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What Causes Constant Fatigue And Hyperphagia While On Diet In An Elderly Man?

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Posted on Wed, 24 Aug 2016
Question: 59 yr male. Moderate exercise. Grew up with very hard farm work and large apetite. 60 pounds overwt. Constant very strong apetite. Yo yo wt loss over past 6 years. Apetite 9/10. thank you


worked 140-160 hours per week during vet emergency internship 1990 and residency in anesthesia. Constant fatigue- should improve nutrition. Walking exhaustion is the feeling but carrying on .
doctor
Answered by Kathy Shattler (43 minutes later)
Brief Answer:
Hello and welcome to Health Care Magic

Detailed Answer:
I can offer some advice to help you I do believe. In my experience, individuals with your symptoms are both leptin and insulin resistant.

I will not be redundant with the need for regular structured exercise at the appropriate target heart rate for age (208-age) x .7 = target heart rate for a minimum of 20 minutes plus a 5 minute warmup and 5 minute cool down combined with resistance training to build muscle.

For regulating the appetite hormones leptin (and gherlin too) along with insulin resistance that comes with having too much body fat, follow these guidelines along with cutting your portion sizes of foods currently eating.

Tips
1.     Eat more, gain body fat.
2.     More body fat means more leptin in fat cells.
3.     Too much fat means that proper leptin signaling is disrupted.
4.     The brain thinks you’re starving, which makes you want to eat more.
5.     You get fatter. And hungrier.
6.     You eat more. Gain more fat.
7.     Fructose aggravates this process. Avoid labels that say High Fructose Corn Syrup and eat fresh fruit as opposed to drinking juices, pops, or drinks with added sugar.

Interestingly, both types of resistance (leptin and insulin) seem to occur together in obese people, though obese men who tend to have more internal belly fat (visceral fat) have higher insulin levels, and women who tend to have more fat under their skin have higher leptin levels.
Your stomach makes ghrelin when it’s empty. Just like leptin, ghrelin goes into the blood, crosses the blood-brain barrier, and ends up at your hypothalamus, where it tells you you’re hungry

Ghrelin is high before you eat and low after you eat.

So, let’s try this
1.     Gradually introduce more fiber, which is filling and will cause distension of the stomach thus inhibiting ghrelin release.
2.     Keep from getting hungry,. Plan 3 meals per day and 2-3 snacks
3.     Always eat protein in am to get you started with a burst of energy

If you want to lose weight you want less ghrelin, so you don’t get hungry.

Both hormones, as I mentioned, regulate appetite and hunger, and both of them regulate homeostasis — in this case, keeping you adequately fed. When you try to lose fat, your body will probably respond by changing hormone levels so that you get hungrier.

1.     Take fish oil. Omega 3 fatty acids are linked to decreased hunger or eat fatty fish 3x per week.
2.     Sleep. Lack of sleep leads to more ghrelin and less leptin, as well as disrupted glucose and insulin metabolism
3.     Exercise. At least 150 minutes per week and work your way up to 240 minutes per week.
4.     Understand that fat will make you fat.
5.     Focus on eating low glycemic foods. Lists can be found online by searching for "high glycemic foods"
6.     Reduce Stress!!! Uncontrolled stress have an unfavorable effect on hunger hormones. Exercise, meditation, there are many methods of stress reduction.
7.     Avoid all food commercials or unnecessary talking about food as it will automatically cause a rise in insulin, which you are already high in as the case with all obesity profiles.
8.     No MSG, per some studies
Two other problems occur when we cut fat. Often we short ourselves on the essential fatty acids. These two are needed everyday.
Fat causes us to gain fat. Cut down on all sources of fat except essential fatty acids, one an omega 3 and one an omega 6.

Essential Fatty Acid
Alpha-linolenic acid is a kind of omega-3 fatty acid found in plants. It is found in flaxseed oil, and in canola, soy, perilla, and walnut oils. Alpha-linolenic acid is similar to the omega-3 fatty acids that are in fish oil, called eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).
Linoleic acid is a type of fat, or fatty acid, found in vegetable oils, nuts, seeds and animal products. An essential omega-6 fatty acid, linoleic acid is required by the human body in small amounts.

Next suggestion, I have found that not only my patients but myself as well have found that taking ASHWAGANDHA or drinking a high quality ginseng tea gives me extra energy during the day.

Anytime I place someone on a reduced calorie diet I also generally advise them to take a hypoallergenic multivitamin pill while we are talking about healthy eating habits.

A good model diet plan to follow would be the Mediterranean Diet or the Mind
Diet. Both can be googled. The MIND diet is a mixture of the DASH diet and another popular diet and is designed to prevent neurodegeneration. Nevertheless, both diets are high in fiber, low in saturated fat and good diets overall. Just stay on a low calorie meal plan. To lose 2 lbs per week, cut out or exercise a total of 1000 calories per day.

To receive personalized meal plans and support/guidance/education, you can always followup with a local Dietitian which you can find on the Academy of Nutrition and Dietetics Site. Look for "Find a Dietitian" and when you find that page put in your zip code and it will lead you to a nearby Registered Dietitian/Nutritionist.

