Low levels of dopamine have been associated with binge eating. Caroline Messer, MD, explains why and how to consult with these patients.
September 05, 2023
In medical school, we were repeatedly advised that there is both a science and an art to the practice of medicine. In these days of doc-in-a-box online consultations for, it's tempting to think that there's a one-size-fits-all purely scientific approach for these new weight loss medications. Yet, for every nine patients who lose weight seemingly effortlessly on this class of medication, there is always one whose body stubbornly refuses to submit.
Adam tends to eat minimally during the day, thereby baffling his colleagues with the stark contrast between his minimal caloric intake and his large belly. However, when he returns from work late at night , the floodgates open. He reports polishing off pints of ice cream, scarfing down bags of cookies, inhaling trays of brownies. No carbohydrate is off limits to him once he steps off the Metro North train and crosses the threshold from work to home.
Does Adam simply lack the desire or common-sense willpower to make the necessary changes in his lifestyle or is there something more complicated at play?triggered a binge-eating disorder that festered unchecked over the past 20 years. Patients with BED typically eat massive quantities of food over short periods of time — often when they're not even hungry! Adam admitted that he would generally continue to eat well after feeling stuffed to the brim.
I may eventually add a semaglutide-like medication if his weight loss plateaus, but for now, I will focus on raising his dopamine levels to tackle the underlying cause of his weight gain.
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