Stephanie Fein MD [00:00:00]:
Hello, fabulous. Dr. Stephanie Fein here with weight Loss for fertility. And I spoke to a client today and she is doing so well. When we first started, she had a brain that was very tightly wired with diet mentality, thinking that's that all or nothing thinking. Where yo yo dieting comes restriction, deprivation. And particularly that all or nothing thinking for her was when it came to losing weight and eating. Now remember, how we do one thing is how we do everything.
Stephanie Fein MD [00:00:31]:
So that can be in all aspects of life. But it was really acute in weight loss and eating. And for her, losing weight only meant one thing, which is restriction. And that mean restriction with a lot of judgment and harshness and punishment and that sort of thing. And when it came to food, she was in the place where she was really only eating highly palatable foods like processed foods, any vegetables were considered diet foods in her brain and threw her into restriction thinking, which then she yo yoed between sort of total restriction and then f it eating, which is exactly what happens if we go into restriction, we will go into binge that. It's just that yo yo it goes back and forth. That's why it's so important to find the middle ground. We cannot do restriction dieting.
Stephanie Fein MD [00:01:23]:
It does not work long term, which is all we really care about. Successful weight loss is long term weight loss doesn't matter if we lose 20 pounds if we gain back 42 months later. So anyway, so we were working of course with the hunger scale and food dates, such important fabulous tools. And she found that locking her hunger scale really made a big difference. And that's something I talk about. Not everyone has to do it, but it does in general and studies support it that when we write things down, we just remember them more like we are really good at forgetting, especially around food. Writing this down has really helped her and she's totally refining her negative 2 and positive 2. Really amazing.
Stephanie Fein MD [00:02:07]:
And in that process she's seen that whole foods, and when I say whole foods, plant based, like minimally processed foods, that they last longer and have her body feeling energized after she eats instead of tired, full bogged down, listless, which is how she felt with the other foods. And we were talking about processed foods was more the kind of thing she was eating. And the whole foods no longer felt like diet. I'm putting that in air quotes. Diet foods, but energizing foods. And that was her words. And this is so huge, I'm like almost burst into tears. And when we were celebrating this, because I 100% had to celebrate it because it's such a huge shift.
Stephanie Fein MD [00:02:58]:
I cannot, I wish I could tell, get the magnitude of what a big shift this is. When we were celebrating this really major, impressive shift, I went back to the concept of food as fuel. A concept that she could not conceive of when we started, but now makes perfect sense. Food as something to fuel your life, not be the center of life. And she said, she talked freely about that. She used to think of food as her reward for a hard day, her friend, her entertainment. And then as we were discussing this, we landed on food as her dopamine hit, which of course is factually true. And that's actually what we're going to get into in a minute.
Stephanie Fein MD [00:03:51]:
The shift from mainly processed foods to whole foods happens naturally as a consequence of this process. That's the magic. My client could not have been told to eat certain foods. She literally would have either just rejected it outright or done it for a little while and then f it, it would not have worked. The only way that she was able to get here was on her own using this, the hunger skill. And the process, the hunger scale has us tuning into our body signals. And when we do, we notice hunger, but we also notice how foods make us feel. It just has to happen that way because we keep checking in and our body feels different on certain foods when we do that.
Stephanie Fein MD [00:04:41]:
When we're checking in, we tend to want more of the foods that have us feeling light and energized and satisfied longer. Particularly we want those foods more than the ones that have us hungry and craving, high and crashing, bloating and heavy. We just, it just naturally makes more sense to have those, to have the whole foods rather than the processed ones. So I wanted to take the opportunity to discuss how processed foods themselves lead to cravings and overeating and how whole foods help us feel balanced in a very steady way physiologically. Okay, so follow with me. I'm going to try, I'm going to do what I can here. So processed foods are, when I think of processed foods, I think of mainly foods high in sugar and flour. So processed usually means things were added in.
