HealthyGamerGG - The Link Between ADHD & Obesity

Episode Date: April 3, 2024

Have you ever eaten a cookie, only to find yourself wondering why you couldn't just stop at one? Do you find that you use food as a mechanism to combat negative emotion? In this episode, Dr. K explores the mechanisms behind why this happens, how your ADHD may exacerbating these behaviours, and even what steps you can take to combat it. If you find yourself relating to any of the issues discussed in this episode, then you could use the information included in Dr K's guide to Mental Health. Get more information here: https://www.healthygamer.gg/about/guide Check out the YouTube Channel for visuals: https://www.youtube.com/channel/UClHVl2N3jPEbkNJVx-ItQIQ Learn more about your ad choices. Visit megaphone.fm/adchoices

Today, we're going to talk a little bit about ADHD and obesity. Now, generally speaking, we think of these two diseases is unlinked. But the more that we're learning about medicine, the more we're realizing that there is a mind-body connection. And what we're seeing sort of really speaks to the connection between these two diseases or conditions. So just as an example, the worse your ADHD is at the age of, let's say, six or seven. The more symptoms of ADHD you have, the more likely you are to be obese at the age of 16. So it turns out that these two conditions are very tightly connected. Because in ADHD, we have altered reward processing, which means that the dopamine release

that we get from food is much more potent and is much more likely to lead to obesity. On the flip side, we tend to think of fat cells or adipocytes as cells that are just storage, but they're not storage. They're actually hormonally active. And it turns out that fat cells actually produce certain chemical signals that will, worsen ADHD. As a simple example of this, there's this chemical called brain-derived neurotrophic factor, which is something that literally stimulates growth of neurons. And what we know is that kids who have low BDNF are more likely to develop ADHD. And it turns out that the more fat cells you have,

the larger your adipocytes actually are, the more that they interfere or stop the production of BDNF. So let's dive a little bit into the neuroscience. because the neuroscience will show us how the brain of someone with ADHD is a little bit different and give us new options for things to do that we don't even bother with in neurotypical individuals because they don't have the ADHD deficits. So let's start with some features of ADHD. Number one is reward processing. So we know that the dopaminergic circuitry in people with ADHD is different.

It's more sensitive in some ways. And specifically when it comes to food, we discover one really interesting thing. So anticipation signals, i.e. cravings for food is increased. Okay. So this comes from the PFC. So the PFC is altered. This is a prefrontal cortex in people with ADHD. And now this would be fine. This isn't that big of a deal. But this is where kids with ADHD really get screwed. So the food reward is actually decreased. Okay. So this is something that's very, very fascinating. This is very different from what most people expect. So most people assume, and this is true in some ways, Okay? That if I eat some unhealthy food, since my dopaminergic circuitry is more sensitive, I get more dopamine. That's true. And we'll get to that in a second. But there's one really interesting dichotomy in ADHD, which is that the cravings that you get are more intense, but the satisfaction you get from food is actually lower. So let's say that I'm a neurotypical person. So I see, I don't know, like a cookie. And so when I see the cookie, I get a craving score of five.

and then I eat the cookie and I get a satisfaction score of five. So this is good, right? I want to eat the cookie. The cookie looks really good. I eat it. I really get satisfied. Everything is great. Now, if we look at someone who has ADHD and they see a cookie, this is what happens.

Their craving score becomes a 10, but their satisfaction score becomes a 2.5. So what are the implications of this? The first implication is that you want food more, but food is less satisfying. So if we look at the brain of someone who has ADHD, what does the brain of ADHD want? So in this case, we just need one cookie to satisfy our anticipation or a craving. But if you really look in the brain of someone who has ADHD, we need four cookies to satisfy this very intense craving. So literally, the reward that you get from food is reduced.

