Healthy Eating & Eating Disorders - Anorexia, Bulimia, Binging
Andrew Huberman:
安德鲁·休伯曼：
Welcome to the Huberman Lab podcast, where we discuss science and science-based tools for everyday life.
欢迎来到休伯曼实验室播客，我们在这里讨论科学和基于科学的日常生活工具。
I'm Andrew Huberman and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine.
我是安德鲁·胡伯曼，斯坦福大学医学院神经生物学和眼科教授。
Today we are going to talk all about healthy and disordered eating, and indeed we are going to talk about clinical eating disorders, such as anorexia, bulimia, and binge-eating disorder, as well as some other related eating disorders.
今天我们要谈论健康和饮食失调，实际上我们要谈论临床饮食失调，例如厌食症、暴食症和暴食症，以及其他一些相关的饮食失调。
However, before we get into this material, I want to emphasize that today's discussion will include what it is to have a healthy relationship with food.
然而，在我们讨论这些材料之前，我想强调今天的讨论将包括什么是与食物建立健康的关系。
We are going to talk about metabolism.
我们要谈谈新陈代谢。
We are going to talk about how eating frequency and what one eats influences things like appetite and satiety, as well as whether or not we have a healthy psychological relationship to food and our body weight and so-called body composition, the ratio of muscle to fat, to bone, et cetera.
我们将讨论饮食频率和吃的东西如何影响食欲和饱腹感等，以及我们与食物、体重和所谓的身体成分、肌肉与脂肪、骨骼的比例等是否有健康的心理关系。
So as we march into this conversation, I'd like to share with you some interesting and what I believe are important findings in the realm of nutrition and human behavior.
因此，当我们进入这次对话时，我想与大家分享一些有趣的、我认为是营养和人类行为领域的重要发现。
Andrew Huberman:
安德鲁·休伯曼：
I know these days many people are excited about or curious about so-called intermittent fasting.
我知道现在很多人对所谓的间歇性禁食感到兴奋或好奇。
Intermittent fasting is, as the name implies, simply restricting one's feeding behavior, eating, to a particular phase of the 24-hour or so-called circadian cycle.
间歇性禁食，顾名思义，就是将一个人的进食行为（进食）限制在 24 小时或所谓的昼夜节律周期的特定阶段。
Other forms of intermittent fasting involve not eating for extended periods of time, for entire days, or some people will extend to two days or three days typically, and hopefully they will drink water during those times, sometimes referred to as water fasting, which means that they are ingesting fluids, and hopefully they are ingesting electrolytes, such as salt, potassium and magnesium, as well.
其他形式的间歇性禁食包括长时间不吃东西，甚至一整天，或者有些人通常会延长两天或三天，希望他们在这段时间内喝水，有时称为水禁食，这意味着他们正在摄入液体，并且希望他们也摄入电解质，例如盐、钾和镁。
Because while one can survive for some period of time without ingesting calories, it is extremely important to continue to ingest plenty of fluids and electrolytes.
因为虽然一个人可以在不摄入卡路里的情况下生存一段时间，但继续摄入大量的液体和电解质是极其重要的。
And the reason for that is that the neurons of your brain and body that control your movements, your thoughts, clarity of thinking in general, et cetera, is critically dependent on the presence of adequate levels of sodium, potassium and magnesium, the electrolytes.
其原因是，控制你的运动、思想、思维清晰度等的大脑和身体神经元很大程度上依赖于电解质中钠、钾和镁的充足水平。
Andrew Huberman:
安德鲁·休伯曼：
And that's because neurons can only be electrically active by way of movement of particular ions, which include things like sodium, potassium and magnesium.
这是因为神经元只能通过特定离子的运动来产生电活性，其中包括钠、钾和镁等离子。
So without those, you can't think, you can't function, and it actually can be quite dangerous.
因此，如果没有这些，你就无法思考，就无法发挥作用，而且实际上可能非常危险。
So why all the excitement about intermittent fasting?
那么，为什么间歇性禁食如此令人兴奋呢？
Well, a lot of the excitement relates to work that was done by a former colleague of mine, down at the Salk Institute for Biological Studies in San Diego, named Satchin Panda.
嗯，很多令人兴奋的事情都与我的一位前同事所做的工作有关，他在圣地亚哥索尔克生物研究所，名叫 Satchin Panda。
Satchin's lab identified some very important and impactful health benefits of restricting one's feeding window to particular times within the 24-hour cycle, or even to having extended fasts that go for a day or two days, or maybe even three days.
Satchin 的实验室发现，将进食窗口限制在 24 小时周期内的特定时间，甚至延长一天、两天甚至三天的禁食时间，对健康有一些非常重要且有影响力的好处。
What they saw was an improvement in liver enzymes, an improvement in insulin sensitivity, which is something that is good, it means that you can utilize the calories and the blood sugar that you happen to have.
他们看到的是肝酶的改善，胰岛素敏感性的改善，这是一件好事，这意味着你可以利用你碰巧拥有的卡路里和血糖。
Being insulin insensitive is not good and is actually a form of diabetes.
胰岛素不敏感是不好的，实际上是糖尿病的一种形式。
Andrew Huberman:
安德鲁·休伯曼：
What Satchin's lab, and subsequently other labs, showed, was that restricting one's feeding window to anywhere from four to eight, or even 12 hours, during each 24-hour cycle was beneficial in mice, and some studies in humans have also shown that it can be beneficial for various health parameters.
Satchin 的实验室以及随后的其他实验室表明，在每个 24 小时周期中，将进食时间限制在 4 到 8 小时，甚至 12 小时对小鼠来说是有益的，一些针对人类的研究也表明，这对各种健康参数也有益。
However, the excitement about intermittent fasting seems to be related to the foundational truth about metabolism and weight loss and weight maintenance and weight gain, which is that regardless of whether or not you intermittent fast, or whether or not you eat small meals all day long, or you eat one meal in the evening and snack up until then, it really doesn't matter in the sense that the calories that you ingest, from whatever source, are going to be filtered through the calories that you burn, by way of exercise, basal metabolic rate, which is just the calories that you happen to burn just being alive and thinking and breathing and your heart beating, et cetera.
