Latest / Health Wealth / What is Food Noise? Why You Can't Stop Thinking About Food | Doctor vs Internet

Transcript

What is Food Noise? Why You Can't Stop Thinking About Food | Doctor vs Internet · Health Wealth

• 0:00
  Speaker 1: This is India Today Podcasts. Why is it that I
• 0:04
  ate food at 8 o'clock? But why am I standing
• 0:06
  in front of the fridge at 11 o'clock?
• 0:08
  Speaker 2: Food is love. I enter the kitchen. On the right
• 0:11
  hand side, there's a wooden almera. I open it and
• 0:15
  there it is. The love of my life. Bujjiya. Khushi
• 0:20
  mein khana, gam mein khana, vile hai khana. Constantly I'm
• 0:24
  talking to you but I'm thinking of how can I
• 0:28
  get a burger? I'll sabotage this very podcast. I'll go outside,
• 0:34
  order a burger and come back. That's food noise. It's
• 0:37
  intruding your day-to-day activities. It's constantly in the background music.
• 0:42
  But now instead of that music, you have a sandwich.
• 0:45
  Have you ever got a high by eating karela? Ek
• 0:49
  aloo dedu aise boil karke, will you eat it? But
• 0:52
  I slice it into thin, crispy things. The aroma is there.
• 0:58
  And then the salt over that.
• 1:00
  Speaker 1: You're making it very difficult to do this podcast. Now
• 1:02
  I'm craving all of that.
• 1:04
  Speaker 2: Everybody understands hunger is a survival instinct. If somebody says,
• 1:10
  I have no hunger, I would be troubled much more.
• 1:14
  Wanting is a process. It's more motivating. That's what craving
• 1:18
  is all about. Process. I took the example of the burger.
• 1:22
  You know the high I'm getting right now? I haven't
• 1:24
  eaten the burger, but I'm planning because I want to
• 1:27
  stay high through the day. That pleasure, that reward.
• 1:31
  Speaker 1: Hunger and craving are two different things.
• 1:36
  Speaker 2: You feel the hunger here. I'm hungry. Mom, I want
• 1:39
  to eat. Simple dry bread, lentils, vegetables, curd is relishing. Oh,
• 1:45
  I loved it. The normal kind of hunger. One hour
• 1:48
  after your food, you've had a bad day. You get
• 1:51
  a picture of a food in your mind. A picture
• 1:54
  of a food in your mind is your body does
• 1:57
  not need it. Your mind is screaming, indulge in me,
• 2:00
  consume those calories. They found that the satiety center in
• 2:05
  the lean people lit up. That didn't light up as
• 2:10
  much in people with obesity. It's very easy to push
• 2:14
  a truck when 10 people are pushing it. You perpetually
• 2:19
  lived in stress. You reach home 10.30 and you don't
• 2:22
  sleep well at night. And there's one T-Rex hunger hormone.
• 2:26
  We still haven't been able to crack that. And then
• 2:28
  you add petrol to the fire. And then water is
• 2:32
  going to get triggered. And then the cycle keeps on
• 2:36
  getting perpetuated. We live in it and say that this
• 2:39
  is the new normal.
• 2:43
  Speaker 1: So I don't know about you, but I grew up
• 2:46
  in a household where food was not just a conversation
• 2:50
  on nutrition. Food was a conversation on emotions. There was
• 2:56
  food which was made on special occasions, food when mother
• 3:00
  was strict at you or food when she was happy
• 3:02
  with you, food when guests came over, food when seasons changed. Basically,
• 3:07
  food was a ritual. Cut to my life now, where,
• 3:13
  don't get me wrong, I love my job as much
• 3:15
  as I perhaps love food or the same memory of it.
• 3:18
  But now my job involves me to think about food
• 3:22
  in a very different way. How many calories does it have?
• 3:26
  At what time did I have the food? What is
• 3:27
  the sequence of it? What is the portion of it?
• 3:30
  And that just gets me thinking about food all the
• 3:33
  time and not in a good way. Cut to a
• 3:36
  couple of days ago where I read this sub-stack which
• 3:41
  introduced this concept to me which really blew my mind.
• 3:45
  It was about food noise. About why we are constantly
• 3:50
  planning one meal or the other.
• 3:52
  Speaker 2: Why.
• 3:53
  Speaker 1: After a full meal of food, we're still staring at
• 3:56
  our fridge at 11 o'clock at night. Why, after a
• 3:59
  pop-up from a Swiggy or a Zomato, we instantly feel
• 4:03
  like the urge to order it. Or watching a food program,
• 4:06
  which my producer got me onto and I totally hate
• 4:08
  her for that, will make you cringe and binge at night.
• 4:13
  Why does all of this happen? Is it hormonal, emotional?
• 4:18
  Is it physiological? What is the matter of eating? And
• 4:22
  how do we understand the difference between your hunger and
• 4:26
  your cravings? What is the difference between hunger and thirst?
• 4:31
  What is the difference between hunger and boredom? So to
• 4:35
  know all these things, I have an excellent guest for
• 4:39
  you because I have so many questions and I couldn't
• 4:43
  think of a better person. Please say hello to Dr. Bazeer. Dr.
• 4:48
  Jasjeet Wazir is really interesting. Why? Because he's one of
• 4:52
  those few doctors who will not look at you and
• 4:56
  just think of a pill, not look at you and
• 4:59
  think of a disease. He will look at you as
• 5:01
  a human being and understand that you are filled with
• 5:04
  emotions and hormones and different kind of setups. And I
• 5:08
  was at one of his talks not very long ago
• 5:10
  where he was talking about why there are different kinds
• 5:15
  of people who respond differently to food cravings. Kisi ko zyada,
• 5:18
  kisi ko kam, kisi ko kisi cheez ki craving aur
• 5:21
  kisi ko kisi ki craving hoti nahi. Aisa kyun hota
• 5:23
  hai and he's got a full science so I can't
• 5:26
  wait to dig into his head and find out more. Officially,
• 5:30
  his designation is that of a director at the Department
• 5:34
  of Diabetes and Endocrinology at Medanta but he likes to
• 5:38
  call himself the New Age Metabolic Physician. So with that introduction, Dr. Wazir,
• 5:45
  have we done justice or is there more?
• 5:47
  Speaker 2: Superb. And it's such a beautiful feeling being here with you.
• 5:53
  And a great day. No traffic. It was a pleasurable
• 6:02
  trip here. And to talk on a topic which is
• 6:05
  very close to my heart. But before we go on
• 6:09
  to the podcast, You missed one word in your introduction
• 6:12
  of hunger. Yes. That was love. Food is love. Love
• 6:19
  is pure. And we can't survive without love. And neither
• 6:25
  can we survive without hunger. Now let's just demystify this
• 6:29
  whole thing and take everyone on this journey of the
• 6:35
  universe of hunger. Yes.
• 6:37
  Speaker 1: The universe of hunger. I think that's what this episode
• 6:40
  is all about. Let me start by this one word
• 6:44
  that has really got me thinking so much over the
• 6:47
  past couple of weeks. And it is food noise. People
• 6:50
  have spoken of this on Instagram, etc. Very often. you know, casually,
• 6:56
  but for the first time this year, we actually have
• 6:58
  evidence of a medical document being written on what exactly
• 7:02
  is food noise. I think it's got to do with
• 7:03
  weight loss drugs coming into being. And I was thinking, dude,
• 7:06
  it's supposed to be my job, you know, to.
• 7:20
  Cut down the health noise, right? It's supposed to be
• 7:23
  my job to know all of these things. And yet,
• 7:27
  I don't want to depend on an injection or a
• 7:30
  pill to shut down that food noise. So before I
• 7:33
  ask you how to control it, first explain to me
• 7:36
  in a very easy language what food noise is.
• 7:40
  Speaker 2: So it's very interesting. Food noise is a very recent
• 7:45
  word which has now been kind of endorsed in the
• 7:50
  medical curriculum, but it jumped the queue, not in science.
• 7:57
  It jumped the queue in naming. And you very rightly
• 8:00
  said the new age medications for weight loss basically cut
• 8:06
  off the food noise. And people would then see the
• 8:10
  evolution of this word. People would come to the doctor
• 8:14
  and then they would say that, Doctor, I used to
• 8:17
  have this constant buzzing in my mind and I used
• 8:21
  to be like literally thinking about food the whole day.
• 8:26
  It was intrusive. It was affecting other parts of my life.
• 8:30
  Now with this drug, that thing is cut. So what happened?
• 8:36
  A easily communicative word has come to me. Yeah. Rather
• 8:40
  than its elder cousin, which is hedonic hunger. When I
• 8:45
  say hedonic hunger... Like, what are you saying? Food noise
• 8:51
  connects with you very easily. So the word food noise
• 8:55
  is now being accepted partially in the medical curriculum. Basically,
• 9:00
  it describes its elder brother, which is hedonic hunger.
• 9:05
  Speaker 1: But if I want to explain food noise to my parents,
• 9:07
  and now this festive season is going on, so I
• 9:11
  can only imagine the conversations at home. Abhi Janmashtami se,
• 9:15
  abhi fir ti jayega and then Navratri shuru ho jayenge
• 9:17
  and a whole host of things that are going to happen.
• 9:22
  How do I explain food noise in simple terms to
• 9:25
  people who think yeh toh life hai?
• 9:29
  Speaker 2: So, there are two parts. Food love and food noise. Fine.
