more fear, and we have another vicious cycle.

Fasting, food intake, exercising, awakening, and psychosocial stressors cause the body to release cortisol. Cortisol is released in a highly irregular manner with peak secretion in the early morning, which then tapers out in the late afternoon and evening. Energy regulation and mobilization are two critical functions of cortisol. Cortisol regulates energy by selecting the right type and amount of substrate (carbohydrate, fat or protein) that is needed by the body to meet the physiological demands that is placed upon it. Cortisol mobilizes energy by tapping into the body’s fat stores (in the form of triglycerides) and moving it from one location to another, or delivering it to hungry tissues such as working muscle. Under stressful conditions, cortisol can provide the body with protein for energy production through gluconeogenesis, the process of converting amino acids into useable carbohydrate (glucose) in the liver.

Additionally, it can move fat from storage depots and relocate it to fat cell deposits deep in the abdomen. Cortisol also aids adipocytes (baby fat cells) to grow up into mature fat cells. Finally, cortisol may act as an anti-inflammatory agent, suppressing the immune system during times of physical and psychological stress. The implications are that when you are stressed, you store more belly fat and are more susceptible to disease because your immune system is on vacation.

Leptin levels can also be high for individuals with anorexia.  However, in this case it is because triglyceride levels are too high due to liver damage and/or anorexia-induced hormone disruptions.

Ghrelin

Ghrelin, discovered in 1999 by scientists, is known as “the hunger hormone”. Produced in the stomach and pancreas, Ghrelin stimulates the appetite for the purpose of increasing the intake of food and promoting the storage of fat. When Ghrelin levels are high, we feel hungry. After we eat, Ghrelin levels fall and we feel satisfied.

Leptin and Ghrelin have a “teeter-totter” relationship. When leptin levels rise, ghrelin levels fall. Likewise, when ghrelin levels rise, leptin levels fall.

Whereas leptin acts as a long-term regulator of body weight, Ghrelin, on the other hand, is a fast-acting hormone that operates as a meal-initiation signal for short-term regulation of energy balance. There are distinct abnormalities in the production of Ghrelin among obese and eating disordered individuals. Part of the problem may be high levels of the stress hormone, cortisol, which is often seen with very low leptin levels. of Chronic stimulation is seen in clinical scenarios with chronic high cortisol levels and very low leptin levels. The more improper signaling that occurs, the more the incretin hormones agouti and ghrelin become disconnected from their master controller, leptin. The gasoline for this reaction is a chronic elevated cortisol. The longer it occurs, the more these abnormal signals are wired for in the person’s brain. This is what makes their treatment so difficult.

Those with anorexia tend to have high levels of ghrelin, which causes them to feel hungry. The sense of hunger is an extremely frightening feeling for most individuals suffering from Anorexia. So much so that they believe that they will never be able to relate normally to food, fearing that once they start eating they will never be able to stop. However, Grehlin levels normalize with weight restoration in individuals that refeed on a clean diet. For those that refeed using traditional refeeding protocols, Grehlin levels are likely to worsen as are Leptin levels. The result is increases hunger, increased fear and more restricting.

Among those with bulimia, Ghrelin does not respond as strongly when food is eaten, which could contribute to binge eating as the individual suffering from Bulimia does not “get full” even if they have overeaten. In the past, the assumption has been that there may be a predisposition in the Bulimic individual that “causes” this reactio and drives this disorder. However, it is possible that the toxins found in most of the foods in the U.S. may be changing brain chemistry in such a way that drives Bulimia.

Obese individuals tend to have low levels of Ghrelin, probably because they are Leptin Resistant, since Leptin and Ghrelin are inversely related. Research also shows that Ghrelin levels are higher after an individual loses weight, causing an increase in appetite, which may make it even more difficult to maintain weight loss for obese individuals.

Peptide YY (PYY)

PYY is a hormone that suppresses appetite. It was discovered to play a role in digestion in 1985. PYY regulates food intake, and is believed to improve leptin sensitivity. The amount of PYY released by our bodies is influenced by the number of calories we ingest; the more calories we ingest, the more PYY is released.