Stephanie Fein MD [00:05:35]:
They don't occur naturally in the world they're created. And that would include, you know, like things through, drive through, or things that come in bags. Like that's how I think about it. So they're designed to be hyper palatable. That's a semi scientific term referring to high sugar, fat and salt foods. And they literally, they light up our tongue, our taste buds. They're designed that way. And hyper palatable is A purposeful word meaning it's more than taste buds were designed to handle.
Stephanie Fein MD [00:06:17]:
So our taste buds were like, ooh, a raspberry that's so delicious. But if we have a million jelly bellies or gummy bears or something, then a raspberry tastes like nothing. But if we're not putting concentrated amount of sugar on our tongue, then raspberries taste delicious and sweet. So processed foods that are designed to be hyper palatable, which we just discussed, they cause a rapid large dopamine spike in the reward areas of our brain. And because of that spike, the brain then interprets whatever caused this spike as a high value reward. And the brain loves high value rewards. It thinks that it's very important for survival. Ooh, that felt really good.
Stephanie Fein MD [00:07:08]:
Like sex is one of those. And it is important for survival, for survival of the species and for well being and a million other things. So the pathway of the large dopamine spike connected with the idea of a high value reward is the same pathway as other addictive substances. So alcohol, drugs, could be shopping, gambling, all sorts of things. So that's that, that's what the processed foods. But whole foods have their nutrients embedded in fiber and natural structures that lead to a slower, smaller dopamine release because the stomach has to work on digesting all that stuff. That's another thing about processed foods is they don't take very much to break down. You chew it, it even could melt in your mouth.
Stephanie Fein MD [00:08:03]:
Like you barely have to chew it and it's broken down. That does not use very much energy. And that's part of what allows the spike to come up because the all the surfaces are exposed and the blood glucose goes high quicker. If your stomach has to work on digesting it and your saliva works on it all the way down, then it releases the blood, the sugar into the blood more slowly because it's only has access to it little by little as opposed to if it's already broken down in your mouth and by the time it hits your stomach, it's already ready to go. This is why you have the glucose and then the dopamine spike. And with the whole foods having the slower, smaller dopamine release, the reward signal is steady and proportional, not overwhelming. Were set up to have like our calibration is that we have a raspberry that gives us dopamine. Wonderful.
Stephanie Fein MD [00:09:08]:
But if we get a gummy bear, it's completely different. That is overwhelming to the receptors because it's too much. It's not, we weren't expecting that. That doesn't Happen naturally in nature, so we're not designed for it. Additionally, repeated large spikes lead to downregulation of dopamine receptors. This is a similar pathway to insulin sensitivity if we are exposed. So if blood sugar, if we're exposed to lots of blood sugar and then lots of insulin, the cells can't handle all that insulin and they start to down regulate, meaning the receptors close off. So there aren't as many places available.
Stephanie Fein MD [00:09:58]:
And they do that to protect themselves from so much, from just a big pool of insulin. And what happens then is it takes more insulin is increased to try to get into those spots. Because it's saying, oh, you're not listening to me, I'm gonna do more and more. Same thing will happen with the dopamine in a different part of the body, but it's the same idea. And that reduced sensitivity means you need more of the processed food to feel the same reward. And so you can see how that the cycle happens is that you need more and more. Whole foods, on the other hand, maintain a normal dopamine sensitivity. So there's no up or down regulation.
Stephanie Fein MD [00:10:46]:
It's just what we're designed for. And whole foods support balanced signaling rather than overstimulation. So there's not overstimulation. Raspberry is a raspberry. It's not a sugar filled raspberry. Whole food activates mechanical fullness. And mechanical fullness means physically takes up space in your stomach. And the stomach is designed for that.
Stephanie Fein MD [00:11:16]:
So it's designed to know how much is in there. That's what we're tapping into when we are looking for our positive 2. So the whole foods activate the mechanical fullness because there's fiber in there and volume because like a piece of broccoli is bigger than four gummies. And the hormonal signals, so dopamine aligns better with the actual nutritional needs. This is an important point. Processed foods encourage cravings, overeatings, and reward chasing. Eating becomes less about hunger and more about stimulation. That is such an important point.
