Reducing exercise and eliminating other purging behaviors Recovering health Cognitive-Behavioral Therapy-Enhanced: This treatment was originally designed for bulimia nervosa and is now being used with anorexia nervosa. CBT-E treatment can involve 20 sessions or 40 sessions over the relative number of weeks, with a follow-up 20 weeks later.
The Hungry Brain gives off a bit of a Malcolm Gladwell vibe, with its cutesy name and pop-neuroscience style. Stephan Guyenet is no Gladwell-style dilettante. He is very serious about what he does and his book is exactly as good as I would have hoped.
He writes The [calories in, calories out] model is the idea that our body weight is determined by voluntary decisions about how much we eat and move, and in order to control our body weight, all we need is a little advice about how many calories to eat and burn, and a little willpower.
The primary defining feature of this model is that it assumes that food intake and body fatness are not regulated.
This model seems to exist mostly to make lean people feel smug, since it attributes their leanness entirely to wise voluntary decisions and a strong character. I think at this point, few people in the research world believe the CICO model. David] Ludwig and I both agree that it provides a poor fit for the evidence.
As an alternative, Ludwig proposes the insulin model, which states that the primary cause of obesity is excessive insulin action on fat cells, which in turn is caused principally by rapidly-digesting carbohydrate.
According to this model, too much insulin reduces blood levels of glucose and fatty acids the two primary circulating metabolic fuelssimultaneously leading to hunger, fatigue, and fat gain.
There are other versions of the insulin model, but this is the one advocated by Ludwig and Taubesso it will be my focus. It acknowledges the fact that body weight is regulated, but the regulation happens in the brain, in response to signals from the body that indicate its energy status.
Chief among these signals is the hormone leptin, but many others play a role insulin, ghrelin, glucagon, CCK, GLP-1, glucose, amino acids, etc. With CICO, at least you know where you stand — confident that everything is based on willpower and that you can ignore biology completely.
And again, with Taubes, you know where you stand — confident that willpower is useless and that low-carb diets will solve everything. The Hungry Brain is a little more complicated, a little harder to get a read on, and at times pretty wishy-washy.
The Hungry Brain begins with the typical ritual invocation of the obesity epidemic. Did you know there are entire premodern cultures where literally nobody is obese?
That the prevalence of obesity has doubled since ? Researchers have been keeping records of how much people eat for a long time, and increased food intake since perfectly explains increased obesity since — there is no need to bring in decreased exercise or any other factors.
Exercise has decreased since the times when we were all tilling fields ten hours a day, but for most of history, as our exercise decreased, our food intake decreased as well. But for some reason, starting aroundthe two factors uncoupled, and food intake started to rise despite exercise continuing to decrease.
Guyenet discusses many different reasons this might have happened, including stress-related overeating, poor sleep, and quick prepackaged food. But the ideas he keeps coming back to again and again are food reward and satiety.
In the s, scientists wanted to develop new rat models of obesity. This was harder than it sounded; rats ate only as much as they needed and never got fat. Various groups tried to design various new forms of rat chow with extra fat, extra sugar, et cetera, with only moderate success — sometimes they could get the rats to eat a little too much and gradually become sort of obese, but it was a hard process.
Then, almost by accident, someone tried feeding the rats human snack food, and they ballooned up to be as fat as, well, humans. Palatable human food is the most effective way to cause a normal rat to spontaneously overeat and become obese, and its fattening effect cannot be attributed solely to its fat or sugar content.
So what does cause this fattening effect? But modern food is calorically dense — it contains many more calories than predicted per unit mass — and fiber-poor. Simultaneously, the extremely high level of food reward tricks the brain into thinking that this food is especially nutritionally valuable and that it should relax its normal constraints.
Meanwhile, we design our meals to include as many unlike foods as possible — for example, a burger with fries, soda, and a milkshake for dessert.
This once again causes the brain to relax its usual strict constraints on appetite and let us eat more than we should.This review explains why regular aerobic exercise is the best thing to prevent coronary artery disease.
LEARNING OBJECTIVES. This is an advanced level course.
After completing this course, mental health professionals will be able to: Determine the level of severity of anorexia nervosa and bulimia nervosa. Analysis of a Toxic Death A year ago two dozen emergency room staff were mysteriously felled by fumes emanating from a dying young woman.
Investigations turned up nothing--until a team of chemists from a nuclear weapons lab got involved. The main theme of A.E. Housman's poem "To an Athlete Dying Young" is death. Study of the structure and meaning of this poem can help an individual more fully understand some of the complexities of death.
A.E. Housman's "To an Athlete Dying Young" gives us a chance to consider just how high a value we place on fame. Your reaction to the poem will be a pretty good indicator of your level of fame-obsession. I tried MealSquares a while back, based on the sidebar advertisement, and liked them pretty well (“liked” in the “this works well for me” sense, not the “food reward” sense).