As I mentioned in part I of this blog, there is a strong association between insulin resistance, diabetes and mental health.

Caught and treated early, insulin resistance is reversible in >90% of patients, and there is a clear improvement in well-being associated with this reversal.  To get to the foundation of the problem, you must do a diagnostic work-up, to identify and deal with the layered factors which promote insulin resistance and diabetes. Factors to be assessed include:

a)     Cortisol-levels which are too high, (as might be the case in anxiety disorders, mood disorders, and psychotic disorders) cause insulin to be elevated, and increase appetite. Cortisol can be reduced easily enough by either supplements or medications, as well as psychotherapeutic methods (e.g., biofeedback, certain therapies, body work etc)

b)     Female and male hormones-low levels of testosterone result in lowered lean body mass (therefore lower metabolic rate), lower energy and vitality. High levels of estrogens (e.g. with potent birth control pills) can also cause weigh gain, albeit in a different pattern of distribution.

c)      Stress-many people over eat when tired, angry, frustrated, bored, lonely; Becoming mindful of your sense of hunger before eating, can, over time, reduce unconscious habitual stress eating. Identifying the situations which make you stressed and problem solving them when possible can help reduce stress eating. Keeping a daily log  (what you ate, when you ate it, and situations in which you over-ate) will definitely raise consciousness

d)     Lifestyle-getting adequate sleep (7-9 hours for most people), moderate exercise 4-5 times per week will reduce the tendency to eat highly processed foods in an out of control manner when you are tired.

e)     Inflammation and toxins: inflammation due to infection, or toxins in your environment can cause weight gain, as a hormone called Leptin can rise to unusual levels. Irvingia Gabonensis has been shown to help reverse leptin elevation and therefore help with appetite reduction and weight loss.

f)       Nutritional deficiencies (e.g., chromium, vanadium, thiamine) can lead to trouble handling carbohydrates in the body.

g)     Caloric restriction-the hardest part of the program is to reduce calories, but with the above measures, perhaps a support group (e.g. weight watchers, over-eaters anonymous, food addicts anonymous), you can do it.

Yours in Health,

Dr. Hedaya

Insulin resistance is a fully reversible condition in which the cells of the body become insensitive to the insulin signal, which itself is designed to take glucose (sugar) out of the blood and into the cells (for energy). If insulin resistance becomes severe enough, it progresses into type II diabetes. Diabetes is more difficult to reverse, and is associated with frequent urination, increased weight, increased thirst, and a host of other problems.

The connection between obesity, insulin resistance, diabetes and mental health problems is no longer questioned. There are number of reasons for the association, including the use of psychotropic medications which cause weight gain, and promote the metabolic syndrome; the social stigma associated with obesity and the lifestyle changes associated with diabetes; and inflammatory activation due to poor diet, high insulin and glucose levels, which in turn changes brain neurochemistry.

A recent study (McIntyre et al.  brain volume abnormalities and neurocognitive deficits in diabetes mellitus: points of pathophysiological commonality with mood disorders?: Adv. Ther. 2010 Feb;27(2):63-80. ) reviewed the literature on brain changes in type one and two diabetes, and concluded that the brain areas which are affected in mood disorders and DM diabetes mellitus, significantly overlap. The association is so compelling that one article in 2007 (Ann. Clin. Psychiatry; 2007 Oct-Dec;1994):257-64) was titled: “Should Depressive Syndromes Be Reclassified as “Metabolic Syndrome Type II”. The association with diabetes (and obesity and insulin resistance) extends beyond just mood disorders, to anxiety disorders, and major psychiatric syndromes such as bipolar disorder and schizophrenia.