然而，间歇性禁食的兴奋似乎与新陈代谢、减肥、体重维持和体重增加的基本事实有关，即无论你是否间歇性禁食，无论你是否整天吃小餐，或者你在晚上吃一顿饭然后吃零食，从某种意义上说，你从任何来源摄入的卡路里都将通过你燃烧的卡路里进行过滤，通过运动、基础代谢率，这只是你消耗的卡路里。你碰巧只是活着、思考、呼吸、心跳等等而感到燃烧。
Andrew Huberman:
安德鲁·休伯曼：
And the reason why many people prefer intermittent fasting to other forms of, let's just call it what it is, diet or nutritional framework, is that many people find it easier to not eat than to limit their portion size.
许多人更喜欢间歇性禁食而不是其他形式的饮食或营养框架，我们就这么称呼它是什么，是因为许多人发现不吃东西比限制进食量更容易。
And here I'm not talking necessarily about eating disorders, I'm talking about the general population.
在这里我不一定谈论饮食失调，我谈论的是一般人群。
So I think that's one reason why there's so much excitement about intermittent fasting.
所以我认为这就是间歇性禁食如此令人兴奋的原因之一。
Now, within the context of intermittent fasting on a circadian time scale, once every 24 hours, you generally find two categories of people, people who prefer to not eat in the morning, either because they are not hungry in the morning or because they find it relatively straightforward to just drink things like coffee or water, et cetera, and push their feeding window out to noon or 2:00 p.m., or 3:00 p.m., and then they'll eat between say 1:00 p.m.
现在，在昼夜节律时间范围内间歇性禁食的背景下，每 24 小时一次，您通常会发现两类人，即那些喜欢在早上不吃东西的人，要么是因为他们早上不饿，要么是因为他们发现喝咖啡或水等东西相对简单，并将进食窗口推迟到中午或下午 2:00 或下午 3:00，然后他们会在 1:00 之间进食下午
and 8:00 p.m., or 9:00 p.m.; it depends on the individual.
晚上 8:00 或晚上 9:00；这取决于个人。
Andrew Huberman:
安德鲁·休伯曼：
Other groups of people find that they are very hungry when they wake up in the morning, they don't feel well if they don't eat breakfast, and so they prefer to eat early in the day, but then they limit their feeding windows such that they cut off their food intake or stop ingesting any calories of any kind somewhere around 5:00 p.m.
其他人群发现他们早上醒来时非常饥饿，如果不吃早餐就会感觉不舒服，因此他们更喜欢在一天中早些时候吃东西，但随后他们会限制进食时间，例如在下午 5:00 左右切断食物摄入量或停止摄入任何形式的卡路里。
or 6:00 p.m., et cetera.
或下午 6:00，等等。
So the duration of the feeding window has not been broken down into the kind of nuanced type of information that one would really want, at least not in human studies saying, well, a six-hour feeding window, or an eight-hour feeding window is ideal.
因此，喂养窗口的持续时间还没有被分解为人们真正想要的那种细致入微的信息，至少在人类研究中没有，六小时或八小时的喂养窗口是理想的。
It really is going to vary, based on lifestyle and circumstances.
根据生活方式和环境的不同，它确实会有所不同。
For instance, some families really want to eat dinner together every night, so do you want to be the person that's sitting there watching everybody eat because you're fasting from 5:00 p.m.
例如，有些家庭确实希望每天晚上一起吃晚饭，那么您是否想成为坐在那里看着每个人吃饭的人，因为您从下午 5:00 开始禁食？
onward?
向前？
I don't know, that's an individual difference.
我不知道，这是个体差异。
Andrew Huberman:
安德鲁·休伯曼：
What you can start to identify however, is that people tend to fall into either one category or the other, people who prefer to skip eating in the morning or people that prefer to, or manage to, skip eating in the evening.
然而，您可以开始识别的是，人们往往属于一类或另一类，即喜欢在早上不吃东西的人或喜欢或设法在晚上不吃东西的人。
And there has been no evidence thus far that one is better or worse, at least in terms of weight loss or overall health parameters.
到目前为止，还没有证据表明一种方法更好或更差，至少在体重减轻或整体健康参数方面是这样。
Now you can imagine that some people might eat breakfast and dinner, and indeed I have several, many colleagues in fact, who just choose to skip lunch because they're busy during the day, they eat breakfast and dinner, that doesn't afford the long fast associated with sleep.
现在你可以想象有些人可能会吃早餐和晚餐，事实上我有几个很多同事，他们只是选择不吃午餐，因为他们白天很忙，他们吃早餐和晚餐，这无法承受与睡眠相关的长时间禁食。
What do I mean by that?
我这么说是什么意思？
Well, if you went to sleep at 11:00 p.m.
好吧，如果您晚上 11:00 睡觉
and you wake up at 6:00 a.m., by extending your fast until 1:00 p.m.
然后您在早上 6:00 起床，并将禁食时间延长至下午 1:00
in the afternoon, you get quite a long period of no ingesting any calories.
下午，你会在相当长的一段时间内没有摄入任何卡路里。
Andrew Huberman:
安德鲁·休伯曼：
Whereas when you don't eat during the middle of the day, you are getting a fasting period that's probably anywhere from four to seven hours, but it's not linked to the longer fasting period of not eating while you are asleep.
然而，当您在中午不吃东西时，您的禁食期可能长达四到七小时，但这与您在睡觉时不吃东西的较长禁食期无关。
Because most all people, and I want to emphasize most, do not eat while they are asleep, but we are going to talk about an eating disorder that does exist where people actually eat in their sleep.
因为大多数人（我想强调的是）在睡觉时不会进食，但我们要讨论的是一种饮食失调症，这种失调症确实存在于人们在睡眠中实际进食的情况下。
I know it sounds pretty wild, but indeed, that eating disorder does exist and has a very interesting underlying mechanism.
我知道这听起来很疯狂，但事实上，饮食失调确实存在，并且有一个非常有趣的潜在机制。
So why are we talking about this, and in particular, why are we talking about this during an episode that includes a discussion about eating disorders?
那么，我们为什么要谈论这个，特别是，为什么我们要在一集讨论饮食失调的节目中谈论这个呢？
The reason is nobody, not the government, no nutritionist, no individual, no matter how knowledgeable they are about food and nutrition and food intake, can define the best plan for eating for any one individual.
原因是没有人，不是政府，没有营养师，没有个人，无论他们对食物、营养和食物摄入有多么了解，都可以为任何人制定最佳饮食计划。
Andrew Huberman:
安德鲁·休伯曼：
I'm going to repeat that.
我要重复一遍。
Nobody knows what truly healthy eating is, we only know the measurements we can take: liver enzymes, blood lipid profiles, body weight, athletic performance, mental performance, whether or not you're cranky all day, whether or not you're feeling relaxed, nobody knows how to define these, and these have strong cultural and familial and socio societal influence.
