Bulimia

lessthanhalf said:

I don't believe every carb affects appetite or hunger the same way. Potatoes get labeled as high glycaemic index, yes, but they also carry very little energy per unit weight — especially the low carb varieties, which sit around 50 kcal/ 100 grams. That makes it genuinely difficult to pack away a huge calorie load from them. Consider that half a kilo of potatoes amounts to just 250 kcal, provided no oil or fat is added. By contrast, 3 slices of bread delivering a comparable carb calorie count go down far more easily and quickly, and they don't leave you as full. To avoid losing weight on potatoes alone you'd have to consume roughly 2 kilos daily, which is a substantial amount and likely beyond what most people could comfortably manage. With bread, on the other hand, it would be very easy to eat enough to gain weight even if it did not include butter or margarine . And based on what I've experienced, plus some experimental confirmation of this, low glycaemic index carbs by definition cause lower glucose peaks, but also cause far less in the way of sudden dips in glucose afterwards, which is presumably the trigger for hunger, or binge eating episodes. I also suspect that the low calorie density of potatoes blunts how much glucose spikes and then dips, even with a fairly high glycaemic index, simply because volume limits how many calories you take in at one sitting.

When it comes to binge eating and bulmia, I can see GLP's helping through several distinct routes. The early satiating effect would presumably reduce the inclination to keep eating after a certain point. The reduction in food noise would reduce general thinking about food as much and lead to less episodes. And the overall reduction in hunger would reduce the basic drive to eat. As well as the alterations in reward circuitry functions, that are thought to reduce many different types of addictive behaviour would help as well. There is no obvious reason they would help with the purging aspects, except by reducing the binging so it is no longer needed.
Click to expand...
I'm not following your point.

Your arguments and the bread analogy all make sense to me, but what caught me off guard was that eating only plain potatoes didn't produce that irritable, hungry edge, whereas a highly processed meal mixing macros frequently does. Unless your point is that a sharp glucose spike by itself can't set off that hangry state unless there's also extra calories involved—whether from that same meal or from what someone's been eating overall lately?
 
I believe the quantity of calories taken in during one sitting is relevant; when more calories are eaten at once, glucose spikes tend to be larger, unless the glycaemic index is zero, so if overall calorie intake is kept down through low calorie density, the peaks ought to be smaller.

After consuming 100 calories of high glycaemic index items, even chocolate that is 50% sugar, I do not appear to experience the intense hunger reaction. Since I do not want to set it off, I have not truly tested precisely how many calories would be required.
 
lessthanhalf said:

I believe the quantity of calories taken in during one sitting is relevant; when more calories are eaten at once, glucose spikes tend to be larger, unless the glycaemic index is zero, so if overall calorie intake is kept down through low calorie density, the peaks ought to be smaller.

After consuming 100 calories of high glycaemic index items, even chocolate that is 50% sugar, I do not appear to experience the intense hunger reaction. Since I do not want to set it off, I have not truly tested precisely how many calories would be required.
Click to expand...
Could it be that we're actually discussing two separate things?

What I have in mind is an intense feeling of hunger that shows up 3-5 hours following a meal, and I brought up that the potato diet never produced that kind of reaction for me, whereas in the past processed food definitely would have. I've never come across anyone blaming calories for that hunger reaction (only the blood sugar spike and dip explanation that keto advocates repeat), but I think you may be correct that calories might be another piece of it. What confuses me is that you're tying the spike/dip to calories rather than to glucose/starch. As far as I understand, it's pretty well accepted that when those extra calories arrive as fat or protein, they usually work to lessen how big the blood sugar spike and dip are (even though they do make it last longer). A lot of diabetics deliberately add fat or protein to a meal heavy in carbs, just to get that dampened blood sugar effect.

A far better documented way calories factor into hunger has to do with prolonged water fasting. There's a commonly cited rough rule that once you're some way into a fast (a day or 2, say), keeping what you take in below about 50 calories at a time lets you avoid "breaking" the fast and continue it. But if you get near or past 50 calories (which I'm sure differs from person to person), you break the fast right away and become extremely hungry almost instantly. I'm curious whether the extreme hunger reaction you mean could be closer to that kind of thing, where the reaction arrives much sooner after eating (rather than hours afterward).
 
No binging = no purging.

Having struggled with eating disorders for the bulk of my life, Reta pretty much fixed the majority of my food issues, and eating no longer brings me any guilt at all. Even if my mind wanted me to, I couldn't binge physically.
 
Back
Top