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Anorexia and Obesity – Are They Both Driven By Carb Cravings?

Published on February 4, 2013,

Dr Bill Wilson has written a fascinating article asking if eating disorders like anorexia are in reality the other side of the coin to obesity, with both sides being driven by carbohydrate cravings, or what he refers to as Carb Syndrome. He believes the right kind of food intake – low carb (especially fructose and high glycemic index carbs), modest protein, and high fat – can improve brain function and in turn return people with either condition back to more normal states. This is an extract from Dr Wilson’s Carb Syndrome blog…

[25/52] sorted colors sugary little things

sugary little things (Photo credit: Davi Ozolin)

Carbohydrate Cravings Are Driving The Bus. 

To see how eating disorders are tied into CARB syndrome, an example might be helpful. Recently I admitted a young woman into the hospital with severe anorexia. Her blood electrolytes were abnormal to the point where it could adversely affect her heart. In the past she has also been diagnosed with severe anxiety and depression. She has the binge-purge type of anorexia and she is extremely under-weight.

The most prominent symptom of CARB syndrome is strong cravings for sweet and starchy foods.When I asked her about this symptom, she denied having such cravings. That’s because when someone with anorexia restricts their food intake to a severe degree, they end up in ketosis which tends to suppress both hunger and carbohydrate cravings. That’s one reason why they can easily avoid eating—they simply have no hunger or cravings. They can only achieve this state by severely limiting food intake. Without huger or cravings, their life settles down somewhat, even though they still have other typical brain dysfunction symptoms.

When I asked her about her past, she admitted that she used to have very strong cravings for sweet and starchy foods and she also used to binge on this type of food. That’s one reason people with anorexia don’t eat. Once they start to eat, the cravings return and when they eat this type of food, they quickly feel worse and start storing more visceral fat even when they are thin. They somehow sense that they are storing too much fat even when everyone else thinks “It’s all in their head”.

Although all patients with CARB syndrome regardless of their size or weight tend to have brain dysfunction symptoms, these symptoms are often worse in people who are thinner. That’s because when they restrict their eating, they consume very little of the amino acids that are necessary to make dopamine, norepinephrine and serotonin. Because they already have low levels of these neurotransmitters, starving the brain seems to make these symptoms worse.

Effective Treatment: Focus on the Brain.

If eating disorders and obesity are connected, then the treatment approach for both conditions should be similar. The only difference between these two groups when it comes to body size is the amount of food they are eating, but both groups are in the same type of fat-storage mode. The key to successful treatment is to slowly move them out of this mode and the best way to do so is to focus on improving their brain function.

The most effective way to improve their brain function is to remove the triggers of CARB syndrome from the diet—excessive fructose and high glycemic carbohydrates. Although someone with anorexia obviously needs to increase their food intake and someone with morbid obesity needs to eat less, I place most of my focus on the type of food they are eating. If they eat the right type of food, their body composition will tend to drift back towards normal. If you give someone with anorexia the wrong type of food, their brain function will get worse, not better and they will strongly appose this by once again reducing food intake.

For both groups I recommend following a low carbohydrate, moderate protein, high fat diet. The fats should be healthy fats like coconut oil, olive oil, omega 3 fatty acids and animal fats, especially from grass fed animals. I also recommend taking certain supplements to improve brain function and I discuss these supplements in detail on other posts on this site. Exercise is helpful mainly because it is a good way to improve brain function.

I believe that Hudson and Pope were right—many common brain disorders are driven by a shared pathology. They just didn’t take their concept far enough. The CARB syndrome disease model completes the connection between common brain disorders, eating disorders and obesity. Treating eating disorders is still very challenging, but this new disease model gives us more effective tools to use. Hopefully future research will help us to better define the connections between these common disorders. In the mean time let’s use the effective tools derived from the CARB syndrome model to help these desperately ill patients.

See the full article at:  Eating Disorders and Obesity – Are They Two Sides of the Same Coin?

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