Also Known as Skipping or Skimping Meals
I am convinced that eating patterns of food-restriction, followed by re-bound, are a weight-control deal-breaker for all or very nearly all people who have an ongoing or significant issue with excess body fat (we keepers).
I think that this is very under-acknowledged. A quiet quicksand pervasive in our culture.
In fact, I think that restrict/re-bound eating patterns have been one of the biggest contributors to today’s obesity crisis. I think this contributes in a very major way to weight gain over time and also strongly sabotages success in achieving weight loss and in weight maintenance.
I suspect that the uncontrolled-for effect of within-day or within-week cycles of restrict/rebound has contaminated a great deal of the obesity reasearch when free-living people have been studied.
I think that the official endorsement and professional recommendation of Hunger-Inducing-Therapy (calorie-restricted dieting) has contributed to the very wide-spread presence of such eating patterns in our society. Also, that this is behind the fact that such eating habits are commonly regarded as fairly benign and have now been the habits of so many people over such a long time that they are now commonly seen even as being perfectly healthy.
Our great-grandmothers would have ‘had none of it’ if their sons or daughters had tried to pull such stunts at the breakfast table.
By restrict/re-bound eating patterns, I include patterns that occur within a day, within a number of days (often week-days versus week-ends) and over a cycle of some weeks or months.
Typically, a within-day cycle would start with skipping or skimping or substantially delaying breakfast and/or lunch. Following this, the re-bound would start in mid or late-afternoon or in the evening. At either or both of these times there is a strong hunger that develops, with recognizable characteristics. The person will generally have a strong urge for food that is calorie dense and that will, at least in part, hit the blood stream quickly. When food is consumed, satiety seems to be dampened or delayed in response.
Under normal appetite conditions (not set-up by prior restriction) one can ‘eye-ball’ in advance fairly well what amount of food to choose as a serving size for a meal or snack that will satisfy. Once most of this serving size is consumed, if the person stopped to think about it they would realize that they are somewhat less hungry. By the end of eating it, or certainly within 20 minutes or so later, they will find that they are substantially less hungry. Even if they still want a bit more, they will feel less hungry than initially – that is, they will feel an effect on their hunger/satiety from what they have eaten. If they then eat more, they will feel progressively less hungry in response.
With re-bound eating, when that serving they have judged for themselves has been eaten, often the person can feel just as hungry as before they ate. It’s like they haven’t eaten at all. If fact, they might feel even hungrier. Several servings may be eaten without feeling much less hungry. It’s like the signalling systems that register food intake have been almost completely shut off. (that’s hint, see below)
This easily results in a net food intake over the day of more calories than the person needs, promoting weight gain. (Unless the lucky person has been blessed with fortunate metabolism that gifts them with a degree of relative resiliency against weight gain.)
When they get up the next morning, they remember they have eaten more than they intended and are determined to make up for it. And what better way to do that and to really get started on some weight loss than to skip breakfast!
The within-week pattern is similar, except the restriction (often with calorie-output-oriented exercise) is on week-days and the re-bound is on the week-end.
Often a lot of coffee is involved, or taking advantage of stress and the morning adrenalin rush as appetite suppressant.
People can be fiercely convinced that this pattern is not only not contributing to their difficulty loosing weight – they can be convinced that it is good for them. They can get really mad if you try to suggest that they test out that idea by even a couple of weeks of trying a different eating pattern just to see if it works better for them.
Doctors who have focused a lot of their practices on weight control know this. Within medical circles, as a group people who have persistent difficulties controlling their weight are famous for their tendency to skip/skimp/delay breakfast and lunch. Doctors and nutritionist get very frustrated with it, although not all would agree with me that it is such a serious or deal-breaker issue. Nutritionists have campaigned against skipping breakfast for decades.
This sounds a lot like binge eating disorder. And it is a lot like binge eating disorder, but they are not identical. Still, this could be an eating pattern that would promote the development of binge eating disorder in someone who was susceptible. Also, such an eating pattern would make it much harder for a person to control their disorder.
This also sounds a lot like what people describe as their experiences with food addiction. Same as above – it is not identical with food addiction, but it might be a factor promoting the development of food addiction in a susceptible person. Food addiction and disordered eating pattern acting together would certainly be a difficult situation for any person to be in. (But what a feeling of relief and accomplishment for them when they break free!)
