The Link Between ADHD & Obesity
Summary
TLDRThis script delves into the intricate connection between ADHD and obesity, highlighting how altered reward processing in ADHD can intensify food cravings but reduce satisfaction, potentially leading to obesity. It explores the hormonal activity of fat cells, which can exacerbate ADHD symptoms. The speaker suggests that by managing emotions and cravings through mindful eating, avoiding impulse purchases of unhealthy food, and daily emotional regulation, individuals with ADHD can mitigate both conditions. The script also underscores the importance of understanding these interconnected neurological mechanisms to develop effective treatment strategies.
Takeaways
- đ§ ADHD and obesity are interconnected conditions influenced by the mind-body connection, with each condition potentially exacerbating the other.
- đ ADHD's altered reward processing can lead to increased food cravings and a higher likelihood of obesity due to a potent dopamine release from food.
- đ« The satisfaction derived from food is lower in individuals with ADHD, which can lead to overeating in an attempt to achieve the same level of satisfaction as neurotypical individuals.
- đ Adipose (fat) cells are hormonally active and can produce chemicals that worsen ADHD symptoms, such as by interfering with brain-derived neurotrophic factor (BDNF).
- đ In ADHD, the prefrontal cortex is altered, leading to increased food cravings but a decreased reward from food consumption.
- đïžââïž Impulse control difficulties in ADHD mean that the gap between the idea of eating and the act of eating is smaller, making it harder to resist food cravings.
- đ Emotional dysregulation in ADHD can amplify sensitivity to dopamine, leading to increased cravings for food as a means of emotional relief.
- đœïž Savoring food and avoiding distractions during meals can help increase the reward from food and counteract the reward processing deficit in ADHD.
- đ« Limiting the availability of unhealthy, packaged foods can help manage impulse eating behaviors in individuals with ADHD.
- đȘ Daily emotional management is crucial for individuals with ADHD and obesity, as it can naturally reduce the drive to eat unhealthy food.
- đââïž Exercise can help combat insulin resistance and improve overall physiology, which is beneficial for individuals struggling with ADHD and obesity.
Q & A
What is the connection between ADHD and obesity as discussed in the script?
-The script suggests that ADHD and obesity are tightly connected due to altered reward processing in ADHD, leading to increased food cravings and a higher likelihood of obesity. Additionally, fat cells are hormonally active and can produce chemicals that worsen ADHD symptoms.
How does the dopamine release from food affect individuals with ADHD differently?
-In individuals with ADHD, the dopamine release from food is more potent, leading to increased cravings. However, there is a dichotomy where the satisfaction derived from food is actually lower, requiring more intake to achieve the same level of satisfaction as a neurotypical individual.
What is the role of brain-derived neurotrophic factor (BDNF) in ADHD and obesity?
-BDNF is a chemical that stimulates neuron growth and is associated with a lower likelihood of developing ADHD in children. However, the size of adipocytes (fat cells) in obesity can interfere with BDNF function, potentially worsening ADHD symptoms.
How does the prefrontal cortex (PFC) in ADHD affect food cravings and satisfaction?
-The PFC in individuals with ADHD is altered, leading to increased food cravings (anticipation signals). However, the actual satisfaction derived from eating is decreased, creating a cycle of intense cravings and lower satisfaction.
What is the impact of altered inhibitory control in ADHD on impulse control related to food?
-Altered inhibitory control in ADHD makes it difficult for individuals to restrain impulses to eat, especially when the idea of food enters their mind. This gap between idea and action is smaller in ADHD, leading to immediate action on food cravings.
How does emotional regulation in ADHD affect eating habits?
-Emotional dysregulation in ADHD can intensify the experience of negative emotions, which can, in turn, amplify sensitivity to dopamine and food cravings. This can lead to overeating as a means to manage emotions, contributing to obesity.
What strategies are suggested in the script to counteract the neurological mechanisms linking ADHD and obesity?
-The script suggests savoring food without distractions, avoiding the purchase of unhealthy pre-packaged food, and managing emotions daily through activities like journaling, therapy, or meditation.
How can savoring food help individuals with ADHD improve their food reward?
-Savoring food with full attention and intention can increase the food reward in individuals with ADHD. This practice can counteract the decreased satisfaction from food by enhancing the experience and appreciation of eating.
What is the significance of the hormonal activity of adipocytes in the context of ADHD and obesity?
-Adipocytes are hormonally active and can produce chemicals that affect the brain and behavior. In obesity, these cells can increase inflammation and affect insulin metabolism, which can worsen ADHD symptoms and contribute to a cycle of overeating.
How does the script relate the concept of dissociation to emotional dysregulation and eating behaviors in ADHD?
-The script suggests that dissociation, a lack of awareness of one's emotional state, can lead to emotional dysregulation in ADHD. This, in turn, can drive overeating as a means to cope with unrecognized negative emotions.