So the way that I kind of understand this is this is a little bit like a skeleton who's eating food. So I remember I saw a cartoon many, many years ago of a skeleton who is very hungry. And what they keep doing is they keep on putting food in their mouth, but there's no stomach, there's no digestion, there's no satisfaction. So no matter how much they eat, they never really feel full or get the benefit of eating. And this is literally what we see due to alterations in the PFC in ADHD. Increased cravings, lower dopaminergic response from receipt of food. Hey, all, if you're interested in applying some of the principles that we share to actually create

change in your life, check out Dr. Kay's Guide to Mental Health. It combines over two decades of my experience of both being a monk and a psychiatrist and distills all of the most important things I've learned into a choose your own adventure format. So check out the link in the bio and start your journey today. The second thing that we see is altered inhibitory control. So this we kind of understand, right? So one of the problems in ADHD is that people have impulse control, difficulties. So if I get an impulse, let's say I see some kind of food. It's very difficult if I get the impulse, If I get the thought of eating it, it is very hard for me to restrain this impulse. And so part of the challenge if you're doing like obesity management is we can sort of tell people,

hey, like, you know, you should eat healthy, like make sure like, you know, you don't eat as much unhealthy food. And then the neurotypical brain is able to restrain their impulses more. So in ADHD, we have a slight problem because the second that the impulse enters your mind, if the idea of food enters your mind, then you will eat the food. The gap between idea and action for people who have ADHD is way smaller. So if we look at the neurotypical person, we have the idea of food, and then the act of eating is further away. Okay?

So this means that they have more ability to restrain their impulses. This is the second problem that we have. The third problem that we have is altered emotional regulation. Okay. So we need a little bit of neuroscience for this. So we have this part of our brain called the amygdala. And the amygdala is connected more broadly to something called the limbic system. So this is where we feel negative emotions.

Okay. Then over here, we have the nucleus accumbens, which gives us dopamine and reinforcement. Anticipation. Okay? So let's just understand dopamine circuitry real quick. So let's say I have a stimulus. If the stimulus activates the nucleus accumbens, we get a dopamine release. And dopamine then goes to other parts of our brain and does three things.

The first is it makes us feel pleasure. The second is it increases cravings of whatever the stimulus is. So this makes sense, right? So if I eat a cookie for the first time, oh my God, the cookie was so delicious. What does that make me do? The next time I see a cookie, I will have a craving for it. The next thing that will happen is that it'll increase behavioral reinforcement. So this is kind of related to the cookie.

So not only will I want the cookie, but it is more likely that I will eat. eat a cookie next time. Okay, so this is the dopaminergic circuitry, basically how it works. Now, what we also know in people with ADHD, so this is highly sensitive in ADHD, which means that the dopamine signal, the anticipation and the reinforcement that we get is amplified. So there's another problem in ADHD, which is emotional dysregulation. So what does this mean? So people who have ADHD feel negative emotions more intensely. So literally, like if something happens, let's say someone cuts me off when I'm driving. Let's say this normally leads to a in a neurotypical person.

This leads to five units of anger. In someone with ADHD, this will lead to 7.5 units of anger. Okay. So we literally know that these parts of the brain are more jittery and are easier to activate. There's another problem. So not only do we feel things more intensely, we also feel the emotion for a longer duration. Okay? So not only am I angry at units of 7.5, but I'm angry for the next.

hour. So what we sort of know is that this emotional dysregulation has even been hypothesized as a subtype of ADHD. So for some people, this is actually their primary symptom. Now, this creates a specific challenge in food because these two circuits and ADHD are not unlinked. In fact, they're synergistic. So what this means is that people who have ADHD in their brains, anytime they have negative emotions, this actually amplifies their sensitivity to dopamine. So what does this mean on a practical sense? So let's take a look at what this practically means. The first is I have my neurotypical kid. Okay. Then I have my kid with ADHD who is happy. And then I have my kid with ADHD who is sad. So in scenario number one, kid sees a cookie. Neuotypical kid. Kid eats

cookie. Kid gets five units of dopamine. Okay. Five units of craving. all right and five units of dopamine. Now let's take our happy kid. So happy kid sees a cookie. This is ADHD happy kid, okay? So sees a cookie, gets 10 units of craving and gets 2.5 units of dopamine from eating it. So already I have to eat four times more cookie

than a neurotypical kid. Now, let's take an angry kid or sad kid. So now what happens is if I've got negative emotions, this is going to amplify this effect twofold. So what this means is when I've got negative emotions, I need something to make me feel better. So I will get 20 units of craving. So now this anger, this negative emotion, needs some kind of relief.

