Sasha has now lived with two full months of a partially open kitchen (one snack cabinet and fridge) and has lived 19 days "unlocked and free" (our tongue-in-cheek version of "clean and sober", lol) with a completely open kitchen. He's doing really great with it and every day I feel increasingly more confident that this experiment is working, yay! His weight wobbles up and down slightly but it is staying in the same BMI range at the 87th percentile (9 percentage points lower than when we started OT one year ago).
An interesting anecdote: last time I blogged, Sasha had a very sugar-intensive weekend due to having eaten the birthday party treats and the apple pie his sister baked with a friend. The next day, his dad bought some trail mix which contained very sweet yogurt-covered raisins. His dad rationed out a portion for Sasha and a separate portion for his sister (as you can tell, we rarely buy foods that contain sugar so it is treated like a precious commodity in our house!).
The next day (Monday), Sasha came home from school and promptly handed me his bag of trail mix saying, "please take these away from me, after eating some, I started to feel the food obsession coming back. I don't like that feeling so I don't want to eat these anymore."
Wow.
I was super impressed. First, he was able to notice the return of the craving feelings; second, he was able to communicate with me about it; third, he was able to return the food he no longer wanted to eat! When I spoke with him more about his experience, he said that he noticed some craving feelings after eating the ice cream and pie over the weekend. However, he said that he noticed the feelings VERY strongly after eating the trail mix. He said that he started to obsess and felt consumed with the intention to eat more sweets. He said that it reminded him of how he used to be before experiencing the relief from the OT/naltrexone; that is, always focused on food- what to eat, when to eat, where to get food, how to get it, etc.
Does his experience sound like the workings of addiction? It does to me. It is certainly possible that his growing cravings were due the cumulative effect of eating sweets three days in a row but whatever it was, Sasha was able to identify his feelings AND stop himself from the addiction process that would soon come to pass if he had not given me back the trail mix.
In writing my case report paper, I have been thinking more about the role of naltrexone in our experiment, and in all fairness, I can't really credit oxytocin alone for Sasha's success since he has been taking a combination of OT (6 iu/day) and naltrexone (100 mg/day) since November. Besides needing to eat for energy/survival, people eat for pleasure. In case you don't know, I added naltrexone right after Sasha stole and ate all of his sister's Halloween candy because although he was losing weight (for two months on OT alone), he was continuing to sneak highly palatable food like sweets. Since he is on a low carb eating plan, these high sugar foods are mostly prohibited so it is certainly understandable that he covets these sweet treats. Out of our desire to help curb his taste for these sugary foods, I wondered if the opiate antagonist would help deter him from seeking these foods. Interestingly, I have read lots of papers about naltrexone's role and it seems that one finding definitely fits to describe our experience- i.e.: naltrexone doesn't necessarily deter the craving BUT it can deter a binging session (stop the continuation of eating once started). My alcoholic patients have also reported similar experiences; they can stop at one beer instead of getting blacked-out drunk while taking naltrexone.
For more info on opiate antagonists, please see post #8 which I recently updated to include papers on the role of the dopaminergic (reward) system and opiate antagonists in eating, obesity, and food addiction.
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