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Carb addiction (and its lack of epidemiology)

I have a friend who some years ago had to go through a medical procedure that left his mobility impaired. He can only walk with crutches. (Whether he will ever be able to fully walk without them is unclear.) He is also quite overweight, and as you might guess, it would be a great help to his mobility and ability to walk around and do everyday tasks if he were to lose a significant amount of weight and become fit. All those excess kilograms aren't exactly helping his everyday life.

He was absolutely decided on losing weight, and become as fit as his physical condition allows him. He prepared himself with the right knowledge for this. In terms of diet and exercise, what works and what doesn't, what's the right kind of food to eat, and how much. How much is too much, and how much is too little. What kind of exercise and diet program are the most efficient and suitable. He acquired a lot of nutritional knowledge, was absolutely prepared and adamant to become healthy, slim and fit, and to lose all that excess fat, not only for him, but also for his family (he has a wife and young children).

Fast-forward a few months, and he has made pretty much a full 180 turn, to the point of being pretty much self-destructive. He has completely and absolutely stopped caring about his own health. All the dieting and the planning to the trashcan. He doesn't measure his blood pressure, or do anything to monitor his health. He says, in all seriousness, that he literally does not care if he dies in 10 years. He says, in all seriousness, "I'd rather live 10 years happy, eating whatever I want, than live 20 years in misery".

He is a family man, with young children. That means that he literally does not care if he never sees them grow up, graduate, get married, and get grandchildren. Even though he loves his family more than anything in the world, it appears he literally does not care the what kind of economic trouble he will be leaving his family in, if he dies in 10 or so years. He just wants to eat whatever he wants, and doesn't give a flying fuck about what happens to his health as a consequence.

In other words, it appears that to him food is more important than his own family. Being able to eat whatever he wants is more important to him than the wellbeing, or what happens to his family.

If that's not addiction, I don't know what is. I have no experience on drug addicts, but I wouldn't be surprised if people who work with that kind of people see similar things all the time from drug junkies.

And this is not a rare one-in-a-million unique case. I have seen pretty much the exact same thing several times, in real life and online. (Heck, I have literally heard that 10 years figure from more than one person. I don't know where that particular number comes from, but it seems to somehow be popular.)

The sad thing is that, besides them destroying their own lives just because of food, they are delusional. They want to think that they will live something like 10 years relatively ok, eating whatever they want, and then one day they'll get a heart attack and die, and that's it. Maybe they won't be running any marathons, but otherwise they will be relatively ok.

Of course that's not what's going to happen. They don't want to think nor accept what it actually means when their health slowly deteriorates over the years because of obesity-related diseases and problems. In general, the older that morbidly obese people become, the more and more health problems they will start suffering from, and the more and more medications they will be on to treat the symptoms of those problems. Their mobility and quality of life will slowly deteriorate, and they will be more and more dependent on other people, and they will feel worse and worse every day that passes.

The "I'd rather live 10 years happy" is a complete delusion: It will be 10 years of worsening and worsening and crippling life quality. It will become more and more of a hell to live.

That's in fact one of the things I told him: "It's not about how long you'll live, but about life quality." To no avail.

The thing is, this kind of thing is extremely common: People get obese, then they decide that they will lose all that weight, and in the vast majority of cases they stop in mere weeks, at most a few months. They stop caring. They lose all motivation. They don't want to do it anymore. They go back to their old habits.

I am no doctor, nor any sort of professional in the field, but what I believe is happening here is what I call "carb addiction" (or "carbohydrate addiction", or "(blood) sugar addiction").

While it could be related, I don't think this is the same thing as food addiction. Food addiction is more severe in its immediate symptoms: Food addiction is when a person feels compelled to constantly eat and overeat. They may go all evening doing nothing but eating, and they eat way, way past their hunger, until they are so full that they could throw up, and they do this day after day after day. It's like compulsive eating.

What I call "carb addiction" does not necessarily present itself in the form of actual food addiction, in the form of compulsive and excessive eating. There's of course excessive eating overall, but it doesn't happen in such excessive manner. The person may well eat completely "normally" in terms of when and how many times he eats, but still be addicted to carbs. It's the quality of the food, and the portion sizes, that mostly determine this.

Carb addiction and obesity, however, go pretty much hand in hand. One causes the other, and the other way around. They feed each other. It's a vicious cycle.