So I crave this cookie even more because as soon as I activate my dopamine ergic secretory, it will help me feel better. So I may still get only 2.5 units of dopamine, but my craving is now induced. So now what happens is anytime I'm angry or sad or have some, kind of negative emotion, I need to eat eight cookies in order to not only give myself some amount of pleasure, but since I have so much more craving, so much more negativity, I sort of have to treat that negativity using this dopaminergic stimulus. And this is in a nutshell, why kids with ADHD are four times as likely to be obese compared with typically developing kids. What happens

is our brain is designed in this way where it becomes sensitive to emotions, which we have difficulty controlling. We are more sensitive to cravings. We get less receipt of food, so we have to eat more. And so this is a basic, basic problem. Now, before you think, oh my God, Dr. K, does that mean I am screwed? I am fucked? No, there's good news.

So let's look at a couple of things that we can do, because there are new interventions that we can use that will counteract these neurological mechanisms. So number one is the problem is that food reward is actually decreased, okay? So what can we do? There are two reasons for this. So what we need to do is savor our food. Huge, huge, huge, huge, huge, huge important thing. The more that you intentionally and attentionally savor your food, this food reward will get increased.

So if you look at people with ADHD, what do they love to do while they're eating? Not just people with ADHD, everybody, right? Everybody loves to watch YouTube, listen to a podcast. Oh, we're being efficient. We're being so efficient. I can't waste my time eating. Oh my God. That's 30 minutes where I'm not learning Spanish or learning to code or having fun.

I'm going to work after I'm done eating. So let me have my break. Let me watch a little bit of e-sports while I have my meal, right? This is what we think. So as we watch this kind of stuff, as we have some kind of dopaminergic stimulus or some kind of distraction, it decreases our attention. And if it decreases our attention on eating, we are going to decrease our food reward. When you go to the movie theater, they give you a fucking bucket of popcorn with like a hundred and twenty-eight ounces of soda, these gigantic jugs of stuff, and you sit there because the movie is so damn good and you don't get any receipt of your food reward.

So there are two things that you need to do, which will help a lot. The first is savor your food. Really sit there and enjoy it, taste it, notice the food as much as you can. Simply noticing will increase the receipt of the food signal. Second thing that you can do is do not distract yourself. Don't do anything while you eat because then your fucking brain is so distractible to begin with. It's not going to pay attention to anything that you're eating. So if you want to counter this reward processing deficit or change in ADHD,

savor your food and don't eat anything, don't do anything else while you're eating. Second thing, altered inhibitory control. Okay. What this means is that the idea and the action are going to be way closer in ADHD. So what we really need to do is space those out. So practically what I tell my patients with ADHD is no unhealthy, available packaged food. Okay?

So what does this mean? This means that if you buy it and it is sitting in your pantry, you will eat it without realizing. You will eat it on an impulse. You cannot control whether you eat it on an impulse or not. So what I tell all of my patients and what works really well for them, At the very beginning, I was saying, don't, you know, stop eating cookies, and that didn't work. And then we discovered something really cool.

You can absolutely eat cookies, but don't buy cookies, make cookies. So if you want to eat something unhealthy, unhealthy food requires work. This is the key thing. We're not cutting out unhealthy food because that's mean. It's cruel. Oh, you poor kid who's obese with ADHD, no more fucking cookies for you. No, bro. Girl, go ahead and have cookies, but just make.

Make them. Bake them from scratch. Buy the flour, buy the brown sugar, by the chocolate chips. We want to increase the gap between an impulse and a reward. And what I find when I work like this with my patients is they're actually totally fine. It's like awesome. Like, okay, it's Friday evening. I've had dinner. I feel like having a cookie.

