Stress nom nom nom

February 13th, 2011  |  Published in Stumpblog  |  6 Comments

Pursuant to my previous post about stress fucking with your head, here’s some stuff on how stress fucks with your body — and how susceptible folks may respond.

I’ll be devoting a section in my upcoming book to appetite and eating behaviour regulation — in other words, what makes us want food? Why do we want the kinds of foods we want?

One of the arguments I’ll make is that appetite, hunger, and satiety are complex phenomena, which are strongly affected by our stress responses. Overweight and obesity can be viewed as the consequence of eating behaviour that is, in part, a coping mechanism. My own experiences, experience with hundreds of nutrition clients, and the clinical literature seems to support this argument.

Folks who tend towards overweight/obese (which, in North America, is the majority) are not necessarily “metabolically” different in the way that is commonly understood (i.e. that fatter folks have “slower metabolisms”). In fact, arguably they are metabolically normal — but responding to abnormal circumstances, whether that’s increased stress, emotional dysregulation, environmental stress (such as the speed and pace of life, or screwed-up light-dark cycles from shift work, etc.), or simply the abundance of tasty foodlike substances.

We can thus understand overweight/obesity (along with a host of disordered eating behaviours that don’t necessarily result in excess body fat, but are still not healthy food relationships) as the consequence of a coping mechanism. Humans and many animals use food and eating in some way to deal with pain, discomfort, and distress.

The coping mechanism operates through several pathways, but basically you can understand eating behaviour as a potential mode of self-medication and self-soothing. Here’s a recent article from Neuropsychopharmacology about one of the ways in which this can occur.

Similar to alcohol and other drugs, highly caloric and palatable foods activate brain stress and motivational pathways that likely evolved to respond and adapt to challenging environments and primary rewards necessary for survival. Chronic substance use and high BMI states are associated with alterations in stress pathways which in turn are associated with stress-related consummatory behaviors. [Krista's note: Not sure this is the best word choice, LOL! Kinda sounds like increased stress-related humping.]

A central component of the stress/reward motivational neurocircuitry involves the ventral striatum (VS), a structure implicated in reward processing (including reward-based learning and expectation, valuation, or anticipation of rewards) and stress responsiveness. Stress, food, and drugs all increase neurotransmission in the VS.

A reduction in striatal dopamine 2/3 (DA D2) receptors in obese individuals similar in magnitude to those observed in drug-addicted individuals has been reported, suggesting alterations in striatal function in obese individuals in stress/reward neurocircuitry. Furthermore, DA D2 receptor measures correlate inversely with BMI, suggesting that individuals with the lowest levels of striatal DA D2 receptors have the highest BMIs.

Together, these data suggest that similar aspects of striatal dysfunction may contribute to drug addiction, obesity, and stress vulnerability.

So basically, what we have here is a situation in which obesity is correlated with some malfunction (or perhaps over-function) of the reward and stress-response systems.

We can understand obesity/overweight as a consequence of this malfunction. If you’re prone to overweight, it likely means that in some way, you are hyper-responsive to stress or discomfort; you seek self-soothing via eating; and you may need a bigger “hit” of eating/palatable food in order to soothe yourself enough.

The dopamine reward system is also trainable — in other words, the more a person opts for a self-soothing choice, the more that choice becomes ingrained as an optimal one. The more you do, the more you want. And the more it seems like that choice is the only option.

OW/OB [overweight/obese] individuals have increased responses in motivation/reward neurocircuitry that are related to peripheral metabolic factors linked to non-homeostatic feeding [aka overeating] in individuals with elevated BMIs. The finding of altered VS activation in the neutral relaxing and stress conditions suggests that treatments targeting stress management or anxiety reductions may prove to be beneficial through their influences on central motivation/reward neural pathways.

Next time you attack that buffet, announce, “I’m doing non-homeostatic feeding!”

Anyway, this study suggests what I have long felt as a nutrition coach: Telling people what to eat is largely useless — we must retrain ourselves in how to eat and understand why we eat. And maybe time spent lecturing people about eating broccoli would be better invested in helping them chill out.

Responses

  1. Sarah says:

    February 13th, 2011at 4:10 pm(#)

    I kind of agree with this – but at the same time, I think certain foods (like, say, sugar) mess with your head more directly and acting in a more opiatoid fashion than things like meat or leafy veggies.

    My experience seems to indicate that if you get onto a decent diet (paleo works for me), not only are non-homeostatic feeds less frequent, they’re less prolonged, as well. In other words, eating good stuff most of the time gives you a bigger bang for your buck when you have a wretched godawful day and need an easter creme egg. One egg will then suffice, unlike 3 years ago when I’d need an egg, some mini-eggs, several almond croissants and probably some ice cream to wash it all down.

    This doesn’t necessarily contradict Krista’s nutrition-coach wisdom, but it’s a refinement: knowing WHY and HOW we eat doesn’t do you much good if you don’t have a “normalized” foundation to work from. If you understand what’s going on – if you can say “I just had a right shitty day and dammit I am going to have that chocolate, but JUST that chocolate, and then I will have a nice hot bath and possibly some sex, and that ought to do it for me” then you’re waaaay ahead of someone who stumbles blindly into the convenience store, grasping for sugary calories with no guiding framework beyond a vague and surpressed sense of guilt. And THAT level of self-awareness is a whole lot easier to come by if your brain isn’t being consistently bombarded with sugar and refined carby crap such that you firstly aren’t thinking straight and secondly need a whomping HUGE amount of “good stuff” to get the buzz you’re looking for.