What is the role of exercise in managing both ADHD and obesity as discussed in the script?
-Exercise can help counteract insulin resistance and improve overall physiology, which is beneficial for weight management. Additionally, it can have positive effects on brain function and emotional regulation, aiding in the management of ADHD symptoms.
Outlines
đ§ Mind-Body Connection Between ADHD and Obesity
The paragraph discusses the correlation between ADHD and obesity, highlighting the mind-body connection. It explains that the severity of ADHD symptoms in childhood can predict the likelihood of obesity in adolescence. The altered reward processing in ADHD, which leads to increased sensitivity to the pleasure derived from food, is a significant factor. Additionally, the paragraph delves into how hormones from fat cells can exacerbate ADHD symptoms, particularly mentioning the role of brain-derived neurotrophic factor (BDNF) and its interference by adipocytes.
đȘ ADHD and the Struggle with Food Cravings and Reward
This section explores the unique challenges individuals with ADHD face regarding food cravings and reward processing. It contrasts the intense cravings for food in ADHD with the diminished satisfaction derived from eating, leading to overconsumption. The paragraph also touches on the role of the prefrontal cortex (PFC) in ADHD and how it contributes to increased anticipatory signals for food cravings, but a reduced dopaminergic response upon eating, creating a dichotomy between desire and fulfillment.
đââïž Impulse Control and Emotional Regulation in ADHD
The paragraph examines the difficulties in impulse control and emotional regulation associated with ADHD, particularly in the context of obesity management. It describes how the gap between the idea of eating and the act of eating is smaller for individuals with ADHD, leading to immediate action on food impulses. Furthermore, it discusses the amplified sensitivity to negative emotions in ADHD and how these emotions can intensify cravings and the desire for dopaminergic reinforcement from food.
đ« Strategies for Managing ADHD and Obesity
This section presents strategies to counteract the neurological mechanisms linking ADHD and obesity. It emphasizes the importance of savoring food to increase the reward of eating, avoiding distractions during meals, and managing impulse control by eliminating easily accessible unhealthy food options. The paragraph suggests that making unhealthy food preparation labor-intensive can help control impulsive eating behaviors in individuals with ADHD.
đ§ââïž Emotional Regulation as a Key to ADHD and Obesity Management
The paragraph underscores the importance of daily emotional management for individuals with ADHD and obesity. It points out that emotional regulation skills, awareness of negative emotions, and the tendency to dissociate during emotional experiences are interconnected with eating behaviors. The speaker recommends integrating emotional processing activities into daily routines to reduce cravings and improve impulse control related to food.
đ€ Hormonal Impact of Adipocytes on ADHD
This section delves into the hormonal activity of adipocytes, explaining that they are not merely storage cells but endocrine cells that produce hormones affecting ADHD. It discusses how inflammation caused by adipocytes can decrease BDNF levels, affecting brain function and potentially worsening ADHD symptoms. The paragraph also explains the role of insulin resistance in obesity and its impact on nutrient signaling and satiety.
đ± Anti-Inflammatory and High-Fiber Diet for ADHD and Obesity
The final paragraph suggests dietary and lifestyle changes to address the intertwined issues of ADHD and obesity. It recommends consuming anti-inflammatory foods and those that positively affect insulin metabolism, such as green tea and ginger. The paragraph also advocates for high-fiber, high-volume foods to leverage gastric stretch and induce feelings of fullness, as well as regular exercise to combat insulin resistance and improve overall health.
Mindmap
Keywords
đĄADHD
đĄObesity
đĄMind-Body Connection
đĄDopamine
đĄReward Processing
đĄImpulse Control
đĄEmotional Regulation
đĄBrain-Derived Neurotrophic Factor (BDNF)
đĄInflammatory Markers
đĄInsulin Resistance
đĄGastric Stretch
Highlights
ADHD and obesity are interconnected conditions influenced by altered reward processing and hormonal activity of fat cells.
Children with more ADHD symptoms at a young age are more likely to be obese in their teenage years.
ADHD is associated with increased food cravings due to altered dopamine release, but decreased satisfaction from food.
Fat cells produce chemical signals that can exacerbate ADHD symptoms, such as reducing brain-derived neurotrophic factor (BDNF).
Neuroscience reveals differences in the brain of individuals with ADHD, affecting reward processing and impulse control.
People with ADHD have a harder time restraining impulses to eat due to a smaller gap between idea and action.
Emotional dysregulation in ADHD can amplify sensitivity to dopamine, increasing cravings for comfort food.
ADHD and obesity can be managed by savoring food and avoiding distractions during meals to increase food reward.
Eliminating easily available unhealthy packaged food can help control impulsive eating in ADHD.
Daily emotional management is crucial for individuals with ADHD and obesity to reduce cravings and improve impulse control.
Fat cells' hormonal activity can negatively impact brain function and contribute to ADHD symptoms.
