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Biology 202, Spring 2005
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There was a case of two British children* who, from the age of four months, were overcome with an unappeasable hunger that came to control their lives. By the time Jenny was eight years old, she could no longer walk and had to be put into a wheelchair, while John, at the age of two, could eat 2,500 calories in just one sitting. As they grew older, their parents were forced to lock refrigerators and cabinets; however, the children would rummage through the trash and anywhere in the house trying to find some food they could eat. Professor Ellen Ruppel Shell published a book called "The Hunger Gene" and investigated the case of these two children (1). Her book touches upon some interesting discoveries.
There are more than 200 genes involved in appetite and weight regulation, and a missing gene, even one, can prevent a person from feel full. In 1994, a gene called Leptin was isolated and found to work as an appetite inhibitor. Those missing this gene may eat and eat because their bodies are telling their brains that they are starving. It turns out that Jenny and John were both missing this gene. Leptin injections fixed this problem and the children lost a significant amount of weight very quickly. We now know that in this case, the missing gene was the cause for their insatiable hunger and overeating. However, Shell touches upon the fact that only 12 people in the world have been found with this deficiency (1). A mutated gene may also be a problem: The melanocortin 4-receptor, as a healthy gene, makes a protein that controls appetite in the brain. A mutated version of this protein may cause it too be too small to affect appetite control, therefore making a person with this mutated gene feel less full (2).
How can we explain compulsive overeating for those who do have the Leptin gene? Is there another factor contributing to the feeling of being sated, or are compulsive overeaters to blame themselves for their overweight or obese conditions? Are our bodies in thrall to our genes, or can we also blame obesity on fast food chains and the huge portions of foods that are high in fat and sugars? Can an overeater overcome his or her problem with therapy? We can see that in Jenny and John's case, it was a genetic problem that was solved with the replacement of Leptin. What causes compulsive overeaters, without a genetic mutation, to develop this disorder? Are compulsive overeaters without genetic mutations afflicted with a chemical change in their brains following this disorder? Could this be compared to a drug addiction? Or is it environmental and social factors that begin early in childhood that cause behavior problems such as compulsive overeating? Let's explore this question.
Compulsive overeating is characterized as an addiction to food and relying on food for comfort or distraction from problems such as stress and emotions. People suffering from this disorder tend to feel guilt and embarrassment after eating too much, and this can lead to a destructive path, like drug use, which leads compulsive overeaters to turn to food once again to hide from this guilt and embarrassment (3). It is important to note that not all compulsive overeaters are overweight or obese; in fact, compulsive overeaters may be of "normal" weight by binging after overeating. This can be caused by many factors such as obsessing over body weight and dieting. Someone who attempts to lose weight by dieting may end up breaking down and overeating, and may perhaps end up throwing the food up (3). I know that when I have tried to cut back any carbs, sweets or sugars, I have ended up having caving in and overloading on carbohydrates and sugars. For people very concerned, even obsessed with their weight, this could become very dangerous and detrimental to their health.
This leads me to consider external environmental factors that could assist in a person's development of compulsive binging. Society today is very weight oriented: Everywhere one looks, one sees extremely thin models in magazines, television and movies, on the runways and in society. Most magazines such as "Glamour" or "Cosmopolitan" present cover girl models or actresses who are very fit, and therefore considered by our society as beautiful. The word thin clearly equals beauty and acceptance in our world today, while the word fat tends to be associated with lack of self-control, laziness, and many more unfair stereotypes. It is no surprise that people, especially women, feel the pressure to be thin.
For most people, it seems that medical treatment and continual monitoring can help compulsive overeaters overcome this disorder. Patients have tried psychotherapy and find it helpful, which hints that overeating may be a mind over matter problem. Perhaps a person can actually be full, and even feel full, yet for some reason they continue to eat. However, I believe that this is something that takes a great deal of will power and support to overcome. Psychotherapy focuses on the behaviors that are associated with compulsive overeating, and changing these behaviors in order to overcome compulsive overeating. It may also help to identify the causes of the disorder, such as personal issues, childhood problems, recent deaths or losses, relationship problems, etc. There has also been a discovery of several new medications that may adjust the brain chemistry that could be responsible for compulsive overeating. Compulsive overeating, which may be linked to depression, could also be treated with antidepressants (4).
In conclusion, compulsive overeating and compulsive binging may be caused either by genes, or by external environmental factors, which may change behavior and eating habits. I have learned that there is an "obesity" or "hungry" gene, which presupposes that victims of compulsive overeating are genetically inclined to have continual hunger, although their bodies may tell their brain that they are indeed full. On the other hand, it may be argued that this is not true for either all or any compulsive overeaters; it may be a problem of associating food and eating with getting away from one's problems. Either way, it is an issue that should be looked at both scientifically and sociologically to help determine a successful treatment.
* Names have been changed to protect identity
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