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Biology & Treatments for Compulsive Behaviors & Binge Eating | Dr. Casey Halpern

Episode 91 Sep 26, 2022 2h 11m 11 insights
My guest is Casey Halpern, M.D., Chief of Stereotactic and Functional Neurosurgery and Professor of Neurosurgery at the Perelman School of Medicine at the University of Pennsylvania. Dr. Halpern’s research and clinical practice focus on using deep brain stimulation to treat compulsive and movement disorders (e.g., binge eating disorders, bulimia, obsessive-compulsive disorder (OCD) and Parkinson’s disease essential tremor, dystonia). We discuss using deep brain stimulation to help patients who suffer from movement and compulsive disorders and applying this treatment to patients afflicted with binge eating. We also explore applications of this technology to other conditions such as OCD, anorexia and tremor, and the future therapeutic directions of the use of non-invasive brain stimulation approaches, including transcranial magnetic stimulation and ultrasound, for the treatment of other psychiatric illnesses and conditions. This episode will interest those curious about the biology of eating, anorexia, bulimia, compulsive thoughts and behaviors, and movement. For the full show notes, visit hubermanlab.com.
Actionable Insights

1. Cultivate Self-Awareness for Behavior Control

Develop self-awareness to detect internal states that precede cravings, binges, or other problematic behaviors. Recognizing these “pre-behavioral states” is a powerful tool to intervene and improve outcomes.

2. Avoid Highly Refined, Palatable Foods

Be cautious of readily available, cheap, highly refined foods high in sugar and fat, as they can negatively alter reward circuits and increase cravings. Our brains are not evolved to manage constant exposure to such palatable foods.

3. Use Exercise and Meditation for Well-being

Incorporate regular exercise (including strength training and cardio) and meditation into your routine to manage stress, improve sleep, and enhance overall well-being. Consistency, even with app-guided meditation, is key.

4. Follow Cardio and Resistance Training Guidelines

Aim for 180-200 minutes of Zone 2 cardio (e.g., jogging, cycling, swimming) per week and approximately six hard sets of resistance training per muscle group per week. Perform these with proper form to maintain muscle, skeletal, and tendon health.

5. Hydrate with Electrolytes Daily

Ensure adequate hydration and electrolyte intake (sodium, magnesium, potassium) daily, as even slight dehydration diminishes cognitive and physical performance. Consider dissolving one packet of an electrolyte mix in 16-32 ounces of water first thing in the morning and during physical exercise.

6. Reduce Stigma Around Eating Disorders

Foster a kinder, more understanding societal view towards individuals with eating disorders and obesity, recognizing the brain’s vulnerability. Reducing stigma can help prevent embarrassment and feelings of giving up, which exacerbate these conditions.

7. Manage Stressors and Vulnerabilities

Recognize that modern society presents stresses and exposures (like stimulants) that human brains may not be evolved to manage, potentially leading to conditions like OCD or anxiety. Be aware of personal vulnerabilities to environmental exposures and stressors.

8. Practice Meditation or NSDR

Engage in meditation or Non-Sleep Deep Rest (NSDR) sessions, even for short durations like 10 minutes, to restore cognitive and physical energy. These practices involve lying still with an active mind.

9. Prioritize High-Quality Time & Efficiency

Cultivate the skill of prioritizing and making time high-quality, even in busy schedules, by cutting to the chase and being efficient. This trait helps manage stress and maintain connections despite demanding work.

10. Incorporate Incidental Movement Daily

Even when time for dedicated exercise is limited, make a conscious effort to incorporate incidental movement, such as taking the stairs instead of elevators, to maintain physical activity. This can become a beneficial habit over time.

11. Exposure Response Prevention for Compulsions

For compulsive behaviors, consider Exposure Response Prevention (a form of cognitive therapy) to habituate to stressors and reduce compulsions. This involves controlled exposure to the stressor to help the brain adapt and function normally.