• 9:36
  I may love something and the food noise, the other part.
• 9:43
  So what happens is food love is something you would
• 9:46
  like to have. It's optional. You can delay that. It
• 9:50
  does not intrude into your day-to-day activities. For example, let's
• 9:55
  take right now, two hours of travel, hush-bush, I missed
• 9:59
  my breakfast. and navigating through traffic and I was so
• 10:04
  stressed that I'm doing a podcast at India Today with you. Automatically,
• 10:10
  something in my mind got triggered. These are cues. The
• 10:15
  emotional state has triggered a picture of a burger. So
• 10:21
  that has generated that noise in my mind. And I'm constantly,
• 10:25
  I'm talking to you, but I'm thinking of how can
• 10:28
  I get a burger?
• 10:30
  Speaker 1: Now, I'm also thinking of a burger.
• 10:32
  Speaker 2: I'll sabotage this very podcast in saying, oh, my phone
• 10:36
  is ringing. I need to take his call. I'll go outside,
• 10:39
  order a burger and come back. That's food noise. It's
• 10:44
  intruding your day-to-day activities. It's constantly in the background music.
• 10:50
  So it's like you've heard of the term earworm. So
• 10:55
  it's like a sound or a music you like. But
• 10:58
  now instead of that music, you have a sandwich. It's
• 11:03
  constantly there and that incites a process to achieve it.
• 11:10
  It's a seeking behavior that gives you the high. That
• 11:13
  surges the dopamine. And the end result is achieving it.
• 11:19
  So you have an emotional state. You have a mental
• 11:22
  picture of a food which is constantly in your mind,
• 11:25
  especially when your tummy is full. That's one way to
• 11:29
  know is it food love or food noise. I just
• 11:32
  finished my meal and suddenly I want a burger. I
• 11:35
  want a gulab jamun. I want this. I want that.
• 11:39
  What's going on? That's food noise. And it runs through
• 11:42
  a specific neurocircuitry which gets attached to the reward center
• 11:47
  and the pleasure center. Who doesn't want rewards? Who doesn't
• 11:52
  want pleasure? And that's where the neurocircuitry is happening. But
• 11:59
  how do I explain to my mother? That was the
• 12:02
  primary question. It's a hunger. Very easily, it's a hunger
• 12:12
  of the mind, not a hunger of the body. The
• 12:14
  body's hunger is actually what we call as homeostatic hunger.
• 12:18
  10 hours of fasting. And I did a very interesting
• 12:24
  experiment on myself. When the CGM came new in the market,
• 12:29
  so we were provided free samples. Just to try it out,
• 12:32
  get the experience. First few days, readings. But then I
• 12:38
  started observing something very interesting. Full day, hectic work, physical,
• 12:44
  mental fatigue, traffic, we all know. And before I was
• 12:48
  reaching home, I had a picture of food in my mind.
• 12:55
  I had my lunch. I had tea. I had something
• 12:58
  with that. But I have this extreme hunger, that urge,
• 13:05
  which is very motivated. I enter home. And the first thing,
• 13:11
  automatic behavior. I enter the kitchen. On the right-hand side,
• 13:14
  there's a wooden almera. I open it. And there it is,
• 13:18
  the love of my life. That one kg pack at
• 13:28
  times has finished over a couple of days, one kilograms
• 13:32
  of maida with salt. Deep fried. Yeah. But then that
• 13:38
  led to one other thing. Calorie overconsumption, salt overconsumption, but guilt.
• 13:46
  And that guilt further triggered the hunger. I'm giving you example.
• 13:52
  And it had nothing to do with my sugar levels.
• 13:57
  Speaker 1: So you're basically saying that you had the knowledge. The
• 14:00
  CGM will tell you exactly or it will monitor everything.
• 14:03
  It will tell you. And I'll get to the crash
• 14:05
  and all of that in a bit because that's slightly
• 14:07
  more nuanced. People need to understand that. But why is
• 14:11
  it happening that if I want to reward myself, if
• 14:16
  I have a good day, I go back home and
• 14:18
  I feel like, oh, today I've earned it. That extra
• 14:22
  piece of chocolate, I've earned it. Or days I'm extremely sad,
• 14:25
  you know, the day didn't go the way I wanted.
• 14:28
  And then I say, oh, today I need it. So
• 14:31
  why does that automatically link to food? It could link
• 14:34
  to some nice things also. Why is it food that
• 14:38
  gets triggered in our head?
• 14:39
  Speaker 2: Because that's the easily, it's the most easy thing available
• 14:45
  to jack up your dopamine. The calorie-dense foods. Have you
• 14:49
  ever got a high by eating karela?
• 14:54
  Speaker 1: Got a low by eating karela, definitely.
• 14:57
  Speaker 2: So that's the science. That's the biology of food. Why
• 15:03
  do we love chips? Ek aloo dedu aise boil karke,
• 15:08
  will you eat it? But I slice it into thin,
• 15:12
  crispy things. make it really super crispy. The color is beautiful.
• 15:17
  The aroma is there. And then the salt over that.
• 15:23
  Speaker 1: You're making it very difficult to do this podcast. Now
• 15:26
  I'm craving all of that. Now I have a burger
• 15:28
  and bhujia and sandwich and chips all in front of me.
• 15:30
  Speaker 2: But yeah. Yeah. So this is neurochemistry and it is evolution.
• 15:36
  So let's remember one thing and everybody who's attached to us,
• 15:40
  let everybody understand hunger is a survival instinct. If somebody says,
• 15:46
  I don't, I have no hunger, I would be troubled
• 15:50
  much more. If you had no hunger, how will you survive?
• 15:58
  If you didn't know, you have to eat food. So
• 16:00
  why are you eating food? It's the body wanting. So evolutionary,
• 16:05
  what has happened now is that food has become excess.
• 16:10
  We lived in scarcity and negative things were always there.
• 16:15
  You had to run to get food and consume as
• 16:18
  much as you could. Survival. And why were you consuming?
• 16:23
  Because that hunger was there. That wanting food and liking food,
• 16:27
  that pleasure of food was always there. That drives us,
• 16:31
  that motivates you. If you had no motivation, would you
• 16:35
  be doing what you're doing right now?
• 16:38
  Speaker 1: But hold on to that thought. You said liking food
• 16:42
  and wanting food.
• 16:43
  Speaker 2: Yeah.
• 16:44
  Speaker 1: Those are two different things.
• 16:45
  Speaker 2: Yeah. Explain. One is... One is humility. Other is aggression.
• 16:57
  Speaker 1: Okay.
• 16:58
  Speaker 2: So which one is humility? Wanting. Liking. What?
• 17:04
  Speaker 1: Yeah. I need like a detail on this one.
• 17:13
  Speaker 2: So... Let's break down these two things. Normally in normal discussions,
• 17:17
  wanting and liking is actually the same. We don't realize
• 17:22
  when you're wanting food, we're doing something else and a
• 17:25
  different neurochemistry is happening and we're liking food, something else
• 17:30
  is happening. Let's thrash out liking first. Liking is a
• 17:35
  sensory pleasure. You can't like something unless you've tasted it.
• 17:40
  We're talking about food. Unless you've tasted it, you cannot
• 17:44
  like it. It's run by smaller little dots in the
• 17:48
  brain which are run by the opioids, the endocannabinoids. Liking.
• 17:55
  So people on substance abuse with opioids just keep on
• 18:01
  eating because they're liking the food, liking the food, liking
• 18:05
  the food. Opioids. It's a small center. It stays for
• 18:09
  a while. It goes off. Have you ever had a
• 18:14
  meal and said, I'm liking it, I'm liking it, I'm
• 18:17
  liking it, I'm liking it for the next 10 hours? No.
• 18:21
  You've had a chocolate. The taste and the feeling will
• 18:25
  stay for a short period of time. That's what liking is.
• 18:28
  You have to have the, it's a sensory pleasure. Now
• 18:31
  here comes the, the, I won't say devil. But T-Rex.
• 18:41
  Here comes T-Rex is wanting. Wanting is motivation. It's the urge.
• 18:46
  It's the craving. It's a process. So you're going from
• 18:52
  Gurgaon to Jaipur. Fine. There is a process. What excites
• 18:59
  us is the process. How will I enjoy the journey?
• 19:03
  What will I do? What is this? How will I drive?
• 19:06
  Which car will I take? air-conditioned... Planning the holiday versus
• 19:10
  being on one. Planning, process formation, that's wanting. And that
• 19:16
  is run by dopamine. So if we take weight by weight,
• 19:21
  the centers in the brain for wanting us so many
• 19:24
  and for liking us so less. And it's driven by dopamine.
• 19:29
  And then you have all these triggers. Khushi mein khana,
• 19:34
  gam mein khana, veli mein khana. I'm unhappy, I eat.
• 19:38
  So when I'm tired, I lose my appetite. There are
• 19:42
  other people who are tired, they just feel like eating.
• 19:45
  When I'm in a happy mood, I stop eating, I
• 19:47
  lose weight.
• 19:49
  Speaker 1: Who are you?
• 19:50
  Speaker 2: You? Yes. Alien. So that's what is coming out of
• 19:56
  this is all of us are different. We've got different
• 19:59
  barometers for taste, for quantity. You'll see families serving food
• 20:05
  in similar quantities. Their choices are similar. So genetics plays
• 20:11
  an amazingly large role. The ethnicity plays a role, but
• 20:17
  the genetics play an amazingly large role in hunger, in
• 20:21
  food choices. And we have research on that. We can
• 20:24
  talk more about that. But essentially, wanting is a process.