Does the liver give morning food aversion? When the liver is ‘sick’, often the very first symptom is a lack of appetite or food aversion. Taken a little farther, this becomes nausea. This is just speculation, but I wonder if the aversion to eating breakfast that some people report when they are into this eating pattern might reflect strain on the liver. Perhaps there is some alcohol involved, perhaps there is too much fructose over a short period of time, perhaps there is fatty liver, perhaps stress combined with the large food load causes a flood of inflammatory molecules from the gut over-night – such as from too many food molecules spilling through a leaky gut.
“I’ve always eaten this way and wasn’t over-weight always!” You were younger, or perhaps you were not as stressed or you have since developed some insulin resistance, or you now have poor sleep or you now have pain or now have fatty liver or you now have some food addiction mixed in, or? A simple test trial of changing the eating pattern for a few weeks will show how important the eating pattern is or isn’t.
What about the bottomless hunger? I think it is a parasympathetic re-bound that disables the normal signals that register food intake. The person has been running on adrenalin and cortisol all day, maybe with some coffee, rushing, anxiety, anger, frustration, conflict and exercise along the way. At some point in the later day, often when mentally one is now ‘off-the-hook’ (e.g. they have arrived home) the parasympathetic nervous system (which is responsible for tissue repair and maintenance) just says “enough of that, matey, I’m flipping a switch and you are now going to sit on a sofa, eyes glazed, brain like a zombie, feeding your face”.
The sympathetic system and the parasympathetic system together make up the autonomic nervous system, which runs un-noticed in the background, running all the automatic functions of the body – everything that you don’t have to think about to make it happen – such as your digestion and your heart beat. The sympathetic and parasympathetic counter-balance each other to manage your body functions in response to all the needs, situations and challenges of your life.
When you have a sudden surge in the sympathetic system, we all are familiar with what that is called – the ‘fight-or-flight’ response. For example, think how you would feel if you had just had a minor fender-bender (with no-one hurt). Your heart might be racing, your breath quicker and shallower, your palms sweaty, perhaps your hands shaking, likely with an anxious or jittery feeling. The response runs with a mind of its own, you would have to be extremely skilled to be able to over-ride these physical effects by, say, willing your palms to not be sweaty.
If your parasympathetic system, on the other hand, has a sudden surge of activity, what do we call that? We ignore the parasympathetic system so much that it almost seems like a non-sensical question. If you asked a hundred friends, no-one would have an answer for that. In western society, we do love the sympathetic system. I think one ways that such a surge of parasympathetic activity could be felt is as the master of the re-bound phase of the restrict/re-bound eating cycle..
The way I see it, this is a tissue repair and body maintenance response. The normal systems that your body uses to sense what you have eaten I think are switched off. The relentless stress throughout the day is perceived as a mini crisis and full control is now handed over to the parasympathetic system, now The Boss. The re-bounding parasympathetic system wants simply “lots” of food so you can re-build tissue torn down during the sustained fight-or-flight metabolism you indulged in all day. The piper is to be paid, but the calibration of the re-payment is wonky. You don’t stand a chance.
Intermittent Fasting – Added Oct 23/12 – I wrote what follows in response to a question (on another post) about intermittent fasting and regarding intermittent fasting producing ketosis.
As always and with everything about health, it all depends on who you are and your present circumstances.
Inermittent fasting would produce some amount of ketosis as in “ketones measurable in the blood” – which is not what we mean by the term keto-adaptation (when your body has become adapted to burning fats and ketones as the major fuel supply). I do think that there is probably something important about intermittent day-by-day periods of ketone production – such as not eating in the later evening/overnight and prolonged periods of activity from time to time. I haven’t seen this being discussed, but I speculate that it likely isn’t a good thing that in our modern society people may go years or even decades and virtually never have a time when they go into ketosis (and thus “wake up” the ketogenic machinery and ketone transportation and burning infrastructure). Given how different people are, including the existence of those mysterious people called “slim” despite our modern ways, perhaps for some people this maintenance of more metabolic flexibility may be all the metabolic “tune-up” they need to have a reasonable time controlling their weight.