Stephanie Fein MD [00:11:54]:
It's about dopamine. It's not about hunger. It's not about the amount of food in your stomach. It's about how much glucose leads to dopamine, how fast that spike comes. That's what processed food does to us. While whole foods encourages natural stopping points. That's the hunger scale. Stable energy, lower compulsions.
Stephanie Fein MD [00:12:21]:
Because of all these mechanical reasons that we're talking about the fiber, the fullness, the dopamine isn't spiked so high. This is what we do with the hunger scale. And this difference is why processed foods are so much more likely to drive overeating and habit formation while whole foods support more stable, self regulated eating because it's easier to stop. So this is actually the next point and it's really interesting. Satiety hormones, which you probably know more about these days, because GLP1 is one of them. GLP1 occurs naturally in our body from our stomach. We have it, every single person has it naturally. It goes up and down.
Stephanie Fein MD [00:13:10]:
If we use it as a medication, it's constant. But anyway, we all have GLP1 and it does make us feel full. And so we stop. We are tapping in when we're using the hunger scale and looking for a positive 2. We are tapping into our natural GLP1. That's what we're doing, which is so amazing because we're going to have to do that anyway. Unless you're going to be if you are on the medication, which you cannot be if you're getting pregnant. But let's say after you have your babies, you have to stay on it forever.
Stephanie Fein MD [00:13:46]:
But learning hunger scale means that you won't because you will heighten your own sensitivity to the signals coming from peptides like GLP1. So satiety hormones directly reduce food intake. This is what we were talking about. You start to feel full and you stop. So it's released during eating and it acts on the brain to stop eating. So they decrease calorie intake, they increase feeling of fullness and they activate stop eating circuits in the hypothalamus, in the brain. So this is what GLP1 does. And there's a couple other ones too.
Stephanie Fein MD [00:14:27]:
And this is the brake system. In normal eating, especially with whole foods, it works really reliably. This is what we depend on when we practice the hunger scale. Processed foods, however, actually, and this is fascinating, they actually blunt the satiety signals, they dampen them, they bypass or delay satiety hormones. They actually impact leptin and GLP1, which means you can keep eating after your energy needs are met. The dopamine signal can override the fullness feeling. So you're not going crazy. And this is relatively new actually research about this, that dopamine can override GLP1 natural GLP1.
Stephanie Fein MD [00:15:20]:
So higher added sugar, that's one of the parts of processed foods. Higher added sugar intake is associated with lower GLP one response after eating. Natural higher brain reward activation to food cues. So people who eat more added sugar show reduced GLP1 release after glucose intake. So you'd expect to see a certain level when you're having more processed foods. Your GLP1 release is lower. And the same people show a greater activation in reward regions so that dopamine is higher. It's fascinating.
Stephanie Fein MD [00:16:01]:
And this explains how we can feel crazy, like a bottomless pit. Like you could eat an entire bag of chips and doesn't feel like anything or only too late. Right? So with processed foods, the stop eating signal is weaker and the keep eating reward signal is stronger. And that combination directly promotes overeating. And if you're using the hunger scale, you're going to be aware of this. Like this is gonna, you're gonna see this play out. And then when you do and you're aware of it, you naturally gravitate to other foods because it doesn't make sense anymore to have a whole bag of chips. So to go a little deeper on this idea that dopamine can override the satiety signals, this is that recent data that shows these systems actively competing.
Stephanie Fein MD [00:16:51]:
So dopamine circuits the reward and the palatability promote continued eating. And the GLP1 satiety pathways try to stop eating. Eating. That's right. GLP1 tries to get you to feel satisfied. Stop eating. Dopamine promotes continue eating. It wants the hit.