Inflammation caused by adipocytes can decrease BDNF levels, affecting brain development and ADHD severity.
Insulin resistance due to obesity can impair satiety signals, leading to overeating in individuals with ADHD.
Exercise can improve insulin sensitivity and counteract the negative effects of a sedentary lifestyle on ADHD and obesity.
Eating high-fiber, high-volume foods can create a feeling of fullness and aid in weight management for those with ADHD.
Professional guidance is recommended for adopting an anti-inflammatory diet to support ADHD and obesity management.
Improving ADHD management can lead to better weight control, and vice versa, indicating a synergistic relationship.
Current clinical trials often exclude individuals with ADHD, leading to interventions that do not address both conditions effectively.
Understanding the neuroatypical mechanisms at play allows for targeted approaches to manage both ADHD and obesity.
Transcripts
today we're going to talk a little bit
about ADHD and
[Music]
obesity now generally speaking we think
of these two diseases is unlined but the
more that we're learning about medicine
the more we're realizing that there is a
Mind Body Connection and what we're
seeing sort of really speaks to the
connection between these two diseases or
conditions so just as an example the
worse your ADHD is at the age of let's
say six or seven the more symptoms of
ADHD you have the more likely you are to
be obese at the age of 16 so it turns
out that these two conditions are very
tightly connected because in ADHD we
have altered reward processing which
means that the dopamine release that we
get from food is much more potent and is
much more likely to lead to obesity on
the flip side we tend to think of fat
cells or adipocytes as cells that are
just storage but they're not storage
they're actually hormonally active and
it turns out that fat cells
actually produce certain chemical
signals that will worsen ADHD as a
simple example of this there's this
chemical called brain derived
neurotrophic factor which is something
that literally stimulates growth of
neurons and what we know is that kids
who have low bdnf are more likely to
develop ADHD and it turns out that the
more fat cells you have the larger your
adipocytes actually are the more that
they interfere or stop the uction of
bdnf so let's dive a little bit into the
Neuroscience because the Neuroscience
will show us how the brain of someone
with ADHD is a little bit different and
give us new options for things to do
that we don't even bother with in
neurotypical individuals because they
don't have the ADHD deficits so let's
start with some features of ADHD number
one is reward processing so we know that
the dopaminergic circuitry in people
with ADHD is different it's more
sensitive in some ways and specifically
when it comes to food we discover one
really interesting thing so anticipation
signals I.E cravings for food is
increased okay so this comes from the
PFC so the PFC is altered this is a
prefrontal cortex in people with ADHD
and now this would be fine this isn't
that big of a deal but this is where
kids with ADHD really get screwed so the
food reward is actually decreased okay
so this is something that's very very
fascinating this is very different from
what most people expect so most people
assume and this is true in some ways
okay that if I eat some unhealthy food
since my dopaminergic circuitry is more
sensitive I get more dopamine that's
true and we'll get to that in a second
but there's one really interesting
dichotomy in ADHD which is that the
Cravings that you get are more intense
but the satisfaction you get from food
is actually lower so let's say that I'm
a neurotypical person so I see I don't
know like a cookie and so when I see the
cookie I get a craving score of five
five and then I eat the cookie and I get
a satisfaction score of five so this is
good right I want to eat the cookie the
cookie looks really good I eat it I
really get satisfied everything is great
now if we look at someone who has ADHD
and they see a cookie this is what
happens their craving score becomes a 10
but their satisfaction score becomes a
2.5 so what are the implications of this
the first implication is that you want
food more but food is less satisfying so
if we look at the brain of someone who
has ADHD what does the brain of ADHD
want so in this case we just need one
cookie to satisfy our anticipation or
craving but if you really look in the
brain of someone who has ADHD we need
four cookies to satisfy this very
intense craving so literally the reward
that you get from food is reduced so the
way that I kind of understand this is
this is a little bit like a skeleton
who's eating food so I remember I saw a
cartoon many many years ago of a
skeleton who is very hungry and what
they keep doing is they keep on putting
food in their mouth but there's no
stomach there's no digestion there's no
satisfaction so no matter how much they
eat they never really feel full or get
the benefit of eating and this is
literally what we see due to alterations
in the PFC in ADHD increased Cravings
lower dopaminergic response from receip
of food hey y'all if you're interested
in applying some of the principles that
we share to actually create change in
your life check out Dr K's guide to
mental health it combines over two
decades of my experience of both being a
a monk and a psychiatrist and distills
all of the most important things I've
learned into a Choose Your Own Adventure
format so check out the link in the bio
and start your journey today the second
thing that we see is altered inhibitory
control so this we kind of understand
right so one of the problems in ADHD is
that people have impulse control
difficulties so if I get an Impulse
let's say I I see some kind of food it's
very difficult if I get the impulse if I
get the thought of eating it it is very
hard for me to restrain this impulse and
