What is metabolic derangement, exactly? - PaleoHacks.com

What is metabolic derangement, exactly?

2011-10-08T18:08:56Z

I was reading the Jimmmy Moore post on "safe starches" [http://livinlavidalowcarb.com/blog/is-there-any-such-thing-as-safe-starches-on-a-low-carb-diet/11809] and noticed a comment from someone named Anthony C. who questioned the term "metabolic derangement," going so far as to demand a definition of the term. Fair enough. So what is it?

If you look at our photos on the "before and after" thread, it's almost like a picture glossary of the term. It's hard to believe I got fat because, all of a sudden in my cases in my early 30s I started eating different foods. Or my hormones changed. ("Manopause" at 32?) It seems likely that my metabolism changed quite dramatically.

Is there such a thing as metabolic derangement? Definition, please! Something quasi-scientific, with some heft and validity! Jimmy didn't want to go there and I don't blame him but I think this deserves a response.

Answer by Beth-WeightMaven for What is metabolic derangement, exactly?

2011-10-08T18:51:18Z

I think this interchange between Jimmy & Kurt Harris indicates he's really talking metabolic syndrome:

Jimmy: Perhaps exhibiting any of the markers of metabolic syndrome being awry is how to best judge if there is metabolic damage. Multiple markers out of whack determines the severity. And that's not to say that it's impossible to reverse this condition if it does exist.

Kurt: Then let's just use the medically accepted term metabolic syndrome in lieu of metabolic derangement or damaged metabolism, to improve communication. And of course not everyone who is obese or can't lose fat has metabolic syndrome, nor is metabolic syndrome by definition irreversible.

Metabolic syndrome is somewhat better defined (here's a definition from NIH). But for purposes of a discussion related to LC and paleo, I think it's essentially the inability for the body to adequately deal with excess calories in general and dietary carbs in particular (reflected by higher postprandrial BG and higher fasting insulin).

Answer by tonysolo for What is metabolic derangement, exactly?

2011-10-08T18:59:12Z

Metabolic derangement is the state of not being able to lose weight because one is not able to lose weight.

Answer by Atkins-witha-loincloth for What is metabolic derangement, exactly?

2011-10-08T19:29:56Z

I think there is not a single, exact answer to this question, as to EXACT mechanism and WHEN this occurs. But I think there is alot of good info out there pointing to the fact that it does occur and that as far as anyone knows, at least some of the resultant changes are very longlasting if not absolutely permanent.

"Yale University researchers have found one of the mechanisms that cause fat cells to lose their ability to efficiently store and use energy - a scientific mystery and a phenomenon that contributes to a major public health problem.

The Yale team discovered a mechanism that allows cellular fat droplets to expand when excess metabolic energy is present - i.e., when the body has taken in more food than it can burn off - helping them to take in fatty acids, the end products of our meals. The obese suffer a myriad of health problems when fat cells can no longer do this job. The scientists report their findings in the Oct. 5 issue of the journal Cell Metabolism. "

http://www.medicalnewstoday.com/releases/235490.php

The following has been cited by myself and others in other threads, but deserves to be cited ad infinitum, in my book, until who this problem affects is really understood by all, and the extent of the problem and its chronic ramifications are understood.

"But what if we had trouble using fat for energy—or using energy at all? Clearly we’d have a problem: we would eat food, and as soon as the energy was either used or stored, we’d be hungry again—even though we were gaining weight!

This is exactly what happens to many people.

I’ve previously discussed metabolic flexibility and the RER (“Respiratory Exchange Ratio”), also known as the RQ (“Respiratory Quotient”), at length in this article. Metabolic flexibility (“met flex”) is the ability of our cells (specifically, our mitochondria) to switch back and forth between glucose oxidation and fat oxidation for energy, and the RER/RQ is how we measure what proportion of glucose vs. fat we’re burning.

It turns out that:

The obese have impaired metabolic flexibility. The obese have impaired mitochondrial capacity to turn nutrients into energy in the muscles. The obese have an impaired ability to oxidize fat for energy, which we can objectively measure. Both the formerly obese and the soon-to-be-obese also suffer these impairments."

Of great import here is this statement, which I think cannot be repeated and emphasized enough:

"BOTH the FORMERLY OBESE and the SOON-TO-BE-OBESE also suffer from these imapirments."

