Subject: An exploration of the potential common pathological links between eating disorders, obesity, and other common brain disorders, as viewed through the lens of the Carbohydrate Associated Reversible Brain syndrome (CARB syndrome) model.

Source: Excerpts from "Eating Disorders and Obesity – Are They Two Sides of the Same Coin?" by Dr. Bill Wilson (carbsyndrome.com)

Date: February 1, 2013 (publication date of the article)

Key Themes and Ideas:

• Challenging Conventional Views: The article challenges the seemingly polar opposite nature of eating disorders and obesity, suggesting they may share underlying commonalities beyond just weight, particularly in relation to brain function and fat storage. "On the surface eating disorders and obesity seem to be conditions that are polar opposites."
• Fat Storage and Brain Function: The article emphasizes that excessive fat storage, particularly abdominal/visceral fat, is a common factor in both eating disorders and obesity. He argues that even those with anorexia, when re-fed, tend to store disproportionate amounts of visceral fat. "In essence they become a thin obese person when they start to eat more food." He highlights the brain's role in regulating fat storage through the hypothalamic-pituitary-endocrine axis. "For some reason people with eating disorders seem to have brains that want to store more fat."
• Co-morbidity with Brain Disorders: Both eating disorders and obesity frequently co-occur with other brain disorders like depression, anxiety, ADHD, PTSD, and OCD. This overlap suggests a possible common pathological process.
• Introducing CARB Syndrome: Dr. Wilson proposes the Carbohydrate Associated Reversible Brain syndrome (CARB syndrome) as a unifying disease model. This model suggests that dietary elements, particularly excessive fructose and high glycemic carbohydrates, lead to food-induced brain dysfunction. "Transition to a New Disease Model: CARB Syndrome. Over the years I have developed the Carbohydrate Associated Reversible Brain syndrome or CARB syndrome disease model to connect these dots. This model is based on the premise that consuming certain dietary elements can over time lead to a form of food induced brain dysfunction where the brain doesn’t work as intended."
• CARB Syndrome and Eating Disorders: The article describes how carbohydrate cravings, a key symptom of CARB syndrome, can drive eating disorder behaviors. Restricting food intake in anorexia can suppress these cravings temporarily, but they return upon re-feeding, leading to feelings of discomfort and further restriction. "Recently I admitted a young woman into the hospital with severe anorexia…When I asked her about this symptom, she denied having such cravings. That’s because when someone with anorexia restricts their food intake to a severe degree, they end up in ketosis which tends to suppress both hunger and carbohydrate cravings."
• Treatment Focus: Dr. Wilson advocates for a treatment approach that focuses on improving brain function by removing the dietary triggers of CARB syndrome (excessive fructose and high glycemic carbohydrates). He recommends a low-carbohydrate, moderate-protein, high-fat diet, emphasizing healthy fats. "The key to successful treatment is to slowly move them out of this mode and the best way to do so is to focus on improving their brain function. The most effective way to improve their brain function is to remove the triggers of CARB syndrome from the diet—excessive fructose and high glycemic carbohydrates."