So what I'm going to do is bake a fucking batch of cookies. That takes 30 or 45 minutes. It's way healthier. There's another processed crap in it. We'll get to that a little bit. But this actually works really well. So do not buy packaged unhealthy food that is easily available. The only packaged stuff that you are allowed to buy are the only stuff that is easily available for you is healthy things.

All of your unhealthy food should be made. So even if you want to make fried chicken, don't buy frozen nuggies, don't buy frozen tennies. Fucking chop up that chicken breast, make your egg wash, grab your breadcrumbs and fry that shit up, man. Like have it and it's going to be delicious. It's going to be good. It's going to be way healthier anyway. Okay? This is critical.

You cannot win this battle when you are fighting it. This battle is won logistically before you even show up on the field of battle. It's won through logistics ahead of time. Third thing, altered emotional regulation. What can we do to fix this? We need to move this way. So this is a prime example of one of the biggest problems that I see with endocrinologist treating obesity. I'm not trying to dog on them.

They're doing a fantastic job. They have great outcomes, whatever, right? So I'm not saying they're doing a bad job. This is just a weakness of our field of medicine where we've over-specialized in bread and weakness. So if you're trying to control your food impulses, what you really need to do is control your emotions. So if we look at studies on people who are binge eaters, what we discover is three core changes when it comes to emotions. The first is that they have poor emotional regulation skills. Okay.

The second is that they are a lexathymic. So they are not aware that they are even feeling negative emotions. You don't even know exactly what's going on. You're kind of like your mind is wandering all over the place. This is sort of I see when my patients with ADHD. They're like mind is all over the place. They have so many things to take care of. They feel like they need to, they're under a lot of pressure, right?

That's what they really describe. They don't describe sadness or shame or fear or anxiety. They're like, I have a ton of shit to do. That's what they're subjective experiences. I mean, what is that? That's some kind of negative emotion. It's fear of the consequences if I don't do it right. It's anxiety.

It's even prospective shame. If I don't do this right, oh my God, I'm going to feel so bad. everyone is going to think I'm pathetic. Everyone is going to hate me. No one's going to want to be my friend. All of these emotions are going on. They're not aware of it. What do they feel? They feel pressure more than anything else. So they are unaware of their internal emotional state. And then what happens is their brain, their amygdala, knows that there's shame, there's fear, there's anxiety, there's panic. There's even some amount of anger, right? Oh my God, how did I get into the situation? Why do I always do this to myself? Right? You feel all these negative emotions, but you're not aware of it.

All you feel is pressure. And so the brain of the ADHD person realizes, okay, we have all this negative emotion. We need to get this shit under control. Boom. Let's go. Let's go. Let's go. Let's get some of those cookies. Let's manage that emotion because we need to manage that emotion. We have shit to do. We can't afford not to eat unhealthy today because there are so much things to do.

So we literally find three features in the brains of people who binge eat. Poor emotional regulation skills, Alexothymia, which is emotional colorblindness. We have a whole lecture on that. We've got guides on that. It's really, really important. Third thing is really fascinating. These people literally dissociate. Oh, interesting.

So when you dissociate, let's see. Oh, fascinating. We are not aware of the food reward. So interesting, right? So what happened is 30 years ago, people did brain scans on people who binge eat. And they're like, wow, these people are dissociating. We didn't understand the mechanism.

Now we understand the mechanism. There is a lack of attention. Literally, that's what dissociation is, is to not be aware in experiencing what is going on in your life. So what do we need to do to correct this problem? What we need to do to correct this problem is manage our emotions. So what I recommend in my patients who are ADHD and obese, because they don't see the problem as emotions. Right. They see the problem as impulse behaviors.

They see the problem as willpower. They see the problem as attentional deficits. Emotions aren't even on their radar, right? So I've heard of very few endocrinologists who when someone comes in who's overweight. First of all, they may not even do an ADHD evaluation, right? Because we're here for weight management. And secondly, they're not going to say like, okay, what's your emotional regulation management on a daily basis?

How do you manage your emotions every single day? That's not a part of obesity treatment. And I'm not dogging on the endocrinologist because these people studied for like three years in fellowship and went to some weight management clinic. It's not a standardized part of our treatment because that's psychiatry. It's over there. So what we need to do if we have ADHD and obesity is daily emotional management, right? I don't care if you journal.

