Can we talk about calorie levels and refeed effects?

[macrophage69alpha]

...bromocriptine...

and other dopamine agonists or MAO-B inhibitors all beneficially affect leptin and neuropeptide Y

cabergoline


selegine + hydergine..


note these will all LOWER PROLACTIN... something that is an issue for women (one that has not been fully explored.. in men this is much less of an issue.. if at all..).. though in many cases lowering prolactin may be beneficial.. but it is a factor that must be considered more thoroughly by women..

 

[MS]

That pretty much sums up what is known, except they didn't look at binge eating non-bulemics, which makes it even more striking.

I disagree with one of their conclusions "The pathological behaviour of patients with bulimia nervosa may result from disturbed NPY release which is the strongest orexigenic factor".
It's a tricky topic when you're trying to disentangle cause and effect, but one could equally conclude that bulemic behaviour CAUSES disturbed NPY release rather than the other way around.

In any event, bulemics certainly have lower leptin levels that BMI matched normal folks, so that method of "refeeding" is clearly not the most efficient approach at resetting a dieters metabolism! Binge eaters have much higher leptin levels than bulemics, but mainly because they tend to end up obese! Mmmmm, moderation in all things????

 

[SteelWeaver]

Niiiiice info coming up here! Cool. This is all good to know.

Can bulimia mess things up permanently? I was bulimic as an adolescent for a few years. Could that have affected any of my "set" levels of hormones and how they deal with things in my body?

And also - if leptin levels are lower in bulimics, isn't that sort of a good thing? Since women's leptin levels are generally higher anyway?

Thanks for the advice for post-comp. MS. I guess I was asking about refeeding for a few weeks, because I was thinking to stay (less) hypocaloric for a few weeks after. I dunno - I just dunno what to do - I'm so far below what technically should be my AMR that it's going to mean like 1000 cal or more jump up - I don't know if it's a good idea to jump that quickly - I was going to try and do it 300 cals per week for 3 or 4 weeks - but to be honest, I don't know if I will be able to do that, mentally. Sigh. And don't think it'll do much for rapid LBM gain either ...

I don't know if I'm putting out that much cortisol - I'm actually feeling strangely at peace. I think finding my trainer, with the very very secure aura that she puts out, helps enormously. And otherwise it's simply a waiting game now ....

And next time, I really will get it right (yeah - I know you've heard that before, but I don't intend to do this this way again if I can possibly help it - it's an incredible challenge, but rather unnecessary. I can find better ways to challenge myself )

 

[macrophage69alpha]

one would venture to guess that bromocriptine might, stressing might, be a potential treatment for some of these eating disorders as low dopamine levels may be a factor (low serotonin is often correlated with binging.. which is why SSRI's have been used to treat this)

dopamine is associated with sense of dominence and control.. many eating disorders are (at least theoretically) associated with compulsion issues related to feelings of LACK OF CONTROL..(ie this purging or starvation allows a form of control) which would seem to indicate low dopamine...

btw- just fanciful musings.. but something that may warrant further delving..

 

[MS]

I dunno if teenage bulemia would have LONG term effects on your metabolism. It's a huge and complicated topic. It IS interesting that you seem to have more of a problem with abdominal fat than lower body fat, and this is the same sort of lipodystrophy seen in a majority of 'recovering' anorexics.

As to the 'why' of eating disorders, it's even bigger and more complicated than the long term effects, mainly because it's tough to say if the bulemia CAUSED the nuerotransmiiter abnormalities, or if an underlying nuerotransmitter imbalance CAUSED the bulemia.

Bromocriptine or SSRIs might help-I believe there have been several threads on the possible usefullness of SSRIs on dieting, and there is no doubt that standard thermogenic stacks work, in part, by boosting dopaminergic activity. This is also the rational for taking tyrosine supps when dieting. There is mounting evidence that SSRIs (with longer term use) also increase noradrenergic and dopaminergic activity, but for some reason women generally respond better to SSRIs than noradronergic/dopaminergic drugs (such as bupropion, MAOIs...).

