Insatiable: A life without eating

(longreads.com)

159 points | by samclemens 13 days ago

22 comments

  • TheCapeGreek 13 days ago
    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 13 days ago
      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 13 days ago
        I don't want to waste food, but I need to regularly remind myself that overeating is also wasting food.
        • mikestew 13 days ago
          It’s just as wasteful to put the food on my ass as it is to put it in the trash, as I tell my spouse on occasion.
        • LorenDB 12 days ago
          If it's not going to waste, it's going to waist.
        • sourcecodeplz 12 days ago
          I try to waste as little as possible. Would have been nice to live in a house with a yard and some chickens. Would give them leftovers. Otherwise just turn it into compost.
        • najra 12 days ago
          That's a great way of looking at it, thanks, I'm stealing it :D
        • appplication 12 days ago
          Wow that’s incredible, this just blew my mind. Thank you.
      • koolba 13 days ago
        I always felt the real lesson to be learned from finishing your plate was to not overfill it in the first place.
      • madacol 13 days ago
        As a descendant of italian immigrants, I am still struggling with that
    • rufus_foreman 12 days ago
      >> 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

      Why didn't you just steal food?

      That's what I did when I was poor. There's a store the size of a city block a 5 minute walk away from me, there are tons and tons of food stacked up in that store, any type of food you could want, and I'm going to go bed hungry? That didn't really make sense to me. I never went to bed hungry.

      I respect property rights now, of course, because my belly is full.

      • sethammons 12 days ago
        When I was poor and in high school, I lived alone for a very long while in a house that my dad had started to remodel but then he got distracted by a woman and moved to her place. This meant winter in a house in the mountains literally missing a whole wall.

        We lived in the middle of nowhere. I hitched rides to school from friends, neighbors, and rarely family. There was no store to steal from, so I stole food from the school.

        I was on free lunch, so I'd steal an extra hamburger, sell it for half price to a kid for 50 cents, and I would use that to buy a can of soup when I could get someone to stop by the store. That would be my dinner that I cooked over a wood burning stove since I could warm up that bedroom but the kitchen was missing a wall and was _cold_ (between 20-40 Fahrenheit, but, again, poor, so no good warm clothes). My dad would give $20 every now and then, and I'd use that to buy potatoes that I'd heat in a toaster oven.

        A plain potato, a school lunch hamburger, and usually a 50ish percent chance for can of soup was what I ate. I was skinny and hungry. A few years later, I would be able to eat regularly (and now I am doing more than ok), but it took nearly two decades to be comfortable throwing out a plate of food; the poor, hungry kid in me wasn't sure when the next food would come even though I now had food aplenty.

      • heavensent 12 days ago
        If there was ever a line between sarcasm and questionable advice, this comment does a good job of walking on it.

        >I respect property rights now, of course, because my belly is full.

      • TheCapeGreek 11 days ago
        I was getting food regularly, just not enough. 2 peanut butter sandwiches, plates of rice and minimal meat don't do much when you walk 2h a day on average.

        I was broke and not in a position to help myself as much as I was studying and building my skillset, not absolutely despondent.

      • riku_iki 12 days ago
        In rich country, one likely can apply for some food stamps if can't afford food. In poor country, store owners are likely not that rich too, and will fight hard those who steal.
        • nasmorn 12 days ago
          In a rich country a few percent of the population can easily live just on the food thrown away at supermarkets.
    • 3abiton 13 days ago
      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.
  • DoreenMichele 13 days ago
    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.

  • mise_en_place 12 days ago
    > As the experiment progressed, Ancel Keys, the nutritionist running the study, noticed odd psychological effects.

    As we know now, Keys was a truly unscrupulous fellow. He took bribes from the AHA to lie about the effects of saturated fats and animal fats on heart disease.

    • Varriount 12 days ago
      Can you provide a source for this assertion?
  • arghwhat 13 days ago
    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 13 days ago
      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 13 days ago
        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 13 days ago
          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...)

          • arghwhat 13 days ago
            That was the quote describing why they originally thought that intravenous feeding was entirely impossible, which proved false, so I didn't take it as an observation regarding solution as it was later invented.

            It was how the original solution was invented and tested, with resistance to mucking about likely limiting it's development significantly.

            It is certainly not a game to entertain without understanding the signficant risks, but healthy people can intentionally take on extreme risks, so I see no reason to stop a patient with a coordinated plan for research into bettering theirs and others situation.

  • Night_Thastus 13 days ago
    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 13 days ago
      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 13 days ago
        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!

        • rincebrain 12 days ago
          When I've tried, occasionally, a lot of weed, in edible or otherwise, it just makes me nauseous, then fall asleep. So not the same experience here, unfortunately.
  • marmaduke 13 days ago
    Well, certainly puts things in perspective, doesn't it?
    • ericmcer 13 days ago
      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 13 days ago
        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.)
        • Retric 12 days ago
          Mild cases of Crohn’s are less likely to be diagnosed in the developing world and far more likely to be deadly when combined with something else like Malaria or TB. So it’s almost impossible to compare statistics between such wildly different countries.

