Tuesday, April 7, 2015

The Science of Hunger

If you're a veteran of traditional weight loss courses, you've probably encountered the efforts to help overweight people distinguish between a psychological craving and actual hunger. Still, more and more the evidence we're seeing here at Dr. Feiz & Associates is pointing to the very strong likelihood that, especially for severely obese people, the distinctions between these feelings may, very often, be close to meaningless.

An extreme example of what we're talking is exemplified in the case of 13 year-old Alexis Shapiro. Recent news stories have told of the the success of bariatric surgery in treating obesity caused by uncontrollable bouts of hunger. As a 9 year-old, young Alexis had a brain tumor removed. Unfortunately, along with the tumor, doctors also had to remove the brain's hypothalamus, which largely controls the body's appetite and metabolism. The result was a rare condition, hypothalamic obesity, caused by the girl's suddenly uncontrolled appetite.

This syndrome is an extreme example of how powerful the brain is in terms of creating the feeling of hunger, a drive which really can be all but uncontrollable...even if we know intellectually that we've had enough to eat. Indeed, while hypothalmic obesity is rare, it appears that nearly everyone who loses any weight deals with an increase in the production of certain hormones, most notably ghrelin, that tell the brain we're hungry and create a feeling all but identical to actual need-driven hunger. This may be be a major reason why it is so difficult to lose weight and to keep that weight off over the long term.

As we've mentioned many times before, this hormonal link may be a significant reason that a sleeve gastrectomy may be especially effective for many patients.That particular surgery removes a large portion of the stomach, including a section, the fundus, believed to be responsible for the production of ghrelin. All in all, it's a sign that we should be spending a lot less time shaming people with weight problems for gluttony and a lot more time examining the role of the brain and hormones in driving overeating.

In the meantime, if you or a loved one is dealing with severe obesity sustained by persistent feelings of hunger, it might well be time to consider weight loss surgery in Los Angeles or one of our other Southern California offices.

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