Simply Health ME

Simply Health ME E80 - Appetite

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There is a pathway in the brain that promotes weight gain

  • Orexigenic Pathway
  • Decreases movement throughout the day (you don’t even notice it!)
  • Increased appetite
  • Stimulated by Ghrelin, cortisol (stress)
  • Sleep deprivation

    • And a pathway to promote weight loss

    • Anorexigen Pathway
  • Increases spontaneous movement
  • NEAT (the biggest thing linked with weight loss)
  • Stimulated by Leptin, Insulin, Serotonin
  • One reason overweight folks with leptin resistance are more hungry
  • Stimulated by a whole host of hormones we will talk about briefly later
  • Stimulated by Stomach stretch

  • Your body sends signals that stimulate one of these pathways.

     

    Hormones that Make that decrease your appetite

    Insulin

    • From the pancreas in response to food
  • Stops the hunger pathway directly
  • A problem if you are insulin resistant
  • Also causes your body to store nutrients (glycogen in muscle / liver)
  • Stores fat as well

    • Leptin

    • Secreted by the fat cell
  • Stimulates the pathway making you full,
  • Inhibits the pathway making  you hungry.
  • This is at the level of the brain
  • Proportional to body fat (less than leaner you are)

    • Serotonin

    • We talked about this on another podcast

    CCK (cholecystokinin)

    • From your small bowel
  • In response to fat and protein
  • Decreases stomach emptying (making you feel full longer)
  • Decreases Ghrelin (your hunger hormone)

    • *Weight Loss leads to CCK NOT elevating as much after food

    BUT if in Ketosis, normal response of CCK after eating is maintained

     

    GLP-1 (Glucagon-like peptide)

    • Small bowel
  • Stimulated by by carbs
  • Lower levels in folks affected by obesity, and people with pre-diabetes / diabetes
  • Dec liver making glucose (gluconeogenesis)
  • Reduces appetite
  • Decrease gastric emptying.
  • E.g Trulicity is an example of drug modeled after this.

    • Others from the small bowel:; PYY, OXM, etc.

     

    Things that make you more hungry

    • Ghrelin is the more powerful
  • What stimulates Ghrelin and makes you more hungry
  • Stress, sleep deprivation,
  • The expectation of food
  • WEIGHT LOSS (any)
  • Fasting

    • Ketones (SIDE NOTE)

    Ketones inhibit the rise in ghrelin that occurs with weight loss

    The pathway that makes you hungry is inhibited by many of the hormones that make you full

     

    Other side notes

    • Fructose does not help your brain to register that it is full
  • E.g candy
  • Fruit has fructose but also fiber which causes stomach stretch

    • So, How can you regulate your appetite

    • When you do eat: Protein > Fat > carbohydrates
  • Eat carbohydrates with fiber
  • Bulk helps (stomach stretch)
  • Sleep More
  • Stress Reduction

    •  

    Mindfulness has its place but intuitive eating may not be a good approach if you have metabolic dysfunction

    • Plan your day / meal times
  • So you are not just eating out of boredom or stress
  • If you just ate, you probably are not hungry
  • Why do you want to eat?

    •  

    ...more
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    Simply Health MEBy Emmy Liscord, MD and Peter Spiegel M.Ed