PYY levels are highest in individuals battling anorexia, followed by those individuals that are lean,which explains why both groups have less hunger and also may have more difficulty eating. PYY levels are lowest among obese and morbidly obese individuals. Individuals with bulimia also experience low levels of PYY, which helps to explain why all three groups feel more hunger. Research shows that the obese individual can decrease their PYY levels by 30% by reducing their body weight by 5.4%. PYY levels are not believed to be effected by weight restoration during recovery from anorexia. It is also important to note that high levels of PYY in anorexic individuals is associated with decreased bone mineral density (BMD).

Our mood also effects our PYY levels. Recent studies show that PYY levels are higher in those suffering from major depression. This explains why many people with major depression have a decreased appetite and experience weight loss.

PYY levels can be regulated through both diet and exercise. Diets high in quality protein tend to raise PYY levels highest, followed by diets high in healthy fats. High carbohydrate diets tend to raise PYY levels the least. Aerobic exercise has also been proven to raise PYY levels, whereas strength-training has no effect on PYY levels (although strength-training does lower ghrelin levels).

In conclusion, PYY regulates our appetite. The higher our PYY levels are, the more satiated we will feel. You can ensure your PYY levels are highest by eating a high protein diet and including aerobic exercise in our workout routine.

1. Eat a balanced diet. Be sure to eat foods that are high in protein, and remember to consume organic fruits vegetables. Even though you are resistant to leptin, you should still consume the proper nutrients.

2. Eat six time a day, on a schedule. If you have leptin resistance, you do not realize when you have eaten enough. To overcome this problem, create a set schedule of when to eat. It is best to have three meals each day. You should eat in the morning, the afternoon and the evening.

3. Create a food diary. In order to organize your schedule, create a food diary of the three meals and three snacks each day and the foods you will have during those meals. This method will help you to make sure that you are consuming a variety of foods. Also, by organizing your meals, you can make sure that you are not consuming an excess of food at a given meal.

4. Do not eat late at night. After you have your evening meal, do not eat anything else. If you eat before bedtime, you will feel uncomfortable, and any excess fat will have a less likely chance of being burned.

5. Exercise regularly. Exercise helps you to improve your metabolism, as well as increase your energy. To keep track of your exercise routine, write down the time of day that you will exercise on your schedule.

6. Understand the role of protein tyrosine phosphates 1B, or PTP 1B, in leptin resistance. When PTP 1B is expressed to a high extent, it blocks the signaling of leptin. A possible way to overcome leptin resistance is to inhibit the PTP 1B. Talk to your doctor about the progress of this research.

7. Learn what is happening in your body. If you are leptin resistant, your own body is essentially sabotaging your efforts at weight control. In the first place, your brain is not receiving signals to cease eating when fat stores accumulate, and you’ll find yourself hungry despite knowing rationally that you should be full. To balance your body’s chemistry, you’ll need to regulate yourself mentally since your body can’t do it for you. This will take consistent determination and will power.


8. Exercise even when your body tells you to quit. When the body becomes leptin resistant, it becomes accustomed to high levels of the chemical in the blood. A little weight loss can trigger a decrease in leptin, making your appetite larger and affecting your metabolism negatively. Even though the body has plenty of fat stores to burn, the muscles cease to do so in response to decreasing leptin. You may not see results quickly because of this, and you may find yourself particularly exhausted by exercise. Do it anyway, because you can’t correct leptin resistance without reaching a healthy weight.

9. Take irvingia gabonensis supplements. Irvingia gabonensis is a plant species whose fruit has been shown in medical studies to correct leptin resistance. In fact, one study showed that individuals taking 150 mg of the supplement twice a day showed marked improvements in body composition after just 10 weeks. This natural supplement is not thought to have any side effects, although longitudinal studies are ongoing.

10. Work with a trainer or accountability partner. The hardest part of overcoming leptin resistance is that you go through the rigors of exercise and the self-discipline of a healthy diet without any encouragement from your body. You’ll probably feel tired and hungry on a frustratingly frequent basis. Until you have reached and maintained a healthy weight, though, your body will never regain the ability to function properly with regard to body composition. Having a consistent ally in your pursuit will help you stay strong in the lowest points when your brain is receiving signals to eat more and exercise less in response to decreasing leptin in the blood. The fight will be hard, but overcoming these signals will help you live a longer, more fulfilling life.