• 20:28
  It's more motivating. That's what craving is all about. Process.
• 20:33
  Now I'm tired. I took the example of the burger.
• 20:37
  You know the high I'm getting right now? is not,
• 20:40
  I haven't eaten the burger, but I'm planning. As soon
• 20:44
  as this podcast ends, how do I get that burger?
• 20:48
  And I want to keep on doing that because I
• 20:52
  want to stay high through the day. That pleasure, that reward.
• 20:59
  Speaker 1: You know, there's an app where you can just order
• 21:03
  food and never really get a delivery.
• 21:05
  Speaker 2: Hmm?
• 21:07
  Speaker 1: There is an app which is now so popular with
• 21:10
  Gen Z and Reddit posts are filled with it. And
• 21:14
  all you have to do is it's just the dopamine kick.
• 21:16
  It's like planning a holiday versus being on one. Just
• 21:18
  the excitement that I'm going to go on. This is
• 21:20
  what I'm going to do. The options. Just looking forward
• 21:23
  to it than just actually living it. So this is
• 21:26
  what happens. And this is typically I'm thinking my day.
• 21:29
  There have been times when, again, I've watched like some
• 21:32
  food show or somebody having something late night. And I
• 21:36
  feel like this urgent need to order it right now.
• 21:40
  Like I need to have a margarita pizza right now.
• 21:45
  Speaker 2: Right.
• 21:46
  Speaker 1: I'll order it by the time it comes. And it
• 21:49
  is so late that I've not even touched it. I've
• 21:51
  probably dozed off to sleep. It'll probably just sit in
• 21:53
  my fridge. But the high, that's when I realized, when
• 21:55
  it happened to me, the high was not in actually
• 21:58
  eating the pizza. It was just in making that order.
• 22:00
  And to tap onto this activity, now there's an actual
• 22:03
  app that exists, which is just nuts, which just explains
• 22:07
  the whole concept. So what I've learned so far from
• 22:10
  you is this, that A, hunger and craving are two
• 22:17
  different things.
• 22:19
  Speaker 2: Craving is a part of hunger.
• 22:21
  Speaker 1: Craving is a part of hunger. So there are two.
• 22:23
  Speaker 2: Hunger is kind of the umbrella.
• 22:26
  Speaker 1: Okay.
• 22:26
  Speaker 2: So you have the body's need, you have the mind's need,
• 22:30
  and you have a third function, executive function. The weakest
• 22:33
  of them all. The weakest part of hunger is the
• 22:40
  executive function, which is run by the front area of
• 22:44
  the brain, the prefrontal cortex. The poor guy is the weakest.
• 22:49
  The first one to get knocked off. How many times
• 22:53
  have we done that? I've done it gazillion number of times.
• 22:56
  Because I'm a professional, I've learnt, I've applied it in
• 22:59
  my life and I enable others to apply it. And
• 23:03
  I always quote my own example. This Bhujia example is
• 23:06
  all over the world. I tell my patients I do that.
• 23:10
  I've done that. Now I have five packs of Bikaner Bhujia,
• 23:13
  one kg packs, which are sealed, lying there. And I'm
• 23:17
  coexisting with them. I'm very happy and they're like, okay.
• 23:20
  Speaker 1: So this happy relationship with Bhujia for you or this
• 23:23
  happy relationship with all things savory and crunchy for me,
• 23:28
  how does one get that? How do I know? Firstly,
• 23:32
  help me understand. How do I know that what I
• 23:33
  have at this point is not the need of my body,
• 23:37
  just the demand of my hormones, maybe, or just the
• 23:40
  demand of my brain. How do I know the difference
• 23:43
  between the two?
• 23:44
  Speaker 2: You're a good mind reader. I was just thinking about this. So,
• 23:48
  very simple. You've just had a meal. And immediately after that,
• 23:54
  whatever you're feeling is not your body. Simple. Second, if
• 23:59
  it stays on through the day, it's troubling you. It's
• 24:05
  intrusive on your functionality. That is a problem. That's the
• 24:11
  mind working. That's where the pleasure centers and the reward
• 24:14
  centers are making you indulge in that process. That's how
• 24:19
  you differentiate. And my journey in that CGM, I found
• 24:25
  those 12 hours of not eating anything, I would feel
• 24:27
  something here. There's no signs. You will not find any signs.
• 24:31
  But practically speaking, everybody in the studio would experience this.
• 24:35
  When you're hungry, your last meal was 10 hours ago.
• 24:38
  You feel the hunger here. And then simple.
• 24:49
  Speaker 1: Is relishing.
• 24:50
  Speaker 2: Oh, I loved it. It's a humble need. You know,
• 24:54
  you said need and want. This is humble. I need food.
• 25:00
  I love the food I had. This is the normal
• 25:04
  kind of hunger. But one hour after your food, you've
• 25:08
  had a bad day and whatever emotional state, this, that,
• 25:13
  you get a picture of a food in your mind.
• 25:16
  A picture of a food in your mind is your
• 25:19
  body does not need it. Your mind is screaming, indulge
• 25:24
  in me, consume those calories. And they are the triggers
• 25:28
  are very well identifiable. Once you identify this hunger is
• 25:32
  hunger of the mind or the wanting, Then the next step,
• 25:37
  this is cognitive behavioral therapy. I'm not a trained psychologist,
• 25:41
  but I've become something like that. Then tell them, identify
• 25:45
  what happened.
• 25:46
  Speaker 1: If you feel like having food, like khana, any kind
• 25:50
  of khana, it is probably your body's need. But if
• 25:53
  you feel like having a specific.
• 25:54
  Speaker 2: Thing, bang on, that's craving. If you have a picture
• 25:57
  of the food in your mind, if you have a name,
• 25:59
  margarita pizza with extra cheese. Hmm.
• 26:05
  Speaker 1: Thin crust.
• 26:06
  Speaker 2: Thin crust. Brother, there's a problem there. But never fight it.
• 26:14
  It's a battle you will lose.
• 26:15
  Speaker 1: I thought there was this 20-minute rule which I've started
• 26:20
  to apply now.
• 26:21
  Speaker 2: Don't fight it. Outlast it. Outlive it. And that is neurochemistry. Again,
• 26:31
  this is what we call as neuroplasticity. My dear colleagues
• 26:37
  who are specialist psychologists know this much more than me.
• 26:41
  I'm more of a functional psychologist than anything else. So
• 26:49
  delaying that urge is again humbling. Fighting it. You guaranteed
• 26:58
  you will fail and then you feel guilty and then
• 27:00
  the whole circuit gets perpetuated again. So outlast it. If
• 27:05
  you can't, give in today. Work in progress. We all
• 27:09
  are work in progress. So behavior modification is a very,
• 27:15
  very big part of chronic disease management. And especially my
• 27:20
  passion expertise of weight management is just full of it. Yeah.
• 27:24
  Speaker 1: So is this 20 minutes enough? Like this 20 minute rule,
• 27:28
  it basically says that If you feel like having that
• 27:31
  one particular thing, wait it out for 20 minutes. If
• 27:34
  after 20 minutes you still want it, perhaps give in.
• 27:37
  If not, then you know it was just a passing thought.
• 27:41
  Speaker 2: You're talking like a math teacher. Very simple thing. And
• 27:47
  I have done it and I get people to do that.
• 27:49
  Don't go by the watch. You're triggering another pathway there
• 27:54
  which you will escape to something else. You've gone to
• 27:58
  a party. You've had your meal. Next thing, what is
• 28:01
  the automatic reaction next? Dessert. Indulge in some social discussions
• 28:08
  or whatever. Delay it as long. You will realize you've forgotten.
• 28:13
  You gave an example. You ordered that pizza. Pizza is
• 28:17
  lying there in the kitchen or in the fridge, just
• 28:19
  sitting there. You might not even look back at it.
• 28:23
  So what have you done? You did it once. It works.
• 28:28
  Let me try it again. And that's how habits form.
• 28:33
  And there is proven science behind it. And when my
• 28:40
  wife would tell me and I would get angry. Yeah,
• 28:43
  I want to eat. I want to enjoy. Why are
• 28:45
  you telling me? But then when the professional part of
• 28:49
  me thought about it and tried it, you mastered it.
• 28:53
  Given sometimes. World is not ending.
• 28:56
  Speaker 1: So how long did it take you to open that
• 28:59
  Bhujia packet?
• 29:02
  Speaker 2: 15 years.
• 29:06
  Speaker 1: I think I can just end this podcast. This is
• 29:08
  not going to go anywhere. How can it take 15 years?
• 29:11
  Speaker 2: But nobody was teaching me. I never had people like
• 29:16
  you who are raising these topics, who are making these discussions.
• 29:20
  Tell me one podcast on hunger. You've been brave enough
• 29:25
  to do it. Kudos to you.
• 29:28
  Speaker 1: I've been hungry enough to do it. Let me put
• 29:31
  it like that. So there are different kinds of hunger.
• 29:36
  There is a difference between hunger and craving. There is
• 29:39
  also a button in your head, which you can not
• 29:43
  switch off, but perhaps can delay. And that delay will
• 29:46
  probably form habits, right? I'm getting it right so far.
• 29:50
  Speaker 2: Okay.
