Hypoglycemia, Carbs, and Hunger

Effects of a high-protein ketogenic diet on hunger, appetite, and weight loss in obese men feeding ad libitum. Via Jimmy Moore's Living La Vida Low Carb blog.


The hardest part of dieting for me is the hunger, or perhaps, the cravings. By cravings, I don't mean just really wanting a candy bar, but intense, nearly overwhelming feelings that I have to eat something now. It's not actual hunger, because I don't have the stomach growling or the feeling of emptiness in my gut, but it is like every cell in my body is just screaming at me to eat. Eventually, I give in.

Since I was a teenager, I've thought that I have reactive hypoglycemia. If I go more than 3 or 4 hours without eating, I start feeling light-headed, and if I have too much sugar or carbs without protein, I get shaky and "hungry" within an hour. Every day of my life since high school has been either a struggle between feeling well and not overeating or feeling pretty well while eating enough to gain up to a pound a week.

By eating small meals or snacks every three hours that I'm awake, including right when I wake and right before I go to bed, I can just barely negotiate that line of feeling well and losing weight. Eat too much at an early meal, though, and there's no way for me to end the day without either going over my calorie limit or feeling like crap.

The only breaks I've gotten from this struggle are the few times I've specifically restricted carbs. Once, I completely abstained from sweets for two months and I felt better than I'd felt in years while simultaneously losing 30 pounds, all with no struggle or serious effort. On several other occasions, I attempted more severe, Atkins-like low carb diets. For the first 2 or 3 days, I felt awful, but by day 4 or 5, I felt amazing -- I had high energy and the near-constant desire to eat was just... gone. I woke up in the mornings without the grogginess that is my constant companion most mornings of my life.

I believed for years that my intense cravings and inability to stick to a diet were due to a condition called reactive hypoglycemia. Now I'm thinking that what I thought of as hypoglycemia could perhaps be more accurately described as a refined carbohydrate addiction. I need my fix every few hours and if I don't get it, I feel like hell. If I remove refined carbs entirely, I feel awful for a couple of days (withdrawal?) and then the cravings just go away.

Unfortunately, the no-sweets period of my life ended with many months of binging on around 1750 calories of chocolate chip cookies per night, leading to the inevitable result of an extra 15 lbs a month. The Atkins-like low-carb pushes never made it to a weak before I decided I couldn't live like that even though I'd already dropped 5 lbs and felt great. I don't think I can go completely low-carb or completely sweets-free.

Anyway, as a New Year's resolution, I'm giving weight loss another serious try. I'm counting calories every day on FitDay and again, I'm running into the problem of hunger or cravings. Usually at this point I would give up, maybe recording my 4000 calorie days for a week or two before giving up the exercise as fruitless. This time, though, I'm more motivated than usual, so I find myself forced to confront this issue. Surely I can find a way to limit myself to 3000 calories without feeling awful, right?

Anyway, I'm coming around to the idea that carbs may be the source of my struggle. First, I read an article called "What if It's All Been a Big Fat Lie?" by Gary Taubes, a science writer. Then I read this interview. And then I got his book, which I have so far only skimmed. Taubes's argument is that there is very little empirical evidence for the low-fat diet that has been pushed for the last few decades by various establishments, and that it is in fact refined carbohydrates that have led to the increase in obesity. He argues that refined carbs stimulate the body to store fat and also to send the signal for more food, resulting almost invariably in overeating.

Taubes, like Atkins, presents a whole bunch of scientific data supporting his view. Unfortunately, as a computer programmer and not an endocrinologist or health professional, I'm not personally qualified to judge whether Taubes and Atkins are following the science better than everybody else. Generally, I'd bet on the establishment when a maverick challenges its accepted wisdom. I believe in science and I'm skeptical about individuals who think they've outsmarted the scientific community.

But here's the thing. Even the establishment cannot seem to point to any evidence that shows a low-carb diet is any worse than a low-fat, or even balanced, diet. I've seen several studies that show that low-carb diets are perhaps even more effective than low-fat ones, and may be easier to stick to. I know personally of several respected physicians who believe in low-carb dieting.

Above all, though, I just know from my experience that carbs mess with me. Of course, if I eat fewer calories than I burn, wherever those calories come from, I will lose weight. I've done it a dozen times. However, I also know that if I cut calories without paying attention to my carbs, I have to struggle with hunger and cravings every day.

This brings me back to the paper that I linked to at the top of this post. It's conclusion: In the short term, high-protein, low-carbohydrate ketogenic diets reduce hunger and lower food intake significantly more than do high-protein, medium-carbohydrate nonketogenic diets. "Reduce hunger and lower food intake." That's exactly what I'm looking for. Trying to force myself to restrict intake while fighting desperate cravings is like hitting my head against the wall. Maybe I can get my body to help me lose weight instead of fighting me.

I'm not ready to go on a program as strict as Atkins. I'm just not a super-disciplined person and I'm not willing to give up that flexibility. But I am going to start paying more attention to my carbs. As long as I'm able to keep my daily calorie intake as low as I need to, I'm not going to worry about my carb intake too much. But when I struggle, as I so often do, I know that I now have a trick up my sleeve to make the cravings stop. I can just cut back on the refined carbs, and the cravings will go away on their own. Instead of eating refined carbs when I'm craving more food than I should eat, I'll have some more protein, or perhaps some complex carbs like old-fashioned oatmeal. Maybe I'll go two- or three-hundred calories over my limit for that day, but I know the next day will be easier. The next day I won't have the cravings, or they will at least be smaller.

Today, I'm sticking fast to my limit, for the first time in months. (I've gone slightly over every day this week, leaving me with enough deficit to lose, but not as fast as I'd like.) I can say that confidently, because I'm going to bed soon, I'm not hungry and I don't have strong cravings, and I still have a big bowl of oatmeal ahead of me. Today I'm managing because I did not substitute a fudge brownie for a sensible snack and try to cram in a 500-calorie cookie as an essential part of my lunch. I did have a small, 200-calorie candy bar, and even two beers, but the majority of my food has been balanced, healthy, and most importantly, low in refined carbs.

Now to my oatmeal. Wish me luck!