so part of the challenge if you're doing
like obesity management is we can sort
of tell people hey like you know the you
should eat healthy like make sure like
you know you you don't eat as much
unhealthy food and then the neurotypical
brain is able to restrain their impulses
more so in ADHD we have a slight problem
because the second that the impulse
enters your mind if the idea of food
enters your mind then you will eat the
food the gap between idea and action for
people who have ADHD is way smaller so
if we look at the neurotypical person we
have the idea of food and then the act
of eating is further away okay so this
means that they have more ability to
restrain their impulses the second
problem that we have the third problem
that we have is altered emotional
regulation okay so we need a little bit
of Neuroscience for this so we have this
part of our brain called the amydala and
the amydala is connected more broadly to
something called the lyic system so this
is where we feel negative emotions okay
then over here we have the nucleus
accumbent which gives us dopamine and
reinforcement anticipation okay so let's
just understand dopamine circuitry real
quick so let's say I have a stimulus if
the stimulus activates the nucleus
succumbent we get a dopamine release and
dopamine then goes to other parts of our
brain and does three things the first is
it makes us feel pleasure the second is
it increases Cravings of whatever the
stimulus is so this makes sense right so
if I eat a cookie for the first time oh
my God the cookie was so delicious what
does that make me do the next time I see
a cookie I will have a craving for it
the next thing that'll happen is that
it'll increase behavioral reinforcement
so this is kind of related to the cookie
so not only will I want the cookie but
it is more likely that I will eat a
cookie next time okay so this is the
dopam energic circuitry basically how it
works now what we also know in people
with ADHD So This is highly sensitive in
ADHD which means that the dopamine
signal the anticipation and the
reinforcement that we get is Amplified
so there's another problem in ADHD which
is emotional disregulation so what does
this mean so people who have ADHD feel
negative emotions more intensely so
literally like if something happens
let's say someone cuts me off when I'm
driving let's say this normally leads to
a in a neurotypical person this leads to
five units of anger in someone with ADHD
this will lead to 7.5 units of anger
okay so we literally know that these
parts of the brain are more jittery and
are easier to activate there's another
problem so not only do we feel things
more intensely we also feel the emotion
for a longer duration okay so not only
am I angry at units of 7.5 but I'm angry
for the next hour so we sort of know is
that this emotional disregulation has
even been hypothesized as a subtype of
ad DHD so for some people this is
actually their primary symptom now this
creates a specific challenge in food
because these two circuits in ADHD are
not unlined in fact they're synergistic
so what this means is that people who
have ADHD in their brains anytime they
have negative emotions this actually
amplifies their sensitivity to dopamine
so what does this mean on a practical
sense so let's take a look at what this
practically means the first is I have my
ner typical kid okay then I have my kid
with ADHD who is happy and then I have
my kid with ADHD who is sad so in
scenario number one kid sees a cookie
neurotypical kid kid eats cookie kid
gets five units of dopamine okay five
units of craving all right and five
units of dopamine now let's take our
happy kid so happy kid sees a cookie
this is 8hd Happy Kid okay so CES a
cookie gets 10 units of craving and gets
2.5 units of of dopamine from eating it
so already I have to eat four times more
cookie than a neurotypical kid now let's
take an angry kid or sad kid so now what
happens is if I've got negative emotions
this is going to amplify this effect
twofold so what this means is when I've
got negative emotions I need something
to make me feel better so I will get 20
units of craving so now this anger this
negative emotion needs some kind of
relief so crave this cookie even more
because as soon as I activate my
dopaminergic circuitry it will help me
feel better so I may still get only 2.5
units of dopamine but my craving is now
induced so now what happens is anytime
I'm angry or sad or have some kind of
negative emotion I need to eat eight
cookies in order to not only give myself
some amount of pleasure but since I have
so much more craving so much more
negativity I sort of have to treat that
negativity using this dopaminergic
stimulus and this is in a nutshell why
kids with ADHD are four times as likely
to be obese compared with typically
developing kids what happens is our
brain is designed in this way where it
becomes sensitive to negative emotions
which we have difficulty controlling we
are more sensitive to Cravings we get
less receip of food so we have to eat
more and so this is a basic basic
problem now before you think oh my God
Dr K does that mean I am screwed I am
no there's good news so let's
look at a couple of things that we can
do because there are new interventions
that we can use that will counteract
these neurological mechanisms so number
one is the problem is that food reward
is actually decreased okay so what can
we do there are two reasons for this so
what we need to do is Savor our food
huge huge huge huge huge important thing
the more that you intend intentionally
and attentionally Savor your food this
food reward will get increased so if you
look at people with ADHD what do they
love to do while they're eating not just
people with ADHD everybody right
everybody loves to watch YouTube listen
to a podcast oh we're being efficient
we're being so efficient I can't waste
my time eating oh my God that's 30
minutes where I'm not learning Spanish
or learning to code or having fun I'm