• 29:50
  Speaker 1: Which brings me to next one then. What are these
• 29:54
  different kind of circuits that are getting triggered. And I
• 29:57
  understand a lot of it has to do with your hormones.
• 30:00
  And there's a certain pleasure hormone and there's a certain
• 30:03
  satiated hormone. What I'm getting at is that if I
• 30:07
  have eaten properly, then why is my brain not understanding
• 30:11
  that stop eating. Even after that, why is it going
• 30:16
  ahead that let's eat a little. Why is that happening?
• 30:20
  Speaker 2: So rather than giving a generalized answer, let's take an example.
• 30:24
  driven by hard science. And I'll make it easy to understand.
• 30:30
  So this group of researchers did functional MRI studies. So
• 30:37
  like if I put a pizza in front of you
• 30:39
  and do a MRI, certain areas will light up. Okay.
• 30:42
  And then when you eat it, something else will happen.
• 30:46
  So they took two cohorts, people with obesity and lean people.
• 30:52
  So first thing they did was they induced low sugar
• 30:58
  levels in them. Fine. So whenever our sugars go low
• 31:04
  or hypoglycemia as we call it, it didn't induce hypoglycemia
• 31:08
  but brought down the sugars. The wanting areas of the
• 31:12
  mind got triggered. Wanting usually is equal to calorie dense food.
• 31:20
  See the creator of That has been created for survival.
• 31:26
  A diabetic patient on insulin gets hypoglycemia. They go into
• 31:31
  auto mode. They will find sweets anywhere in the house.
• 31:38
  The husband has hidden it. The wife has hidden it.
• 31:40
  They will reach there and consume it. It becomes an
• 31:44
  automatic behavior. So they found that the wanting areas in
• 31:49
  people who had obesity... lighted up much more than the
• 31:56
  lean people. That's one part. Manageable hai. But then what
• 32:00
  happened in the satiety part, both were fed similar amounts
• 32:08
  of food, standardized. They found that the satiety center in
• 32:14
  the lean people lit up. Prefrontal cortex, ki aap khana
• 32:18
  ho gaya, buss. That didn't light up as much in
• 32:23
  people with obesity. So what you have is inability to
• 32:30
  say no. I'm translating into what I am feeling. But
• 32:34
  what is happening that cessation signal is not reaching there.
• 32:39
  That area is not getting lit. And they are driven
• 32:42
  by all the neurotransmitters, the GLP, the CCK, the insulin.
• 32:48
  And the hunger is driven by ghrelin, all these kind
• 32:51
  of hormones. But it's more relevant for us to internalize
• 32:55
  what is happening. So when people lose weight, you find
• 33:00
  changes in the satiety and hunger happening. It's a journey.
• 33:05
  It's not a short-term thing that you lose weight in
• 33:09
  three months. Life is sorted.
• 33:11
  Speaker 1: It will come back.
• 33:14
  Speaker 2: So this is what is happening. Imbalance, insatiation. hunger, wanting
• 33:20
  is all driving the under, not under, the over consumption
• 33:25
  of food that we see. And then the direct link
• 33:28
  with obesity, the starting point for 250 diseases or disorders.
• 33:34
  Now it makes a linear line from apes to gen
• 33:40
  alpha or whatever we call them. So we've done it all. Yeah.
• 33:45
  Speaker 1: If this is noise, And it can be trained.
• 33:50
  Speaker 2: Yeah.
• 33:51
  Speaker 1: Where do I start?
• 33:54
  Speaker 2: Identify. Accept. Any behavior change, at least in my field,
• 34:01
  requires acceptance. Acceptance requires me to make you understand. It
• 34:05
  requires a coach. Once you've accepted, then there are various
• 34:12
  ways you can take care of these things, delaying it.
• 34:16
  You have to coexist with it. If you think they
• 34:20
  are gone, they're not gone. All of our neurocircuitry is there.
• 34:25
  Now I'll give you an example of substance abuse, de-addiction.
• 34:31
  The circuits stay there and once that substance usage stops,
• 34:37
  at times the wanting sensation keeps on increasing, making relapse
• 34:43
  rates very high in very addictive substance abusers.
• 34:48
  Speaker 1: But are you saying that food addiction is same.
• 34:51
  Speaker 2: As substance addiction? As a healthcare giver, my conversations never
• 34:56
  dwell on negative expressions. I may use very soft words
• 35:01
  like attraction.
• 35:02
  Speaker 1: But in your brain, it's the same circuit?
• 35:03
  Speaker 2: Yeah, it's the same circuit. It's the same. See, you
• 35:08
  have an anatomical structure which is this by this and
• 35:12
  weighs one and a half or two kgs or whatever.
• 35:15
  But see the amount of processing happens. You can't have
• 35:18
  one different center for coffee, one for pizza, one for burger,
• 35:22
  one for whatever.
• 35:23
  Speaker 1: It's just one.
• 35:25
  Speaker 2: Yeah.
• 35:25
  Speaker 1: Which is reward. Yes.
• 35:27
  Speaker 2: Reward, pleasure. That's the beauty of the creation. We're just
• 35:32
  deciphering all of that right now.
• 35:34
  Speaker 1: So is there any way to clear your mind's signals?
• 35:39
  So that your mind knows that you are now full.
• 35:45
  The very popular theory is that it takes about 20
• 35:47
  minutes for the signal from your gut to go to
• 35:50
  your brain to say that now you're full. And generally
• 35:54
  people who overeat or who eat very quickly get it
• 35:57
  wrong over there. So they say that, okay, you should
• 36:01
  first start with your fiber, then eat your proteins, have
• 36:05
  your carbs in the end. And hopefully after that, take
• 36:08
  a little bit of a break. And if you're still hungry,
• 36:10
  then go for something. Now, this sounds very right on paper.
• 36:13
  But who eats? Who stays on the table for 20 minutes?
• 36:15
  No one will wait for 20 minutes to tell if
• 36:18
  they're hungry or not. It's all practical. So, what is
• 36:22
  a practical way of knowing that this much is done
• 36:26
  and that's it?
• 36:27
  Speaker 2: Grandma and grandma. My wife, one of her, you know, most,
• 36:32
  she repeats this so many times, is her grandma used
• 36:35
  to say that when there's 60% space in the stomach, 40%,
• 36:42
  something like that. Stop eating then. Same thing what you're saying.
• 36:49
  And you feel that. And if you're in a hurry,
• 36:52
  then nothing is happening. How will those neurotransmitters go, do this,
• 36:57
  do that? So how fast we eat food? Where are
• 37:03
  we eating food? Are we in a situation where, oh,
• 37:07
  I've got to catch this flight. Let me carry the
• 37:10
  burger with me or, you know, make something which I
• 37:13
  can carry with me is disturbing the whole system. You
• 37:18
  can't change that. The impact is visible. It's happening. We
• 37:23
  have to change.
• 37:25
  Speaker 1: So there's no food on the go.
• 37:27
  Speaker 2: Shouldn't be.
• 37:28
  Speaker 1: Food should be like a dedicated time. where you sit
• 37:32
  with yourself and only the food, which is what they
• 37:34
  say for kids, that let them feel their hunger cues,
• 37:37
  let them understand, let them feel the texture, taste, all
• 37:40
  of that. That's what you also have to do. But
• 37:42
  what difficult, dog?
• 37:44
  Speaker 2: No, it's possible. And as I told you in the beginning,
• 37:47
  I give my example and my life examples to make
• 37:51
  things clearer. I don't quote anybody. My two daughters, they're
• 37:55
  one year apart. And for the longest I remember, they
• 37:59
  would be sitting on their chairs, And would be having
• 38:03
  their food. And my wife again jokes about it. That
• 38:11
  she used to tell my daughters that I don't know
• 38:13
  how to run the TV. Dad will come in the
• 38:16
  evening and he will do that. But that, you know,
• 38:19
  that thing of sitting there, enjoying the food. And believe me,
• 38:24
  I see how my daughters, they're 19 and 20, how
• 38:29
  they relish food. And that has made me understand one thing,
• 38:34
  that wherever possible, I want to just sit and enjoy
• 38:38
  the food. If you gobble the food, you won't even
• 38:41
  remember what you've had. The savor, the taste of food,
• 38:47
  you don't know. So you'll keep on consuming more and
• 38:50
  more and that wanting feeling is going more and more.
• 38:56
  So you can want something. So I may want a
• 39:00
  burger really loud. Same process as I described earlier. I
• 39:05
  go out, I order it, but I just have half
• 39:08
  of it and leave it.
• 39:09
  Speaker 1: But if you are not taking GLP-1 drugs or weight
• 39:12
  loss drugs, GLP-1 is basically a hormone that is made
• 39:16
  in your body, right? What is the way to activate it?
• 39:20
  Let me give you an example. Say a patient comes
• 39:24
  to your clinic and he comes and says, I am
• 39:26
  very hungry. I'm not trying to control it. So, what
• 39:47
  would you say to such a patient? What should they
• 39:50
  be doing?
• 39:52
  Speaker 2: Fortunately, there is an answer. Unfortunately, it's not applicable. Fortunately,
• 39:59
  the answer is cognitive behavioral therapy. But then, you know
• 40:05
  what the word therapy means. Multiple sessions, long sessions, and
• 40:11
  people who need to be qualified in understanding this axis.