          Essentially unless the healthcare system is good enough and population healthy enough you only capture severe casss.

          • jessriedel 12 days ago
            I don’t think that’s the expert consensus at all, unless you’re using a much more expansive definition of CD and UC (vague “IBS-like symptoms”). People have studied this question very carefully, and the strong consensus is that these diseases, which are very often deadly if left untreated (and sometimes even if treated), occur at vastly lower rates in the developing world. It’s not mere measurement error.
            • Retric 12 days ago
              I’ve heard both views from experts. If you look at the methodology used to collect data, and consider how different health system would what was available for review, it’s easy to question the validity of these studies.

              Ex: https://www.thelancet.com/journals/langas/article/PIIS2468-1...

              “To model IBD mortality, we used the causes of death database, which includes data from vital registration and verbal autopsy data.”

              “To estimate the non-fatal burden of IBD, we used two separate databases, one for Crohn's disease and another for ulcerative colitis. Both included data from literature, hospital discharges, and claims data (the latter available only from the USA in 2000, 2010, and 2012; further information on IBD data is provided in the appendix, p 21). ”

              • jessriedel 11 days ago
                Do you have links to papers that argue for your position, or are you just saying you personally talked to a researcher who held it? The paper you link reports a 60 fold difference in prevalence of a deadly illness, which is not the sort of thing that can be easily obscured by the measurement issues you bring up.
                • Retric 11 days ago
                  Researcher, I don’t know if they published anything on the topic.

                  As to the 60 fold difference, I’m not sure if you realize just how vast the difference in healthcare systems are worldwide. Chad for example has 1/60th the doctors per person as the US, how many colonoscopies do you expect they preform per year?

  • theonlyjesus 13 days ago
    I'm a fellow Crohnie.

    Crohn's disease is a long, exhausting disease. I hope we see a cure in our lifetime.

    • spondylosaurus 13 days ago
      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 13 days ago
      [flagged]
      • knodi123 13 days ago
        Is there a cure that has been shown to be real in a double-blind trial? Or maybe that has widespread agreement among the medical community? I'm ready to hear it, but I've gone down this road a lot with people saying things like "just stop eating chemicals!" or whatever.
        • swatcoder 12 days ago
          Chron's wasn't an issue I struggled with myself, but I've successfully resolved many wellness and comfort issues through personal experimentation.

          Science is slow in general and medical science mostly examines population-wide efficacy rather than individual efficacy, as its these population-wide conclusions that help form guidance for practicioners serving a population.

          For any given potential treatment or remedy, an individual may be an outlier whose specific attributes weren't represented or analyzed in that kind of research or whose response would have fallen into the noise floor.

          You can certainly choose to only accept those population-scale conclusions, but many of us only have so many decades to try to sort ourselves out.

          And further, because of the feedback loop between thought and many autonomic processes in the body, one can even experience real remedy from formally invalid treatments. For an individual, that's all you need.

          • knodi123 12 days ago
            Yeah, but the challenge is filtering those personal experiments through traps like "regression to the mean" and the placebo effect. And then generalizing them enough to recommend them to other people.

            I have no objection to personal experimentation, but the guy I responded to said he knew a cure for Crohn's that "the man" wouldn't let him talk about. That's a pretty dicey claim.

      • selfie 12 days ago
        Spill the beans. That statement by itself sounds like the byline of a 5G/flat earth crank.
        • AnimalMuppet 12 days ago
          Seconded. Don't vaguepost, and don't tease. If you've got a point to make, make it.
      • reverius42 13 days ago
        Is it banning glyphosate?
      • drekipus 13 days ago
        I'm ready for mass downvotes, let's hear it
  • IncreasePosts 13 days ago
    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 13 days ago
      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 13 days ago
        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 13 days ago
          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.

        • sethammons 12 days ago
          Your gut bacteria is amazing - it will signal even what kids of food it wants. By passing those hungry bacteria will eventually kill of those specific cravings I guess, but meanwhile, I'd wager a lack of satiation if bypassing the gut.
        • mcmoor 12 days ago
          Yeah I've heard that the reason artificial sweetener makes people fatter instead is that the body feels robbed when they don't get the supposed caloric intake they should get when eating something sweet. So they crave more.

          I actually do feel it, I still feel hungry if I eat lots of something that has little caloric value. So eating lots of vegetable and water doesn't fool my body into satisfaction.

      • bluefirebrand 13 days ago
        > 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

        • tibbydudeza 12 days ago
          The lower the rate at which the stomach empties into the intestines so you feel fuller for longer - the bad side effect is sometimes it causes stomach paralysis.

          Your stomach stops working (the rythmic muscle contractions that turns food into mush).

      • tibbydudeza 12 days ago
        The stomach has stretch sensors which is used to determine the feeling of fullness via the vagus nerve - somebody will hack it one day and no need for Ozempic.
    • knodi123 13 days ago
      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!