没有人知道什么是真正的健康饮食，我们只知道我们可以采取的测量方法：肝酶、血脂、体重、运动表现、精神表现，无论你是否整天胡思乱想，无论你是否感到放松，没有人知道如何定义这些，而这些具有强大的文化、家庭和社会影响力。
So if you hang out with people that intermittent fast all day, that will seem normal.
因此，如果你和整天间歇性禁食的人一起出去玩，这看起来很正常。
If you spend time with people that have never heard of intermittent fasting, intermittent fasting is going to seem very abnormal.
如果你和从未听说过间歇性禁食的人在一起，间歇性禁食会显得非常不正常。
Now we are going to talk about eating disorders that really fall into the category of clinically diagnosable eating disorders, for which there's actually serious health hazards and even the serious risk of death; we will get to that topic.
现在我们要讨论的饮食失调确实属于临床可诊断的饮食失调的范畴，实际上存在严重的健康危害，甚至有严重的死亡风险；我们将讨论这个主题。
But for the time being, I want to emphasize a new set of findings that I think many people will find interesting and at least will want to consider in light of their current nutritional plan or pattern of eating, whether or not you're intermittent fasting or not.
但目前，我想强调一组新的发现，我认为许多人会觉得有趣，并且至少会根据他们当前的营养计划或饮食模式来考虑这些发现，无论你是否间歇性禁食。
Andrew Huberman:
安德鲁·休伯曼：
And I want to queue up an important framework for the rest of the conversation on healthy and disordered eating, which includes an understanding of thinking, decision-making, and what we call homeostatic processes, meaning regulation of things that are going on in our brain and body and reward mechanisms.
我想为剩下的关于健康和饮食失调的对话建立一个重要的框架，其中包括对思维、决策以及我们所说的稳态过程的理解，即对我们大脑和身体中发生的事情的调节以及奖励机制。
I'm going to return to that in a moment, but first I want to share with you these new findings that were just published in the journal Cell Reports, a Cell Press journal, excellent journal.
我稍后会回到这个话题，但首先我想与大家分享刚刚发表在 Cell Reports 杂志上的这些新发现，这是 Cell Press 的期刊，非常优秀的期刊。
This was a study that was performed both in mice and it included a crossover study with a human population.
这是一项在小鼠身上进行的研究，其中包括与人类的交叉研究。
The human population was women, but it relates to a previous study that was also carried out in men.
人口是女性，但这与之前也在男性中进行的一项研究有关。
I'm going to simplify this study, we will provide a link to the full study so you can explore it in more detail.
我将简化这项研究，我们将提供完整研究的链接，以便您可以更详细地探索它。
And if you're really excited about the results, I would encourage you to explore some of the references within that paper as well.
如果您对结果感到非常兴奋，我会鼓励您也探索该论文中的一些参考文献。
Andrew Huberman:
安德鲁·休伯曼：
What was the study?
研究内容是什么？
The study looked at giving mice or humans two meals and explored whether or not putting those meals early in the day or late in the day had an impact on muscle hypertrophy, muscle growth, and overall protein synthesis of muscle.
该研究着眼于给小鼠或人类提供两顿饭，并探讨在一天的早些时候或一天的晚些时候进食是否会对肌肉肥大、肌肉生长和肌肉的整体蛋白质合成产生影响。
So when we eat, the amino acids from various foods are broken down and synthesized into different types of tissues, they can be utilized for energy, burned up for moving about and thinking, et cetera, or those amino acids can be synthesized into skeletal muscle, the sorts of skeletal muscles that allow you to move your limbs.
因此，当我们吃东西时，各种食物中的氨基酸会被分解并合成不同类型的组织，它们可以用作能量，燃烧以移动和思考等等，或者这些氨基酸可以合成骨骼肌，这种骨骼肌可以让你移动四肢。
Andrew Huberman:
安德鲁·休伯曼：
This study explored how protein intake, which included what are called branch chain amino acids and amino acids like leucine, which are important for muscle protein synthesis, it explored whether or not emphasizing or skewing the protein intake toward early day or late day was better in terms of muscle hypertrophy, and they also looked at some parameters of strength, like grip strength.
这项研究探讨了蛋白质的摄入量，其中包括所谓的支链氨基酸和亮氨酸等对肌肉蛋白质合成很重要的氨基酸，它探讨了强调或偏向清晨或晚些时候的蛋白质摄入是否对肌肉肥大更好，他们还研究了一些力量参数，例如握力。
Now mice are nocturnal, so before you say, "Wait, mice are nocturnal, how did they look during the day?
现在老鼠是夜行性的，所以在你说“等等，老鼠是夜行性的，它们白天看起来怎么样？
And it doesn't apply because it's in mice." Of course they knew that and they looked during the mice's active phase of their circadian cycle, which corresponds to our day.
它并不适用，因为它是在老鼠身上。”他们当然知道这一点，并且他们观察了小鼠昼夜节律周期的活跃阶段，这对应于我们的一天。
And in humans, they looked at whether or not eating most of one's protein early in the day was better than if the protein intake in these branch chain amino acids were placed later in the day.
在人类中，他们研究了在一天的早些时候摄入大部分蛋白质是否比在当天晚些时候摄入这些支链氨基酸的蛋白质更好。
Andrew Huberman:
安德鲁·休伯曼：
And yes, they had the mice do resistance training.
是的，他们让老鼠进行阻力训练。
They did that by emphasizing overload to one limb of the mouse and that actually generates hypertrophy, it's a form of resistance training in mice.
他们通过强调小鼠一侧肢体的超负荷来做到这一点，这实际上会产生肥大，这是小鼠阻力训练的一种形式。
So they don't have them weight training, they weren't doing curls and dips and squats and things of that sort.
所以他们没有进行重量训练，也没有做弯举、臂屈伸、深蹲之类的事情。
They were moving their own body weight, but they skewed that distribution of body weight by restricting a limb and forcing them to use one limb that did indeed grow in response to that.
他们正在移动自己的体重，但他们通过限制肢体并强迫他们使用确实会相应生长的肢体来扭曲体重的分布。
And then in humans, there was an exploration of grip strength, and then with resistance training that was also carried out through a peripheral study.
然后在人类中，对握力进行了探索，然后进行了阻力训练，这也是通过外围研究进行的。
Basically the takeaway from this study was that mice and humans can utilize amino acids that are ingested early in the day better than they can utilize amino acids ingested later in the day, in particular, toward muscle hypertrophy and growth, or maintenance of muscle.
