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H U N G E R M O T I VAT I O N
Thurs day, Se p te mbe r 29 , 20 16
HOMEOSTASIS (see pg. 114, Deckers *not tested on thirst and temperature)
We need both physiologically-based and environmentally-based models to understand hunger and heating
Eating can be strongly determined by incentives and environmental stimuli
Environment is able to override drives, physiological mechanisms and metabolic requirements
Glucose: simple breakdown of carbohydrates (starches and sugars) quick energy source, trigger insulin
response
Lipids (fats): broken down into fatty acids and glycerols (stored in body for future use)
Amino acids (products of proteins): used for growth, repair, energy, and to make neurotransmitters
The CNS can only use glucose
Other cells of the body use glucose (but only in the presence of insulin) and fatty acids
Evolutionarily programmed to eat whenever food is available, and to love the taste of salt, fat, and sugar
o Our ancestors: must eat right away because food may not be available for the next few days
o Sugar is an instant energy source, easily digested and used by our body, distinguish between sweet
edible foods to poisonous foods (e.g. berries)
o Advantageous to be able to attain a lot of food quickly (in case of famine)
o Salt helps us retain water and avoid dehydration
o Foods with more fat also have more energy (calories)
Dopamine system responds to attractive food, makes you want it (e.g. food advertising)
As nutrients are absorbed in the digestive tract, the level of glucose in the blood rises
The pancreas secretes insulin and this allows glucose to be transported into the cells to be used for energy
o All cells are using glucose as fuel at this point
Insulin also allows excess glucose to be converted to glycogen to be stored in the liver and muscles as a shortterm reservoir
a. This energy is easily available to the brain when food is not in the digestive system
b. Several hours after eating, energy in the stomach and intestines is no longer available (resting
metabolism phase) and stored muscle and liver glycogen is now converted to glucose and now used
for energy
4.
If you run out of glycogen (longer period of food deprivation), then fats must be converted to fatty acids for
energy use
5. Fats are not used during the absorptive phase or for short-term use but are stored in case they are ever
needed in the future (e.g. fasting or famine)
Listen to 1:35: chart
Se ns at io ns of hunge r
In stomach: feeling empty, contractions, rumbling (however, stomach contractions not essential for hunger
feelings)
Other sensations: anxiety, weakness, dizziness, tiredness, dry mouth, headache
Insulin surge when you see food in front of you, readily available makes you hungrier
Insulin injection leads to strong hunger feelings
Fasting: normally with food deprivation, youd feel really hungry, but if you go days/weeks without food,
hunger sensations start to disappear
Amount you eat at previous meal affects amount you eat at next meal
Wh at st a rts a me al?
A) Social and environmental cues are powerful determinants of eating
Most of the time, humans begin a meal simply because it is time to eat
E.g. At friends event there are ham& cheese sandwiches available - Its lunchtime, how many quarter
sandwiches would you eat? (4?)
o Now to go to a luncheon with 7 types of sandwiches: now how many quarter sandwiches would you
eat? (one of each?)
o Were attracted to variety more appetizing increases consumption (buffets encourage people to
eat more)
If youre really hungry, satiety signals have to be strong to get you to stop eating
Moderate hunger can be stopped by moderate satiety signals
Why do es f ee d ing st op ?
Issue: feeding stops before nutrients are absorbed. Why?