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Contact Dr Norton by phone 513-205-6543 or by form

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Medical Advice Disclaimer: The information included on this site is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan. Reading the information on this website does not create a physician-patient relationship.

© 2012, Dr J Renae Norton. This information is intellectual property of Dr J Renae Norton. Reproduction and distribution for educational purposes is permissible. Please credit ‘© 2012, Dr J Renae Norton. http://edpro.wpengine.com’

The Potential Effects of Yoga on Overall Health

Adiponectin, leptin, and yoga practice

photo used under a creative commons license

A recent study published by Ohio State University investigated the mechanisms of hatha yoga’s potential stress-reduction benefits. To do so, researchers compared adiponectin and leptin levels in yoga novices and yoga experts; a novice was defined as an individual that participated in 6-12 yoga sessions in the past year, an expert was defined as an individual that had participated in 1-2 yoga weekly yoga session for at least two years AND at least 2 weekly sessions in the past year.

Leptin is also known as the “starvation hormone”.Leptin sends a signal to our brains that fat cells have enough stored energy to engage in normal metabolic processes. Every individual has an optimal level of leptin, which is thought to be determined genetically. When leptin levels are below optimal levels, the brain receives a message to conserve energy because the body is in a state of deprivation. When this occurs, the brain sends a message to the body that it is hungry (in an attempt to get the individual to eat) so that leptin levels can be restored to an optimal level. Leptin has pro-inflammatory properties. Leptin levels are typically high in obese individuals and low in underweight, malnourished individuals. Individuals with Major Depressive Disorder (MDD) typically have high leptin levels.

Adiponectin is a hormone that is produced in fat cells; it is released from adipose tissue. Adiponectin has an impact on the regulation of glucose and a role in the processing of fatty acids. Adiponectin has anti-inflammatory properties. Adiponectin levels are typically low in obese individuals, low in individuals with Binge-Eating Disorder (BED), and high in individuals with anorexia or bulimia. Individuals with MDD typically have low adiponectin levels. Adiponectin and leptin counter-regulate each other to regulate body weight; when leptin levels increase, adiponectin levels decrease, and when leptin levels decrease, adoponectin levels increase.

Fifty well-matched women between the ages of 30-65 participated in the research study; 25 were yoga novices, 25 were yoga experts. Three fasting leptin and adiponectin blood samples were taken from each woman on three separate occasions. Leptin was 36% higher in yoga novices in comparison to yoga experts, adiponectin was 28% higher in yoga experts in comparison to yoga novices. Additionally, adiponectin/leptin ratios were nearly twice as high in yoga experts in comparison to yoga novices. Among the expert group, leptin levels were lower in those experts with the most yoga experience.

There have been several studies completed that have highlighted the importance of leptin and adiponectin in the prevention of type II diabetes, hypertension, and heart disease. This study raises the possibility that long-term or more intensive yoga could possibly have a positive effect on overall health through the alteration of leptin and adiponectin production. These hormones are especially of importance in the recovery process for eating disorders and obesity.

Let’s Connect!

Like me on facebook.

Twitter @drrenae.

Contact Dr. Norton by phone 513-205-6543 or by form.

Inquire about booking Dr. Norton for a speaking engagement.

Read about Dr. Norton.

View a video about Dr. Norton and the Norton Center.

Medical Advice Disclaimer: The information included on this site is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan. Reading the information on this website does not create a physician-patient relationship.

© 2012, Dr J Renae Norton. This information is intellectual property of Dr J Renae Norton. Reproduction and distribution for educational purposes is permissible. Please credit ‘© 2012, Dr J Renae Norton. http://edpro.wpengine.com’

Sources: Kiecolt-Glaser JK, et al, Adiponectin, leptin, and yoga practice, Physiol Behav (2012), doi:10.1016/j.physbeh.2012.01.016

Why Rapid Weight Gain Decreases Treatment Success Rates

At many inpatient eating disorder treatment centers patients with anorexia nervosa are required to restore their weight quickly; I’ve had patients that were forced to gain 20 pounds in 21 days! Not coincidentally, 21 days was the amount of time that managed care would cover.  There are numerous reasons as to why gaining weight this quickly actually sets the patient up for relapse. Let’s look at what gaining weight at a rapid rate does to leptin levels.

