Thursday, February 21, 2013

Brightening the Lights

Recently, I've been learning more about the brain's reward system pathway. I don't want to go too deeply into it because, frankly, even people who know a little about it get frustrated and irritated when I go deep into the details. It's pretty dense stuff, and only those who want to know the science very well need to know about it. So, I'm going to speak in general terms, and entertain questions about details should my readers want more concrete answers.

What I've learned recently enhances what I talked about in the previous several posts, and it has mainly applied to substance use and abuse. In particular, I've learned a thing or two about how drugs that affect the parts of your brain that experience pleasure mess up your ability to take joy in anything else. The woman who was teaching the class I was sitting in on told us a story which, after hearing it, ran a bell very strongly with my experience with food.

This woman has a PhD, is a registered nurse, and a practicing licensed therapist as well as a teacher at a private graduate school. One can conclude she has a lot of practical as well as book-oriented knowledge. She told us about a client that she had who had spent several years using cocaine. Prior to his cocaine use, he used to enjoy music greatly. After using cocaine, music no longer could offer him the same joy, not even long after he'd stopped using the drug.

What had happened to this man was that the parts of his brain that were stimulated by the drug were the same ones that allowed him to take pleasure in other things. By abusing the drug to hyper-stimulate those areas, he changed the way they experienced the world forever. That's right. Forever. They were permanently changed such that nothing would ever give him pleasure in the same way again.

The reason this story really hit home with me was that, when I started changing my relationship with food, I wrote about how my life was changing. In this post (12th paragraph), "I should note that there is very much an aspect of this which is “duller” than things used to be. That is, the lights were more brilliant and the colors were brighter when food was fully centralized". This was a reflection of the fact that food was the thing that lit up the pleasure centers in my brain in a way nothing else could.

A lifetime of using food for comfort has almost certainly altered my brain's reward pathways just as those in the cocaine addict were altered. The highs were rarely as high for me as they were when I was fully invested in partaking in food with not restriction. However, I do believe that there is a difference between what happened to me and what happened to the cocaine addict. He was damaged and can't be repaired. I am damaged and am in the process of being repaired.

It continues to be a long and complex  path. Due to the psychological processing I've done, I can never regard food as the end all and be all of pleasure. The "buzz" I got from it died and I can't honestly say that anything has replaced it in intensity. I can say that things have slowly gotten better as I've tried to replace that pleasure with other types of pleasure, but it's more about collecting little bits of thing to enjoy then one whopper that delivered it's payload of joy in one sitting.

I don't know about the biology for certain, but I'd be shocked if people like me didn't see their reward pathways light up like a Christmas tree from food and provide dim lighting from other sources of pleasure. I think that this could be part of the complex picture of why people who lose weight regain. Just as the cocaine addict goes back to the drug because life becomes dim and joyless without it, the addicted eater may similarly find that the lights need some brightening when they try to abandon their drug of choice.

I know that it has taken me years to decouple destructive pleasure seeking in food and it's still there to some extent (as my last few posts illustrate) and similarly has taken years to elevate other pleasures to a meaningful status in terms of my response. I'm not saying every fat person does this, but I do think that for those of us who became fat as children and continue to be fat as adults, there's a good chance that our brains are built around this way of deriving pleasure from our world.


The Paris Chronicles said...

This makes strikingly good sense, especially when one looks at addiction transfer and weight loss surgery patients. Since that cohort cannot light up the pleasure pathways with their substance, they are at risk for gravitating to another pleasure-producer e.g., alcohol or shopping, or even(more beneficially, of course) exercise.

This is an interesting subject, especially when we think of why some obese people fall victim to this and some don't. I agree that there could be a link between the age of obesity onset and the deeper-embedded pathway. I've recently concluded that there is a "tipping point" in obesity where, once one tips, the only pleasure left to the obese person is food (because they can no longer partake in other pleasure activities such as social interaction, sex, walking about, participating in community networks). Seeking to still have the pleasure pathway lit up, they turn to the only thing left which is the food groups that "do it" for them. It's an unconscious act, of course, but even if the obese person realizes it, very difficult to break due to the biochemicals involved.

Obesity researchers in the pharmaceutical industry would do well in concentrating efforts at developing a molecule to shut down the feedback loop. If we didn't derive pleasure from eating the substance, I suspect we would just put it down. After all, no one turns to celery when wanting to light up this pathway, right?

Anonymous said...

This is very interesting. I've been on a weight loss plan for 3 years now, and I'm hoping to hit my goal this year.
Most people would be horrified at the length of time it took - I know you have been at this for several years too.
I wonder if by doing it slowly over a long period of time it may help heal some of those pathways?
Unfortunately I'm not one of those who can say "Oh, I never even think about fast food anymore, I only eat fruit for dessert, etc." I still like all that stuff, but I've learned to eat in in moderation, and I don't feel the "pull" so much anymore. When I do feel it, I can satisfy it normally with one meal and that's enough.
By never saying "never again" I was able to release the hold it mostly has on me.
It reminds me of an infographic I saw recently about how the body heals after quitting smoking...I wonder if there is something similar at play for some of us.
I have always been a large child - not superfat, but definitely always the "fat girl" in the class...and this was in the 70s/80s when I could literally be the only fat kid in a room.
I look back now and I certainly wasn't enormous.
I know people throw around the term "food addiction" a lot, mostly erroneously in my opinion, but what you've written here seems to support a certain aspect of this idea.
Sorry for the rambly comment! I've definitely enjoyed / learned from your last few posts.

--Eliza (I've posted as anon a few times before, figure I should give a name!)

Anonymous said...