1. Signals from senses: sight, taste, and odour give meaningful information about calorie intake
o From past eating experiences
2. Stomach distension: feeling full
o Important, but calorie detectors are important as well
o E.g. if you eat food that doesnt have a lot of calories (lettuce, celery) you will have stomach
distension but calorie detectors dont see much energy going in, so you might feel hungry again
sooner
3. Nutrient receptors in stomach: signals that stomach is being filled with food
4. Specificity of satiation:
o Variety increases appetite
o e.g. if youre eating a big plate of pasta: as you continue to eat more of the same food, it starts to
become less palatable, you start to lose your appetite
o But, because of specificity to that particular food, your appetite renews with a new food (thats why
dessert is so appealing)
o Also if you have a lunch out and you have leftovers when you have it again its not as exciting (eating
the same thing for subsequent meals is less appetizing)
5. Satiation of hormones
o CCK hormone
o Secreted by duodenum, fat-rich foods are detected
o Hormone that causes gallbladder to bile (which helps digest fats)
o Suppress feeding in mice (doesnt work as directly in humans)
o If we give CCK injections to humans, it inhibits eating but stomach also has to be some somewhat full
too
o High levels of CCK in bloodstream associated with high degrees of satiety
o Aversion signal to suppress eating, perhaps changing palatability of food
6. Osmotic dehydration: food pulls fluid from body tissues (automatic process)
7. Liver reinforces satiety signals once it starts to receive nutrients (glucose)
o Shutting down feeding, sends signals to brain to reinforce previous satiety signals
8. Memory: brain damage patients whether theyre willing to accept another meal after finishing eating
o Lack of memory (e.g. amnesia, Alzheimers) person may accept 2nd meal soon after 1st meal
o Memory is important in determining whether you accept another meal or not
Ad d it io nal Co ncep t s
Insulin
Allows glucose transfer from blood into cells to give energy and fat for storage
Appearance of food or anticipation of eating can trigger release and high levels of circulating insulin associated
with availability of glucose due to ingestion of food
high amounts of insulin means that youve ingested food, and you also get a surge of insulin when you
anticipate food
Hyperinsulinemia
Oversupply of insulin resulting in reduced levels of glucose in the blood and greater conversion of glucose to
fat storage
Summary: oversupply of insulin, drops blood sugar (glucose) levels, leads to greater feelings of hunger
Leptin
With obesity however, leptin resistance occurs, receptors become less sensitive and the signals are easily
overridden
relative to fat storage
when your leptin levels decrease, maybe you havent eaten much (e.g. sickness, flu, diet), metabolism goes
down (not taking in as much energy), amount of fat you have in your body drops starts to prompt your
appetite
increased leptin means charging up metabolism
o e.g. if youre eating more during Christmas, then the body/brain sense that theres lots of energy
stores, your metabolism might go up a bit during the break
Ghrelin: hunger hormone
if injected with ghrelin, you would feel more hungry (may even have images of food)
HFCS (High fructose corn syrup)
Sweetener (concentrated form of sugar) in soft drinks, processed foods, and often low fat foods
Doesnt trigger satiety signals but adds calories and may trigger hunger instead
METABOLISM
Ene rg y us e
Resting metabolism: used for body maintenance (60-75%) pumping blood, neural activity, etc.
Thermic effect: energy cost of digesting, storing and absorbing food (10%)
o You need calories to digest calories, continues for several hours after a meal
o Protein takes the most to digest (25% of the protein that you eat)
o 5% of the carbs you digest are used to digest it
o 2% of the fats you digest are used to digest it
Physical activity: voluntary movement (15-30%)
Spontaneous activity: fidgeting, stretching, and maintenance of posture (genetically programmed)
NEAT: Non-Exercise Activity Thermogenesis
o Major cause of individual differences in energy expenditure when physical activity held constant
o Listen to 44:00
o Fidget factor: includes fidgeting, spontaneous activity (nothing to do with the amount we walk/run)
o Goes beyond basic body maintenance to account for individual differences
NEAT Experiment:
o Metabolism varies greatly with age and between individuals
o Resting metabolism slow at approx. 2% per decade
o University age men need avg. of 2900 calories per day and women 2100
o However some people can gain weight if they go over 1300 calories, and others do not gain weight if
they eat an extra 1000 per day even over 8 weeks and do not increase exercise
Metabolism INCREASES:
Metabolism DECREASES:
Children have higher resting metabolism, and then it slows down with age
Adults also increase weight with age because theyre often less active than they were as children/teenagers
Body weight is correlated with biological parents (genetics)
Decline in blood glucose instigates eating and high level inhibits eating (at least in animal models; note the
environmental factors and incentives relevant to humans)
Depletion of nutrients stimulates hunger.