In the malnourished, underweight anorexic, leptin levels are typically very low, due to low fat reserves. Usually, leptin levels reach normal levels during weight restoration. However, when weight is gained too quickly, leptin levels rise too quickly and may exceed the normal range. Of course this has the opposite effect needed for refeeding and individuals experience suppressed appetite and suppressed energy expenditure. As a result, it becomes increasingly difficult for the patient to eat, often interfering with the refeeding process.  Many of the patients who have had this experience, were told, in effect, that they were at fault, or “not trying”. The reason that this happens is that not enough practitioners know about Leptin and the role that it plays in re-feeding. For someone who already has control issues, this is an extremely painful and often damaging experience.

At the Norton Center, our anorexic patients are helped to restore their weight slowly, but steadily. This, along with other important nutritional factors, plays a major role in our high success. It is important to note that many treatment programs use weight gain at the conclusion of treatment as the measure of success.  This is a distortion in as much as the 20 pound weight gain is often gone in a matter or months, and sometimes in a matter of weeks. We measure success as weight gain that is maintained for a at least one year post treatment.  Currently, our success rates  for those patients that remain in treatment is about 90%; in comparison, many inpatient treatment centers experience a much lower success rate, or about 30 to 40%.

How Low Leptin Effects the Physical Complications and Behaviors Typical of Anorexia Nervosa

Low leptin plays a significant role in many of the physical complications and behaviors that are typically associated with anorexia nervosa; amenorrhea, hypothyroidism, hypercortisolism, osteopenia, immune changes, and increased physical activity.

Leptin levels of less than 1.85 µg suggests amenorrhea and subnormal luteinizing hormone (a hormone that stimulates ovulation) in women with anorexia nervosa. As leptin levels normalize through weight restoration, the hypothalamic-pituitary-gonadal axis may be activated. Not all patients with anorexia nervosa resume menses upon weight restoration.

The majority of women with anorexia nervosa exhibit osteopenia. Low leptin levels are also associated with a reduction in bone formation rate. Although there are other endocrine changes that contribute to osteopenia, low leptin levels appear to play a significant role.

Individuals with anorexia nervosa, often experience a compromised immune system. This could also be due, in part to low leptin levels although most of the compromised immunity is due to increased cortisol levels.  Cortisol is the hormone that we associate with stress.  Patients who are gaining weight too rapidly, are under considerably more stress, and may also be experiencing increased cortisol levels

Finally, up to 80% of patients with Anorexia Nervosa tend to engage in excessive physical activity. It is believed that there is an inverse correlation between food intake and physical activity during the weight loss phase. In other words, the lower the leptin levels, the more drive there is to exercise excessively, which causes more weight loss or less weight gain. One study demonstrated that patients reported a decreased feeling of restlessness or hyperactivity (need to exercise) as leptin increased during the refeeding/weight restoration phase of treatment.

Let’s Connect!

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Contact Dr Norton by phone 513-205-6543 or by form

Inquire about booking Dr Norton for a speaking engagement

Read About Dr Norton

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Medical Advice Disclaimer: The information included on this site is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan. Reading the information on this website does not create a physician-patient relationship.

© 2012, Dr J Renae Norton. This information is intellectual property of Dr J Renae Norton. Reproduction and distribution for educational purposes is permissible. Please credit ‘© 2012, Dr J Renae Norton. http://edpro.wpengine.com’

Sources: Monteleone P. Di Lieto A. Castaldo E, et al. Leptin functioning in eating disorders. CNS Spectrums. 2004;9:523–529. [PubMed]

Neuroendocrine System Changes: Anorexia vs. Normal Starvation

Whether a person experiences normal starvation or starvation through anorexia, the neuroendocrine system tries to adapt. Below is a comparison of the changes to cholecystokin, leptin, serotonin, dopamine, neuropeptide YY, ghrelin, galanin, and norepinephrine in normal starvation, anorexia, and in post-recovery from anorexia.

