Cravings. Cravings for food, drinks, a pair of Louis Vuitton shoes. Cravings are a form of desire and we all have them.
In this week's episode, we are talking about cravings. I will explain the physiology, why you are setting yourself up for them, and what you can do to manage them with kindness and compassion. If you have ever found yourself fighting with a box of thin mint cookies, or sitting in bed with a bag of chips while binging on Netflix, this episode is for you.
Welcome to Health Bite, the podcast dedicated to providing you with small, actionable bites towards better mental, emotional, and physical well being. Our wellness culture is filled with gimmicks, tricks, and fake news. Our strategies are all about quick fixes and false promises using fear based tactics that are filled with judgment and shame.
My name is Dr. Adrienne Youdim. I am a Board-certified Internist, Obesity Medicine Specialist, and Physician Nutrition Specialist, here to give the wellness culture a different spin. You can expect here no nonsense, evidence-based guidance, with kindness and compassion in the areas of nutrition, fitness, habit change, and mindset that I use with my patients and clients in my medical practice every day.
I promise to leave you feeling motivated, empowered and inspired.
So let's dig in.
So again, this week, we are talking about cravings.
Cravings is a form of desire, and we all have them. Whether it is craving for chocolate, for chips, for an alcoholic drink, for a pair of Prada shoes or Louis Vuitton’s, we all experience cravings. And in today's episode, I'm going to give you the physiology behind them, and some evidence-based tips and tricks on how to manage them.
Reason behind Cravings #1: How Sleep Deprivation Affects Our Hunger and Cravings
So first off, let's talk about cravings, and let's talk about why we are experiencing them.
Many of my patients are telling me that they've always had cravings, but over the past two years, they have really amplified. And there's a reason for that. We're going to get into it.
So, number one. Number one reason that I hear cravings in my patients is because you are tired, and it's not just because of the time change that we have just experienced, but we are tired because of a change in our routine and a change in our sleep. And fatigue and sleeplessness physiologically amplify our cravings. Studies have shown, in fact, that as little as two nights of sleep deprivation will increase hunger hormones. Hunger hormones, like ghrelin, for example, that are released by the stomach and physiologically send a signal of hunger to the brain are increased by 30% when we are sleep deprived. Other hormones that signal energy sufficiency or fullness are actually reduced. So for example, there's a hormone called leptin. We release leptin from our fat cells, and it gives our brain a signal of fullness or energy sufficiency. We know that with sleep deprivation, leptin levels drop by 20%, reducing that signal to shut off hunger at the level of the brain.
And in fact, when they survey these people who they have sleep deprived in a laboratory setting and hand out surveys on hunger and cravings, subjects will report a 30% increase in their hunger. And when asked what they are hungry for, they are in fact hungry for highly palatable foods. That means foods that are higher in salt, sugar, and fat.
So, the truth is that when we are sleep deprived, we don't hunger for broccoli, we are not craving veggies, but we are physiologically craving those foods that are more palatable, perhaps because these are the foods that release a greater dopamine response. They're the foods that get us jazzed up and more awake. And it's not uncommon for my patients to tell me that they're eating to stay awake, sometimes because they're feeling tired or fatigued during the day. Food serves as a way to wake us up to keep us awake, energized, and sometimes motivated.
So tip number one is get adequate sleep. If you're not sleeping well, if the pandemic ruined your routine, then let's reset that routine. Create some good habits with sleep hygiene, and shoot for seven to eight hours of sleep per night.
Reason behind Cravings #2: The Power Alcohol Holds Over Our Cravings
Number two. The number two reason for cravings is alcohol. Whether you have started drinking more during the pandemic, or now you're trying to scale back, alcohol is a reason for cravings.
First off, we all know that when we drink, that we are less inclined to manage ourselves. We are more likely to eat out of reactivity rather than mindfulness. And so, alcohol does create this kind of lack of mindfulness around food and munchiness.
But what happens when we try and scale back?
Well first, it's important to understand the physiology of alcohol. When we drink alcohol on a regular basis, we start to develop a resistance to dopamine. Remember that we get a dopamine hit in the brain – dopamine is that feel-good hormone, the neurotransmitter that gives us a sense of pleasure and reward – to every drink we take. Over time though, our brains become resistant. We require more and more alcohol in order to get that dopamine hit, in order to get that emotional payoff, and our receptors or our reactivity to dopamine also get blunted. And what happens as a side effect is that our baseline natural amounts of dopamine are blunted or reduced.
And so, when we take away alcohol or try and scale back and reduce that artificial form of dopamine, in the setting of a now lower dopamine baseline, our body starts to crave dopamine. And sugar cravings are a major way to accomplish that. Drinkers will experience and will describe a wicked sugar-like craving when they try and scale back their alcohol.
So, the point here is to just be aware. Know that your body and your mind are kind of playing a trick on you in order to regain that dopamine setpoint.
The good news is that if you ride that wave – which we'll talk about at the end of the podcast – and give it time, within two to four weeks, your body and mind are going to back off and give you a break. You are going to recalibrate your baseline or natural dopamine levels in the brain, and no longer seek or crave artificial sources.