• 40:17
  giving multiple sessions. It is painstaking. Everything is fast. I
• 40:22
  need instant results. That's the unfortunate part of it. The
• 40:27
  fortunate part is we have a solution. But the thing is,
• 40:31
  will you be able to, you will start, but will
• 40:34
  you be able to persist it because the results become
• 40:38
  slower and then you open up your app or there
• 40:41
  is a solution to hunger. Take the pill, take the injection.
• 40:46
  It's something which I never put into my moral compass
• 40:50
  that is this right or is this wrong. These are options.
• 40:54
  Wherever applicable, apply them. So that's how I've become like
• 40:59
  three-fourth psychologist along with this.
• 41:02
  Speaker 1: Help me understand this. From what I know about cravings
• 41:06
  and what drives cravings is that it's multiple factor. There
• 41:11
  is a component of the amount of protein you're eating,
• 41:13
  how you're sleeping. amount of water in your system, all
• 41:17
  of that. Is there a checklist or a way in
• 41:21
  which a sustained lifestyle will ensure that my signals are
• 41:24
  working uninterrupted? They're not getting triggered by cravings, not getting
• 41:28
  triggered by emotional eating, not getting triggered by, say, you know,
• 41:33
  hangry feelings. Is there a way in which I can
• 41:37
  look at it more holistically?
• 41:39
  Speaker 2: So that's what lifestyle is. Let's go back in time
• 41:44
  and look at our grandparents. They were the perfect chronobiology.
• 41:51
  Suraj utha, wo uthe. Suraj duba, wo sohe. And I'm
• 41:58
  quoting my grandmother. Her day used to start with walnuts, almonds,
• 42:03
  a cup of tea, thodi si sugar usme, no biscuits, nothing.
• 42:08
  Then her breakfast. And then you could you could predict
• 42:13
  the time by watching her, what is she doing. And
• 42:18
  she couldn't read a watch. This is in harmony. And
• 42:23
  she had answers to all of my science questions in
• 42:25
  her own ways. She didn't know what gravity is, but
• 42:31
  she would surely tell you what happens with gravity. If
• 42:34
  you jump off the fifth floor, you know what is happening. So,
• 42:38
  That is what needs to be done. The lifestyle needs
• 42:41
  to be tailored to that. If we micromanage things, it's difficult.
• 42:47
  It's not difficult. It's kind of impossible. And if you're
• 42:51
  monitoring multiple things, the quantity, just imagine doing this for
• 42:55
  a day. How much water? What kind of water? How
• 42:59
  much protein? What kind of protein? What fat? Good fat?
• 43:03
  Bad fat? Carbohydrate? Refined? Complex carbohydrates? Micronutrients. This is just
• 43:11
  one breath. Is it easy?
• 43:16
  Speaker 1: But it should be easy.
• 43:19
  Speaker 2: Well, then if it was so easy, if it was mathematics,
• 43:25
  we won't be having this podcast.
• 43:27
  Speaker 1: I particularly want to know what's the matter with night cravings.
• 43:30
  Why have I eaten well at 8 o'clock? I've had
• 43:35
  a complete meal. But why am I standing in front
• 43:37
  of the fridge at 11 o'clock? Why is that happening?
• 43:40
  Speaker 2: It's very easy to push a truck when 10 people
• 43:43
  are pushing it. You've had a hectic day. Extreme physical
• 43:55
  and mental fatigue. You've navigated through the traffic and you
• 43:59
  know what it is like. Even if you're being driven,
• 44:03
  there are people who are crossing you, honking you, looking
• 44:07
  at you like this. That's one part. And you work
• 44:13
  like 16-18 hours a day. You reach home. 10.30 9.30
• 44:22
  You've already broken the physiological stream of hormones. Chrono medicine. Subha, sunrise, sunset.
• 44:34
  You've already broken that. So you're Cronobiology is destroyed. You
• 44:43
  perpetually lived in stress through the day. Stress increases which hormone?
• 44:51
  Speaker 1: Cortisol.
• 44:52
  Speaker 2: Cortisol. At that point of time, what should cortisol be
• 44:57
  at night?
• 44:58
  Speaker 1: It should be dipping.
• 45:00
  Speaker 2: Yours is like beyond the roof. And then what is
• 45:06
  going to get triggered? Hunger. You have all the obvious reasons.
• 45:14
  And then you add petrol to the fire. You're watching
• 45:20
  a favorite show. A food show.
• 45:23
  Speaker 1: That's it.
• 45:25
  Speaker 2: Done. Ten people gathered. Truck ran away. This is what
• 45:31
  is happening. And you don't sleep well at night. I
• 45:36
  mean you mean somebody doesn't sleep well at night. One day.
• 45:41
  One poor night. Next day morning your ghrelin levels are
• 45:45
  all over the place.
• 45:46
  Speaker 1: Ghrelin levels?
• 45:47
  Speaker 2: It's a hunger hormone. So there are these many satiety
• 45:52
  hormones and there's one T-Rex hunger hormone. We still haven't
• 45:58
  been able to crack that. That's evolution. It's all over
• 46:02
  the place. So you don't sleep well. You get up
• 46:07
  in the morning. You have that ghrelin really all over
• 46:11
  the place. And then the cycle keeps on getting perpetuated.
• 46:15
  We live in it and say that this is the
• 46:17
  new normal. Can we do something about it? Maybe not everything,
• 46:24
  but put the pieces in a better place.
• 46:29
  Speaker 1: So I like the example you've given. You're saying that
• 46:32
  nothing is driving your cravings. It's a combination of things.
• 46:36
  It's the fact that you are imbalanced about your work schedule,
• 46:41
  poor sleep, stress levels, all of this is contributing to
• 46:47
  hunger cravings. Is there anything else that contributes?
• 46:50
  Speaker 2: Food technology. Oh. Instant. Instant noodles, instant burger, instant... Why
• 46:59
  do we call it fast food? Let's understand. My understanding
• 47:03
  of fast food. Fast in ordering. Fast in delivery. Fast
• 47:10
  in food, fast in happiness. So, is it fast food?
• 47:16
  That's what it is.
• 47:17
  Speaker 1: Fast in sugar spike. And if that sugar spike happens, then....
• 47:22
  Speaker 2: Up, down, cortisol is going somewhere. GLP is going somewhere.
• 47:27
  Ghrelin is going somewhere. Insulin resistance is telling its own story. So,
• 47:33
  your hunger, your satiety... Your prefrontal cortex, your executive functions
• 47:40
  are all disordered. Instant. Instant.
• 47:45
  Speaker 1: But it won't happen in everyone. What I'm quoting is
• 47:48
  science that.
• 48:06
  Speaker 2: They have done studies to support these things. They found
• 48:10
  defects in them. Will it happen with me? Will it
• 48:13
  happen with you? We don't know. But it is likely
• 48:16
  to happen. The new buzzword is cortisol. Doc, my cortisol
• 48:22
  is very high. It's all over the place. They're right.
• 48:26
  They're right. But is there a drug to set that right? No.
• 48:32
  It's my lifestyle. It's getting up in time, sleeping on time.
• 48:37
  I know I sound like my mother or my grandmother,
• 48:41
  but they were always right.
• 48:43
  Speaker 1: No, you're not. Actually, this is not surprising me because
• 48:46
  every right-minded doctor I have met, even longevity experts, even
• 48:51
  people who understand food science very, very deeply, they all
• 48:53
  tell me it's got to do with the basics. If
• 48:57
  you're eating at the right time, sleeping at the right time,
• 49:02
  hours of work.
• 49:05
  And you try and stay happy as much as possible
• 49:08
  and you're doing the right kind of exercise. That's all
• 49:10
  that you really need. Everything else, it's like a symphony.
• 49:14
  Speaker 2: Right?
• 49:14
  Speaker 1: Everyone has to do their own thing in their orchestra.
• 49:17
  If even one person is off, you'll be off tune.
• 49:20
  Speaker 2: Yeah.
• 49:20
  Speaker 1: Right? It's something like that. And you're saying the same
• 49:23
  thing contributes to hunger as well. And once you've eaten
• 49:26
  a lot, then your vicious cycle will start. This is...
• 49:30
  This is... Okay. But let's talk about this entire secret
• 49:38
  of making food... Addictive. In the beginning, we talked about
• 49:43
  your addiction, drug addiction, abuse addiction. The circuit in your
• 49:49
  brain is the same as food addiction as well. And now,
• 49:54
  there is a secret that the food industry knows of
• 49:58
  how to ensure that that is triggered. This bliss point.
• 50:04
  Can you explain to us Because for far too long,
• 50:08
  this has been a secret, but it needs to get out.
• 50:12
  Speaker 2: Can I enact the bliss point? Yes. Yeah. Fine. That's bliss.
• 50:22
  It's a four-lettered word, but it's like an amazing experience. So,
• 50:30
  there was this gentleman by the name of Howard Moskovich. So...
• 50:36
  He started working on different food combinations and this and that.
• 50:42
  Speaker 1: You're talking about Howard Moscovich in the 1970s and 80s? Yeah, yeah, yeah.
• 50:48
  Speaker 2: And then later on, there was this Pulitzer Prize, Michael...
• 50:54
  Michael Moss. Michael Moss. So he put it in his book. Sugar,
• 51:02
  salt and fat. That was the name of the book.
• 51:07
  where they described how the food industry is making the
• 51:12
  various permutations combinations of these very things to make the
• 51:18
  palatability possibly obviously for commercial gains. That's what the bliss
• 51:27
  point is all about engineering these things for maximum palatability
• 51:35
  maximum pleasure And maximum reward. So if you search the
• 51:43
  literature of functional MRI studies for bliss point, you'll find
• 51:48
  some evidence. But these are expensive things. You'd rather have
• 51:52
  people taste it and say, oh, wow, I feel good.