      • lkuty 12 days ago
        Reminds me that typically I prefer smelling wine that tasting it and of course than swallowing it. I often find a wine very good by smelling it and am disappointed when I taste it. Of course it also depends on the wine. I mean on average.
        • sethammons 12 days ago
          That's me and coffee. Smells great, tastes like literal ash (no, not from over-cooked beans; coffee fanatics have offered me their best and it all tastes like someone filtered it through an ashtray).
      • mixmastamyk 12 days ago
        Not the swallowing exactly, but the result of filling a previously empty stomach. That’s where the satisfaction comes from, depending on how hungry you were.
      • arghwhat 13 days ago
        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.

        • knodi123 13 days ago
          I was partly tongue in cheek. I certainly don't spit my meals into a bucket, despite being a little overweight. But I stand by what I said about not enjoying the act of swallowing. The closest I can get is the joy of not feeling hunger anymore- but that's just the absence of discomfort.

          I don't understand it, but I can't dispute it.

          • coldtea 13 days ago
            >I was partly tongue in cheek. I certainly don't spit my meals into a bucket, despite being a little overweight. But I stand by what I said about not enjoying the act of swallowing. The closest I can get is the joy of not feeling hunger anymore- but that's just the absence of discomfort.

            You're conflating the joy of food with its mere taste.

            A lot of the joy (which you might just attribute to the taste part) comes as the food is digested. Not just the joy of not feeling hunger anymore, but the various chemicals making their way to the bloodstream and releasing endorphins and such. Sugar, chocolate and co for example.

            Even easier examples would be coffee and alcohol. Their taste is hardly the major satisfaction factor.

    • sandspar 12 days ago
      Aristotle talks about gluttony in his book about ethics. He mentions a Greek gourmand who fervently wished to have the neck of a crane, since he felt that swallowing is the most pleasurable part of eating.
  • PunchTornado 13 days ago
    One of those reads that changes your perspective on life in a way.
  • gcanyon 12 days ago
    The best meal I've ever had was clear chicken broth and it's not even close. Let me explain: in my 20s I was in a motorcycle accident. I was in a forced coma for over a week, and in the ICU for four weeks. No food, only an NG (nasogastric) tube. When they took the tube out, the first thing they gave me was a toothbrush. I brushed for something like five minutes, it was indescribably pleasant. Then they gave me a cup of clear chicken broth: basically salty water with something to color it yellow.

    It. Was. Heavenly. I have literally never in my life enjoyed eating anything as much as I enjoyed sipping that broth.

    • DoreenMichele 12 days ago
      That falls under the saying "No spice like hunger." It's just kind of an extreme situation for it.

      I can relate, actually.

      I had a terrible first pregnancy and threw up constantly for most of it. Once the baby was born, my husband rushed off to Burger King to get me a burger and fries and I wolfed it down. It was half gone before I realized what was "weird": I had been picking at my food for months.

      I don't even usually eat burgers, but was also all "Wow, soooo good!"

      • gcanyon 12 days ago
        What I always say: "When you're really hungry -- I mean really hungry -- nothing satisfies like food."
  • omoikane 12 days ago
    The idea that taking away food also takes away what's human reminds me of Dazai Osamu's "Ningen Shikkaku"[1], where the narrator wrote in the first chapter that he had no idea what being hungry means, that he never understood what it means to feel hungry. People must eat to survive and thus must work in order to eat, but because the narrator never felt hungry, he does not understand how humans operated at all.

    [1] https://en.wikipedia.org/wiki/No_Longer_Human

    "No Longer Human" seem to be the official English title, although a more literal translation would be "disqualified as human".

  • gwern 13 days ago
    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.
  • tonnydourado 12 days ago
    Well, that was some nightmare fuel early in the morning. I've been diagnosed with Crohn's almost 20 years ago, had two surgeries, and am currently on meds. No fistulas, thankfully, but the whole thing is a Damocles sword, nevertheless. Reading this made it a little extra sharp.
  • Ductapemaster 12 days ago
    There’s an excellent Radiolab episode that ends with a similar story of someone on TPN. If you found this interesting, it’s worth a listen.

    https://radiolab.org/podcast/197112-guts

  • RCitronsBroker 12 days ago
    This is what pulled me out of an eating disorder as a teen. Got diagnosed with Crohn’s, also was put onto a mush-diet for almost half a year, and got so pissed over that timespan, that the primal joy of eating just straight up overpowered any sort of disordered obsessiveness i was fighting with before. Life is so damn strange.
  • Koshkin 11 days ago
    When I was younger, I thought that we eat in order to live. Growing older, I realized that the opposite is true.
  • smeej 13 days ago
    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.

  • davidkuennen 12 days ago
    I'm amazed Stanley Dudrick didn't win the Nobel Prize for inventing TPN.
  • bruce343434 12 days ago
    I wonder if a hunger inhibitor like ozempic would help
  • John_da 13 days ago
    [flagged]