And of course, the import of the following statement is HUGE:

"In other words, obese people have a greatly decreased ability to create energy from the nutrients they ingest.

The ability to oxidize fat is also impaired. How great is this impairment?"

There are a number of studies that are utilized here and they are all available as links for readers who really want to understand the basis for these statements, and they are all here:

http://www.gnolls.org/2407/when-satiety-fails-why-are-we-hungry-part-4/

Scroll down to: Satiety Failure #3: Energy Stuck in Storage

Here's a quote from the abstract of a paper which for me, best pulls it all together. The full text version of the research is available in a PDF link on the link page supplied below.

"To develop an explanation for this apparent contradiction in energy homeostasis and the chronic overeating relative to energy used in obesity, a review of the literature was conducted. The resulting model of obesity is based on a growing body of research demonstrating that altered mitochondrial energy production, particularly in skeletal muscles, is a major anomaly capable of setting off a chain of metabolic events leading to obesity. Alterations in skeletal muscle mitochondria distribution and their oxidative and glycolytic energy capacities in obesity are described. The metabolic responses of obese and normal individuals to exercise are contrasted, and the effects of weight loss on energy production are presented. The effect of altered fat oxidation is considered in relation to energy regulation by the central nervous system and the development of major obesity comorbidities, including systemic inflammation, insulin resistance and diabetes, and cardiovascular disease."

http://brn.sagepub.com/content/10/4/356.abstract

Even as much attention (and rightfully so!) has been given to J.Stanton's excellent satiety series, I have not seen any real discussion of the following paper, which I think it a HUGE piece of the puzzle for some of us, and I am one of them for sure!

"They came to the laboratory on two separate days to consume breakfast; on one day the principle energy source was fat and on the other day carbohydrate. Satiety responses were determined by ratings of hunger and fullness for 2 h after breakfast, and intake at a mid-morning snack test. Those scoring high on the TFEQ-disinhibition scale consumed more energy at the snack test than those with low TFEQ-disinhibition, but this was only following the high carbohydrate breakfast. The TFEQ-restraint scale did not independently predict food intake or interact with the TFEQ-disinhibition related overeating. In normal-weight females the tendency to overeat may be related to insensitivity to the satiating effects of carbohydrate."

http://www.ncbi.nlm.nih.gov/pubmed/21219950

For me, this research is highly suggestive of a*key* issue for some of us, which I "secretly" hypothesize may worsen over time...that of carbohydrates NOT being satiating for some subset of people. This is absolutely true of me. And the consequences of this are great...REAL HUNGER which occurs too often and too quickly after a "normally" carbohydrate laden meal.

We have to get to the point where we really understand that for one group of people, carbohydrates are satiating and indeed, make them feel "good." And in another group of people, this is absolutely the opposite and will cause real metabolic issues if the macronutrient ratios of meals are too high in carbohydrates.

For now, I think this is enough to chew on...and as my computer is acting up, I will not go into more. Arya Sharma's work should certainly be considrered and I amy provide some links later.

I also feel that we need to be careful about separating the specifice medical diagnosis of metaboic syndrome that some of the obese suffer with, from the larger and different metaboic changes cascade we are talking about here which is a much larger and perhpas more generalized phenomenon among the soon to be obese, obese and formerly obese.

EDIT: OK, at the rsik of making this waaay too long, I cannot leave out Dr. Sharma and a link that so well addresses the question, though, of course, not absolutely definitively. There is no one on earth, right now, who can do that. So, let me just lift a few quotes and supply the link for those who really might give a hoot...

"As readers will recall, the biology of the post-weight loss state is nothing like the biology of someone who has never lost weight. There are countless ways in which the psychoneurobiology, energy physiology and metabolism in anyone who has lost weight are remarkably different from someone ‘naturally’ of that weight."

"The consistent finding from all such studies is that all individuals or animals in a post-weight-loss state face considerable ‘homeostatic pressure’ that aims to drive their weight back to initial levels.

The paper extensively discusses how changes in biological signals of fat stores (e.g. leptin) elicit profound metabolic and behavioural adaptations - a topic that I dealt with extensively in previous posts.