• 51:56
  Than doing a MRI and putting them in a machine
• 51:59
  and like, let's see which area pops up. So you'd
• 52:01
  rather ask them, how do you feel? And then that's
• 52:04
  how the food industry is is kind of culturing the
• 52:09
  food for palatability.
• 52:11
  Speaker 1: Yeah, and this is very interesting because I was reading
• 52:13
  that if you give more than one of these three,
• 52:17
  people will stop. Like if you have something which is
• 52:19
  too much sugar, you will perhaps reach a point and
• 52:21
  you say it's too sweet. If it has too much salt,
• 52:24
  you will say it's too salty. If it is too
• 52:25
  greasy or it has too much fat, you will say
• 52:27
  it's too much fat. But it's somehow the combination of
• 52:30
  three that does not make you stop and makes you
• 52:34
  want to go and reach for the next one, right?
• 52:36
  And which again got me thinking that perhaps the reason
• 52:39
  why the Supreme Court is now asking FSSAI that you
• 52:42
  put high sugar content, high salt content, high fat content
• 52:45
  in big labels in front of the pack. So that
• 52:48
  people understand. It's precisely to break this bliss point, right?
• 52:53
  To make, to expose the industry and to say that
• 52:55
  you are giving food addiction to people by doing this combination,
• 52:58
  that will have to be stopped.
• 53:02
  Speaker 2: So I'll put some more science to that because I
• 53:05
  myself consider, I'm considered to be a political person. But
• 53:12
  through our efforts, let's first, before we have a change
• 53:16
  in the labeling and all, let's first create that awareness.
• 53:21
  So there is a U-shaped curve. The lower part of
• 53:25
  the U is the bliss point. Too less, too much.
• 53:31
  Palliability is bad. So that lower part of that U,
• 53:35
  this applies in health and disease. Weight is very less,
• 53:41
  so it is a disease. Weight is very high, so
• 53:43
  it is a disease. That's where we came up with
• 53:46
  the definition of obesity. That's where we came up with
• 53:50
  the numbers for blood glucose levels. That's where we came
• 53:54
  up with the cutouts for blood pressure. This is the
• 53:57
  healthy point. If it is too less, it's a problem.
• 54:00
  If it is too high, it's a problem. Same thing
• 54:03
  is applying for the bliss point. So it's like a
• 54:07
  graphic equalizer, which gives you the most pleasant sound. So
• 54:11
  you listen to it more and more and more. That's
• 54:14
  sound engineering. This is food engineering. You get the best result.
• 54:18
  I love my songs. I love my burger. Because somebody
• 54:23
  decided I need to play around with... But it's a
• 54:26
  good thing. But too much indulgence will make it bad.
• 54:31
  Speaker 1: So is there a way to a cheat code to
• 54:35
  find out that this is a bliss point and I
• 54:38
  should stay away from it? In your mind, can you
• 54:41
  give a signal to know that listen, this is a trap.
• 54:44
  Don't fall for it. Yeah.
• 54:46
  Speaker 2: Photo of the food and information which you provided, which
• 54:50
  we are providing that these are calorie dense foods. Have
• 54:54
  it sometimes. But If you're repeatedly having the same thoughts,
• 54:58
  that is a problem. It's a simple way to know.
• 55:01
  There's no rocket science to that.
• 55:04
  Speaker 1: Let's talk about emotional eating. A lot of people, I mean,
• 55:10
  the movies have abused this. If you break up, you're
• 55:12
  sitting with a tub of ice cream. And if you're
• 55:17
  going through a rough patch in your life, you'll probably
• 55:20
  see people expand in size or lose too much weight.
• 55:24
  All of that has been shown. But how does emotional
• 55:26
  eating trigger? And is this a way to stop it?
• 55:31
  To understand the pattern. That this is emotional eating. I
• 55:35
  have to put a check. I have to delay it,
• 55:37
  like you said. Not cut it off, but delay it.
• 55:40
  Speaker 2: So, it's like you know, you've had a bad day.
• 55:47
  As you mentioned, you had a breakup. Somebody humiliated you.
• 55:52
  Speaker 1: And Can I give you my example from yesterday? It
• 55:57
  wasn't a bad day. It was an okay day. It
• 56:02
  wasn't like exceptionally great or whatever, but it was an
• 56:04
  okay day. I was happy with how the day went
• 56:06
  or whatever. I do IF. So I finish eating by 6.30
• 56:10
  most of the time. I reached home, everything was fine.
• 56:13
  And I generally make it a point to eat high
• 56:15
  amount of protein so that it stays in my stomach
• 56:17
  for longer and I'm not craving, etc. Everything happened. But
• 56:20
  for some reason... At 10.30 at night, I was craving
• 56:24
  a peanut butter shake. Now in my head, I know
• 56:28
  why this is happening. Because just yesterday, I shot a
• 56:31
  video comparing peanut butter with almond butter. And for some reason,
• 56:35
  that image did not leave my head. And I had
• 56:38
  to go at 10.30 at night to make myself a
• 56:41
  peanut butter shake. And I know exactly the amount of
• 56:44
  calories I'm eating. I know exactly why this is bad
• 56:47
  for me. But I feel, you know what? How long
• 56:49
  will I keep thinking about this? Let's just go and
• 56:51
  make it and just finish.
• 56:52
  Speaker 2: Right?
• 56:53
  Speaker 1: Maybe I'll get good sleep after that.
• 56:55
  Speaker 2: Exactly.
• 56:56
  Speaker 1: Why did that happen?
• 56:58
  Speaker 2: Did you have it? Yes, you did.
• 57:00
  Speaker 1: Yes.
• 57:00
  Speaker 2: You did good for yourself. But did you feel guilty
• 57:03
  after that?
• 57:03
  Speaker 1: Yes.
• 57:04
  Speaker 2: But that's the wrong thing. Most of the days, last
• 57:08
  10 times, this has happened. 9 times. If you walk
• 57:13
  through it, you've done great. And that one time you
• 57:18
  gave into it is that pleasure which you love. It
• 57:22
  hasn't harmed your body, has it?
• 57:24
  Speaker 1: But the calories are.
• 57:25
  Speaker 2: In, no? There's nothing in a day's calories. It's in
• 57:28
  a lifetime what you're doing that makes the difference.
• 57:31
  Speaker 1: But if I start thinking like this every day, then
• 57:33
  there's a problem, right?
• 57:35
  Speaker 2: That you're aware of. Awareness. Awareness. So you have everything
• 57:41
  it takes. You have that awareness. You identified the trigger. Now,
• 57:48
  just by saying stress is not enough, you put a
• 57:52
  label on it that I saw X, Y, Z thing,
• 57:56
  which triggered it. Now, this is again neurobiology. It's psychology.
• 58:02
  When you put a label on an emotion, you're already
• 58:05
  taken care of it 50% times. I'm sounding more like
• 58:09
  a psychologist. So once you've labeled that, half of the
• 58:16
  thing is done. You could read the textbook and see
• 58:20
  what I'm saying. Next thing, what you did is don't
• 58:24
  resist it. Delay it or give in to it. Just
• 58:32
  that one time.
• 58:35
  Speaker 1: Yeah, but I did delay it. I was thinking about
• 58:39
  it at 8.30 also. I waited till 10.30, which made
• 58:42
  it worse. And then at 10.30, I had half a glass,
• 58:46
  though I had made a full glass. And then I
• 58:49
  told myself, let me finish the damn thing. So I
• 58:53
  went in with the whole glass. And this morning I
• 58:56
  woke up and I was craving coffee. And I'm like, see,
• 59:00
  I have to pay more and I have to have
• 59:02
  that coffee again.
• 59:04
  Speaker 2: This also proves one thing that that circuit will stay there.
• 59:08
  Remember that what I said. We don't lose any such circuitry.
• 59:13
  It becomes redundant. But the slightest of trigger, we don't know.
• 59:18
  We can't identify. It may be the smallest of things.
• 59:20
  You're watching a show. It has triggered the same thing
• 59:23
  with a similar vengeance and you failed. Shit, I have failed.
• 59:28
  I failed. No, it's nothing like that. That's the biology.
• 59:32
  It will happen. But the frequency of these things happening
• 59:36
  will keep on becoming more and more. Relapse, remission, all
• 59:42
  these things. It's a part of neurobiology. It's a part
• 59:46
  of food attraction, drug abuse. All these things run on
• 59:53
  similar pathways. They can always get reactivated.
• 59:57
  Speaker 1: Right. Let me ask you one more thing. Is it
• 1:00:00
  true that if you're craving some day's sugar, something is
• 1:00:05
  off with your hormones?
• 1:00:07
  Speaker 2: No. Unless you're hypoglycemic.
• 1:00:12
  Speaker 1: So all these Instagram reels that say that because you
• 1:00:15
  did not have enough protein, that's why you're craving sugar.
• 1:00:17
  Or because you've not slept, that's why your body is
• 1:00:20
  craving sugar.
• 1:00:20
  Speaker 2: Because you've not slept is right. And that sugar is
• 1:00:24
  a metaphor for calorie-dense food. It could be a burger,
• 1:00:31
  it could be a pizza, it could be a gulab jamun,
• 1:00:33
  it could be a samosa. Everyone's end result is the same,
• 1:00:36
  that spike. So why are we demonizing that sugar?
