How Your Appetite Is Affected By Your Hormones

Mark Hyman, MD

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Dr. Mark Hyman: Coming up on this week's episode of the Doctor's pharmacy, people are victims of an environment that is driving their hormones in the wrong direction that makes them unable to regulate their appetite and their hunger. Welcome to Doctor's Pharmacy. I'm Dr. Mark Hyman. That's pharmacy enough, a place for conversations that matter. If you're wondering if your hormones are making you hungry, this is going to be a good one for you because they can and will. And if you don't get your hormones straight, it's hard to regulate your appetite. You're kind of a victim of your biology. But how do you actually learn how to use science, not willpower, to control hunger and appetite? That's what we're going to talk about today on this special version of the doctor's pharmacy called Health Bites, which are little bites of information that helps you take small steps every day to make big changes over time. So hormones are important, right? What are hormones? Basically, they're the messenger molecules in your body. They regulate so many functions. We know about your pituitary, your hypothalamus hormones, your thyroid, your adrenals, your sex hormones. There's so many hormones, right? So how do they work? There's also hormones you've probably never heard of, which are ones we're going to talk about today, particularly ghrelin or ghrelin, however people say it, or, and leptin. And these regulate our appetite. So may Courtney, many, many functions in the body from metabolism to sexual function, your circadian rhythms, stress, mood, everything else. They're basically chemical messengers. And these messengers play a big role when it comes to food, specifically regulating when on how much we eat. Now, most of us live in countries with staggering rates of obesity. There's now over 2 billion people in the world who are overweight in America. It's normal to be overweight. 75% of us are overweight, 42% are obese. And it is important to understand what's going on because it's not because people want to be fat. Nobody's like, Hey, I want to gain weight. I want to be chubby. I want to be 300 pounds. Nobody is saying that. Nobody wants that. But people are victims of an environment that is driving their hormones in the wrong direction that makes them unable to regulate their appetite and their hunger. So we're going to talk about that. We're going to talk about leptin and ghrelin. Two hormones you may not have heard about, but that have a direct impact on your appetite and the regulation of your body, weight and fat. And so let's get into it. Now, leptin and ghrelin are two of the most important hormones that control your appetite. They affect your sense of fullness and hunger. And they're pretty new. I mean, they were only discovered after I graduated from medical school in the nineties. Yeah, I'm old. So while there's a lot to learn about them and we're still learning so much about appetite, scientists have unlocked some of the secrets of these appetite regulating hormones. So what's ghrelin? Start there. Ghrelin is made in your stomach. Now there's hormones that are made all over, but ghrelin is a hormone made in your stomach and it signals that you're hungry. It's the hunger hormone and it also helps you store fat. So it also plays a role in sugar metabolism, glucose metabolism, and your energy and many other things. Now, when you stomach is empty and you're hungry, it releases ghrelin, which means that it's highest before you eat and lowest after you finish eating, which is normal right now. What about leptin? Leptin is actually the satiety hormone. It's the feeling full hormone and what tells your body to stop eating. Now we're going to talk about why this hormone is so dysregulated and not working in our society and why people, despite high levels of leptin, which are supposed to tell you to stop eating, don't work right, but when it's working properly, it helps regulate your body weight long-term by sending signals to your brain when you've eaten enough and letting know you're full. So you're not going to keep down on that bag of potato chips. Now, if your body has high levels of leptin, your brain recognizes that you're plenty of stored food and stored fat, and it basically says, I'm not hungry and I'm full. But if you have low leptin levels, your brain thinks maybe you need to store more fat and it signals that you probably should be eating. So it's kind of really regulating an appetite and weight and metabolism. Now you can think of leptin and ghrelin as sort of two sides of the same coin. One side ghrelin triggers hunger and lets you know when it's time to eat while the other side leptin tells your body when you've had enough and when you need to stop. Now, what happens when these hormones are out of whack, which is pretty much for the majority of people in America and increasingly around the world. So it's important to understand when these hormones go out of whack, you get into trouble. So let's start with ghrelin. People who are overweight tend to eat more because their appetite's dysregulated, and there are