In any event, most nuerotransmitter levels will be reduced by long term caloric restriction, so it's no surprise that boosting these chemicals (via bromo, SSRIs, CARBS, tyrosine, tryptophan or whatever) results in improvement of symptoms of anorexics and bulemics.

 

[JJFigure]

None of the articles on bulemia I browsed through went into the long term effects on hormones - might have to do another search. I was surprised that bulimics are normal or above normal in weight - I guess I expected the range to be below normal to normal.

Also, wouldn't purging/use of laxatives increase cortisol? That seems like a lot of stress to put your body through, especially when the clinical definition of a "purging" bulimic is someone who purges 3+ times/week.

 

[starfish]

None of the articles on bulemia I browsed through went into the long term effects on hormones - might have to do another search. I was surprised that bulimics are normal or above normal in weight - I guess I expected the range to be below normal to normal.

Also, wouldn't purging/use of laxatives increase cortisol? That seems like a lot of stress to put your body through, especially when the clinical definition of a "purging" bulimic is someone who purges 3+ times/week.

Does purging really work anyway???

SSRI's causedme to crave massive carbs and gain weight. In the short time I researched it, I found that to be a major complaint in people. Much more than people think.

 

[JJFigure]

Leptin, neuropeptide Y, and peptide YY in long-term recovered eating disorder patient

Here's another abstract I found - doesn't look like bulimia impacts long-term hormonal balances.

Here's the link too:
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=10418705&form=6&db=m&Dopt=b


Leptin, neuropeptide Y, and peptide YY in long-term recovered eating disorder patient

Gendall KA, Kaye WH, Altemus M, McConaha CW, La Via MC.

Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, PA 15213-2593, USA.

BACKGROUND: Disturbances of leptin, neuropeptide Y (NPY), and peptide YY (PYY) have been found in women who are ill with anorexia or bulimia nervosa. It is not certain whether peptide disturbances are cause or consequence of eating disorders. METHODS: Plasma leptin and cerebrospinal fluid leptin, NPY, and PYY concentrations were measured in women who were recovered from anorexia or bulimia nervosa to determine whether alterations persisted after recovery. RESULTS: NPY, PYY, and leptin concentrations were similar across all diagnostic groups. CONCLUSIONS: Alterations in NPY, PYY, and serum leptin concentrations are probably secondary to pathological eating behaviors. Alterations of these peptides are unlikely to be trait-related disturbances that contribute to the etiology of eating disorders.

 

[MS]

Yes, that is the current best theory about eating disorders. They are MAINLY psychiatric rather than organic in origin, and the eating behaviour alters nueroendocrine function rather than the other way around (which is why I disagreed with the conclusions of that first article you posted).

As for bulemics being normal weight, this is not really a surprise when you think about bulemics in comparison to binge eating disorders. The only behavioural difference between the two disorders is that the bulemics keep down less of the calories they eat on a binge. If this didn't happen, they almost certainly WOULD be fat. So in some respects you'd have to say that purging prevents them from getting fat, but it doesn't make the lean!

 

[SteelWeaver]

Well, I guess if the binge causes a surge in insulin, that would certainly prevent any fat burning from happening, even if the calories themselves don't stay down.

But SOME of those calories must stay down - if a binge lasts an hour, say, within the first 20 mins a bunch of carbs could easily have been absorbed, couldn't they?

And how long would the insulin float around after purging?

JJ - I think the cortisol comment was aimed at my current somewhat extreme diet situation - I'm not actively bulimic now. I have had occasional relapses in times of extreme stress in the past decade or so (it amazes me how easily one can slip back without thinking), but I'm frankly not interested in punishing my body more than I have to, or in ways that are so patently unhealthy.

Does the body pump out cortisol in reaction to low calories? Or is it the stress of dealing with the cravings that causes cortisol release? Or both?