going to work after I'm done eating so
let me have my break let me watch a
little bit of Sports while I have my
meal right this is what we think so as
we watch this kind of stuff as we have
some kind of dopaminergic stimulus or
some kind of distraction it decreases
our attention and if it decreases our
attention on eating we are going to
decrease our food reward when you go to
the movie theater they give you a
bucket of popcorn with like 128
o of soda these gigantic jugs of stuff
and you sit there because the movie is
so damn good and you don't get any
receipt of your food reward so there are
two things that you need to do which
will help a lot the first is Savor your
food really sit there and enjoy it taste
it notice the food as much as you can
simply noticing will increase the
receipt of the food signal second thing
that you can do is do not distract
yourself don't do anything while you eat
because then your brain is so
distractable to begin with it's not
going to pay attention to anything that
you're eating so if you want to counter
this reward processing deficit or change
in ADH Savor your food and don't eat
anything don't do anything else while
you're eating second thing altered
inhibitory control okay what this means
is that the idea and the action are
going to be way closer in ADHD so what
we really need to do is space those out
so practically what I tell my patients
with ADHD is no
unhealthy available
packaged food okay so what does this
mean this means that if you buy it and
it is sitting in your pantry you will
eat it without realizing you will eat it
on an Impulse you cannot control whether
you eat it on an Impulse or not so what
I tell all of my patients and what works
really well for them at the very
beginning I was saying don't you know
stop eating cookies and that didn't work
and then we discovered something really
cool you can Absolut absolutely eat
cookies but don't buy cookies make
cookies so if you want to eat something
unhealthy unhealthy food requires work
this is the key thing we're not cutting
out unhealthy food because that's that's
mean it's cruel oh you poor kid who's
obese with ADHD no more cookies
for you no bro girl go ahead and have
cookies but just make them bake them
from scratch buy the flour buy the brown
sugar buy the chocolate chips we want to
increase the gap between an impulse and
a reward and what I find when I work
like this with my patients is they are
actually totally fine it's like awesome
like okay it's Friday evening I've had
dinner I feel like having a cookie so
what I'm going to do is bake a
batch of cookies that takes 30 or 45
minutes it's way healthier there's none
of this processed crap in it we'll get
to that a little bit but this actually
works really well so do not buy packaged
unhealthy food that is easily available
the only packaged stuff that you are
allowed to buy or the only stuff that is
easily available for you is healthy
things all of your unhealthy food should
be made so even if you want to make
fried chicken don't buy Frozen nuggies
don't buy Frozen tendies chop up
that chicken breast make your egg wash
grab your breadcrumbs and fry that
up man like have it and it's going to be
delicious it's going to be good it's
going to be way healthier anyway okay
this is critical you cannot win this
battle when you are fighting it this
battle is won logistically before you
even show up on the field of battle it's
one through Logistics ahead of time
third thing altered emotional regulation
what can we do to fix this we need to
move this way so this is a prime example
of one of the biggest problems that I
see with endocrinologists treating
obesity I'm not trying to dog on them
they're doing a fantastic job they have
great outcomes whatever right so I'm not
saying they're doing a bad job this is
just a weakness of our field of medicine
where we've over specialized in bread
and weakness so if you're trying to
control your food impulses what you
really need to do is control your
emotions so if we look at studies on
people who are binge eaters what we
discover is Three core changes when it
comes to emotions the first is that they
have poor emotional ulation skills okay
the second is that they are almic so
they are not aware that they are even
feeling negative emotions you don't even
know exactly what's going on you're kind
of like your mind is wandering all over
the place this is sort of why I see with
my patients with ADHD they're like mind
is all over the place they have so many
things to take care of they feel like
they need to they're under a lot of
pressure right that's what they really
describe they don't describe sadness or
shame or fear or anxiety they're like I
have a ton of to do that's what
their subjective experience is and what
is that that's some kind of negative
emotion it's fear of the consequences if
I don't do it right it's anxiety it's
even perspective shame if I don't do
this right oh my God I'm going to feel
so bad everyone is going to think I'm
pathetic everyone is going to hate me no
one's going to want to be my friend all
of these emotions are going on they're
not aware of it what do they feel they
feel pressure more than anything else so
they are unaware of their internal
emotional state and then what happens is
their brain their amydala knows that
there is shame there's fear there's
anxiety there's Panic there's even some
amount of anger right oh my God how did
I get into this situation why do I
always do this to myself right you feel
all these negative emotions but you're
not aware of it all you feel is pressure
and so then the brain of the ADHD person
realizes okay we have all this negative
emotion we need to get this under
control boom let's go to the nucleus
cumbin baby let's go let's get some of
those cookies let's manage that emotion
CU we need to manage that emotion we
have to do we can't afford not to
eat unhealthy today because we have so