1. Receptors in liver and hypothalamus detect drop in level of glucose available to cells hunger increases
2. A reduced amount of fatty acids in storage (particularly a severe drop) induces hunger (also relevant to longterm regulation)
3. If both glucose and lipids (fats) are moderately reduced, consumption is greatly increased
Long term
Set point model suggests that the body regulates itself around a certain leveland adjusts the resting metabolic
rate to reduce energy consumption if less food is consumed
(in the short term, the body also shows increased thermic effect if eating more calories)
Problems with the set point model:
1. Set point = body weight or fat storage?
2. How does the brain monitor deviation from the set point?
3. How ist eh set point fixed and what changes it?
4. There is no rationale why fuel in reserve should be maintained at a specific amount
(Listen to 1:04)
If you fall below the lower boundary, you have feelings of hunger and the further you fall below (e.g. empty
stomach, weakness), the greater the impetus to eat
If you reach the satiety boundary (e.g. feelings of fullness), you stop eating
Between the two biological boundaries is the zone of biological indifference where social factors and
palatability of food determine eating
Normal eaters are assumed to be more responsive to physiological boundaries to determine when to start and
stop eating
Ex. Taste test ice cream
Before we give you the ice cream, heres a milkshake
Predict: if theres a difference between restrained and nonrestrained eaters amount of ice cream they eat
What the hell effect: I had the milkshake, might as well enjoy the ice cream! Tomorrow is another day.
o Or: Im under a lot of stress, so I will have a cheat day and try again tomorrow.
Zone of biological indifference varies between normal eaters, restrained eaters, and people with anorexia or bulimia
Dieters impose a cognitive boundary that often falls short of the satiety boundary
o This diet boundary is under fragile cognitive control and can be easily breached (What the hell
effect)
Diet boundaries can also be removed due to positive moods, negative moods, and stress in restrained eaters
Binge eaters have a higher satiety boundary and/or are unable to stop eating at the usual satiety boundary
o They may only stop when they reach physiological capacity or when interrupted
People with anorexia have a very low diet boundary and feel full easily
o They may be unresponsive to or ignore hunger signals and their zone of biological indifference is
shifted downwards
Make food life mindful. Remove the cues that cause overeating: size bias, priming, distraction, fast eating
In sight, in mind (priming effect):
o When seeing or imagining food temptation, and impulsiveness increases
o Salivation increases and pancreas secretes insulin
o You can keep fruits and vegetables in clear containers, and unhealthy in opaque containers to help
use this to heat healthier
Slim diners have different strategies at buffets (e.g. sit facing away from food, have a look at all foods first
and choose your favourites)
Eating
Redesigning your kitchen: make healthier foods more visible than tempting, unhealthy foods; dont make
kitchen too comfortable with chairs (dont spend as much time there), smaller serving utencils
Never snack and multitask
Half plate rule: way to have consciousness of what youre eating half of your plate has to be filled with fruit,
veggies, or salad (and other half anything you want), and have to do this with each new plate you get as well
Dont bring bread, bring water: when restaurants bring bread, people overindulge
Kids: What would Batman [superhero/best friend/favourite teacher] pick?, then now what do you want?
making them more conscious about their choice (being specific between two choices, and non-judgmental)
Thinking about what a well-liked person would do makes us less indulgently compulsive
Disorders:
Sociocultural pressures on people
75% of women are weight preoccupied
Social values: people associate acceptance, willpower, and maturity with visual appearances
Men: pressures are on body form, musculature, time at the gym
Certain sports: visual appearance is important, or body weight/size is important (categories, competitions,
etc.)
o Gymnastics (women): highest rate of dieting
o Ballet dancers, body builders, wrestlers, diving, figure skating, synchronized swimming, etc.
