Question: My wife eats one meal a day – usually dinner. She basically starves herself all day long. For breakfast she has coffee. For lunch she has a diet soda or 2 and then eats a regular dinner at about 7pm each day. She is very frustrated because even though she is starving herself she can’t lose weight. In fact she has gained 2 pounds in the past month. I’d like to be able to help her, but don’t know what to say or do.
Answer by Dr. Vera Tarman: Without knowing her history, this information is enough for me to predict a few things: I am guessing that she is probably tired but racy, has difficulty sleeping at night, is hungry and obsesses about food throughout the day (i.e. is counting the hours until dinner), binges at night or has to fight off the urge to eat far more than she planned, and is irritable much of the time. And if she is not gaining weight, she is not losing either. All of these features are a result of a body responding to starvation.
From the biological point of view, starvation is tremendously stressful. The body attempts to rectify this stressful state in several ways. First, the body feels hungry, the first unpleasant prompt to get us to eat. Keep in mind, that if the body does not get food, the brain does not get its glucose and becomes necessarily stressed as a result – witness a diabetic who is suffering from too much insulin. They become irritable, agitated and even violent as their blood sugar drops to dangerous levels. If they do not eat, they could die. Most of us who are not diabetic experience a lesser version of this phenomenon which we call hypoglycaemia: the symptoms are agitation, anxiety, foggy headedness yet feeling racy and wired. Our body is telling us to look for food, asap. The upshot of this is that your wife is stressed for most of the day.
The body will also adapt to the lack of food by deliberating slowing down its base metabolic rate so that fewer calories are needed to function. This means that fewer calories are burned in the attempt to conserve energy, and when the person finally does eat, more calories are stored in the fat tissue – this is the mechanism behind hibernation. This means that less the one eats over time, the more one’s body will try slow down in order to stabilize or even increase one’s weight as soon as food is introduced into the body.
People will often attempt to ‘save’ their daily caloric allotment to the evening time – presumably because they can distract themselves with activities though out the day, as well as drink coffee, soda and water to fill up. Excess coffee in diet soda as well as in multiple coffees acts to stave off hunger but caffeine is not a good solution, as it also boosts adrenaline and stresses the body. This leads to increased fatigue, sugar cravings and irritability over the course of the day.
People are also tempted to delay eating until night time when they are really hungry because they enjoy their food more then. The reward value of food actually increases the hungrier a person becomes. As soon as the person starts to eat, the reward circuitry in the brain is stimulated and the person often finds that the pleasure of the food and the relief of quelling the hunger pains make it hard to stop eating. In this state, it is very easy to eat a day’s caloric content in one sitting.
Notice that people will often say that they aren’t hungry during the day, but the moment they start to eat – they binge, as they realize how hungry they are. The pleasure of the food is enhanced, and people eat more quickly and in large amounts. By the time their hunger ‘thermostat’ Leptin has kicked in to tell them they are full, they have eaten far more than was necessary.
This reward mechanism of food when very hungry makes sense, as the brain is trying to entice the body to eat – it is a survival mechanism. Your wife does not want to set this primal mechanism off more than is necessary. Added to this is the timing of the evening meal. Along with a sluggish metabolism, your wife is eating at a time when her body is least able to burn off the excess calories of the evening meal.
Furthermore, the digestion of her food, intended to occur during her waking hours, will occur instead at night making it difficult to sleep. Lack of sleep further stresses the body, and leads to further weight gain. If a person must eat only once a day, it is far better to eat a major breakfast and eat little or nothing at night.The trick to weight loss, however, is to NOT be hungry (for more than two hours in any case), to ensure that there is ‘fuel’ throughout the day. In this way, the body’s metabolism stays at a steady hum and the person never gets too hungry.
People who eat only once at night may over the long term be actually be inadvertently encouraging a food addiction. Anything that heightens the reward value of a food will make it difficult for a person to appreciate the normal reward value of that food, and thus a person can lose the sensitivity to gage when to stop eating. Under normal circumstances, Leptin, our satiety hormone, is released as we eat. It acts to subdue the rewarding quality of food, so that we want to stop eating. Food addiction hijacks the normal circuitry of the pleasure of eating food, and takes on a momentum of its own, overriding the effect of Leptin and the sense of satisfaction and fullness. The person is left craving and obsessing about food, even when full. They still want more food. In this way, prolonged dieting can lay the groundwork for food addiction.
You also mentioned that your wife drinks diet soda. First of all, while diet soda has no calories, it has a significant amount of caffeine in it, which is problematic. It also contains artificial sweeteners, which have been designated as potentially addictive for some individuals. The sweetening effect of an artificial sweeteners triggers the brain to anticipate sugar, and that anticipation spikes the dopamine levels, giving a reward value to a substance that has no nutritional value. It can encourage a budding food addiction to develop over time. For more insight, there is an excellent post in my blog written by a diet soda addict, “Can Diet Soda Lead To Relapse?”
There are many food plans that your wife can go on, that will help her lose weight while not being hungry and while not craving or obsessing about food. These will help treat someone prevent a food addiction or treat one that already exists. You can find some of these on my website on the “Resources” page.