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    February 14th, 2011at 4:31 am(#)

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  3. Kristen says:

    February 16th, 2011at 10:53 am(#)

    I agree with you both! I just heard Gary Taubes (Good Calories, Bad Calories and Why We Get Fat and What to Do About It) talk about how getting fat is because we eat too many carbohydrates (they are fattening). It’s not a behavior issue in that if we realize why we eat – I’m upset so I’m having a candy bar! – somehow we’ll lose weight if we eat fewer candy bars when we’re upset. If we “behave better”, we’ll not be fat, if we didn’t soothe our moods with food, we’ll not be fat, etc. Fat is caused by too many carbs, creating insulin swings and fat storage over allowing fat to be used for energy.

    That said, many people don’t understand why carbs upend and sabotage what is a normal bodily function: to be hungry when you’ve expended energy and eat to replace that energy. Hunger is seen as evil. And that’s hot healthy either. So understand the what, why and how is crucial. Getting off the blood sugar roller coaster enables a person to know when they’re hungry, and when they are just craving a blood sugar spike. They are very different feelings!

    I think of it as a body issue like if I had a broken leg, but I didn’t address the physical problem, I’d be depressed and anxious because I couldn’t walk on my leg. I’d see a therapist to talk about my feelings about not being able to walk, but it would never heal my leg. If I had the broken leg tended to, I wouldn’t be wondering why I couldn’t walk or be depressed about not being able to walk and not knowing why. In fact, I’d think it strange if someone suggested that I modify my behavior to make my leg feel better.

    I agree that stress does do all sorts of horrible things, and heightened awareness is the key to coping with it in a healthy way.

    A great book about how the body is affected by stress is Robert Sapolsky’s Why Zebras Don’t Have Ulcers.

  4. Gingersnapper says:

    February 17th, 2011at 6:44 am(#)

    I think I’m always trying to figure out how much is mental and how much physical. On the one hand, I’ve ALWAYS been fat, since birth, which seems to indicate an inherent tendency that might not be easily mitigated by behaviors. On the other hand, I’ve had a crappy diet and no exercise for most of my life. On the other other hand, high vs. low carb seems to have little influence on my weight.

    I’m agreeing with Sarah, though, that when I’m eating clean, the occasional treat is just that – occasional and a treat. My need for mood elevation is lessened when I have a good diet and am physically active, and it takes a lot less of a “treat” for me to be satisfied with it. I tend to believe that’s both physical and mental.

    There’s a good article on Lou Schuler’s blog. I don’t know if I can post a link, so on his blog, search for a post called Weight Loss, Part 2: When the Weight Is There for a Reason.

  5. Linds says:

    February 17th, 2011at 3:22 pm(#)

    This is a very interesting post! I truly believe that stress and depression have an effect on our eating habbits and vice versa. In the past, when I have delt with bouts of depression and extreme stress, i actually LOOSE my appetite which results in excessive weightloss.

    However I have noticed that after I converted to a healthier way of eating (less processed food, more veggies, good fish, and the ever wonderful hemp) I am able to deal with stress and depression much better. Is it because of a change in eating habits or a change in lifestyle and life outlooks?? I don’t know. But it sure would be interesting to see a study that looks at the corelation of a diet and how it affects the way we REACT to stressors.

  6. Kristen says:

    February 18th, 2011at 10:08 pm(#)

    I’d like to see that, too, Linds. Would be interesting!

    In Gary Taubes new book (Why We Get Fat…), he mentions that we obtain all of our essential vitamins, etc., from meat, the exception being Vitamin C. However, Vit C, he says, is needed more when we are processing carbs. So….ergo….do we get more colds when we overdo on carbs??? Is that why Vit C works well with preventing colds?

    Gingersnapper, I read Dr. Felitti’s article about the study they did with obese individuals with a history of abuse. A couple of things troubled me. One, he associated obese people with abuse, and talks about the fact that they were able to finally express their feelings about the abuse. He does not say if that resulted in weight loss, nor does he have information about people who have suffered abuse but are also in therapy – did they lose or not lose weight after this treatment?

    The second thing is that he says:

    “Nutrition is an interesting and important subject that has no more relationship to obesity than it does to anorexia.”

    This goes against what has been known by doctors and researchers for 100+ years about what causes obesity, according to Gary Taubes, who says that carbohydrates cause insulin response which causes fat storage. That is, nutrition is definitely related to obesity.

    I propose that individuals with a history of abuse could come in all shapes and sizes; however, with the carby foods that are readily available today, it would be extremely easy to overeat carby food if one was feeling down and out. If a person is suffering from insulin swings, they would be more susceptible to readily-available insulin fixes (carby foods).

    On the other hand, I don’t discount that a person who was suffering from a traumatic experience could seek to make themselves feel better through food. The problem, though, then becomes physical: fat is stored, then the whole insulin response is dis-regulated, causing blood sugar swings, and fat storage, fat *holding* and making the person feel hungry all the time because their fat tissues will not release energy, so the person eats more and more to give themselves a bit of energy (though not enough to feel less-than-torture while exercising).

    We humans are seeing the results of developing technology at a pace that outdoes our understanding of the implications of said technology. We have a huge supply of foods in our local grocery stores. However, which of those foods will serve us; which of those foods will be our undoing?


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