I don't care if you go to therapy. I don't care if you meditate. I don't care if you take your dog out for a walk or you cuddle your cat or whatever. But everyone who is struggling with ADHD and obesity must have some kind of daily emotional processing, cleaning that stuff out. It'll reduce this craving, literally, neuroscientifically. It'll make it easier for you to eat. Okay? And it's not even, that once again is a battle that we're going to win the battle before we

ever show up on the battlefield. As you regulate and take care of your emotions, your drive to eat unhealthy will naturally go down. The reinforcement of that behavior will actually decrease if you manage your emotions. What that means is that your cravings will decrease. The pleasure that you get from the unhealthy food will decrease all by managing your emotions. Okay. So there's a lot of good stuff that we can do. Now, we're not done.

We're just halfway. And this may be way too long, but hey, this is like important to understand. So now let's talk about obesity. All right. So the first thing to understand about obesity is that adipocytes are not fat storage cells. This is what we used to think. We think, oh my God, your fat is just energy storage. It's just sitting there.

No, no, no. We have a whole video about this. Fascinating. Adipocytes are hormonally active. Oh my goodness. So I want you to think about it this way. Adipocytes are endocrine cells. What are your other endocrine organs of the body?

Your testes, your ovaries. So what this means is that when we have someone who is obese, there are adipocytes. They usually don't have more adipocytes. The adipocytes just grow. So if we double the volume of adipocytes, it's like doubling your ovaries or doubling your testes. We see spikes in hormonal production. And all of these hormones will affect the ADHD.

So let's start with a couple of core mechanisms. Okay? The first is increased inflammation. Okay? So what we literally know is that adipocytes produce something called IL-6. So IL6, along with IL1, IL-10, tumor necrosis factor alpha. There are all these. So interleukins are chemical signals that activate immune cells.

Okay, that's what these are. So these will activate your immune system and increase inflammation. What is inflammation? It's activation of your immune system. But specifically, we know that adipocytes will create IL-6. Now, IL-6 does something really problematic. It decreases BDNF. Now, what is BD&F?

brain derived neurotrophic factor. So something that is neurotrophic is something that causes neurons to grow, a stimulant for the brain. Now, I don't mean stimulant the way that like methylphenidate or Adderall or not those kinds of stimulants. These are growth factors. So they promote the growth and development of your brain. If you look at children and you measure their BDNF, the lower the BDNF, in the lower the BDNF in the child during development, the more likely they will develop ADHD later in life. So literally,

this is a chemical compound, hormonal compound, that triggers brain growth in development. And it is low in levels of people with ADHD. So there are some very small trials that are sort of hypothesizing that stimulating BDNF will improve symptoms of ADHD. It may be one of the mechanisms through which ADHD treatments work on some way, that stuff hasn't really been sorted out. But we certainly know that fat cells increase IL-6 and IL-6 decreases BDNF. So how does that work? Let's understand this. See, our body has two modes.

It has fighting mode and it has building mode. So our brain is just like any kind of RTS, right? So let's think about Starcraft or Warcraft. I don't know one plays RTS anymore. We kind of have our economy, right? We're going to build things up. We're going to acquire more minerals. We're going to build more pylons.

And then we make a lot of units, and then we send those units into war. And when we are building up our economy, we're not making like zealots or Marines or whatever. Like either we're building peons and pylons or we're building like zealots and dragoons. I know this is a reference that y'all fucking gamers aren't going to understand. So either we're investing in our economy or we are investing in like wartime units. So our brain and body are the same way. Either we are fighting off an infection or we are building things. And the problem is that since adipocytes increase our inflammation, they put our body into combat mode.

And then it stops building things. It literally reduces BDNF, which results in problems in our brain. Reduces the function of our brain, makes our ADHD worse. Second thing that adipocytes do is mess with our insulin. Okay, now we're going to have to learn more complex physiology. This is the most complex thing I'm going to teach all today. So let's understand this. Here is me.

