[HN Gopher] Insatiable: A life without eating
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       Insatiable: A life without eating
        
       Author : samclemens
       Score  : 78 points
       Date   : 2024-04-18 19:06 UTC (3 hours ago)
        
 (HTM) web link (longreads.com)
 (TXT) w3m dump (longreads.com)
        
       | marmaduke wrote:
       | Well, certainly puts things in perspective, doesn't it?
        
         | ericmcer wrote:
         | If I had been born ~90 years earlier I would have died before I
         | formed my first memory. That thought comforts me when I feel
         | like life is unfair or difficult. The whole thing is a bonus
         | for me... I should be dead. Maybe similar feelings provide some
         | comfort for people who have to manage their lives with diseases
         | like Crohns.
        
           | jessriedel wrote:
           | OK, but note that Crohn's (and ulcerative colitis) are nearly
           | unknown in the developing world. For reasons we don't
           | understand, they are caused by modernity. So 90 years ago
           | having Crohn's would be much less likely. (Symptoms from both
           | Crohn's and ulcerative colitis don't usually present until
           | the teens or early twenties, so this is not a case of infants
           | with the disease simply dying early in the developing world.)
        
       | theonlyjesus wrote:
       | I'm a fellow Crohnie.
       | 
       | Crohn's disease is a long, exhausting disease. I hope we see a
       | cure in our lifetime.
        
         | spondylosaurus wrote:
         | Same and same. It broke my heart a little to read that this
         | essayist got diagnosed at age 11... it's bad enough as an
         | adult, but I can't even imagine dealing with it as a little kid
         | :(
        
         | notshift wrote:
         | There's a cure, but the folks using this forum aren't ready to
         | hear it.
        
           | reverius42 wrote:
           | Is it banning glyphosate?
        
           | drekipus wrote:
           | [delayed]
        
       | IncreasePosts wrote:
       | I've always thought we should have a digestive system bypass in
       | the esophagus. Give us the joy of tasting, chewing, and
       | swallowing food, but then have it go into an external bag before
       | it hits the stomach.
        
         | arghwhat wrote:
         | Unfortunately, we also sense the mechanical filling of the
         | stomach, and the movement through the bowels.
         | 
         | Unless you stop the hunger altogether I don't think you'll feel
         | satisfied without the whole process.
        
           | mateo1 wrote:
           | It's not just that. I'm pretty sure your stomach and gut also
           | provide information regarding caloric intake, on top of other
           | sensors detecting the raise in blood
           | sugars/lipids/aminoacids. And even if it didn't, you'll get
           | hungry when your body/brain detects you've switched to using
           | reserve power. If eating doesn't satiate the hunger by
           | providing energy, the response would likely be to make you
           | hungrier and hungrier.
        
             | arghwhat wrote:
             | Well, "reserve power" is from starvation, intense exercise,
             | or weird diets, not hunger.
             | 
             | From brain perspective, "reserve power" would be when it
             | ends up relying on ketone bodies, which start to be
             | produced in higher numbers when you have been in high
             | glucagon, low insulin condition for a longer period of
             | time. Long enough that the liver burned through its
             | glycogen stores and the liver cells redirect oxaloacetate
             | to gluconeogenesis (producing glucose from stuff in the
             | blood) to the point where the cells become unable to finish
             | its own metabolism of free fatty acids. It then turns the
             | intermediate products it can't use itself into ketone
             | bodies.
             | 
             | That part can be regulated with nutrition, glucagon and
             | insulin, but having plenty of glucose won't replace
             | sensations from the digestive system itself.
        
           | bluefirebrand wrote:
           | > Unless you stop the hunger altogether
           | 
           | My understanding is this is how drugs like Ozempic work. They
           | make you feel fuller quicker and prevent "food noise" where
           | you think about food and eating even when your stomach isn't
           | empty
        
         | knodi123 wrote:
         | Know what's weird to me? I don't get any pleasure out of
         | swallowing food. Tasting, sure. Chewing, sometimes. But
         | swallowing? Just a necessary mechanical coda, as emotionally
         | laden as the period at the end of a sentence
         | 
         | But if someone suggests that we enjoy an ice cream sundae, but
         | spit each bite into a bucket? Suddenly they're a reviled
         | heretic!
        