much things to do so we literally find
three features in the brains of people
luing poor emotional regulation skills
Alexia which is emotional colar
blindness we have a whole lecture on
that we've got guides on that it's
really really important third thing is
really fascinating these people
literally dissociate oh interesting so
when you dissociate let's see oh
fascinating we are not aware of the food
reward so interesting right so what
happened is 30 years ago people did
brain scans on people who binge and like
wow these people are dissociating we
didn't understand the mechanism now we
understand the mechanism there is a lack
of attention literally that's what
dissociation is is to not be aware in
experiencing what is going on in your
life so what do we need to do to correct
this problem what we need to do to
correct this problem is manage our
emotions so what I recommend in my
patients who are ADHD and obese because
they don't see the problem as emotions
right they see the problem as impulse
behaviors they see the problem as
willpower they see the problem as
attentional deficits emotions aren't
even on their radar right so i' I've
heard of very few endocrinologists who
when someone comes in who's overweight
first of all they may not even do an
ADHD evaluation right because we're here
for weight management and secondly
they're not going to say like okay
what's your emotional regulation uh
Management on a daily basis how do you
manage your emotions every single day
that's not a part of obesity treatment
and I'm not dogging on the
endocrinologist because these people
studied for like 3 years in fellowship
and went to some weight management
clinic it's not a standardized part of
our treatment because that's Psychiatry
it's over there so what we need to do if
we have ADHD and obesity is daily
emotional management right I don't care
if you Journal I don't care if you go to
therapy I don't care if you meditate I
don't care if you go for a walk I don't
care if you take your dog out for a walk
or you cuddle your cat or whatever but
everyone who is struggling with ADHD and
obesity must must have some kind of
daily emotional processing cleaning that
stuff out it'll make it'll reduce this
craving literally neuroscientifically
it'll make it easier for you to eat okay
and it's not even that once again is a
battle that we're going to win The
Battle Before we ever show up on the
battlefield as you regulate and take
care of your emotions your drive to eat
unhealthy will naturally go down the
reinforcement of that behavior will
actually decrease if you manage your
emotions what that means is that your
Cravings will decrease the pleasure that
you get from the unhealthy food will
decrease all by managing your emotions
okay there's a lot of good stuff that we
can do hey y' I want to take a second to
talk about star Forge PCS so I am in
love with these Game Machines because I
love gaming the problem is that I
started building PCS when I was 12 and I
just don't have the time for it anymore
and if you really think about it like
sure you can keep up with all the trends
and stuff but chances are especially if
you're a healthy gamer you may have
better things to do with your time so if
you're like a college student I love
that they have the horizon line which is
like more economical really solid gaming
PC and instead of like spending 15 hours
following trends like you know study
your for your final and like get a
better grade and then get a better GPA
then get a better job and then go live
your life so if you're like me and
you're like a professional and you want
a really solid gaming PC because you're
a gamer but you also don't want to waste
the time to figure out what's good and
what's not I highly recommend star Forge
all of their PCS are built in Austin by
Gamers who really know what they're
doing and if you're like me like you
build a PC once every 3 years and you
screw up the gel on the heat sink if you
know what I'm talking about you know
what I'm talking about all this kind of
crap you don't have to worry about
they're going to do everything for you
it'll be a solid PC it'll run your games
and this is the crazy thing every single
one of their PCS I've ever used also run
Zoom at top specs so check out star
Forge I absolutely love
him now we're not done we're just
halfway and this may be way too long but
hey this is like important to understand
so now let's talk about obesity all
right so the first thing to understand
about obesity is that adipocytes are not
fat storage cells this is what we used
to think we think oh my God your fat is
just energy storage it's just sitting
there no no no we have a whole video
about this fascinating adipocytes are
hormonally active oh my goodness so I
want you to think about it this way
adipocytes are Endocrine cells what are
your other endocrine organs of the body
your testes your ovaries so what this
means is that when we have someone who
is obese they're eposides they usually
don't have more adipocytes the
adipocytes just grow so if we double the
volume of adipocytes it's like doubling
your ovaries doubling your testes we see
spikes in hormonal production and all of
these hormones will affect the ADHD so
let's start with a couple of core
mechanisms okay the first is increased
inflammation okay so what we literally
know is that adipocytes produce
something called il6 so il6 along with
il1 il10 t tumor necrosis fa Factor
Alpha there are all these so inter
lucans are chemical signals that
activate immune cells okay that's what
these are so these will activate your
immune system in increase inflammation
what is inflammation it's activation of
your immune system but specifically we
know that adipocytes will create il6 now
il6 does something really problematic it
decreases
bdnf now what is bdnf brain derived
neurotropic Factor so something that is
neurotropic is something that causes
neurons to grow a stimulant for the
brain now I don't mean stimulant the way