• 1:00:43
  Speaker 1: Got it.
• 1:00:44
  Speaker 2: It's coming from everywhere. The sugar spike will happen that way.
• 1:00:47
  If you have raw sugar, it may be more. But
• 1:00:50
  it's similar in all of them. Everything is refined. The
• 1:00:55
  more you refine it, the more the peak happens. Right.
• 1:01:00
  Speaker 1: So sleep you're saying is the biggest contributor to your
• 1:01:06
  body not getting the signal of fullness.
• 1:01:09
  Speaker 2: How good are you at investing? If you got a
• 1:01:13
  one crore lottery, what would you do?
• 1:01:17
  Speaker 1: Apply the 60-40 rule.
• 1:01:18
  Speaker 2: You diversify your investment. Yeah. That's intelligent. But here, why
• 1:01:25
  did you go the other way around? You put everything
• 1:01:27
  on one thing. Multi-factorial means it is multi-factorial. There is nutrition,
• 1:01:37
  there is fitness, there are medications, and then there is sleep,
• 1:01:41
  then there is stress. If I give five reasons, that
• 1:01:45
  means I'm automatically creating five solutions. That becomes the power
• 1:01:52
  punch of health. Isn't it simple? Back to the sleep
• 1:01:56
  part of it. Sleep is disturbing your circadian rhythm. We
• 1:02:01
  talked about ghrelin. That's totally beyond the scales. Your cortisol
• 1:02:09
  is disturbed. Cortisol goes to your mood centers, goes to
• 1:02:12
  your appetite centers and triggers hunger. Your cravings and likings
• 1:02:18
  and all. And then you have insulin resistance. If you
• 1:02:21
  keep on gaining weight, insulin resistance will come. So all
• 1:02:24
  those centers are essentially becoming resistant to the normal feedback Suppression.
• 1:02:32
  You have leptin. The satiety hormone. People who gain weight.
• 1:02:38
  It fails to suppress the appetite. Up there. Insulin resistance.
• 1:02:43
  What happened? He is also doing the same. Excess cortisol.
• 1:02:47
  It stimulates. That part. That wanting. That craving. That urge.
• 1:02:53
  That process making. So you. And then you have. The
• 1:02:58
  T-Rex monster. ghrelin. So everything seems to be in sync
• 1:03:06
  to promote hunger. Triggered by these things that we talked about.
• 1:03:11
  Speaker 1: I think it's a good time on the podcast to
• 1:03:15
  do a quick check because on Instagram or basically on
• 1:03:18
  social media, you have a lot of these myths where
• 1:03:22
  people say that if you eat this, hunger will be suppressed.
• 1:03:26
  So I want to do a take it or trash
• 1:03:28
  it with you which is On hunger suppressants. So what
• 1:03:33
  do we do in this segment is that I tell you, okay,
• 1:03:35
  will this work? And you tell me whether you should
• 1:03:37
  take it or you should just flush it out, like
• 1:03:39
  trash it away.
• 1:03:40
  Speaker 2: Okay.
• 1:03:41
  Speaker 1: So are you ready?
• 1:03:42
  Speaker 2: Okay.
• 1:03:43
  Speaker 1: This is take it or trash it, hunger suppressants edition. Okay.
• 1:03:48
  This is very popular online. Berberine, calling it nature's ozempic.
• 1:03:53
  Speaker 2: Trash it. Why? Because there is no enough science.
• 1:03:58
  Speaker 1: Just not enough science. Okay. Chewing gum can curb appetite.
• 1:04:02
  Speaker 2: Yes, it can. Your mind gets diverted.
• 1:04:05
  Speaker 1: So it works.
• 1:04:06
  Speaker 2: It's a mind game. Okay.
• 1:04:10
  Speaker 1: Fenugreek as an appetite suppressant.
• 1:04:13
  Speaker 2: Some science, but not clinically proven. If it works for you,
• 1:04:17
  do it.
• 1:04:18
  Speaker 1: So take it.
• 1:04:19
  Speaker 2: Yeah. Okay.
• 1:04:21
  Speaker 1: Okay, this is interesting. Fiber appetite tablets.
• 1:04:24
  Speaker 2: Yes.
• 1:04:26
  Speaker 1: Or some people just have E sub gold to suppress hunger.
• 1:04:29
  Does that work?
• 1:04:30
  Speaker 2: So fullness. So you're creating fullness. With fullness, the satiety
• 1:04:35
  signals go. But it's not as easy as mechanical stretching
• 1:04:40
  of the stomach. The calories, the carbohydrates, the fat, all
• 1:04:45
  are triggering those satiety and those hunger hormones. So it's
• 1:04:49
  not that if you have E sub gold, it suppresses
• 1:04:52
  your appetite. But that fullness signal... would lead to a
• 1:04:56
  reduction in the appetite. But over a period of time,
• 1:04:59
  you get used to it. It doesn't work. So take it,
• 1:05:05
  but don't use it as a single pillar for health
• 1:05:08
  management or weight loss. Got it.
• 1:05:10
  Speaker 1: Drinking water first to curb your appetite.
• 1:05:14
  Speaker 2: Same fullness. Same fullness. Some people say it dilute your
• 1:05:18
  stomach enzymes or your acid. No major science in that. Okay. Okay.
• 1:05:24
  Speaker 1: The 20-minute rule. Wait for 20 minutes for the craving.
• 1:05:27
  Speaker 2: Do it.
• 1:05:28
  Speaker 1: Take it.
• 1:05:29
  Speaker 2: Okay.
• 1:05:30
  Speaker 1: Protein powder before meals to curb hunger.
• 1:05:33
  Speaker 2: So protein is thermogenic. It burns a lot of calories.
• 1:05:38
  It triggers the satiety hormones. Should work. Okay.
• 1:05:44
  Speaker 1: Jeera water or ajwain water on an empty stomach will
• 1:05:47
  suppress appetite throughout the day.
• 1:05:50
  Speaker 2: Let's not be categorical here. If it works for you,
• 1:05:54
  please do it. It's a natural thing, won't harm you.
• 1:05:57
  If it benefits you, thumbs up. Okay.
• 1:06:01
  Speaker 1: And this is one of the things that really gets
• 1:06:05
  me going. This is the soft after meals. Supposed to
• 1:06:10
  be a good replacement for a sugar craving.
• 1:06:15
  Speaker 2: I have no idea, but I know it smells good.
• 1:06:19
  Speaker 1: Okay, another one which is very popular with people to
• 1:06:23
  swap a low calorie version of what they're craving. Does
• 1:06:27
  that work? Or should you just eat what you're really
• 1:06:29
  craving for?
• 1:06:30
  Speaker 2: So you can work around the quantity. Well, end of
• 1:06:35
  the day, in metabolic medicines, calories is the end result.
• 1:06:40
  Whatever path you're taking, be it nutrition, be it fitness,
• 1:06:44
  be it cognitive behavioral therapy be it the weight loss
• 1:06:49
  medications end of the day the final determinant is the
• 1:06:52
  calorie intake and the meal composition so if you have
• 1:06:58
  to eat means your mind has said brother you have
• 1:07:02
  to have reduce the quantity the calorie goes down so
• 1:07:07
  what is diet coke diet coke is that less calories
• 1:07:11
  if you have to have means nothing in this world
• 1:07:14
  stopping you might as well indulge in a diet coke
• 1:07:18
  and reduce the calorie. But see, it's never about one moment.
• 1:07:24
  It's a movement. It's a process. It's a journey you
• 1:07:27
  have to do all your life. Got it.
• 1:07:30
  Speaker 1: And the last one. Have you heard of this exotic
• 1:07:33
  food for weight loss? It's called the African mango extract.
• 1:07:37
  It's very popular online.
• 1:07:39
  Speaker 2: It's above my bandwidth.
• 1:07:42
  Speaker 1: So definitely trash it. So one thing which has been
• 1:07:46
  absolutely revolutionary in understanding food noise has been actually the
• 1:07:50
  discovery of food noise came in through understanding of GLP-1 drugs,
• 1:07:54
  weight loss drugs as well. What is GLP-1 drugs doing?
• 1:07:59
  That conversation has been removed from your mind. What was
• 1:08:03
  constantly going on in your mind was that I want
• 1:08:04
  to eat Gulab Jamun today. Today I am going in
• 1:08:07
  the evening so I want to have this fish. Or
• 1:08:11
  I want to have bujjiya in your case, a margarita
• 1:08:14
  pizza in my case, right? What is this drug doing
• 1:08:19
  to you?
• 1:08:19
  Speaker 2: So it's basically activating those satiety centers, the hedonic hunger centers,
• 1:08:25
  the wanting centers. It just clips it. So GLP is
• 1:08:30
  one of the strong drivers. It's not the only driver,
• 1:08:33
  but for suppressing them. So this is an agonist. So
• 1:08:37
  it stimulates that and you get satiated. More importantly, those
• 1:08:45
  feelings are dispelled. Also, at the level of the stomach,
• 1:08:51
  it reduces the gastric emptying. So your tummy is more
• 1:08:55
  full most of the time. That's something we kind of
• 1:08:58
  forget inside. discussions. But the primary benefit is happening from
• 1:09:04
  killing the food noise. But it doesn't happen in everyone.
• 1:09:09
  Speaker 1: Yeah, so there are some people who just don't respond.