many reasons for that. But we typically see higher levels of GH line in people who are hungrier. And if your ghrelin are not regulated well then you're in trouble for one of the things, for example, that we found is that people who don't sleep enough, which is majority of Americans are sleep deprived and they're sleeping six or seven hours instead of eight or nine hours, which our bodies need. And they did a study with young college students where they basically took one group and they got them normal sleep schedule. Another group, they sleep deprived them every night for a while, and the ones that were sleep deprived had higher levels of GH grillin, they were hungrier and they craved more carbs and sugar. So if you're having GH grillin level problems and you rein's high, you're going to actually eat more carbs and sugar. So really that needs to be regulated. So make sure you get enough sleep. And there's a lot of other tricks. We're going to talk about how to regulate this. Now the other issue is leptin. Now, most of the time, if you're healthy, leptin levels will go up when you finished a meal and then they'll go down. What happens is when people have inflammation, when they start putting on visceral fat or belly fat, which is basically like a fire in your belly, it's produces things called adipose cytokines, which are inflammatory cytokines that are produced by your fat cells. They're not just holding up your pants. They produce hormones, neurotransmitters and cytokines. Cytokines we heard about from covid, which are inflammatory molecules that go throughout your body and create havoc, and they actually create havoc even in your brain, and they lead to leptin resistance. And resistance to leptin means you make more and more leptin, but it doesn't actually work. And so you'll see a lot of obese people with high levels of leptin, which gives you a clue that they have inflammation and leptin resistance, and you have to address the inflammation. So basically, when your body is having leptin resistance, you don't get that feeling of being fully, even though your leptin's high, your brain thinks you don't have enough fat reserves, which you do if you're obese and it causes you to kind of think you're starving, it decrease your energy level, lowers your metabolic rate, and it makes you have more weight gain. So it's kind of a double whammy. You really need to understand what's driving leptin resistance. A friend of mine, Leo Gallen, one of great functional medicine doctors, wrote a book about leptin resistance, which I encourage you to check out if you're interested in this topic. And we'll put a link in the show notes to that book. Alright, so let's put it together and talk about what to do when your hormones are out of whack and your appetite's dysregulated, because I always say to people, look, it's not your fault. You're overweight. There's something going on here. It's not about willpower and white knuckling your way through just restricting calories and exercising more and eating less. It's just not how your metabolism works. Nobody's trying to gain weight. And so what's going on here is something that's dysregulating our biology. And there are many things that do it. It could be our microbiome, it could be inflammation, it could be toxins, it could be pesticides, it could be heavy metals, it could be even infections. Viruses can be linked to inflammation. So anything that drives inflammation will cause weight gain and dysregulate your metabolism. And it's something that can be addressed and fixed. So when you have imbalances in these hormones, you have dysregulated appetite and you don't actually feel full. So you tend to be hungry or more and not feel full regardless of whether you're eating. And that has huge adverse effects, which makes you gain weight. And then of course, if you're doing that, you're going to see higher levels of blood sugar, higher levels of insulin, you'll get pre-diabetes, hep two diabetes, you'll even dysregulate your sleep cycles and circadian rhythms, melatonin signaling, and it's a vicious cycles. You get more dysregulation. It's like it's a feedforward negative cycle. So how do you keep your ghrelin and leptin levels balanced? What do you do? Well, there are hormones that are naturally produced, but we don't have a particular supplement or food that's going to do it. But there's a number of strategies that actually can help reduce inflammation in the body that can help regulate your appetite and that make a huge difference. And there's much research on this. First is, again, not rocket science, but eat real food. Get rid of all the ultra processed food. We know, for example, from Kevin Hall's and ICE study where he gave people unlimited amounts of ultra processed food crossover study, and the other part of the study gave them unlimited amounts of whole real food. And the people who were eating the ultra processed food at the time ate 500 calories more a day. That means basically their appetites were dysregulated, they weren't feeling full, and they were eating all this industrial processed food that was driving imbalances in their hormones. So studies show that also high levels of fructose