I eat food. Food makes glucose in my bloodstream. Glucose triggers insulin. Okay. Insulin causes the absorption of glucose into cells. So now my cell is full of glucose. Okay? So insulin is triggered anytime we eat something.

So what does insulin end up doing? Insulin signals to our brain and our body that we have nutrients. Check. Nutrients acquired. Okay? So it kind of travels to our brain and it triggers things like leptin and ghrelin. We're not going to get into too much detail. But it kind of makes sense, right?

So when I'm hungry, I will have glucagon levels that are high. Glucagon is the opposite of insulin. So glucagon tells us, oh, crap, we're running low on energy. We're hungry. And glucagon will stimulate hunger. And then we eat something. We get glucose. Insulin shows up, puts the glucose into cells.

And insulin goes here and tells our brain, hey, nutrients acquired. You don't need to feel hungry anymore. There is another issue at play, which is that the more fat cells we have, or the larger our fat cells are, the more. we have insulin resistance. This is why people who are diabetics, type 2 diabetics, who are oftentimes overweight or obese, require insulin. We have to literally inject extra insulin because their cells are resistant to insulin.

I want to ask you all a question. If I have a resistance to insulin, what do you think it will do to my nutrients acquired signal? It decreases it, right? So the insulin is what tells our brain, hey, We have enough nutrients. You can stop feeling hungry now. And as I increase my adipocytes, adipocyte mass, my insulin resistance increases, which means that my body, brain, cannot detect the signal of fullness.

It is literally neurologically impaired. So people, even when they eat, they do not feel full. And this is mediated by adipocytes. The last thing that I'm going to touch on, I kind of forgot this, is that IL-6 works by two mechanisms. One is BDNF. But then the other thing is that we know that inflammation increases mood problems and anxiety. So there are some theories of inflammatory hypotheses of the brain.

So if you sort of think about this, if you get the flu, what happens to your mood? It goes into the pitter, right? So this is something that's very important to understand. Anytime we have inflammation in the brain, we will feel more depressed, we will feel more anxious. Now we see where everything is coming together. Because if you all have been paying attention, why does this hurt? more for people who have ADHD compared to the neurotypical person. Inflammation from adipocytes, right?

So here's the sequence. Adipocyte increase in obesity. Isle 6. Mood goes down. Anxiety goes up. And what happens in the brains of people with ADHD? Did you all pay attention? Did you all remember?

Amygdala? Hypersensitivity. So now what we're going to do, do you all remember, do you all remember? We're going to go up to this column. Where is it? Here it is. You guys remember this?

Okay, doesn't have enough space. So now what we're going to do, remember this one, where emotional, remember we have the sad kid who's got ADHD, so now we're going to add a fourth column. I'm sad and now I'm obese. So if I'm obese, it doubles the sadness. If I double the sadness, I get 40 units of craving. And now 2.5 units of satisfaction, which means I need to eat 16 cookies. And oh, that's right.

as I'm eating these 16 cookies, what would normally stop us from eating 16 cookies in one sitting? That's right, because every cookie that I eat releases insulin and tells my brain, hey, bro, we've had enough. But if I have insulin resistance from a large amount of adipocytes, I do not receive a satiety signal from all of the fucking cookies I'm eating, which is how I eat a whole package of cookies in one sitting if I have ADHD and a obesity. Everything comes together. So does this mean we are screwed? No. This just means we have been mistargeting the mechanisms. So the first thing is as we increase emotional regulation techniques,

we will actually fix this problem automatically. The other thing that we're going to do is recruit a couple of other interesting things. So now we're going to use kind of anti-obesity mechanisms. So our body has multiple ways of detecting the food that we eat. One is through this insulin and glucose metabolism thing, but then we also have this thing called gastric stretch, which is that we literally have stretch receptors in our stomach. So as our food, as our stomach fills with volume, we get a completely different pathway, right? So you can't eat like this much food in terms of volume. Why not? Because what happens is I eat a large, not quantity, not nutrient density, but literally a large volume of food, my stomach stretches out. It expands. I feel full and I'm bloated. Oh my God,