o Exercise-induced anorexia: less incentive to eat
Anorexia
Diagnostic Criteria:
o Restricting calorie intake leading to weight loss or failure to gain weight
o Significantly low body weight for age, sex, and height
o Intense fear of weight gain (even though underweight) and persistent behaviour that interferes with
weight gain
o Distortion of body image and of their condition
Prevalence:
o 1-2% of general population
o women comprise 90% of cases
o 2.5% of students; young white middle/upper class families
Health consequences
o Cardiac problems including heart failure
o Kidney failure
o Osteoporosis and bone fractures
o Long term digestive problems
o Brain abnormalities: enlarged ventricles and grooves suggesting loss of brain tissue
Prognosis
o 6-18% fatality rate
o 25-50% experience reoccurrence after treatment
o Follow-up after long term therapy shows 29% had good recovery
o Recovery better if caught earlier
Treatment
o Combination of therapies including behaviour modification, cognitive therapy, nutritional counseling,
anti-anxiety drugs or antidepressants
o Periodic checks and long term follow-up necessary
o Family based treatment (Maudsley approach)
One of the issues for families is guilt, blame this approach steps back from that
Severity of illness treat it as a disease, similar to how youd treat a child with cancer (were
there for you, we support you, I know the medicine makes you sick but I need you to take this
medicine) dont blame the child, everyone working together to support
2/3 of patients regained normal weight without having to be admitted to hospital, better family
dynamics, etc.
Some are so resistant to treatment that they have to be hospitalized (treatment programs, intensive therapy)
Bulimia
Diagnostic Criteria
Health consequences
Prognosis
Treatment
o Cognitive behavioural therapy: tends to work quickly but interpersonal therapy and family dynamics is
also often effective after a year or so
o Sometimes SSRI used in treating bulimia
Anorexia notes?
Due to extreme food deprivation the body loses ability to digest and absorb food
Intestines starved of food: when you try to get person to eat, food becomes classically conditioned as aversive
makes patient sick and uncomfortable (low incentive for food)
Uptake of phosphorous and serotonin causes breathing problems, heart problems, feelings of distress
Dont want to eat food but are still preoccupied with food (e.g. may prepare snacks and bake food for friends
but wont eat it themselves)
Serotonin (important): in people that dont have an eating disorder makes you calm and happy
o People with anorexia: serotonin linked with anxiety, rigidity, obsessive compulsive disorder
o Abnormally low in people who are suicidal, depressed
o Abnormally high with people who have anxiety, obsessive compulsive disorders
o Paradoxical effect for people with anorexia: not sure if its an overproduction or if its an oversensitivity
to serotonin, or increased number of serotonin receptors SSRIs when given to people with anorexia, it
lowers the number of postsynaptic receptors over time, because theres lots of serotonin available
o Brain then starts to regulate itself (number of serotonin receptors), but takes about 2 weeks for the
SSRI to work, until weight is closer to normal level
o Restricting food intake seems to be a way for people with anorexia to reduce levels of serotonin
(reduce anxiety, calming themselves, feeling that theyre in control)
Causes and associated factors
Genes vs.
environment
Family
issues
Social
pressures
Personality
issues
Potential
triggers
Anorexia
Bulimia
Age of onset
Early to mid-teens
2.
Dont nag about eating or not eating. Dont spy. People with eating disorders are extremely self-conscious
about their eating habits
Types of Therapy
o Individual therapy
o Group therapy
o Art therapy
o Nutritional therapy
o Drug therapy
o Cognitive behavioural therapy
Anorexia
o Dancers: during anorexia, got more attention, got more parts, nurtured
Exercise-induced anorexia:
o Exercised more than she could consume
o Anxiety is a common trait/disorder (sometimes from childhood)
o Patient took drug that affects serotonin
o Medications like prozac doesnt work on underweight patients
Traits:
o Wanting to be in control
o Worry about consequences of behaviour