The Gremlin Inside You might think you're hungry, but that's just the hormones talking. When it comes to your desire for food, you're largely at the mercy of the hormones leptin and ghrelin. A rising ghrelin level prompts your brain to register the sensation of hunger. As you eat and fulfill your body's need for nourishment, leptin rises, ghrelin drops, and hunger fades. Simple. But when you're trying to lose weight - not so simple. Anyone who sets out to lose weight with a program of exercise and restricted calorie intake will have to face down ghrelin - a formidable adversary. A 2002 New England Journal of Medicine study followed subjects' ghrelin levels over the course of a six-month weight reduction effort. After the first three months, each of the overweight subjects had lost an average of nearly 40 pounds. By the end of the study they had managed to maintain that level of weight loss. But here's the bad news (and possibly the key reason dieters typically regain lost weight): As body weight dropped, ghrelin output increased. At the end of the study, the subjects' LOWEST ghrelin levels were almost as high as their pre-meal ghrelin peaks before their weight-loss program began. That's daunting. Here you are, working hard, week after week, exercising and depriving yourself of calories, while ghrelin lays the groundwork for backsliding the moment you let your guard down. Now for the good news: There are three steps you can take to tame the ghrelin gremlin. 1) Get enough sleep Research shows that ghrelin levels are generally higher and leptin levels are lower in people who regularly get inadequate sleep. As a result, hunger is more pronounced during the day. And worse: Sleep deprived people tend to desire calorie-dense, high-carbohydrate foods. But for most people, a full eight hours of sleep each night may not be necessary to moderate ghrelin/leptin levels. A 2006 sleep study shows that many overweight people may experience benefits by adding just 20 minutes of additional sleep each night. 2) Avoid fructose Fructose makes ghrelin rise. And fructose is in a wide range of processed foods. In the e-Alert "Soft and Sweet" (6/22/04), I told you about a study in which subjects of normal weight drank a fructose drink or a glucose drink after each meal for 24 hours. Results: High fructose intake was linked to higher ghrelin levels, and lower leptin and insulin levels. 3) Don't attempt a crash diet A weight-loss diet that starts right in with a steep drop in calories is a shock to the system - a shock that's more likely to prompt ghrelin increase. Your body gets a chance to adjust incrementally if you ease into a new regimen of less caloric intake. And of course, avoiding simple, refined carbs is a must. Consumption of inferior carbs just makes you hungry for more carbs. Sources:
"Plasma Ghrelin Levels after Diet-Induced Weight Loss or Gastric Bypass Surgery" New England Journal of Medicine, Vol. 364, No. 21, 5/23/02, content.nejm.org
"Dietary Fructose Reduces Circulating Insulin and Leptin, Attenuates Postprandial Suppression of Ghrelin, and Increases Triglycerides in Women" Journal of Clinical Endocrinology and Metabolism, Vol. 89, No. 6, 6/4/04, ncbi.nlm.nih.gov
"Overweight and Obese Patients in a Primary Care Population Report Less Sleep Than Patients With a Normal Body Mass Index" Archives of Internal Medicine, Vol. 165, No. 1, 1/10/05, archinte.ama-assn.org | 