基本上，这项研究的结论是，小鼠和人类可以更好地利用一天早些时候摄入的氨基酸，而不是利用当天晚些时候摄入的氨基酸，特别是在肌肉肥大和生长或维持肌肉方面。
Andrew Huberman:
安德鲁·休伯曼：
Which for those of you that aren't interested in muscle hypertrophy, that aren't trying to grow your muscles, I've talked before in the episode on building strength and hypertrophy, that maintaining muscle, regardless of one's athletic prowess, regardless of one's age is extremely important, because loss of skeletal muscle is one of the major causes of injury as we age.
对于那些对肌肉肥大不感兴趣、不想增长肌肉的人来说，我之前在关于增强力量和肥大的剧集中谈到过，无论一个人的运动能力如何，无论一个人的年龄如何，保持肌肉都非常重要，因为随着年龄的增长，骨骼肌的丧失是受伤的主要原因之一。
It's one of the major causes, believe it or not, of cognitive and metabolic deficits as we age.
不管你信不信，这是随着年龄增长认知和代谢缺陷的主要原因之一。
So maintaining muscle is important, building muscle might be important to some of you.
所以保持肌肉很重要，锻炼肌肉对你们中的一些人来说可能也很重要。
But what they found was ingesting protein early in the day and these amino acids early in the day, led to more muscle hypertrophy than if the majority of amino acids and proteins were ingested late in the day.
但他们发现，在一天的早些时候摄入蛋白质，与在一天的晚些时候摄入大多数氨基酸和蛋白质相比，在一天的早些时候摄入这些氨基酸会导致更多的肌肉肥大。
So this translates to intermittent fasting, such that if you are interested in muscle hypertrophy, you might, and I want to emphasize might, consider making sure that you're getting sufficient protein intake early in the day.
因此，这转化为间歇性禁食，这样，如果您对肌肉肥大感兴趣，您可能（我想强调可能）考虑确保您在一天的早些时候摄入足够的蛋白质。
What sources of protein you use is going to be highly individual.
您使用的蛋白质来源将因人而异。
Andrew Huberman:
安德鲁·休伯曼：
Some of you are meat eaters, some of you don't eat red meat.
你们中有些人是肉食者，有些人不吃红肉。
Some of you eat chicken and fish and eggs, some of you don't.
你们中有些人吃鸡肉、鱼和鸡蛋，有些人不吃。
Some of you are vegans.
你们中有些人是素食主义者。
It has been shown that the amino acid leucine is vital for the cell growth process, including muscle growth, because of its relationship to the so-called mTOR pathway, mammalian target of rapamycin — could talk about that more if you like in a future episode.
研究表明，氨基酸亮氨酸对于细胞生长过程（包括肌肉生长）至关重要，因为它与所谓的 mTOR 通路（雷帕霉素的哺乳动物靶点）有关——如果您愿意，可以在以后的剧集中详细讨论这一点。
This means that if you're somebody who wants to maintain or increase the amount of muscle mass that you have, ingesting a high-protein meal early in the day ought to be beneficial for that.
这意味着，如果您想要保持或增加肌肉量，那么在一天的早些时候摄入高蛋白膳食应该对此有益。
Does it mean that you should not eat protein in the afternoon and evening?
是不是说下午和晚上就不能吃蛋白质了？
No, I think a lot of people might have misinterpreted this study, and I don't want that to happen.
不，我认为很多人可能误解了这项研究，我不希望这种情况发生。
This is only pointing out the fact that ingesting sufficient quality amino acids, including leucine, early in the day can be beneficial for maintenance and growth of muscle tissue.
这只是指出这样一个事实，即在一天的早些时候摄入足够的优质氨基酸（包括亮氨酸）有利于肌肉组织的维持和生长。
It does not say that you should avoid protein later in the day.
它并没有说你应该在当天晚些时候避免摄入蛋白质。
Andrew Huberman:
安德鲁·休伯曼：
Now for you intermittent fasters, this could be relevant.
现在，对于间歇性禁食者来说，这可能是相关的。
I, for instance, was somebody who for a very long time skipped breakfast.
例如，我就是一个很长一段时间不吃早餐的人。
My first meal of the day would be in the early afternoon, mostly protein and salad, in my case, animal protein because that's in alignment with my values.
我一天的第一顿饭是在下午早些时候，主要是蛋白质和沙拉，就我而言，是动物蛋白，因为这符合我的价值观。
Then in the evening, I would eat pasta, vegetables, et cetera, I might have some protein, some small piece of fish or chicken or something like that, but I didn't really emphasize that.
然后晚上，我会吃意大利面、蔬菜等等，我可能会吃一些蛋白质，一些小块鱼或鸡肉之类的东西，但我并没有真正强调这一点。
On the basis of these results, I am experimenting with, I want to emphasize experimenting with, I haven't completely tossed out my old protocol, but I'm experimenting with eating proteins early in the day and eating lunch, and then dinner might be a light supper of some sort, but not so much protein later in the evening.
根据这些结果，我正在试验，我想强调试验，我还没有完全抛弃我的旧方案，但我正在试验在一天早些时候吃蛋白质并吃午餐，然后晚餐可能是某种清淡的晚餐，但晚上晚些时候不要吃太多蛋白质。
Andrew Huberman:
安德鲁·休伯曼：
Again, if you want to eat six meals a day, you want to eat around the clock, I'm not going to stop you, I'm not telling anybody what to do.
再说一遍，如果你想一天吃六顿饭，你想全天候吃东西，我不会阻止你，我不会告诉任何人该怎么做。
As I mentioned earlier, nobody knows exactly how to eat for one's particular goals.
正如我之前提到的，没有人确切知道如何为了一个人的特定目标而饮食。
But this study was really interesting, because it really did show that we can utilize the proteins that are ingested early in the day better than we can utilize the proteins that are ingested later in the day.
但这项研究真的很有趣，因为它确实表明我们可以更好地利用当天早些时候摄入的蛋白质，而不是利用当天晚些时候摄入的蛋白质。
And of course there will be factors that can shift that.
当然，有些因素可以改变这种情况。
For instance, if you work out very hard with resistance training later in the day, resistance training is known to increase protein synthesis, so it stands to reason that ingesting amino acids after that training would be beneficial.
例如，如果您在当天晚些时候进行非常努力的阻力训练，众所周知，阻力训练会增加蛋白质合成，因此理所当然，训练后摄入氨基酸是有益的。
However, in this study, it did not seem to matter when the resistance training fell within the 24-hour schedule.