Somewhat similarly, I believe, if one has a developmental brain disability like mine, then by steadily increasing consumption of sugars and starches (which turn into glucose and are stored as fat), resulting in increased size and number of fat cells, which in turn strengthens neuro-endocrine signalling between fat cells and specific brain cells (e.g. dopamine and norepinephrine neurotransmitters in the frontal cortex), which in turn provides improved functioning of impaired brain functions (i.e. executive functions involving organization, planning, motivation, short-term memory, concentration, sensitivity to environmental distractions, etc). Therefore as a woman weighing over 300 plus lbs, with my developmental brain disorder, my *reward* (for maintaining high numbers of enlarged fat cells) did not involve pleasure centers or pathways linked to feelings of pleasure, but instead (as a result of being very fat) my brain's impaired executive functioning was physiologically mediated such that I experienced less impairment in these (above noted) cognitive functions. Since mine was a pre-existing brain condition, weight loss does not eventually lead to healing of neurological deficits. Therefore, while I experience no struggle to maintain a normal weight, now, I continue to struggle greatly with neurological (cognitive function), and I continue to search for alternatives to improve a disability that can (with medication) only improve for short periods of time and to a limited extent. Thanks for letting me share. Continued good luck and good health to you!

LHA said...

I found this so interesting. I agree that those of us who were fat as children must have a more entrenched need for food as a comforting device. Speaking for myself, I have seen photos and movies of being fed baby formula from a bottle propped in my crib. I was positioned under it as an infant, so when I cried that was the way I soothed myself. That was so long ago that the formula was full of corn syrup and other sweeteners, setting up a life long craving for sweets and carbs when stressed or frightened. I know that my dear mother didn't mean for this to be a consequence of her feeding methods but she was busy with a toddler when I was born and the formula propped in my bed was probably considered a modern convenience.

I wonder if you have seen any information on breastfed babies having fewer problems with obesity and food addiction? I breastfed all of my children with no formula substitutions as a way to minimize their chances of becoming obesity. Thanks for a great blog. So informative.

screaming fatgirl said...

First of all, my apologies to everyone for the delay in moderating comments. A lot of difficult things have been going on in my life psychologically and sometimes I can't even get myself to deal with anything else. However, I don't want to put anyone off and I do want everyone to know that comments are appreciated!

Paris: I absolutely agree about the concept of a tipping point. I believe it applies to many things, including food and obesity. I think that the real question is whether or not we can recover and to what extent, and that is highly personal.

What you say about closing down the loop with some chemical intervention is something that has been on my mind as of late. There's a drug called Naltrexone which is used to assist drug addicts and alcoholics in extinguishing their addictions. It's not like other medications in that it's not meant to help you just stop. In fact, for alcoholics, Naltrexone, when used with something called "The Sinclair Method", requires one to keep drinking. They take a pill 20 minutes before drinking and then can drink in moderation because the pill blocks the compulsion to drink more by dampening the pleasure centers in the brain. I have wondered, in fact, if Naltrexone might not perform the same function for those who eat compulsively. However, it could be that these addictions hit different receptors in the brain and that the same drug won't work for food addicts as other types.

screaming fatgirl said...

Eliza: I agree with that "food addiction" is a term that gets tossed around a lot with little explanation of what exactly is meant. In fact, one could say that the word "addiction" in general gets passed around a lot without a concrete definition. Many people believe marijuana isn't addictive because it's doesn't not have withdrawal, but, in fact, it can be addictive as well. My definition of "addiction" relates to how a substance impacts receptors in the brain (generally altering their functionality such that a difficult to resist 'craving' for the substance is established) and a psychological difficulty is experienced consequentially when that craving is denied. That means food can be addictive.

I do believe, like you, that the body can heal from the types of addictions which aren't not actively destroying cells. I feel that receptors can be slowly altered to receive less and less input from the substances they are addicted to and regain at least some of their "normal" shape and form. The extent to which that may be possible is individualized, and hard to quantify, but I do believe that what you and I are doing (no denial, but tapering, moderation, and slow loss) is a part of the process for people with neurological issues as a result of long-term weight issues.

hopefulandfree: I have actually heard of cognitive issues that respond to dietary changes and that some conditions can be managed with fats and carbohydrates in particular. Given what I know about medications, especially SSRIs, stimulants, and MAOIs, I can understand the difficulty in trying to manage ones condition through medication instead of diet. I imagine that you may have tried drugs which regulate dopamine and norepinephrine and found them wanting (as many do), and been placed in the position of making one of several bad choices - remaining very overweight, taking drugs that have side effects and make you feel "wrong", or doing nothing and suffering your cognitive problems. It is not a good place to be in, and I hope that you've found a solution that is the least difficult for you.

LHA: Your question about breast-feeding and obesity is a very interesting one. I was not breastfed. My husband was. He grew up thin and I grew up fat. This is utterly anecdotal, but I do wonder if there is a connection. Mind you, I don't recall how I was managed in terms of how I was fed as a baby, but my mother was so squeamish about anything body-related or what she perceived as sexual in nature, I'm pretty sure there's no way she had a baby clamped to her breast.

Thanks to everyone for the comments! Once again, my apologies for the delay.

Human In Progress said...

Loving the articles as of late!

Wanted to add to the conversation. While pregnant and reading books/taking classes on breastfeeding and baby care, I repeatedly encountered the claim that breastfed babies have a lower lifetime risk of obesity, diabetes, and other related conditions. I never looked into the sources for these claims, but there must be studies that these breastfeeding advocates use to back themselves up. I'm betting the La Leche League site would have some leads for further research and reading.

Adding to the anecdotes, my mom breastfed me and my 4 siblings. Two of us are fat and 3 are normal. My nephew was raised on formula and shitty processed food, and he's trim and handsome. I just don't know! So many factors in the mix.