that like methyl idate or arerol or not
those kinds of stimulants these are
growth factors so they promote the
growth and development of your brain if
you look at children and you measure
their bdnf the lower the bdnf in the
child during development the more likely
they will develop ADHD later in life so
literally the this is a chemical
chemical compound hormonal compound that
triggers brain growth and development
and it is low in levels of in people
with ADHD so there are some very small
trials that are sort of hypothesizing
that stimulating B bdnf will improve
symptoms of ADHD it may be one of the
mechanisms through which um ADHD
treatments work on some way that really
that stuff hasn't really been sorted out
but we certainly know that fat cells
increase il6 and il6 decreases bdnf so
how does that work let's understand this
see our body has two modes it has
fighting mode and it has building mode
so our our our brain is just like any
kind of RTS right so let's think about
Starcraft or Warcraft I know no one
plays RTS anymore we kind of have our
economy right we're going to build
things up we're going to acquire more
minerals we're going to build more
pylons and then we make a lot of units
and then we send those units into war
and when we are building up our economy
we're not making like zealots or Marines
or whatever like either we're building
peons and pylons or we're building like
zealots and drons I know this is a
reference that y'all Gamers
aren't going to understand so either
we're investing our in our economy or we
are investing in like wartime unit units
so our brain and body are the same way
either we are fighting off an infection
or we are building things and the
problem is that since adipocytes
increase our inflammation they put our
body into combat mode and then it stops
building things it literally reduces
bdnf which results in problems in our
brain reduces the function of our brain
makes our ADHD worse second thing that
adipocytes do is mess with our insulin
okay now we're going to have to learn
more complex physiology this is the most
complex thing I'm going to teach yall
today so let's understand this here is
me I eat food food makes glucose in my
bloodstream glucose triggers insulin
okay insulin causes the absorption of
glucose into cells so now my cell is
full of glucose okay so insulin is
triggered any time we eat something so
what does insulin end up doing insulin
signals to our brain and our body that
we have nutrients check nutrients
acquired okay so it kind of travels to
our brain and it triggers things like
leptin and gin we're not going to get
into too much detail but it kind of
makes sense right so when I'm hungry I
will have glucagon levels that are high
glucagon is the opposite of insulin so
glucagon tells us oh crap we're running
low on energy we're hungry and glucagon
will stimulate hunger and then we eat
something we get glucose insulin shows
up puts the glucose into cells and
Insulin goes here and tells our brain
hey nutrients acquired you don't need to
feel hungry anymore there's another
issue at play which is that the more fat
cells we have or the larger our fat
cells are the more we have insulin
resistance this is why people who are
diabetics type 2 diabetics who are often
times overweight or obese require
insulin we have to literally inject
extra insulin because their cells are
resistant to insulin I want to ask
youall a question if I have a resistance
to insulin what do you think it will do
to my nutrients acquired signal it
decreases it right so the insulin is
what tells our brain hey we have enough
nutrients you can stop feeling hungry
now and as I increase my adipocytes ocy
mass my insulin resistance increases
which means that my body brain cannot
detect the signal of fullness it is
literally neurologically impaired so
people even when they eat they do not
feel full and this is mediated by
adipocytes the last thing that I'm going
to touch on I kind of forgot this is
that il6 works by two mechanisms one is
bdnf but then the other thing is that we
know that inflammation increases mood
problems and anxiety so there are some
theories of inflammatory hypotheses of
the brain so if you sort of think about
this if you get the flu what happens to
your mood it goes into the pitter right
so this is something that's very
important to understand anytime we have
inflammation in the brain we will feel
more depressed we will feel more
anxious now we see where everything is
coming together because if y'all have
been paying attention why does this hurt
more for people who have ADHD compared
to the neurotypical person inflammation
from adipocytes right so here's the
sequence epoy increase in obesity Isle
six mood goes down anxiety goes up and
what happens in the brains of people
with ADHD did y'all pay attention did
y'all remember amygdala hypers
sensitivity so now what we're going to
do do y all remember do y all remember
do you all remember we're going go up to
this column where is it here it is you
guys remember this Dr K didn't doesn't
have enough space so now what we're
going to do remember this one where
emotional remember we have the sad kid
who's got ADHD so now we're going to add
a fourth column I'm sad and now I'm
obese so if I'm obese it doubles the
sadness if I double the sadness I get 40
units of craving and now 2.5 units of
satisfaction which means I need to eat
16 cookies and oh that's right as I'm
eating these 16 cookies what would
normally stop us from eating 16 cookies
in one sitting that's right because
every cookie that I eat releases insulin
and tells my brain hey bro we've had
enough but if I have insulin resistance
from a large amount of adipocytes I do
not receive a satiety signal from all of
the cookies I'm eating which is
how I eat a whole package of cookies in
one sitting if I have ADHD and obesity
everything comes together so does this
mean we are screwed no this just means
we have been mistargeting the mechanisms