What I think is happening with carb addiction, ie. blood sugar addiction, may be something very similar to what happens with certain drugs, like heroin: Heroin stimulates certain receptors in the brain that are responsible for, among other things, controlling the amount of hormones in the bloodstream (I think it was dopamine, or some other similar hormone). This hormone dulls pain and, as a side effect, causes pleasurable and euphoric feeling when there's an excess of it.

The human body is a complete mess caused by evolution, and full of ugly hacks and kludges over kludges. Nerve endings and pain receptors in the human body are, in fact, constantly sending signals to the brain, and the only way that the brain keeps them "quiet" is by releasing dopamine (or whatever hormone it was) that acts as a kind of analgesic. (The human body is, in fact, full of such "kludges".)

What happens with drugs like heroine is that it confuses the brain, and sets a new "normal" level for blood dopamine levels that's too high. This means that what is the actual normal blood dopamine level starts now looking like "way too high" to the brain, so it stops producing it. But this causes these levels to go too low, which is what causes the sometimes absolutely horrendous withdrawal symptoms of heroin addiction. The worst withdrawal symptoms that heroin addicts have reported is that they literally feel like their skin is on fire. Like they were lying on a fiery furnace surrounded by fire constantly burning their skin at full blast. It's absolutely unbearable. Heroin withdrawal symptoms can be so strong that people can literally die from them.

I believe that chronic elevated blood sugar levels cause something similar. Of course with withdrawal symptoms that are not even nearly as bad as those of heroin, but withdrawal symptoms nevertheless, caused by a similar reason: I believe that when a person has constantly an elevated blood sugar level for years and years, the brain's blood sugar control mechanism gets rewired and accustomed to that level, and starts considering it the new "normal" blood sugar level.

So, like with heroin addiction, now when the blood sugar level returns to its actual normal level, the responsible receptors in the brain believe that it's too low, and starts signaling the rest of the brain that there's a bad blood sugar deficiency in place, and the rest of the brain starts acting on that.

The most immediate and rapid symptom of this is, rather obviously, the feeling of hunger. However, a more fundamental symptom, especially if this continues for several days, is a very low-level instinct that one needs to eat, or bad things will happen. These instincts probably come from very deep, from the most primitive parts of the brain. One gets a craving for food even if there's no physical feeling of actual hunger (eg. because of having just eaten very low-carb food, that has physically filled the stomach, but is not elevating the blood sugar levels much).

If this still keeps continuing, this causes all kinds of other symptoms, mostly psychological: The most prominent and strongest one, by far, is an enormously strong feeling of loss of motivation.

At the start of the dieting the person can be the most motivated person in the world, and 100% decided on going all the way through with it, but give it just mere weeks, sometimes even just mere days, and all of that motivation will be completely gone. Completely. The person will have an incredibly strong craving for high-carb high-fat food, a very strong instinctual feeling that if he doesn't eat something really bad is going to happen, and a complete loss of all motivation to avoid eating all that food.

Quite often this loss of motivation will be so strong that it even persists after the person has succumbed to the cravings and eaten a full meal. The psychological effects of the deep-rooted "hunger" will persist. Very often the person does not regain the motivation immediately when his carb addiction is satiated. In fact, quite often the person will remain completely demotivated even after weeks of returning to his old diet and eating habits. The effects are incredibly persistent.

As mentioned above, the effects of this can be so devastating as to make the person pretty much self-destructive, almost suicidal in the lack of self-care, lack of caring about what happens to them and their own health.

Also, like with many drugs, even if someone does eventually get over it, and loses all his extra weight and becomes healthy, fit and strong... the danger of that craving for excessive carbs still remains, deep down there. It might not be a question of merely eating one meal of junk food to immediately go back (like what can happen eg. with alcoholism), but it's still extremely easy to succumb and go back to it slowly, one little concession at a time. Many a person who has lost significant amount of weight may see himself having gained it all back in 5 to 10 years. It's extremely hard to keep the healthy life habits even after having achieved them. The brain probably never forgets, and is always ready to go back.

Over the decades there has been a discussion among health professionals about which substance is the most addictive. Not necessarily in terms of how quickly you get addicted to it, or how strong the withdrawal symptoms are, but how hard it is to get rid of the addiction. Some have suggested that nicotine is, in fact, the most addictive substance, even more so than "harder" drugs like heroin and alcohol.

I would, however, posit that carbohydrates are the most addictive drug. And by far the most common, by a long, long shot.

Yet, I'm not aware of "carb addiction" being considered a form of addiction, or even an eating disorder, by medical professionals. "Food addiction" is, but I think it's not the same thing (although rather obviously most people with a food addiction also have a carb addiction, especially if they are obese).

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