I have tried to explain your nutritional problem, interventions to address the problem and a referral for follow-up which I recommend. I wish you luck with any needed lifestyle changes that are recommended to address your heavy appetite. Regards, XXXXXXX Shattler, MS,RDN
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
Answered by
Kathy
Kathy Shattler

Dietitian & Nutritionist

Practicing since :1985

Answered : 901 Questions

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What Causes Constant Fatigue And Hyperphagia While On Diet In An Elderly Man?

Brief Answer: Hello and welcome to Health Care Magic Detailed Answer: I can offer some advice to help you I do believe. In my experience, individuals with your symptoms are both leptin and insulin resistant. I will not be redundant with the need for regular structured exercise at the appropriate target heart rate for age (208-age) x .7 = target heart rate for a minimum of 20 minutes plus a 5 minute warmup and 5 minute cool down combined with resistance training to build muscle. For regulating the appetite hormones leptin (and gherlin too) along with insulin resistance that comes with having too much body fat, follow these guidelines along with cutting your portion sizes of foods currently eating. Tips 1. Eat more, gain body fat. 2. More body fat means more leptin in fat cells. 3. Too much fat means that proper leptin signaling is disrupted. 4. The brain thinks you’re starving, which makes you want to eat more. 5. You get fatter. And hungrier. 6. You eat more. Gain more fat. 7. Fructose aggravates this process. Avoid labels that say High Fructose Corn Syrup and eat fresh fruit as opposed to drinking juices, pops, or drinks with added sugar. Interestingly, both types of resistance (leptin and insulin) seem to occur together in obese people, though obese men who tend to have more internal belly fat (visceral fat) have higher insulin levels, and women who tend to have more fat under their skin have higher leptin levels. Your stomach makes ghrelin when it’s empty. Just like leptin, ghrelin goes into the blood, crosses the blood-brain barrier, and ends up at your hypothalamus, where it tells you you’re hungry Ghrelin is high before you eat and low after you eat. So, let’s try this 1. Gradually introduce more fiber, which is filling and will cause distension of the stomach thus inhibiting ghrelin release. 2. Keep from getting hungry,. Plan 3 meals per day and 2-3 snacks 3. Always eat protein in am to get you started with a burst of energy If you want to lose weight you want less ghrelin, so you don’t get hungry. Both hormones, as I mentioned, regulate appetite and hunger, and both of them regulate homeostasis — in this case, keeping you adequately fed. When you try to lose fat, your body will probably respond by changing hormone levels so that you get hungrier. 1. Take fish oil. Omega 3 fatty acids are linked to decreased hunger or eat fatty fish 3x per week. 2. Sleep. Lack of sleep leads to more ghrelin and less leptin, as well as disrupted glucose and insulin metabolism 3. Exercise. At least 150 minutes per week and work your way up to 240 minutes per week. 4. Understand that fat will make you fat. 5. Focus on eating low glycemic foods. Lists can be found online by searching for "high glycemic foods" 6. Reduce Stress!!! Uncontrolled stress have an unfavorable effect on hunger hormones. Exercise, meditation, there are many methods of stress reduction. 7. Avoid all food commercials or unnecessary talking about food as it will automatically cause a rise in insulin, which you are already high in as the case with all obesity profiles. 8. No MSG, per some studies Two other problems occur when we cut fat. Often we short ourselves on the essential fatty acids. These two are needed everyday. Fat causes us to gain fat. Cut down on all sources of fat except essential fatty acids, one an omega 3 and one an omega 6. Essential Fatty Acid Alpha-linolenic acid is a kind of omega-3 fatty acid found in plants. It is found in flaxseed oil, and in canola, soy, perilla, and walnut oils. Alpha-linolenic acid is similar to the omega-3 fatty acids that are in fish oil, called eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Linoleic acid is a type of fat, or fatty acid, found in vegetable oils, nuts, seeds and animal products. An essential omega-6 fatty acid, linoleic acid is required by the human body in small amounts. Next suggestion, I have found that not only my patients but myself as well have found that taking ASHWAGANDHA or drinking a high quality ginseng tea gives me extra energy during the day. Anytime I place someone on a reduced calorie diet I also generally advise them to take a hypoallergenic multivitamin pill while we are talking about healthy eating habits. A good model diet plan to follow would be the Mediterranean Diet or the Mind Diet. Both can be googled. The MIND diet is a mixture of the DASH diet and another popular diet and is designed to prevent neurodegeneration. Nevertheless, both diets are high in fiber, low in saturated fat and good diets overall. Just stay on a low calorie meal plan. To lose 2 lbs per week, cut out or exercise a total of 1000 calories per day. To receive personalized meal plans and support/guidance/education, you can always followup with a local Dietitian which you can find on the Academy of Nutrition and Dietetics Site. Look for "Find a Dietitian" and when you find that page put in your zip code and it will lead you to a nearby Registered Dietitian/Nutritionist. I have tried to explain your nutritional problem, interventions to address the problem and a referral for follow-up which I recommend. I wish you luck with any needed lifestyle changes that are recommended to address your heavy appetite. Regards, XXXXXXX Shattler, MS,RDN