so the first thing is as we increase
emotional regulation techniques we will
actually fix this problem automatically
the other thing that we're going to do
is recruit a couple of other interesting
things so now we're going to use kind of
anti-obesity mechanisms so our body has
multiple ways of detecting the food that
we eat one is through this insulin and
glucose metabolism thing but then we
also have this thing called gastric
stretch which is that we literally have
stretch receptors in our stomach so as
our food as our stomach fills with
volume we get a completely different
pathway right so you can't eat like this
much food in terms of volume why not
because what happens is I is I eat a
large not quantity not nutrient density
but literally large volume of food my
stomach stretches out it expands I feel
full and I'm bloated oh my God I've got
a food baby in my belly once I have a
food baby it's a completely different
pathway it is a physiologic stretch
pathway and this will help us feel full
this has nothing to do with dopamine
nothing to do with emotions this is a
completely separate pathway and this is
what we need to utilize so what I
recommend to all of my patients who are
struggling with weight loss and ADHD is
that you eat foods that are going to
make your belly stretch make that belly
stretch that is usually high fiber foods
high volume Foods so if you look at
something like broccoli you have to eat
like a large volume of broccoli to
equate the calories of a single Twinkie
the problem with a Twinkie is that most
neurotypical brains if I eat a Twinkie I
will feel somewhat satisfied because
those sugar receptors the insulin
receptors are all kind of in working
well so I get this nutrient load right
and then my brain is like okay we've had
enough because this is like 400 calories
no big deal I'm done that doesn't work
in people who have ADHD and obesity so
we need to use gastric stretch so eat as
much high fiber food as you can have it
easily available this will stretch your
belly and will make you feel full next
thing we want to really start exercising
so the more that we exercise the more it
fixes this whole insulin resistance
thing so we know that for example even
type 1 diabetics to a certain degree I
think is type one definitely type two so
the more that you exercise it kind of
counteracts all of this physiologic
stuff and all this sedentary lifestyle
is half the reason why ADHD and obesity
are getting worse so the more you can
exercise the better it will be for your
stomach and your physiology and stuff
like that it'll even help your brain we
want to also eat anti-inflammatory food
so this is where I would strongly
recommend that you seek a professional
so someone like a dietitian or an
endocrinologist or medical doctor and
try to really start eating
anti-inflammatory foods and also foods
that affect insulin metabolism so in my
practice I'll use things like margam in
you know urtic medicine we'll use bitter
melon a lot uh coffee green tea
chamomile Ginger these are these all of
these foods have had some evidence that
they will affect our sugar metabolism
and our inflammation so if you start to
eat these things you can start to
counteract some of these principles so
just in summary so we're seeing a rise
of ADHD and we're seeing a rise of
obesity there's another problem that we
have which is that if you have ADHD
often times we don't consider the impact
of obesity on your brain and on the flip
side if we're trying to treat obesity we
do not consider the impact of your ADHD
emotional regulation reward processing
brain in terms of resisting food so what
ends up happening is that we use all of
these interventions which are designed
from clinical trials but as part of
those clinical trials because they're
very controlled we start excluding
people who have problems like ADHD and
so what we're seeing is a rise of ADHD
and obesity partially because our
interventions don't account for both of
them and there are certainly there's
certainly a synergistic effect of obes
on ADHD it makes our brain more
vulnerable and there is a synergistic
effect of ADHD on eating and so this is
why a lot of people lose hope but the
good news is that if we understand the
mechanisms at play we can Target these
neuroatypical mechanisms and hopefully
get a handle on both ADHD and obesity
and this is what I've seen as a
clinician this seems like a a battle
that's really hard to win because one
screws over the other but the good news
is that if you start moving in the
positive direction with one if I have a
patient who has ADHD and their weight
gets under control their ADHD improves
if I have a patient who is obese and I
get their ADHD under control their
weight improves so both of these things
it's kind of they combine together to
screw you over but you can also actually
improve both of them two birds with one
stone you can get kind of a nice fatty
crit in there and hit both of them at
the same time so definitely try some of
the stuff that we're talking about today
if you're someone who has a clinician
that you're working with right now I
strongly recommend that you talk to them
about these kinds of mechanisms and see
if there's something you can do about it
the last thing is if yall are really
interested in this stuff and you like
these kind of mechanisms and stuff like
that we have a awesome guide to ADHD
where we dive into a lot of Neuroscience
and give youall a lot of interesting
techniques so check that out too hey Dr
K how do I get my kid to put down the
game without it being a fight every
single time the problem with gaming is
that it tricks our brain into being a
substitute for Life once we start to get
our psychological needs met through the
game that's when we become addicted how
to raise a healthy gamer combines the
latest in Neuroscience research along
with a decade of clinical practice check
it out anywhere books are
[Music]
sold
5.0 / 5 (0 votes)