So, hang in there.
Reason behind Cravings #3: The Rapid Spike of Sugar that We Get from Simple Carbohydrates
Number three. The third reason that we experience carb cravings, or cravings in general, is because we are consuming simple carbohydrates.
So, think about this. Simple carbohydrates, things like bread, pasta, pastries, sugary items – these are carbohydrates in which the sugar is simple, meaning that they're already broke down into their basic components. What that means is that the body doesn't have to work hard in order to absorb that sugar, and therefore, when we consume these foods, we get a rapid jump in our sugar levels. When the body experiences a rapid spike in sugar, it responds by releasing a rapid dose of insulin.
Insulin, again, is the hormone that helps us manage blood sugar, that helps store sugar into the cells. When you get a big burst of insulin, then your sugar is going to plummet, and that quick rise and quick plummet of sugar will induce a craving, because your blood sugar has now plummeted.
You may experience this when you have simple sugars for breakfast. And our breakfast foods typically don't serve us. Breakfast foods like pancakes, toast, waffles, even some of our highly-processed instant oatmeals – these are foods in which the carbohydrate has really been simplified; it's already been broken down. And you may experience it when you eat breakfast, 30 to 60 minutes later, you experience hunger or craving. Sometimes, my patients will conflate this with not needing breakfast. They'll tell me, “You know what? If I don't eat breakfast, I am fine all day, but when I eat breakfast, I'm actually hungrier.”
Well, that's because of what you're consuming.
If we are to consume more complex carbohydrates or high protein foods, we won't have that crash of blood sugar, which stimulates a feeling of hunger or craving 30 to 60 minutes later.
So if this is your experience, I want you to try and experiment this week. Try to reduce the simple sugars in your breakfast and see what happens, not only 30 to 60 minutes later, but what happens later in the day.
Reason behind Cravings #4: Why it’s a Must for Us to Consume Adequate Protein
Which brings me to the fourth point, which is you are not consuming adequate protein.
We know that protein is the macronutrient that staves off hunger the most. In fact, higher protein meals will reduce the level of GLP-1 and PYY – I'm sorry, flip that over – will actually enhance the levels of these hormones. These are gut hormones that signal fullness at the level of the brain. So, we've explained the physiology in prior podcasts, but when we consume nutrients and that food goes down into the gut and the intestine, our body responds by releasing these hormones, which then travel to the brain and shut off that hunger valve.
So when we consume higher protein levels, we are setting ourselves up for more satiety, for more fullness, and thereby reducing cravings.
So, the second part of that food tip is not only I want you to experiment by reducing your simple sugars in your breakfast, but actually increase the protein levels and see what happens to your cravings, not only in the morning, but later in the afternoon, as studies have shown having a higher protein at breakfast in the morning will reduce snacking and cravings even in the afternoon time.
The Witch Hour: Why We Experience Cravings Later in the Afternoon and At Night
Which then takes us to this point – why do we experience cravings later in the afternoon and at night?
Patients will always tell me that they are fine most of the day, until the witching hour. And if you want to know more about the witching hour, look back in our catalog. I talked about it, a few podcast episodes ago.
But what happens? We're doing great all day until we hit that time of day. Usually, it's 3-4 in the afternoon, where we start to feel snacky, where we start to experience cravings we haven't experienced all day, and those cravings will continue throughout the evening and in the night, and despite our best attempts, will culminate at the very evening right before we're about to go to bed, when we've done great all day, that craving will undermine us. Why is that?
Well the first is, again, let's go back to reason number one – we're tired.
So, notice what's happening in your body, and if you're feeling tired, take a nap in the afternoon. A power nap. 10, 15, 20 minutes. Don't tell me you don't have time. When I was in college, I used to put my head down on the desk reliably at 1pm every day, and I would take a 10-12 minute nap, feeling refreshed for the rest of the day. So, try taking a nap. If it's late at night and you're in bed, just go to bed, turn off that Netflix, put away the phone, and go to bed because that is what your body wants.
But what if you're not tired? You're not sleepy? What else might be going on?
There's a concept called “decision fatigue”, and decision fatigue relates to the fact that we have spent all day making micro decisions, right? What to eat, when to exercise, when to start that project, how to complete our tasks. There are so many decisions that we engage in throughout the day, that by the time you hit that afternoon mark, you are just tired from decision making. You have decision fatigue, and therefore, your wherewithal, your willpower for certain things, have been whittled away, and you find yourself unable to deal with cravings.
So, the way to manage decision fatigue is to just reduce your decision making. There are certain things that we do every day. We eat breakfast every day. We consume lunch every day. We have certain tasks that we have to check off our to-do list. So, automate these tasks. Meal prep and plan your meals. Make a decision on when you're going to exercise and don't negotiate. Automating your tasks and defining your times for certain activities will reduce decision fatigue, so that you save that power, you save that will for later in the day when you really need it most.