Neuroendocrine Changes - Anorexia, Normal Starvation

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Contact Dr Norton by phone 513-205-6543 or by form

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Medical Advice Disclaimer: The information included on this site is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan. Reading the information on this website does not create a physician-patient relationship.

© 2012, Dr J Renae Norton. This information is intellectual property of Dr J Renae Norton. Reproduction and distribution for educational purposes is permissible. Please credit ‘© 2012, Dr J Renae Norton. http://edpro.wpengine.com’

Source:

Guisinger, Shan (2009). Is Anorexia Addictive? [powerpoint slides]. Retrieved from http://www.shanguisinger.org/2009/08/is-anorexia-addictive-hbes-berlin/

Sugar Consumption Among US Children and Teenagers

Sugar Consumption in the US

photo used under creative common license

“For the past 10 years, I have noticed a connection between childhood obesity, eating disorders, and the increasing complications of both in my clinical work as well as in my research.  As part of my mission to shed light on these problems, particularly as they relate to US children, I find it important to provide both by readers and clients with relevant informative articles.”

Recently, the Center for Disease Control (CDC) released a data brief which examined the consumption of “added sugar” among American children and teenagers. On average, today’s children and teens obtain 16% of their daily calories from added sugar; the USDA recommends that no more than 5-15% of daily calories come from a combination of added sugar AND solid fats. CDC defines added sugar as “all sugars used as ingredients in processed and prepared foods such as breads, cakes, soft drinks, jams, chocolates, ice cream, and sugars eaten separately or added to foods at the table”. Examples of added sugars include white sugar, brown sugar, raw sugar, corn syrup, corn syrup solids, high fructose corn syrup, malt syrup, maple syrup, pancake syrup, fructose sweetener, liquid fructose, honey, molasses, anhydrous dextrose, crystal dextrose, and dextrin.  Other key findings from the study include:

  • Non-Hispanic white children and teenagers consume more added sugar than Mexican-American children and teenagers
  • There was no difference in consumption by income among children and teenagers
  • More added sugar calories are coming from foods than beverages
  • More added sugar is consumed at home rather than away from home

Although it is unrealistic to remove all added sugar from our children’s diets, there are several dietary changes that can be made that will greatly reduce sugar consumption:

  • Cut out sugary sports drinks, soda and flavored milk.
  • Cut out artificially sweetened foods. “Diet” foods, such as diet soda, tend to increase cravings for sugary foods.
  • Replace sugary foods with foods that are low in added sugar. This can include fresh fruit, small amounts of unsweetened dried fruits and unsweetened cacao nibs.
  • Avoid foods that contain sugar, corn syrup, or high fructose corn syrup. Look for foods that contain “no added sugar”, “reduced sugar, or that are “low in sugar”, just make sure that the sugar hasn’t been replaced with an artificial sweetener.
  • Avoid processed foods that are marketing as being “low fat”. When food manufacturers remove fat from a product, they often add in more sugar to compensate for the reduction in flavor and texture.
  • Avoid products that contain “hidden” sources of sugar such as, flavored yogurt, processed cereal, granola bars, dried (sweetened) cranberries, energy bars, fruit snacks, sweetened apple sauce, ketchup, flavored instant oatmeal, fruit spread, store-bought salad dressings, store-bought bread.

Diets high in added sugar reduces the production of Brain-Derived Neurotrophic Factor (BDNF). Reduced levels of BDNF has been linked to reduced memory function, learning disabilities, depression, schizophrenia, obsessive-compulsive disorder (OCD), Alzheimer’s disease, Huntington’s Disease (HD), dementia, anorexia nervosa, bulimia nervosa, and binge-eating disorder (BED). Decreased levels of BDNF negatively affect leptin and insulin signals in the brain, resulting in an increased tendency to overeat.

