← Huberman Lab

Healthy Eating & Eating Disorders - Anorexia, Bulimia, Binging

Episode 36 Sep 6, 2021 2h 13m 18 insights
In this episode, I discuss what drives hunger and satiety, and the role our brain, stomach, fat and hormones play in regulating hunger and turning off the desire to eat more. I also address how protein is assimilated better early in the day than it is later in the day, and why those using intermittent fasting might want to shift their feeding window to earlier in the day. Then I delve into the topic of disorders of eating: Anorexia Nervosa, where people starve themselves and Bulimia Nervosa where people binge and purge their food. I discuss some common myths about Anorexia such as the role of media images increasing the rates of anorexia and the myth of the "perfectionist" anorexic. I also review the symptoms, and the brain and chemical systems disrupted in this condition. I explain how anorexics become hyperaware of the fat content of foods and develop reflexive habits of fat-hyperawareness. Then I discuss the most effective treatments ranging from family-based models to those that target the habitual nature of low-fat/calorie food choices. I also discuss new more experimental clinical trials on MDMA, Psilocybin and Ibogaine for Anorexia, and both their promise and risks I review the latest work on binge eating disorder and brain stimulation, drug treatments and thyroid disruption in Bulimia and why the treatments for Bulimia are so similar to those for ADHD. Finally, I discuss "cheat days," body dysmorphia and the growing list of novel forms of eating disorders start to finish. As always, science and science-based tools are discussed. Read the full show notes for this episode at hubermanlab.com.
Actionable Insights

1. Leverage Knowledge for Change

Understand the underlying mechanisms of your behaviors and decisions, as this ‘knowledge of knowledge’ drives neuroplasticity and can eventually make healthy behaviors reflexive.

2. Define Personal Healthy Eating

Determine what healthy eating means for you by monitoring personal metrics like liver enzymes, blood lipid profiles, body weight, athletic and mental performance, and overall mood, rather than adhering to a universal definition.

3. Prioritize Muscle Maintenance

Actively work to maintain muscle mass throughout your life, as its loss is a major cause of age-related injury, cognitive decline, and metabolic deficits.

4. Ensure Daily Hydration, Electrolytes

Maintain proper hydration and adequate electrolyte intake (sodium, potassium, magnesium) daily, as these are critical for optimal brain and body function and prevent diminished cognitive and physical performance.

5. Prioritize Early Protein Intake

To support muscle hypertrophy and maintenance, ensure you ingest sufficient quality protein and amino acids (especially leucine) early in the day, ideally between 5 a.m. and 10 a.m.

6. Choose Flexible Fasting Schedule

Select an intermittent fasting schedule (skipping morning or evening meals) that best fits your lifestyle and preferences, as current evidence shows no superior option for weight loss or overall health.

7. Intermittent Fasting for Portions

If your goal is weight management, consider intermittent fasting as a strategy, as many individuals find it easier to abstain from eating for periods than to consistently limit portion sizes.

8. Practice NSDR for Energy

Incorporating yoga nidra or non-sleep deep rest (NSDR) into your routine, even for short 10-minute sessions, can significantly restore cognitive and physical energy.

9. Seek Professional Diagnosis

If you or someone you know exhibits symptoms of an eating disorder, consult a qualified healthcare professional for an accurate diagnosis and appropriate treatment.

10. Combine Anorexia Therapies

For anorexia treatment, combine habit rewiring (teaching self-awareness of internal cues and habits) with a family-based therapy model for comprehensive support.

11. Shift Anorexic Exercise Habits

Encourage individuals with anorexia to transition from catabolic (calorie-burning) exercise to anabolic (muscle-building) resistance training, reframing activity as a means to strengthen the body and food as nourishment.

12. Utilize CBT for Anorexia

Implement cognitive behavioral therapy (CBT) alongside habit recognition and rewiring approaches, potentially with pharmacologic therapies, for effective anorexia treatment, especially when started in adolescence.

13. Combine Bulimia Treatments

For bulimia and binge eating disorder, combine behavioral interventions with drug-based interventions for the most effective treatment outcomes.

14. Consider Bulimia Medications

Explore pharmacologic treatments for bulimia and binge eating disorder, such as SSRIs (e.g., fluoxetine), stimulants (e.g., Adderall, Vyvanse), or bupropion (Wellbutrin), to increase top-down control and reduce impulsivity.

Employ calming techniques like the physiological sigh (two inhales through the nose, one long exhale) or mindfulness meditation to reduce anxiety specifically related to eating and food.

16. Avoid Anxious Meal Approach

Strive to approach meals in a calm state and avoid eating when feeling anxious, as this can contribute to a healthier and more mindful relationship with food.

17. Supplement Basic Nutrition

Consider using an all-in-one vitamin, mineral, and probiotic drink to ensure basic nutritional needs are met, address potential deficiencies, and support gut microbiome health.

18. Electrolyte Mix for Hydration

Drink an electrolyte mix dissolved in water first thing in the morning and during physical exercise to easily maintain proper hydration and electrolyte balance.