然而，在这项研究中，阻力训练何时落在 24 小时计划内似乎并不重要。
Andrew Huberman:
安德鲁·休伯曼：
The morning ingestion, or early day ingestion, of amino acids seemed to be beneficial.
早晨摄入或清晨摄入氨基酸似乎是有益的。
How early?
多早？
Between the hours of about 5:00 a.m.
上午 5:00 左右的时间之间
and 10:00 a.m.
和上午 10:00
for humans.
对于人类来说。
Now, just a bit of mechanism to explain why this happens.
现在，我们用一些机制来解释为什么会发生这种情况。
So why would it be that ingesting protein early in the day would lead to more synthesis of muscle than ingesting protein later in the day?
那么为什么在一天的早些时候摄入蛋白质会比在当天晚些时候摄入蛋白质导致更多的肌肉合成呢？
And the reason it turns out is related to the circadian clock mechanism that is present in all cells, including muscle cells.
事实证明，其原因与所有细胞（包括肌肉细胞）中存在的生物钟机制有关。
So muscles have fibers, I think most people are aware of that, that your muscles are not just one big blob of tissue, a lot of these little fibers that contract.
所以肌肉有纤维，我想大多数人都知道，你的肌肉不仅仅是一大团组织，还有很多收缩的小纤维。
Within those fibers however, there are cells with nuclei, those nuclei contained DNA.
然而，在这些纤维中，有带有细胞核的细胞，这些细胞核含有 DNA。
DNA is transcribed into RNA.
DNA被转录成RNA。
RNA is translated into proteins.
RNA被翻译成蛋白质。
The DNA of your cells, including these muscle cells, are under strong circadian regulation.
您的细胞（包括这些肌肉细胞）的 DNA 受到强大的昼夜节律调节。
Andrew Huberman:
安德鲁·休伯曼：
Each one has a pattern of gene expression that is different at different times during the 24-hour cycle.
每个基因在 24 小时周期的不同时间都有不同的基因表达模式。
This is an unescapable reality of all cells in your body, from your hair cells to your brain cells to your retinal cells to your toe, on both feet.
这是你体内所有细胞无法逃避的现实，从你的毛细胞到你的脑细胞到你的视网膜细胞到你的脚趾、双脚。
These cells make a gene called BMAL, B-M-A-L is a clock gene.
这些细胞产生一个称为 BMAL 的基因，B-M-A-L 是一个时钟基因。
And the expression of this clock gene varies across the 24-hour cycle, and proteins that are downstream of this BMAL gene influence protein synthesis.
该时钟基因的表达在 24 小时周期内变化，该 BMAL 基因下游的蛋白质影响蛋白质合成。
The circadian regulation of this BMAL gene turns out to be vitally important for this protein synthesis mechanism.
该 BMAL 基因的昼夜节律调节对于这种蛋白质合成机制至关重要。
How do we know that?
我们怎么知道这一点？
Well, in this particular study, because they had a mouse that lacked BMAL, the gene was knocked out, they had a bunch of these mice, they were able to explore whether or not this early day feeding effect was present or absent in these mice that lacked the gene BMAL, and indeed it was absent.
嗯，在这项特殊的研究中，因为他们有一只缺乏 BMAL 的小鼠，所以该基因被敲除，他们有一群这样的小鼠，他们能够探索这些缺乏 BMAL 基因的小鼠是否存在这种早期喂养效应，事实上它是不存在的。
Andrew Huberman:
安德鲁·休伯曼：
In other words, the effect of increased protein synthesis early in the day was eliminated in the absence of the BMAL gene.
换句话说，在没有 BMAL 基因的情况下，当天早些时候蛋白质合成增加的影响就被消除了。
So what this means is that when you wake up in the morning, assuming you're following a standard schedule of being asleep at night and awake during the day, your muscle cells are primed to incorporate amino acids and synthesize muscle, regardless of whether or not you weight trained the night before at 8:00 p.m., or you don't weight train at all, or you weight train afterwards or before.
因此，这意味着，当您早上醒来时，假设您遵循晚上睡觉、白天清醒的标准时间表，您的肌肉细胞就会准备好吸收氨基酸并合成肌肉，无论您前一天晚上 8:00 是否进行了重量训练，或者您根本没有进行重量训练，或者您在之后或之前进行了重量训练。
I said five to 10:00 p.m.
我说下午 5 点到 10:00。
is the sort of critical window for this increased protein synthesis, all this means is that if you are interested in maintaining or enhancing muscle tissue volume, that you might want to consider eating quality protein and amino acids early in the day.
是增加蛋白质合成的关键窗口，所有这一切意味着，如果您有兴趣维持或增强肌肉组织体积，您可能需要考虑在一天的早些时候吃优质蛋白质和氨基酸。
You could train first, you could train after, you could not train at all, that's an entirely different discussion.
你可以先训练，也可以先训练，也可以根本不训练，这是完全不同的讨论。
Andrew Huberman:
安德鲁·休伯曼：
What is quality protein?
什么是优质蛋白质？
Well, quality protein is going to be a protein that includes most of the essential amino acids and, in particular, leucine.
好吧，优质蛋白质将是包含大多数必需氨基酸，特别是亮氨酸的蛋白质。
Now, there's a lot of debate as to whether or not you can get all the essential amino acids from a purely plant-based diet, or whether or not you need to ingest animal-based foods or not.
现在，关于是否可以从纯植物性饮食中获取所有必需氨基酸，或者是否需要摄入动物性食物，存在很多争论。
The term "quality protein" has no strict scientific definition.
“优质蛋白质”一词没有严格的科学定义。
Some people define quality protein as a protein that has a high essential amino acid to caloric ratio.
有些人将优质蛋白质定义为具有高必需氨基酸与热量比率的蛋白质。
Now what that means is a small piece of chicken or steak or eggs, for instance, will have many essential amino acids with a low caloric content relative to, say, beans or plant-based foods that can also get you essential amino acids, but it requires more calories to access those essential amino acids.
现在这意味着，例如，一小块鸡肉、牛排或鸡蛋将含有许多热量含量较低的必需氨基酸，而豆类或植物性食物也可以获取必需氨基酸，但它需要更多的卡路里来获取这些必需氨基酸。
Now, that's a debate that has many exceptions and nuances, and I for one, am perfectly respectful of the folks that just want to ingest plant-based foods in order to get their high-quality protein.
现在，这是一场有许多例外和细微差别的争论，我个人非常尊重那些只想摄入植物性食物以获得高质量蛋白质的人。
I think that actually can be done.