There are several simple lifestyle changes that can be made to increase and maintain brain levels of BDNF:

  • The most effective way to increase BDNF levels in the brain is through aerobic exercise. After exercising, levels of BDNF surge. Exercise regularly and BDNF levels remain increased.
  • BDNF can also be increased through dietary changes. Acetyl-L-Carnitine, omega-3 fatty acids (such as those found in fish oil), pantethine (found in foods like dairy, eggs, sweet potatoes, peas, spinach, and mushrooms), blueberries, and the curry spice curcumin have all been shown in increase or maintain BDNF levels.
  • Anti-depressants are proven to increase BDNF levels in the brain, so if prescribed anti-depressants be sure to take them as directed.

Let’s Connect!

Take my new Eating Disorder survey!

Like me on Facebook

Twitter @drrenae

Contact Dr Norton by phone 513-205-6543 or by form

Inquire about booking Dr Norton for a speaking engagement

Read About Dr Norton

View video about Dr Norton

Medical Advice Disclaimer: The information included on this site is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan. Reading the information on this website does not create a physician-patient relationship.

© 2012, Dr J Renae Norton. This information is intellectual property of Dr J Renae Norton. Reproduction and distribution for educational purposes is permissible.

Please credit ‘© 2012, Dr J Renae Norton. http://edpro.wpengine.com’

Sources:

BDNF Prevents and Reverses Alzheimer’s Disease
Consumption of Added Sugar Among US Children and Adolescents
What Eating Too Much Sugar Does to Your Brain

Chronic Sugar Intake Dampens Feeding-Related Activity of Neurons Synthesizing a Satiety Mediator, Oxytocin
Tips for Reducing Your Child’s Sugar Intake

The Connection Between Eating Disorders, Obesity and Our Food Supply

Fooducate

I was recently asked by the folks at Fooducate to write an article for their blog readers about how eating real (clean) food helps those with eating disorders overcome their challenges. It was such an honor to be able to share my work with their readers!

Be sure to visit the Fooducate blog to read my article “The Connection Between Eating Disorders, Obesity and Our Food Supply

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Medical Advice Disclaimer: The information included on this site is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan. Reading the information on this website does not create a physician-patient relationship.

© 2012, Dr J Renae Norton. This information is intellectual property of Dr J Renae Norton. Reproduction and distribution for educational purposes is permissible.

Please credit ‘© 2012, Dr J Renae Norton. http://edpro.wpengine.com’

Appetite Hormones 101: Peptide YY

“I’ve been treating eating disorders (ED’s) and obesity for nearly 25 years and have always had good outcomes.  My rate of success improved dramatically, however, when I discovered the critical role that processed food plays in causing as well as in preventing recovery from Anorexia, Bulimia, Bulimarexia, (a combination of the two) Binge Eating Disorder (BED,) Emotional Eating and Obesity. To this end, I find it of great importance to provide both my patients and readers with relevant nutrition information to aid in their recovery. You can view all my Nutrition, Fitness, and Health articles here.

In this third and final installment of the series, “Appetite Hormones 101”, we will discuss Peptide YY (PYY). The purpose of this series is to explain the role of hormones on both appetite and body weight goals, as it relates to both weight loss and weight restoration. If you’re a new reader, be sure to check out “Appetite Hormones 101: Leptin” and “Appetite Hormones 101: Ghrelin“.

Peptide YY (PYY)

PYY is a hormone that suppresses appetite. It was discovered to play a role in digestion in 1985. PYY regulates food intake, and is believed to improve leptin sensitivity. The amount of PYY released by our bodies is influenced by the number of calories we ingest; the more calories we ingest, the more PYY is released. The diagram below shows how our PYY levels, ghrelin and leptin levels typically fluctuate before and after meals:

PYY levels are highest in individuals battling anorexia, followed by those individuals that are lean,which explains why both groups have less hunger and also may have more difficulty eating. PYY levels are lowest among obese and morbidly obese individuals. Individuals with bulimia also experience low levels of PYY, which helps to explain why all three groups feel more hunger. Research shows that the obese individual can decrease their PYY levels by 30% by reducing their body weight by 5.4%. PYY levels are not believed to be effected by weight restoration during recovery from anorexia. It is also important to note that high levels of PYY in anorexic individuals is associated with decreased bone mineral density (BMD).