Our Cravings as a Rubber Band: The Importance of Having Compassion for Yourself Whenever You React to Your Cravings
And finally, let's cut yourself some slack, because cravings are physiologic. They are things that we experience, all of us. It is a form of desire. And if you react and engage in your cravings, you are human, because desire creates this kind of sympathetic response. When we feel a craving or desire, we may experience this heightened intensity, this heightened sympathetic drive in our body. I kind of think about this as a rubber band. It is like a rubber band that has been pulled so taut, and is now let go and ready to snap. That is what a craving or a desire is. And so if you are reacting, have compassion for yourself, because this is normal. It's a normal, physiologic, and psychologic response.
But we can do something about it. There are ways in which we can engage with our urge and desire to manage that intensity, to reduce its amplification, and to create a scenario in which we can kind of put our arms and minds around this craving in a way that is more manageable.
Dr. Adrienne’s Treat: The Technique Called “Urge Surfing”
So, I'm going to treat you. I am going to treat you. I'm going to give you a treat, but I'm going to teach you a technique. A technique that is called urge surfing. And this is a way to manage your urges.
Here's an important distinction. This is not a way to resist your urges. This is not a way to fight with your urges. This is a way of engaging with your urge or craving, in order to manage it.
And here's the important point. When you try and fight and resist your urges, you are only giving them power. You are only giving them fuel to amplify them. So don't fight. Don't resist. But engage. Engage with this urge and see where it takes you.
Urge surfing asks us to think of that urge or desire as a wave, because our urges really mimic that wave. A wave will slowly rise as it reaches its peak. It amplifies, it gains momentum, and then it peaks. But what happens after its peak? That wave will settle, it will decrescendo, and it will fall. So, one point is to notice that urge peaking and knowing that we can manage it. We will break, crumble, or die as it peaks, as uncomfortable as it may feel, and know that following that intensity and that peak, that wave will crash. So imagine that urge, like a wave, and surf that urge. Imagine yourself riding that wave to the peak, and then coming back down the other side.
How do we do this?
Let’s Surf: How to Ride the Wave as You Practice Urge Surfing
Number one, notice your bodily sensations. What do you feel when you are experiencing that craving? How do you literally feel it in your body? You may feel it like an intensity in your chest. You may experience a feeling of heart racing. You may even experience nervousness or jitteriness. Maybe you experience it as tingling in your hands, your feet, or in your trunk. Really identify what that bodily experience is, and then name it. This is heart racing. This is jaw clenching. This is tingling. Give that bodily sensation a name, and then notice its intensity. Maybe you want to give it a number between 1-10.
So, really identifying and defining concretely that bodily sensation.
Second, I want you to notice your emotions. What are you feeling in that moment? Maybe you're feeling frustration. Maybe you're feeling irritability or anxiety. Maybe you're feeling tired. Maybe you're feeling loneliness.
By doing this, by really engaging with your bodily sensations and your emotions, you're allowing yourself the opportunity to know what you're truly hungry for. What is it that your body is telling you? What is it that that emotion is signaling?
Next, I want you to think of your thoughts. What are you thinking in this moment when the intensity of that craving or desire is so high? Maybe you're telling yourself that this is too much to bear, that you can't handle it, that you're going to break or snap. Maybe you're saying unkind words to yourself and thinking, “Man, here I am again. Why can't I do this? Why am I a failure?” Notice your thoughts. And in that moment, give yourself some kindness and compassion. Know that this is a universal experience and a universal feeling.
This may feel intense – noticing your bodily emotions, your sensations, your thoughts and feelings. If you feel like the intensity is too much, go back to your breath. Go back to that inhale through your nose and exhale through your mouth. By coming back to your breath, you give your mind a break, and you give yourself a tool to dial back that sympathetic nervous system by turning on the parasympathetic or rest-and-relax part of our nervous system. Know that deep breathing techniques actually ramp up your parasympathetic nervous system, which will then reduce your heart rate, dilate your blood vessels, thereby reducing blood pressure, reduce skin temperature, and turn down all of that heightened sympathetic response.
Final Thoughts: Parting Advice as We End This Episode
So, final thoughts.
Urges and desires are physiologic. They will try and get the best of you, because they are wired for reactivity. They are wired to get you to respond and get what you need. But there may be things that you're doing in your day-to-day life that are setting you up for greater cravings. So, take a survey of your lifestyle. How are you sleeping? How are you feeding yourself? Are you consuming unnatural sources of dopamine that are heightening your reactivity to cravings? And what can you do in your day-to-day lifestyle to scale those back? Give yourself kindness and compassion, remind yourself that these things and feelings are natural, and then use urge surfing as a strategy of mindfulness to not only ratchet down the feeling of craving and desire, but also as a tool to determine what is it you're craving, what is it you are truly hungry for.
I hope that these strategies and tools are useful to you.
I would love if you find me on Instagram – @dradrienneyoudim – and let me know how these tools served you. Let me know what your biggest cravings are and how you're managing them.
You can also find me at https://www.dradrienneyoudim.com. Shoot me an email there. I read every single one of my emails myself. You can also find other offerings like journal exercises, my book Hungry For More, and a catalog of our prior podcasts.
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To a happy and healthy week. I look forward to seeing you then.