           | arghwhat wrote:
           | I think the exact positive sensation differs between people.
           | I certainly find joy in swallowing the food - which makes
           | sense as it's a pretty important step. Tasting and chewing
           | feels like only the precursor to _eating_ , and taking only
           | those steps reduce the sensation to that of chewing a
           | bubblegum.
           | 
           | ... But if someone has a non-bulemic reason to simulate
           | eating, by all means go ahead. Just don't make it a big trend
           | as we waste enough food as is.
        
       | arghwhat wrote:
       | The post says that the TPN solution is fed slowly and that the
       | body barely reacts.
       | 
       | What if it was intentionally fed with periodic bursts, simulating
       | strong blood sugar, fat and protein spikes from eating and
       | triggering stronger insulin responses with resulting lows? I
       | wonder if that would substantially change the experience.
       | 
       | Maybe tuning the nutrition mixture. I vaguely remember the
       | journey of the Soylent guy experimenting with the composition and
       | hitting various snags along the way before he finally got to a
       | point where it made him feel satisfied and not crave any other
       | foods. Soylent still has the mechanical feeding sensation
       | though...
       | 
       | Sometimes medical developments plateau when it reaches a point of
       | _working_ , before it reaches the point of being _good_.
        
         | rincebrain wrote:
         | I think the whole framing was that the reason the problem space
         | is hard, is that if you deliver too much at once, your body
         | notices and treats it much like if it found splinters stuck in
         | you - invasion of foreign mass to trigger inflammatory
         | response.
        
           | arghwhat wrote:
           | I am not sure if the burning was related to inflammation. I
           | recall the sensation of marker fluid aburning as it moves
           | towards the heart, but it might just be a sensation rather
           | than a reaction. Wasn't clear from the post at least.
           | 
           | Maybe one could burst only some convenient nutrition that is
           | easier to deliver in higher doses like glucose, while still
           | drip-feeding the bulkier macronutrients.
           | 
           | Another crazy idea could be to intentionally introduce
           | glucagon and insulin to artificially induce highs and lows.
           | 
           | I'm sure it's a very hard problem space, but it might be one
           | looking for a creative patient willing to put effort into
           | further research...
        
             | rincebrain wrote:
             | The explicit quote from the article was "believing it
             | required so much liquid, and such a high concentration of
             | chemical nutrients, that it would cause inflammation and
             | burning when administered.", and I am assuming that the
             | former was not just redundant with the latter.
             | 
             | Directly mucking with glucagon and insulin for anything
             | short of directly demonstrable life and death is going to
             | be a fraught proposal in almost any circumstance, I would
             | speculate, given that the risk is not just wasting away
             | from malnutrition but much more direct tissue damage and
             | death. (Much like I suspect something with a risk profile
             | like Accutane's would not get approved again _now_ with the
             | body of evidence we have for what happens if you introduce
             | something that's "almost, but not quite, vitamin A" into
             | rapidly growing bodies...)
        
       | Night_Thastus wrote:
       | Very dark, but also very insightful.
       | 
       | We take a lot of simple pleasures in our lives for granted. The
       | feeling of stretching, scratching an itch, relaxing our muscles,
       | sleep, the taste of food, the smells around us, feeling warmth or
       | cold on our skin, etc.
       | 
       | I've wondered a lot about what a life would be like without these
       | things - even if you were otherwise completely healthy.
        