Our mood also effects our PYY levels. Recent studies show that PYY levels are higher in those suffering from major depression. This explains why many people with major depression have a decreased appetite and experience weight loss.

PYY levels can be regulated through both diet and exercise. Diets high in quality protein tend to raise PYY levels highest, followed by diets high in healthy fats. High carbohydrate diets tend to raise PYY levels the least. Aerobic exercise has also been proven to raise PYY levels, whereas strength-training has no effect on PYY levels (although strength-training does lower ghrelin levels).

In conclusion, PYY regulates our appetite. The higher our PYY levels are, the more satiated we will feel. You can ensure your PYY levels are highest by eating a high protein diet and including aerobic exercise in our workout routine.

Medical Advice Disclaimer: The information included on this site is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan. Reading the information on this website does not create a physician-patient relationship.

© 2012, Dr J Renae Norton. This information is intellectual property of Dr J Renae Norton. Reproduction and distribution for educational purposes is permissible.
Please credit ‘© 2012, Dr J Renae Norton. http://edpro.wpengine.com)’.

Sources
J Clin Endocrinal Metab. 2009 Nov; 94(11): 4463-71 Epub 2009 Oct 9
http://news.sciencemag.org/sciencenow/2006/09/06-02.html
http://jcem.endojournals.org/content/91/3/1027
http://www2.massgeneral.org/harriscenter/about_bn.asp
http://www.eatingdisordersreview.com/nl/nl_edr_18_1_5.html
http://www.thebonejournal.com/article/S8756-3282(08)00162-2/abstract
http://ajpregu.physiology.org/content/296/1/R29.full
J Endocrinal Invest. 2011 Dec 15 [Epub ahead of print]

Appetite Hormones 101: Leptin

This series is designed to explain the role of hormones on both appetite and body weight goals, whether it’s weight loss or weight restoration. “Appetite Hormones 101” will be made up of three articles that describe the major appetite hormones: leptin, ghrelin, and peptide YY.

Leptin

Leptin, discovered by scientists in 1994, is also known as the “starvation hormone”. According to leptin expert, Dr Robert Lustig, leptin sends a signal to our brains that fat cells have enough stored energy to engage in normal metabolic processes. Every individual has an optimal level of leptin, which is thought to be determined genetically. When leptin levels are below optimal levels, the brain receives a message to conserve energy because the body is in a state of deprivation. When this occurs, the brain sends a message to the body that it is hungry (in an attempt to get the individual to eat) so that leptin levels can be restored to an optimal level.

Leptin levels are typically high in obese individuals and low in severely underweight/malnourished individuals. When leptin levels are too high, the individual experiences leptin resistance.

When an individual becomes leptin resistant, the body prevents leptin from passing through the blood brain barrier, which also prevents the brain from receiving the signal that leptin levels are at an optimal level. Instead, the brain senses that the body is in a state of starvation, and the individual becomes hungry. Leptin levels go up as a result.

High triglyceride levels also contribute to the prevention of leptin passing through the blood brain barrier. Triglyceride levels are often high in obese individuals as a result of poor dietary choices. In the individual with anorexia, triglyceride levels are often high because of liver damage and anorexia-induced hormone disruption.

If you think that you may be suffering from Leptin Resistance, there are several things that you can do.

  • Get plenty of sleep. Lack of sleep disrupts many hormonal processes, including leptin levels.
  • Avoid non-fruit sources of fructose. Studies show that fructose raises triglyceride levels, blocking leptin from crossing the blood brain barrier.
  • Avoid lectins, (carbohydrate-binding proteins that are found in most plants, particularly seeds and tubers such as cereal crops, potatoes, and beans) especially those from cereal grains (rice, wheat, barley, corn and oats) as they tend to bind to leptin receptors, preventing leptin binding. This intensifies the affect of leptin resistance.
  • Cook and supplement with healthy fats, like coconut oil. Coconut oil lowers triglyceride levels, increases metabolism, and promotes healing in the gut (and liver for those recovering from anorexia).
  • Eat a high protein, low carb diet and stay active! Diet and exercise have the greatest effect on overcoming leptin resistance.