In the context of ketogenic diets (here, as always, I use the term “diet” for its meaning of “pattern of food intake”), intermittent fasting will deepen ketosis – at least briefly (although there may be considerable cycling of ketone levels depending on the meals consumed). I suspect that this is part of what is going on regarding Jimmy Moore’s quite high ketone levels. However, there can be too much of a good thing and too rapid a transition to a good thing. We need to pay more attention to learning from the experiences of the keto kids and adults in the epilepsy community – where they have learned to treat ketone levels with great respect and have been forced to learn a certain caution and wariness about rapid increases in ketone levels and individual tolerances of different ketone levels. (Book review coming soon of “Dietary Treatment of Epilepsy: Practical Implementation of Ketogenic Therapy”.)
Intentional intermittent fasting can be done 3 ways (1) deliberately not eating for a period of time, despite hunger, (2) truly spontaneous lack of food intake and (3) deliberately not eating for a period of time and telling yourself that you are not hungry. Note that “intentional” means not counting when due to such things as drugs or illness – such as cocaine or flu. Situation “1″, if practiced routinely, is a version of the ever popular “hunger therapy” that disguises itself in countless ways. Some hunger in the 30 – 60 minutes (or so, not to be taken literally as a specific number) before meals is fine and likely healthy (if it doesn’t make your over-all eating goals more tenuous due to emergence of cravings or unplanned eating). Sometimes some hunger is difficult to avoid for a brief period of time while making certain transitions in your eating pattern or lifestyle – meaning occasionally, not as an intentional recurrent pattern. (I use “difficult to avoid” rather than “desirable”.) All versions of hunger therapy carry risk of setting off disordered patterns of eating – although it must be acknowledged that some people have done well over time with calorie restriction and value that choice.
How different is the new darling “intermittent fasting” from the old nemesis “breakfast skipping” that has been infamous as the bane of weight control. It always comes down to “how is that working for you”, which sounds fine, but often it can be surprisingly difficult to know the true answer to that. Depending on how young and how healthy and how much other stress and genetics and past stress exposure (including programming in utero and in infancy) and on and on, a person might do well (or appear to do well) with this over even quite a period of time. There isn’t any kind of testing that can tell you how much stress you are putting on your body and your body control systems with this. If over-done, it can sneak up behind you and bite. Your appetite control system is designed to put a stop to this and doesn’t mind some excessiveness in the rebound. Many an over-weight body has been built by the systematic application of breakfast skimping/skipping. Caffeine and stress both count as “stimulants” that fool people into thinking they aren’t hungry. I think hunger therapy, in all its versions, runs a close second behind high carbs as a major causative factor in the development of the obesity “epidemic”.
What about truly spontaneous periods of not eating for, say 12 – 24 hours? Ketosis does have some appetite suppressing effects and some people may be having a fair amount of ketones if they are generally low carb, or a very high level of ketones is they are generally keto-adapted. Some might also be using stimulants such as coffee or high intensity exercise to suppress appetite. We will have to see over time how people do with this. The body might not send “rebound, please” signals if the flow of fat from fat stores is ample and metabolised well. Trouble is, the fat may not readily come out of the fat stores in all people all the time – or at least not at the high rate required with fasting. When eating to appetite, you will intuitively respond to this by eating, thus preventing over-stressing your body, raiding your muscles for energy, developing cravings or having your metabolism slow. Besides that, some people may not feel well at the suddenly higher level of ketosis.
Finally, I think that calorie restriction is so insidiously woven into our thinking and our culture that it can be at play even when a person isn’t aware of it. For example, one manifestation of this is people telling you that what you’re feeling “can’t be hunger” – because it doesn’t match with their idea of when you should be hungry. Most of this re-labelling of various hunger sensations (not all) is still hunger therapy, under another guise. When people say they are fasting and not hungry – I’m sure some people really aren’t, but I also have my concerns that some may not mean the same thing when they say this. For anyone who has struggled with weight over time, it could be difficult not to hear at least some small inner whisper of “you did good” when some form of calorie restriction is done.
You might be aware of this already, but Stefani at Paleo for Women is quite interested in this topic. http://www.paleoforwomen.com/category/fasting/
Time will bring more insight and knowledge on these topics. Hope this has been of some help. Dr Dea
Added Oct 31/12 – Dr. Vera Tarman has a good post about the pattern of restricting food in the day and saving eating for the evening. LINK