我认为这实际上是可以做到的。
Andrew Huberman:
安德鲁·休伯曼：
One has to be careful and thoughtful in their choices about how to do that.
人们在选择如何做到这一点时必须小心谨慎。
So this really isn't about animal-based versus nonanimal based foods, this is about getting quality amino acids early in the day from whatever foods are in alignment with your particular values and your particular eating plan.
因此，这实际上并不是关于动物性食品与非动物性食品的问题，而是关于在一天的早些时候从符合您的特定价值观和特定饮食计划的任何食物中获取优质氨基酸。
So that's a lot of information, but the key takeaways are every cell in your muscles has a clock gene, the clock genes vary, such that protein synthesis is greater early in the day than it is later in the day, such that in both mice and in humans, ingestion of quality proteins early in the day will be more so incorporated into muscle than the proteins that are ingested late in the day.
这是很多信息，但关键的要点是肌肉中的每个细胞都有一个时钟基因，时钟基因各不相同，因此蛋白质合成在一天的早些时候比在一天的晚些时候更多，因此无论是在小鼠还是在人类中，在一天的早些时候摄入的优质蛋白质都会比在一天的晚些时候摄入的蛋白质更多地融入肌肉中。
And of course, there are the caveats of if you're training hard late in the day, if you're adjusting your hormone status through whatever mechanism, et cetera, protein synthesis can also be high later in the day.
当然，需要注意的是，如果您在当天晚些时候进行刻苦训练，如果您通过任何机制调整激素状态等等，蛋白质合成在当天晚些时候也可能会很高。
But for most people, it's going to taper off due to this circadian BMAL gene-related mechanism.
但对于大多数人来说，由于这种昼夜节律 BMAL 基因相关机制，它会逐渐减少。
Andrew Huberman:
安德鲁·休伯曼：
Again, we will provide a link to the study.
同样，我们将提供该研究的链接。
And the other key takeaways were that nobody knows.
其他关键要点是没人知道。
Nobody can tell you what healthy feeding windows are, what the best feeding windows are.
没有人可以告诉您什么是健康的喂养窗口，什么是最好的喂养窗口。
There's absolutely no information in that context.
绝对没有这方面的信息。
You talk to 10 nutritionists or academics or trainers or individuals about what healthy eating is, and you are going to get vastly different answers.
你和 10 位营养师、学者、培训师或个人谈论什么是健康饮食，你会得到截然不同的答案。
And that's one of the reasons why I believe that the Internet, in particular social media, are so filled with contradictory opinions, but the calories-in-versus-calories-burned formula is the more or less holy foundation of all things about nutrition, eating and weight.
这就是为什么我相信互联网，特别是社交媒体，充满了相互矛盾的观点的原因之一，但卡路里摄入与卡路里燃烧公式或多或少是所有有关营养、饮食和体重的神圣基础。
And as we transition today into the discussion about eating disorders, I'd like you to keep this in mind, because for the treatment of eating disorders, it doesn't matter what psychological or early trauma-based effects led to the eating disorder if the person isn't adjusting their feeding behavior in a way that is going to ameliorate the symptoms of that disorder, which is ultimately the goal.
当我们今天开始讨论饮食失调时，我希望你们记住这一点，因为对于饮食失调的治疗，如果患者没有以改善饮食失调症状的方式调整进食行为，那么无论什么心理或早期创伤影响导致饮食失调，这都是无关紧要的，而这才是最终的目标。
Andrew Huberman:
安德鲁·休伯曼：
Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford.
在开始之前，我想强调一下，这个播客与我在斯坦福大学的教学和研究角色是分开的。
It is however part of my desire and effort to bring zero-cost-to-consumer information about science and science-related tools to the general public.
然而，我的愿望和努力的一部分是将有关科学和科学相关工具的零成本消费者信息带给公众。
In keeping with that theme, I'd like to thank the sponsors of today's podcast.
为了与这个主题保持一致，我要感谢今天播客的赞助商。
So let's talk about eating disorders, and as we do that, I want to emphasize again that nobody can really define what healthy eating is with a single protocol.
因此，让我们谈谈饮食失调，当我们这样做时，我想再次强调，没有人可以通过单一方案真正定义什么是健康饮食。
However, there is some general agreement about what unhealthy and disordered eating is.
然而，对于什么是不健康和饮食失调，人们存在一些普遍共识。
There are clear criteria in the psychiatric and psychological communities to define things like anorexia, bulimia, binge-eating disorder, all of which we will talk about.
精神病学和心理学界有明确的标准来定义厌食症、贪食症、暴食症等疾病，所有这些我们都会讨论。
But as we have that discussion, I want to emphasize that self-diagnosis can be both a terrific but also a very precarious thing.
但在我们进行讨论时，我想强调的是，自我诊断既是一件很棒的事情，但也是一件非常不稳定的事情。
Andrew Huberman:
安德鲁·休伯曼：
We talked about this a little bit in the episode about depression.
我们在关于抑郁症的一集中谈到了这一点。
There's always a temptation as one learns about the symptomology of a given disorder, doesn't really matter what the disorder is, to ask the question, "Well, do I have that?
当一个人了解某种特定疾病的症状时，总会有一种诱惑，不管这种疾病是什么，都会问这样的问题：“嗯，我有这种病吗？
Does so-and-so that I know have that?
我认识的某某有这个吗？
I see this sort of behavior or that pattern of thinking in that individual." It's tempting to diagnose them and/or ourselves as either having or not having a particular disorder.
我在那个人身上看到了这种行为或那种思维模式。”人们很容易诊断他们和/或我们自己是否患有某种特定疾病。
However, diagnoses really need to be carried out by people who are trained in that particular field and that have deep expertise in recognizing the symptomology, including some of the more subtle symptomology of eating disorders.
然而，诊断确实需要由在该特定领域接受过培训并且在识别症状学方面具有深厚专业知识的人员进行，包括饮食失调的一些更微妙的症状学。
So if any of the symptoms resonate with you by way of you thinking that you have this particular disorder, or someone that you know has this disorder, I would take that seriously, but I would take that information to a qualified healthcare professional that could diagnose or rule out any of these possible disorders.
因此，如果任何症状让您产生共鸣，认为自己患有这种特定的疾病，或者您认识的人患有这种疾病，我会认真对待，但我会将这些信息带给合格的医疗保健专业人员，他们可以诊断或排除任何这些可能的疾病。
Andrew Huberman:
安德鲁·休伯曼：
I say that not to protect us, but to protect you, because information is valuable, and I do believe that knowledge of knowledge can be very valuable in navigating any topic and improving our thoughts and behaviors around that topic.