Stephanie Fein MD [00:17:10]:
So dopamine driven eating, it's called in these studies, it's called hedonic eating, which is food ingestion that is driven by palatability rather than bodily need. We want the taste, our body doesn't need it, but we want the taste. This eating for palatability, the dopamine driven eating has you eating more longer, continuing to eat independent of what the body needs, which is always what we're talking about when we're talking about the hunger scale. Eat what your body needs, food for fuel. But the dopamine overrides that all and you just keep eating. What I love about this is it explains what we already know. We see that happening with ourselves when we're in this processed food eating times. So even when your body says you're full, a strong reward signal that dopamine can override that signal.
Stephanie Fein MD [00:18:12]:
Isn't that amazing? So we get to learn a lot about GLP1s and including the natural GLP1 that's in you. So the whole foods support stronger satiety signaling, so they do the opposite of dopamine. Fiber rich, minimally processed foods increase satiety. Hormones like GLP1 and also PYY, they slow digestion so you feel fuller, longer fiber intake. Intake is linked to higher satiety hormone activity. So remember how the other was? When you had high sugar foods, you had less GLP1 releasing with fiber intake, in particular protein and fiber. Higher satiety hormone activity is noted after those meals, which reduces hunger and calorie intake. It's like really basic and it's amazing to be able to show it that it's happening.
Stephanie Fein MD [00:19:13]:
So the processed food pattern is lower GLP1, which is a weaker fullness signal, increased dopamine response, which is a stronger reward signal, and increased brain response to food cues. So there's more eating, less stopping. With whole foods, you have increased GLP1, stronger fullness signal and a decrease in rapid dopamine spikes. Meaning? So the reward learning patterns are not coded which would worsen habits. Okay, so that means it's not spiking, it's more even the spike and the decrease. So a spike, if you think about it, it's a rapid increase and then a rapid decrease. That's the problem. There's a relative change from going up high, coming back down.
Stephanie Fein MD [00:20:08]:
So you're still at the same level when after the spike, but you feel let down because you were so high and now you're so low. You don't have that with whole foods. So you don't have to go through that process, which codes a habit. When you have that dopamine spike, remember it clocked it as a reward. You won't have that happening with whole foods. And there's also slower digestion and more volume. So there's a natural stopping point. It's much easier to stop at positive 2.
Stephanie Fein MD [00:20:42]:
Processed food uncouples reward from satiety, and whole food aligns reward with satiety. That's such an important difference. That's why with processed food, you can feel full physiologically but still driven to keep eating. So we talked about, like, you don't even feel full. You can feel full and you still want to eat. So you're like, yep, I'm at a positive three and I keep going. Whereas with whole foods, fullness and motivation to stop eating tend to match. So you're feeling, you're getting to your positive too.
Stephanie Fein MD [00:21:19]:
And you're like, yeah, no problem, I can stop. The hunger scale nudges you towards food and eating. That balances your brain and your blood sugar. And when you do, it's like an upward cycle, right? You keep having a balance in your brain and you keep having a balance in your blood sugar. And you just want to keep that going because it feels so good. You don't have the yo yo and the up and down and the feeling crazy. And there's no need to force yourself to stop eating certain foods. Your body will tell you.
Stephanie Fein MD [00:21:51]:
All you have to do is listen. So like my client, you can go from mostly processed foods to whole foods with without forcing. It just happens naturally, both physiologically as we've described. But it starts by tuning into the hunger scale. And your body, your body will tell you and as you go towards feeling better, you will continue to feel better. And in order to do that, we have to listen with love to our body, we have to believe our body, we have to love our body. And when we do, we want to help it feel its best. So it naturally happens that we go from more processed to less in this process of using the hunger scale.
Stephanie Fein MD [00:22:43]:
I loved having an example to talk to you about this. This is good stuff. And if you have any questions, as always, you can always reach out to me. I'm on Instagram @stephaniefeinmd. You can always go to my website, stephaniefeinmd.com and you can contact me there. You can also lose weight with me there. Click the lose weight with me button and we will be connected. I would love to help you with this.
Stephanie Fein MD [00:23:07]:
Until next week, I am sending you so much love.