Sources:

BMC Endocrine Disorders – “Agrarian diet and diseases of affluence – Do evolutionary novel dietary lectins cause leptin resistance?” (http://www.biomedcentral.com/1472-6823/5/10)

Mark’s Daily Apple – “A Primal Primer: Leptin” (http://www.marksdailyapple.com/LEPTIN/)

The Fat Resistance Diet – “Leptin Resistance” (http://fatresistancediet.com/leptin-weight-loss/66-leptin-resistance)

Live Strong – “High Cholesterol Levels in Anorexia” (http://www.livestrong.com/article/86767-high-cholesterol-levels-anorexia/)

Medical Advice Disclaimer: The information included on this site is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan. Reading the information on this website does not create a physician-patient relationship.

© 2011, Dr J Renae Norton. This information is intellectual property of Dr J Renae Norton. Reproduction and distribution for educational purposes is permissible.

Please credit ‘© 2011, Dr J Renae Norton. http://edpro.wpengine.com’

What Whole Foods Market Is Doing To Help Us Reduce Our Exposure to Obesogens.

 

 

 

 

Whole Foods
“Is Your Shampoo Affecting Your Weight Management Goals?”
revealed a lot of information about the presence of obesogens in our environment. Since that post, I’ve found some really comforting news! Whole Foods Market is taking steps to make us more aware of products containing obesogens.   This means we will be able to make more informed decisions without having to read every label for every product we purchase, they’ve already done some of the work for us. What are they doing to make us more informed consumers?

  1. The take-out containers in their Prepared Foods Area are made of uncoated “molded pulp”. As mentioned in “Is Your Shampoo Affecting Your Weight Management Goals?”, many leaders in the food industry line use BPA-lined take-out containers to prevent grease and other liquids seeping through the containers.

According to ‘Inhabitat – Green Design Will Save the World’, some of the take-out containers at Whole Foods are manufactured by a company called ‘EATware’. EATware manufactures the containers using natural raw pulp fibers. The organic containers are water resistant, oil resistant, and free of chemical and insecticides. They are also biodegradable, recyclable and renewable. So, not only are we protecting ourselves, but we are protecting the environment too. Double win!

  1. On September 23, Whole Foods Market announced that they are moving towards an “eco-scale rating system” on their cleaning products. This new system is expected to be implemented by Earth Day 2012. This will allow time for their current suppliers to meet the new standards being set by Whole Foods Market. According to the Whole Foods Market blog, they are the first major retailer to set standards on their household cleaners.
  1. All cleaning products will be rated using a color system. No phthalates will be permitted in any cleaning products sold at Whole Foods Market (for a complete list of ingredients that will be considered ‘unacceptable’ for each color rating, check out www.wholefoodsmarket.com/eco-scale/unacceptable.php). All products will be reviewed by a third-party company.
    • An “orange” rating will be assigned to those cleaning products that are free of phosphates, chlorine and fake colors.
    • A “yellow” rating will be assigned to those cleaning products that contain 100% natural fragrance and have minimal safety concerns
    • A “green” rating will be assigned to those cleaning products that contain 100% natural ingredients and non-petroleum ingredients.
    • Any products that are rated “red” will contain ingredients that Whole Foods Market has deemed ‘unacceptable’. These products will not be sold in Whole Foods stores.

It doesn’t stop here! Check in tomorrow to read more about what Whole Foods Market is doing to help us reduce our exposure to obesogens!

Sources:

Whole Foods Market – Products (http://wholefoodsmarket.com/products/)

Inhabitat – EATware Compostable Food Containers (http://inhabitat.com/compostable-containers-by-eatware/)

Medical Advice Disclaimer: The information included on this site is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan. Reading the information on this website does not create a physician-patient relationship.

© 2011, Dr J Renae Norton. This information is intellectual property of Dr J Renae Norton. Reproduction and distribution for educational purposes is permissible.

Please credit ‘© 2011, Dr J Renae Norton. http://edpro.wpengine.com’