The key findings of increased hunger and appetite, reduced satiety and substantially increased ‘fuel efficiency’ have very real underlying biological drivers - drivers powerful enough to ultimately wear down even the most persistent dieter."

"The paper also extensively discusses some of the lesser known metabolic adaptations to weight loss including profound changes in gut biology that enhance caloric extraction from food as well as alterations in liver function, skeletal muscle and fat tissue that promote weight regain."

http://www.drsharma.ca/obesity-why-diet-and-exercise-is-not-a-treatment-for-obesity.html

Answer by JayJay for What is metabolic derangement, exactly?

2011-10-09T00:15:10Z

I just always assumed that when people say metabolic "derangement" they are speaking of metabolic syndrome...is that not clearly enough defined? I read Anthony C.'s comments and thought he was kind of a douche/troll.

In general we like to name things then apply treatments to that name. The idea that all states of disease are simply states of altered physiology based on current stressors is lost on most. When you have a drug (hero) you have to have a disease (villain). Heck we invent diseases just to sell more drugs. I guess my point is whats in a name? Call it whatever you want, but the symptoms include insulin resistance, leptin resistance, hypertension, overweight/obese, diabetic/prediabetic...and so on and so forth.

We could make this like a number of diseases (fibromyalgia comes to mind) where you meat 11 of 16 criteria or something then you get the diagnosis (like its some sort of prize). In the end if you (not OP personally, just a generalization) need an authoritative figure to explain specific parameters outside of which you will have this diagnosis....just give it a few more years. The drug companies will eventually put out some "standards" for which if you are outside of then you will be prescribed their brand new Metabolic X drug. Its guaranteed to help your metabolic syndrome....(side effects may include: nausea, depression, diarrhea, death, dismemberment, rectal prolapse, schizophrenia, double vision, blindness, hypertension, hypotension, oh and increased symptoms of metabolic syndrome... ect.....).

Edit: After that drug advertisement I meant to add in that a paleo diet would fix achieve better results than said drug with absolutely no side effects except for better health.....but who would wanna do that?

Answer by Fred for What is metabolic derangement, exactly?

2011-11-10T03:46:23Z

'Metabolic derangement' is Jimmy-speak for 'Goshdarnit! I can't eat all the low carb frankenfoods I want [now 'paleo' foods] and still lose weight...' Matt Stone's piece from 2010 still pretty much sums it up: http://180degreehealth.com/2010/03/poor-poor-jimmy-moore.html. Hoping for anything even resembling an honest debate on Jimmy's site is wishful thinking at best. It's one of the most heavily-moderated blogs out there - people with whom he disagrees are banned, their comments edited beyond recognition (usually favorably to Jimmy), or simply ignored altogether. All of this creates the very false sense of a veritable army of LLVLC admirers - one that simply does not exist (unless you count the scores of failed dieters on his forum trying to the lose the same twenty pounds for the fifth year in a row).

And yeah, this is attacking the messenger. But in this case the messenger's an idiot.

Answer by Scott for What is metabolic derangement, exactly?

2011-11-23T21:06:58Z

Now THAT'S paleo BAY-BEE!!!

http://livinlavidalowcarb.com/blog/low-carb-strawberries-cream-cheesecake-with-dark-chocolate-drizzle/12381

Answer by Nance for What is metabolic derangement, exactly?

2011-11-23T21:15:08Z

I'm fairly sure I don't have metabolic syndrome and I'm doubtful I ever did since I've never had the markers that define the syndrome except for being very obese.

However, I describe myself as having deranged metabolism because I have binge eating disorder and my binges were spectacular and repetitive. Since I didn't want to binge, or more accurately I didn't want to be fat, I do assume my metabolism was seriously out of whack no matter what you choose to call it. Also, I became deranged whenever I tried to diet until I stumbled onto ancestral eating. :-))

Still, if you just saw my vital stats you'd assume I'm at an ideal weight.

Answer by TAJ for What is metabolic derangement, exactly?

2012-10-14T19:04:54Z

metabolic derangement is when something in your metabolism is off, and causes psychological symptoms. It has nothing to do with carbs or weight. Think psychosomatic. for instance hypothyroidism can cause depression, and even paranoid delusions if it is severe. over-active adrenals can cause anxiety. Many things on a metabolic blood panel can also cause mental health symptoms.