are a problem. Fructose is often found in soda and juice and fruit. Fruit is okay, but when you're having high fructose corn syrup, it's driving huge amounts of leptin resistance, which makes you not feel full. It makes you eat more and pretty much any kind of sugary stuff will do the same thing. And when you have high levels of fructose, sugary beverages or simple carbs like refined starch, it also impairs your ghrelin response. So your appetite doesn't go down, you don't feel full, and then you get in this vicious cycle. So eat real whole foods as close to nature as possible. Stuff that I've talked about in my book, food, what the heck should I eat? And the pegan diet also, another trick is don't eat at night. We should not be eating at night for a whole host of reasons, but don't eat within three to four hours of bed. I heard a guy the other day talking, he leaves eight hours between his last meal and bedtime so he can actually sleep better. So I think that's hard, but you should not use your refrigerator as a nightlight. And a Harvard study found that nighttime eating had profound effects on hunger and the appetite regulating hormones, leptin and ghrelin. In fact, leptin levels decreased for 24 hours after indulging in a late night snack, which basically means your appetite control break, the break on your appetite was turned off. So you basically have no breaks for 24 hours if you eat late at night. So you're going to eat more the next day. You're going to want to eat, be hungrier again. Vicious cycle. Next is protein. Protein is so key, it's the most important macronutrient. It suppresses ghrelin so you don't feel hungry. And of course you know this, when you eat protein, you feel full longer. When you eat fat, you feel full longer. So at high quality protein, I like regenerative raised animals like pasture raised chicken, regenerative raised beef, bison, elk. You can go to force of nature.com, you can get grass fed meats from lots of different places. I talk about this again, where you can find these on my book. We'll put in the show notes, stay active. Being active and exercising helps improve leptin sensitivity. So whatever leptin you have, it'll work better, meaning it'll shut down your appetite. So hi training, high intensity immuno training really regulates leptin, which is when you kind of sprint, you go for 30, 45 seconds full out like you're running from a tiger. And then three minutes kind of walk. So you can do on a treadmill, you can do it running, you can do on a bike, but it's really powerful exercise, pretty much is a wonder drug. Also sleep, like I said, if you don't sleep, you're going to be hungrier. You're going to shut down the regulatory system and you're going to have higher levels of graylin, lower leptin, and just getting far asleep on back-to-back nights had huge disruptions in leptin and graylin. And I know this, if I don't sleep, or for example, I fly across the world somewhere and I come back and I haven't slept for a long time, all I want to do is eat carbs. All I want is sugar. All I want is ice cream. It's like I know better, but my body is telling me, find that bagel, find the pasta, find the ice cream. That's kind of what's going on. So make sure you're getting up sleep. Really, really important. And also stress. We have to learn how to regulate and manage stress. None of us can avoid stress, but we have to become masters at regulating our nervous system. And we have an on and off switch. The on is the sympathetic go, go, go stress response. And the parasympathetic is the off switch. It's a deep relaxation. It can be breath work, it can be yoga, meditation, massage, guided imagery, sound healing. Whatever works for you, do it. It's got to be an active process. Research shows that cortisol, which the stress hormone has a big impact on leptin production. So it'll lower leptin production, meaning you won't feel full again. Stress makes you hungry. When you look at people who are stressed, they want to eat more carbs, they want to eat more sugar, they want to eat to, they call it stress eating. It's a thing, right? It's not because you're a bad person or if you're a willpower, it's because you're a victim of hormone dysregulation. So the key thing to understand is it's not your fault. Your hormones are out of whack and there's a way to reset them. And this is a lot of what my work is about. And hopefully you'll find the resources in the show notes. It'll help you do that more. And I hope you've learned a lot about what regulates your appetite today. We still dunno everything about leptin and ghrelin, but what we do know is enough to encourage us to reset our dietary patterns, to reset our lifestyle, and to regulate those hormones. So you're actually using science, not willpower, to regulate your appetite and your weight. So that's it for today's Health Bite. I hope you enjoyed it. Please share with your friends and family on social media. I'm sure they'd love to hear about this. I'll leave a comment, how have you learned to regulate your metabolism, appetite and weight? We'd love to know and subscribe wherever you get your podcasts. And we'll see you next week on the Doctor's Pharmacy.