Wednesday, April 19, 2017

Suppressing Hunger with Non-Invasive Brain Stimulation

Does magnetic resonance stimulation of the brain prevent hunger and help treat obesity?

When we were treating patients in Spokane with magnetic resonance stimulation for the FDA approved indication of improving refractory depression, I often wondered if it was also helping treat obesity, based on careful observation of our patients' metabolic health and parameters.

There were some obvious reasons why this might be happening, I thought.   The most important reason being that when patients were treated with MR stimulation of the prefrontal cortex of the brain, they would need less and use less use of antidepressants, and lower doses.  Most antidepressants are "weight positive", that is they induce weight gain.  So it made sense to me that patients seemed to lose some of their excess weight with MR stimulation, since this treatment reduced the need for these weight inducing antidepressants, while continuing to improve their depression.

However, a recent metanalysis by Peter Hall at the University of Waterloo in Canada presents a new twist on that theme - possibly the MR stimulation is having a much more direct effect on obesity.  This metanalysis suggests that stimulating the prefrontal cortex with non-invasive magnetic resonance stimulation, which is the modality we used in our practice, directly suppresses binge eating and cravings.  The results are a little mixed, and it is not clear that reduced use of antidepressants was controlled for in these studies, but promising insights and trends seen nonetheless.

April 19, 2017    Debra Ravasia

Artificial Sweeteners Allow More Sugar into Fat Cells

For years, I have thought that artificial sweeteners are likely fairly harmless, and less likely to cause weight gain than table sugar, thus a useful tool in combatting obesity.  I still believe that is probably true.

However, I have had the discussion many times with friends about how diet drinks without sugar seem to cause a little weight gain, compared to tea or coffee without sugar.  Not nearly the kind of weight gain one sees with a fully sugared soda - it's more subtle than that - but I've wondered for a few years if there might be a dysmetabolic effect that these sweeteners are having.

This poses a big dilemma for those of us trying to lose (or not gain) excess belly fat, if it's true. Everything "diet" is, of course, loaded with artificial sweeteners. 

But why would artificial sweeteners cause fat gain and metabolic dysfunction if they have absolutely no calories? 

This article that a friend shared with me last night peaked my interest: 
Low Calorie Sweeteners May Allow More Glucose to Enter

Essentially, there are many metabolic pathways at a cellular level, by which these sweeteners may be opening the gate for glucose to enter the fat cell and be converted into fat.  (Table sugar = glucose plus fructose)

4/19/17  Debra Ravasia