• 1:09:11
  Speaker 2: Yeah, they don't respond.
• 1:09:12
  Speaker 1: So I know somebody who's on GLP-1 drugs and they
• 1:09:16
  weren't like a big drinker, but they would enjoy that
• 1:09:18
  drink once in a while. And somehow they didn't even
• 1:09:22
  realize that their reward centers were so affected by GLP-1
• 1:09:29
  that now it seems like nothing in life really gives
• 1:09:32
  them the same amount of pleasure. Does that happen?
• 1:09:35
  Speaker 2: Yeah. So that's a very interesting observation and we see
• 1:09:40
  lots of it. So let's demystify this part. Mood and GLP, right? Conventionally,
• 1:09:49
  out of 100 people who are successfully losing weight on
• 1:09:52
  GLP-based therapy, most of them would come in an elevated mood.
• 1:09:58
  Speaker 1: Why?
• 1:09:58
  Speaker 2: They've lost weight, which had a major impact on the
• 1:10:01
  mind and the metabolism and everything. So first thing they
• 1:10:05
  say when they enter is, doctor, I feel great. It's
• 1:10:09
  a feeling. I mean, I can't quantify that. So that's
• 1:10:13
  most of them. But then there would be the other
• 1:10:15
  part of people who may have certain mental health issues,
• 1:10:22
  which are primarily driving the hunger and then the excess
• 1:10:28
  weight or obesity. Clipping the hunger here at times may
• 1:10:33
  worsen the mood. So before starting these medications, we should
• 1:10:42
  be very cautious.
• 1:10:44
  Speaker 1: So what, these people just get sad in life or
• 1:10:47
  they just have, nothing gives them pleasure anymore?
• 1:10:51
  Speaker 2: It's not as radical as nothing gives them pleasure, but
• 1:10:54
  the relative mood does go down, may go down more
• 1:10:59
  where you would need, these are orange and red flags.
• 1:11:04
  Being on these medications, if the mood is getting disordered,
• 1:11:08
  At least pause it. Don't increase the doses. And I
• 1:11:13
  have a very low threshold in involving our mental health
• 1:11:17
  specialists in such conditions because they could backfire. So this
• 1:11:23
  is what can happen. So most of people are feeling great,
• 1:11:26
  but some of them may have disturbances in the mood
• 1:11:30
  which may vary. There's no harm. Stop the medication. Get help.
• 1:11:36
  you may actually diagnose something which was pre-existing and was
• 1:11:40
  taken as everything is happening because of weight. It does happen.
• 1:11:44
  We should be aware of that. I'm very well aware
• 1:11:47
  of that. And we could actually catch a lot of
• 1:11:50
  such things before they went south.
• 1:11:54
  Speaker 1: Got it. Also, help me understand that it's been a
• 1:11:59
  little over a year since GLP-1 was in the market.
• 1:12:02
  Are you now... Has your observation on JLP1 changed in
• 1:12:07
  this past one year? And is there anyone you know
• 1:12:11
  who has successfully gone off the drug? And I'm saying successfully,
• 1:12:16
  that means not put on the weight after having stopped it.
• 1:12:20
  Speaker 2: Yeah. So successfully off the drug, I could name those people,
• 1:12:27
  but that it's very young years now, like six months
• 1:12:31
  or three months. And let me correct you here. GLP-based
• 1:12:36
  therapies have been there for nearing two decades, primarily for
• 1:12:42
  diabetes control. Now they've got approval for weight management and
• 1:12:47
  it's a little longer, maybe about two years legal availability.
• 1:12:53
  But people have been on these medications for far longer
• 1:12:57
  than the legal approval. So And that's a perpetual question.
• 1:13:03
  Speaker 1: How long?
• 1:13:03
  Speaker 2: Yeah. And that's one question. So five questions which people
• 1:13:08
  want to know in the consultation. Why have I gained weight?
• 1:13:12
  Why does weight always come back? Why to lose weight?
• 1:13:16
  How long do I need to be on these medications?
• 1:13:19
  And the side effects. So very simply in my consultation chamber,
• 1:13:26
  I have this whiteboard where with large number of spelling mistakes,
• 1:13:30
  I've written these questions. People just as they sit down
• 1:13:33
  there and this photograph stays with them forever. And these
• 1:13:37
  are the questions always ruminating in their mind.
• 1:13:40
  Speaker 1: Yeah, I want one answer right now.
• 1:13:43
  Speaker 2: Yeah.
• 1:13:44
  Speaker 1: How long?
• 1:13:45
  Speaker 2: Exactly. So science, this is a question in everybody's mind.
• 1:13:51
  more so the people who come for these medications is
• 1:13:56
  how long. Science says that most of the people, about
• 1:13:59
  60% would have regained their weight. In a certain time period,
• 1:14:04
  they've been followed up. Now it's all a matter of time.
• 1:14:08
  How long do you follow them up? If you say
• 1:14:11
  60% at one year or 72 weeks or two years,
• 1:14:15
  at five years, what will happen? In lifestyle changes, we
• 1:14:19
  have clearly documented with longer follow-ups, the weight regain becomes greater.
• 1:14:24
  But whatever data we have at this point of time,
• 1:14:28
  that people crossing their previous weights is not as much.
• 1:14:33
  Weight regain happens in almost all. If you want a number,
• 1:14:37
  let me give you 60%. People regain. It's a matter
• 1:14:40
  of time till we know. But let's understand. Why are
• 1:14:44
  we asking this question? The reason is, We still haven't
• 1:14:50
  accepted excess weight or obesity or adiposity as a disease.
• 1:14:59
  There's no quick fix to that. It's a journey. How
• 1:15:02
  many times do we say that your diabetes will be cured?
• 1:15:06
  You got a heart attack, it will be cured. You
• 1:15:10
  got a cholesterol problem, which will be cured. You got
• 1:15:14
  these non-communicable things. things which will be cured. This is formally,
• 1:15:22
  scientifically been put in the category of a disease. But
• 1:15:27
  are we ready to accept it as a disease is still,
• 1:15:32
  we're not there at this point of time.
• 1:15:34
  Speaker 1: I have a couple of questions from our viewers online,
• 1:15:37
  which I want you to answer. There's one person who writes,
• 1:15:40
  What does the non-drug version of quietening food noise actually
• 1:15:45
  look like day to day and is there a real
• 1:15:47
  toolkit for it?
• 1:15:49
  Speaker 2: That's a complicated one. Non-drug choice for quietening is cognitive
• 1:15:54
  behavioral therapy or what I would be explaining to you
• 1:15:58
  or what we've discussed in the last hour, hour and
• 1:16:01
  a half would be the truth. There is no pill
• 1:16:04
  for that. There is no pill. And if you look
• 1:16:08
  at the strength of evidence, I would put GLP, incretin-based
• 1:16:12
  therapies on one side and the other side for a
• 1:16:15
  relative balance would be cognitive behavioral therapy. Everything in between
• 1:16:21
  is unbalanced.
• 1:16:22
  Speaker 1: Is unbalanced. There's another one which says, if I've been
• 1:16:26
  aware and health conscious my whole life and I still
• 1:16:29
  struggle with this daily, what am I doing wrong?
• 1:16:32
  Speaker 2: You're not doing anything wrong. It's genetics. Simple as that.
• 1:16:38
  60-80% of excess hunger, excess weight is genetically determined. And
• 1:16:47
  then we have an environment which is triggering everything. You've
• 1:16:52
  been to hostel? You studied there? Did everybody weigh the same? Why?
• 1:17:00
  Fundamental question. Same mess. People order lots outside but we
• 1:17:05
  used to play we used to do this all of
• 1:17:08
  us together but we didn't have a similarity of weights
• 1:17:13
  why and we have science behind it i'm just giving
• 1:17:17
  you an experience which all of most of us have
• 1:17:19
  been through the hostel and everybody weighing differently genetics our
• 1:17:25
  food choices our food quantities our our acceptance of spicy
• 1:17:30
  food the aroma of food is all genetically determined and
• 1:17:34
  we have little bit of evidence coming from our country also.
• 1:17:39
  Speaker 1: That how genes are responsible for all your cravings. Yes. Okay.
• 1:17:45
  So my last question really, what is the one takeaway
• 1:17:50
  that or one sentence you think people should really hold
• 1:17:54
  dear to them or one mantra, let's call it that.
• 1:17:58
  Is there a mantra for food cravings that one must
• 1:18:01
  keep in mind?
• 1:18:03
  Speaker 2: If I can give Just one word to that, it'll
• 1:18:07
  be acceptance of existence of food noise. Rest you leave
• 1:18:14
  it to me.
• 1:18:17
  Speaker 1: So if I am standing, God forbid like yesterday, wanting
• 1:18:22
  to have that peanut butter shake at night.
• 1:18:24
  Speaker 2: Please enjoy it.
• 1:18:25
  Speaker 1: No, two days in a row.
• 1:18:27
  Speaker 2: Please enjoy it. See what all you've done to reach here.
• 1:18:32
  It's worth a pat on the back.
• 1:18:37
  Speaker 1: Not what you would expect a doctor to say, but
• 1:18:40
  on that note, thank you so much, doc, for being
• 1:18:43
  here and explaining this entire concept of food noise to us.
• 1:18:47
  This is so, so, so fascinating.
• 1:18:49
  Speaker 2: I thoroughly enjoyed it and I can go on forever.
• 1:18:54
  Speaker 1: Thanks so much.