         | rincebrain wrote:
         | It can be a strange experience, to try and describe to people,
         | something missing from your shared vocabulary.
         | 
         | I had a number of rounds of an IV drug treatment 4 or 5 years
         | ago, and on one and only one of them, shortly after being
         | treated, I found myself feeling a strange sensation, one that I
         | couldn't place, but that I definitely remembered having
         | experienced before.
         | 
         | After 5 minutes or so of wondering and racking my brain, I
         | placed it.
         | 
         | It was hunger.
         | 
         | At some point in my early teenage years, that particular piece
         | of wiring stopped working, and I didn't really pay much
         | attention at the time, so I can't place precisely when, but I
         | had no severe injuries or medical maladies crop up. The two
         | likely causes of that are apparently a brain tumor or hormone
         | problems, but my bloodwork and brain scans turned up nothing
         | exciting then or since, so ...who knows. (I did, many years
         | after this started, start drinking caffeine sometimes, but it
         | doesn't stop happening if I stop drinking caffeine for months,
         | so I don't think it's related. I'm not on anything stimulant-
         | like or adjacent either.)
         | 
         | But it's a difficult thing to explain, the absence of that -
         | and the knock-on effects, the absence of motivation to avoid it
         | that results, the absence of satisfaction from eating causing
         | it to vanish.
         | 
         | How you can sincerely ask "why am I having a pounding headache
         | - oh I forgot to eat for 2 days", and not have had any sign
         | unless you set deliberate calendar events and phone alarms to
         | serve as a reminder that this basic feedback system is broken.
         | (I usually don't need them, these days, because habit is a
         | powerful thing, but I keep them around so that I don't become
         | sufficiently sick or taxed by life that something breaks down
         | and I forget...again.)
         | 
         | I can't exactly offer an A-B comparison of the difference, my
         | memories of my childhood are not clear enough for that at this
         | point, but while I will be sad if I end up not eating something
         | especially tasty or unusual, there's not a visceral absence of
         | satiation in it, it's an intellectual lament.
        
           | jamiek88 wrote:
           | Hey this happened to me too.
           | 
           | I never feel hunger just the effects of not eating.
           | 
           | My thirst mechanism is messed up too.
           | 
           | If it wasn't for my wife I'd be a real mess.
           | 
           | I at least eat one good meal a day because she does!
           | 
           | If I get really, really stoned I'm talking 500 mg of thc
           | level stoned, I can feel hunger.
           | 
           | But that isn't conducive to a good routine!
        
       | PunchTornado wrote:
       | One of those reads that changes your perspective on life in a
       | way.
        
       | smeej wrote:
       | This really puts the two years my UC and I could only eat one
       | meal for every meal in perspective. I eventually got used to
       | being the weirdo who brought my own food, or just declined
       | everything if we made spontaneous plans while we were already
       | out.
       | 
       |  _But at least I could eat._
        
       | DoreenMichele wrote:
       | _Everything was vigorously wiped with alcohol because any
       | bacteria would be injected straight into my heart._
       | 
       | Anyone with a serious medical condition that requires home care
       | on par with hospital care deals with this -- often, while at
       | their very worst. It's probably one of the scarier aspects of
       | living with a serious chronic condition.
        
       | gwern wrote:
       | I wonder how much appetite suppressants like GLP-1s could help
       | here? They seem to hit appetite at a high level and curiously
       | reduce other cravings or addictions, so they might be able to
       | deal with the hunger here.
        
       | TheCapeGreek wrote:
       | The bit about the 1944 study and how they rebounded eating way
       | more food after their starvation really struck an emotional chord
       | with me.
       | 
       | I had a few years of financial struggle as a high schooler and
       | student, to the point where I was constantly hungry and very
       | skinny. It was a bit of a traumatic time for me for other
       | reasons, and this article gave me more insight into another
       | dimension of it.
       | 
       | Since I hit a career stride and haven't been walking nearly as
       | much, I've been at my largest ever. A kind of eternal
       | overcompensation. My father also sometimes excused wasteful
       | grocery expenditure saying "I've gone without before; I refuse to
       | do it again".
        
         | mlinhares wrote:
         | Been there as well. Took me a while to recognize I did not have
         | to finish every plate of food, that i could either save it for
         | later when i was hungry again or just throw it away.
        
           | rikthevik wrote:
           | I don't want to waste food, but I need to regularly remind
           | myself that overeating is also wasting food.
        
           | madacol wrote:
           | As a descendant of italian immigrants, I am still struggling
           | with that
        
           | koolba wrote:
           | I always felt the real lesson to be learned from finishing
           | your plate was to not overfill it in the first place.
        
         | 3abiton wrote:
         | I think the literature is clear enough on the difference
         | between calory restrictions and intermittent fasting. The
         | latter being much effective because it also reduces the
         | production of hunger hormone, not the case with the former
         | approach.
        
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