I've got a food baby in my belly. Once I have a food baby, it's a completely different pathway. It is a physiologic stretch pathway, and this will help us feel full. This has nothing to do with dopamine, nothing to do with emotions. This is a completely separate pathway, and this is what we need to utilize. So what I recommend to all of my patients who are struggling with weight loss and ADHD is that you eat foods that are going to make your belly stretch. Make that belly stretch. That is usually high fiber foods, high volume foods. So if you look at something like broccoli, you have to eat like a large volume of broccoli

to equate the calories of a single twinkie. The problem with the twinkie is that most neurotypical brains, if I eat a twinkie, I will feel somewhat satisfied because the sugar receptors, the insulin receptors, are all kind of working well, so I get this nutrient load, right? And then my brain is like, okay, we've had enough because this is like 400 calories. no big deal, I'm done. That doesn't work in people who have ADHD and obesity, so we need to use gastric stretch. So eat as much high fiber food as you can, have it easily available. This will stretch your belly and will make you feel full. Next thing, we want to really start exercising.

So the more that we exercise, the more it fixes this whole insulin resistance thing. So we know that, for example, even type 1 diabetics to a certain degree, I think is type 1, definitely type 2. So the more that you exercise, it kind of counteracts all of this physiologic stuff. the sedentary lifestyle is half the reason why ADHD and obesity are getting worse. So the more you can exercise, the better it will be for your stomach and your physiology and stuff like that. It'll even help your brain. We want to also eat anti-inflammatory food. So this is where I would strongly recommend that you seek a professional, so someone like a dietitian or an endocrinologist or medical doctor, and try to really start eating anti-inflammatory foods and also foods that affect insulin

metabolism. So in my practice, I'll use things like Marjoram in, you know, Ayurvedic medicine, and we'll use bitter melon a lot, coffee, green tea, chamomile, ginger, all of these foods have had some evidence that they will affect our sugar metabolism and our inflammation. So if you start to eat these things, you can start to counteract some of these principles. So just in summary,

so we're seeing a rise of ADHD and we're seeing a rise of obesity. There's another problem that we have, which is that if you have ADHD, oftentimes we don't consider the impact of obesity on your brain. And on the flip side, if we're trying to treat obesity, we do not consider the impact of your ADHD emotional regulation reward processing brain in terms of resisting food. So what ends up happening is that we use all of these

interventions, which are designed from clinical trials. But as part of those clinical trials, because they're very controlled, we start excluding people who have problems like ADHD. And so what we're seeing is a rise of ADHD and obesity, partially because our interventions don't, account for both of them. And there's certainly a synergistic effect of obesity on ADHD. It makes our brain more vulnerable. And there is a synergistic effect of ADHD on eating. And so this is why a lot of people lose hope. But the good news is that if we understand the mechanisms at play, we can target these neuro atypical mechanisms and hopefully get a handle on both ADHD and obesity. And this is what I've seen as a clinician. This seems like a battle that's really

hard to win because one screws over the other. But the good news is that if you start moving in the positive direction with one, if I have a patient who has ADHD and their weight gets under control, their ADHD improves. If I have a patient who is obese and I get their ADHD under control, their weight improves. So both of these things, it's kind of they combine together to screw you over, but you can also actually improve both of them two birds with one stone. You can get kind of a nice fatty crit in there and hit both of them at the same time. So definitely try some of the stuff that we're talking about today. If you're someone who has a clinician that you're working with right now, I strongly recommend that you talk to them about these kinds of mechanisms and see if there's

something you can do about it. The last thing is if y'all are really interested in this stuff and you like these kind of mechanisms and stuff like that, we have a awesome guide to ADHD where we dive into a lot of neuroscience and give you all a lot of interesting techniques. So check that out too. Hey, Dr. Kay, how do I get my kid to put down the game without it being a fight every single time? The problem with gaming is that it tricks our brain into being a substitute for life. Once we start to get our psychological needs met through the game, that's when we become addicted. How to Raise a Healthy Gamer combines the latest in neuroscience research along with a decade of clinical practice. Check it out anywhere books are sold.

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