我这么说不是为了保护我们，而是为了保护你，因为信息很有价值，而且我确实相信，知识中的知识对于导航任何主题以及改善我们围绕该主题的思想和行为非常有价值。
But one doesn't want to, or I should say one shouldn't start to self-diagnose simply on the basis of information, without running that through the filter of a qualified professional.
但人们不想这样做，或者我应该说，人们不应该仅仅根据信息进行自我诊断，而无需经过合格专业人士的筛选。
So what is an eating disorder?
那么什么是饮食失调呢？
Well, we have to take a step back and confess to the fact that every society, every culture, every family and every individual has a different relationship to food.
好吧，我们必须退一步承认这样一个事实：每个社会、每种文化、每个家庭和每个人与食物的关系都不同。
Eating disorders, however, have particular criteria that allow us to define them and to think about different modes of treatment, as it relates to the particular symptoms, in particular the psychological and biological symptoms of those disorders.
然而，饮食失调有特定的标准，使我们能够定义它们并考虑不同的治疗模式，因为它与特定的症状有关，特别是这些疾病的心理和生物学症状。
Now that's a mouthful, no pun intended.
现在这只是一句拗口的话，没有双关语的意思。
Andrew Huberman:
安德鲁·休伯曼：
What are the major eating disorders?
主要的饮食失调有哪些？
Anorexia nervosa, most commonly referred to as anorexia, is perhaps the most prevalent and the most dangerous of all eating disorders.
神经性厌食症，最常被称为厌食症，可能是所有饮食失调中最普遍和最危险的。
In fact, anorexia is the most dangerous psychiatric disorder of all, even more than depression.
事实上，厌食症是最危险的精神疾病，甚至比抑郁症还要严重。
The probability of death for untreated anorexia is very high, and sadly, the prevalence of anorexia is very high.
未经治疗的厌食症死亡的可能性非常高，可悲的是，厌食症的患病率非常高。
So what is anorexia, and how prevalent is it?
那么什么是厌食症，厌食症有多普遍？
Anorexia, if you look it up online or you talk to a qualified professional, is essentially a failure to eat enough to maintain a healthy weight.
如果您在网上查找或与合格的专业人士交谈，厌食症本质上是没有吃足够的食物来维持健康的体重。
You can see all sorts of very troubling symptoms of somebody who's been anorexic for some period of time, a general loss of muscle mass because they're ingesting fewer calories than they burn; muscle is very metabolically active; they tend to lose a lot of muscle mass.
你可以看到患有厌食症的人在一段时间内会出现各种非常令人不安的症状，肌肉质量普遍下降，因为他们摄入的卡路里少于燃烧的卡路里；肌肉的新陈代谢非常活跃；他们往往会失去大量肌肉。
Andrew Huberman:
安德鲁·休伯曼：
They will have a low heart rate, this is the body and brain's attempt to lower energy output.
他们的心率较低，这是身体和大脑试图降低能量输出的结果。
They'll have low blood pressure.
他们会有低血压。
They'll sometimes have symptoms like fainting.
他们有时会出现晕厥等症状。
They will have sometimes even hair growth on the face, something called lanugo, which is essentially the body's attempt to insulate the body because of loss of body heat when you're that thin.
有时，他们的脸上甚至会长出毛发，称为胎毛，这本质上是身体试图隔离身体，因为当你那么瘦时，身体会失去热量。
Loss of bone density, osteoporosis, loss of periods, in girls and women, and all sorts of disrupted gut and immune functions.
女孩和女性骨密度下降、骨质疏松、月经减少，以及各种肠道和免疫功能紊乱。
So there are just tons of terrible symptoms of anorexia that really place the anorexic into a very risky state, which is why mortality from anorexia, gone untreated, is extremely high.
因此，厌食症有很多可怕的症状，确实使厌食症患者处于非常危险的状态，这就是为什么如果不治疗厌食症，死亡率极高。
Now, one of the misconceptions about anorexia is that it stems from an overemphasis on perfectionism, or that because of all the images in social media and in advertising of extremely thin and fit or muscular people, that individuals are looking at themselves and comparing themselves to those images, and thinking that they don't match up and developing anorexia.
现在，关于厌食症的误解之一是，它源于对完美主义的过分强调，或者由于社交媒体和广告中的所有极瘦、健康或肌肉发达的人的图像，人们正在审视自己并将自己与这些图像进行比较，并认为他们不匹配并发展厌食症。
That turns out to not be the case.
事实证明并非如此。
Andrew Huberman:
安德鲁·休伯曼：
If you look at the prevalence, or the rates, of anorexia in the last 10 years or 20 years, and you compare that to when anorexia was first identified, which was in the 1600s, and perhaps even earlier, what you find is that rates of anorexia are not going up.
如果你观察过去 10 年或 20 年厌食症的患病率或发病率，并将其与首次发现厌食症的时间（1600 年代，甚至更早）进行比较，你会发现厌食症的发病率并没有上升。
So this idea that the images that we're being bombarded with are causing anorexia doesn't seem to be true.
因此，认为我们受到的图像轰炸会导致厌食症的想法似乎并不正确。
Now, that is not to say that the images that we, in particular young people, are being bombarded with are healthy for their psychological state of mind, but classically defined anorexia has existed at essentially the same prevalence for the last 100, 200, 300 and 400 years, which is incredible and really speaks to the likelihood that there's a strong biological contribution to what we call anorexia nervosa.
现在，这并不是说我们，特别是年轻人，所受到的轰炸对于他们的心理状态来说是健康的，但是在过去的100年、200年、300年和400年里，经典定义的厌食症的患病率基本上是相同的，这是令人难以置信的，并且确实说明了我们所说的神经性厌食症可能有很强的生物学因素。
Anorexia nervosa is extremely common: it's anywhere from one to two percent of women, and the typical onset is in adolescence, close to puberty, but it can show up later in life as well.
神经性厌食症非常常见：有百分之一到百分之二的女性患有这种病，典型的发病时间是青春期，接近青春期，但也可能在晚年出现。
Andrew Huberman:
安德鲁·休伯曼：
In fact, the identification and diagnosis of anorexia tends to be in the early 20s, but if you look back at the history of those individuals, there were typically signs of anorexia that stem back into their early teens, or maybe even before that.
事实上，厌食症的识别和诊断往往是在 20 岁出头，但如果你回顾这些人的历史，就会发现厌食症的迹象通常可以追溯到十几岁出头，甚至可能更早。
Now of course, men can be anorexic as well, but anorexia nervosa does seem to occur at 10 times the rate in women and young girls than it does in men and young boys.
当然，现在男性也可能患有厌食症，但女性和年轻女孩的神经性厌食症发病率似乎是男性和男孩的 10 倍。
So while there does seem to be more of a prevalence of anorexia in boys and young men these days, that's probably due to better diagnosis and detection than it is to some sort of societal shift related to imagery, et cetera.
因此，虽然如今男孩和年轻人中厌食症的患病率似乎更高，但这可能是由于更好的诊断和检测，而不是与图像等相关的某种社会转变。
Later we will talk about body dysmorphia and some of the images that are present in media and social media, and how those are impacting other forms of eating disorders.
稍后我们将讨论身体畸形以及媒体和社交媒体中出现的一些图像，以及它们如何影响其他形式的饮食失调。
Andrew Huberman:
安德鲁·休伯曼：
But when you look at anorexia nervosa, this failure to maintain weight, even to healthy levels, and often drops in weight that are very dangerous or even deadly, that has existed for a very long time and seems to be somewhat hardwired into the biology of individuals that suffer from it.
但是，当你观察神经性厌食症时，这种无法维持体重的现象，甚至无法维持在健康水平，并且体重经常下降，这是非常危险的，甚至是致命的，这种情况已经存在了很长一段时间，并且似乎在某种程度上根植于患有该病的个体的生物学中。
Now, when I say hardwired, that doesn't mean that it can't be treated or cured, and indeed it can.
现在，当我说硬连线时，这并不意味着它不能被治疗或治愈，事实上它可以。
Bulimia, which is defined as binge eating or overeating.
暴食症，被定义为暴饮暴食或暴饮暴食。
Let me explain what that is: binge eating is consuming vast amounts of calories in a short period of time; overeating can be ingesting more calories than one needs, but over an extended period of time.
让我解释一下这是什么：暴饮暴食是指在短时间内消耗大量的卡路里；暴饮暴食可能是指摄入的热量超过一个人的需要，但持续时间较长。
Both can exist, of course, but bulimia is also very common.
当然，两者都可能存在，但暴食症也很常见。
It's more common in young girls and in women than it is in young boys and in men, but it is present in both sexes.
它在年轻女孩和女性中比在年轻男孩和男性中更常见，但它在两性中都存在。
Andrew Huberman:
安德鲁·休伯曼：
Bulimia, and rates of bulimia, might be increasing, that's sort of an interesting finding.
贪食症以及贪食症的发病率可能会增加，这是一个有趣的发现。
It's not quite clear whether or not it's existed in its same form for a long period of time, or whether or not they're new forms that are evolving or showing up.
目前尚不清楚它是否以相同的形式长期存在，或者它们是否是正在演变或出现的新形式。
We're going to drill into bulimia and what it actually is and what it represents.
我们将深入探讨贪食症及其实际含义和代表意义。
But one thing I want to be clear about, just as the perfectionist mindset has been associated with anorexia, and it turns out that's not the case — it can be, but it's not always associated with anorexia.
但我想澄清一件事，就像完美主义心态与厌食症有关，但事实证明并非如此——它可能是，但并不总是与厌食症有关。
There was the idea that bulimia is associated with early trauma in childhood, in particular sexual trauma, and while that can be the case, there's no direct correlation between the two.
有人认为贪食症与童年早期创伤有关，尤其是性创伤，虽然情况可能如此，但两者之间没有直接关联。
Now obviously, psychological phenomena and trauma can have a profound impact on the way that the brain wires up and the way that people approach food and other types of behaviors.
显然，心理现象和创伤会对大脑的连接方式以及人们对待食物和其他类型行为的方式产生深远的影响。
Andrew Huberman:
安德鲁·休伯曼：
But the sort of classic idea was that all anorexics are perfectionists, they want to perform well, it's all about control and autonomy, and bulimics are kind of dysregulated and acting out against some early sexual trauma.
但那种经典的想法是，所有厌食症患者都是完美主义者，他们想要表现良好，这一切都与控制和自主有关，而贪食症患者则有点失调，并针对一些早期的性创伤做出了反应。
Those stereotypes of the psychological framework of anorexics and bulimics doesn't hold up when you look at the data.
当你查看数据时，那些关于厌食症和暴食症心理框架的刻板印象并不成立。
Many meta-analyses have been done, it just simply is not the case.
已经进行了许多荟萃分析，但事实并非如此。
And in both instances, both anorexia and bulimia, they're clear biological underpinnings to what's driving the undereating or the overeating.
在这两种情况下，无论是厌食症还是暴食症，它们都是导致饮食不足或暴饮暴食的明显生物学基础。
So we're going to talk about the biology of undereating and overeating and appropriate levels of eating, and by doing that, we will start to identify some of the mechanisms that serve as entry points for the treatment of both anorexia and bulimia.
因此，我们将讨论饮食不足和饮食过量的生物学以及适当的饮食水平，通过这样做，我们将开始确定一些作为治疗厌食症和贪食症切入点的机制。
And as some of you are probably aware, anorexia and bulimia can be comorbid, they can exist with one another.
你们中的一些人可能已经意识到，厌食症和贪食症可能是共病，它们可以同时存在。
Andrew Huberman:
安德鲁·休伯曼：
There are anorexics who will binge and then purge in order to maintain that unhealthily low weight; there are bulimics who fit the psychological criteria of anorexia, and so there's a lot of overlap between those two categories.
有些厌食症患者会暴饮暴食，然后再暴饮暴食，以保持不健康的低体重。有些贪食症患者符合厌食症的心理标准，因此这两个类别之间有很多重叠。
Now let's talk about the categorization for a second and why the categorization has led to, now, a bunch of other eating disorders, as defined by the psychiatric community.
现在让我们讨论一下这种分类，以及为什么这种分类现在导致了精神病学界所定义的一系列其他饮食失调症。
One of the classic symptoms of anorexia is a loss of menstrual cycles, loss of periods.
厌食症的典型症状之一是月经周期减少。
And the reason for that is when the body is undernourished, the body fat stores send signals to the brain to inform that the body is undernourished, or they turn off the signals that say, "Look, there are enough body fat cells out here to support healthy metabolism, and therefore let's shut down ovulation," literally signals sent from the fat and muscle to the brain, and the brain, the hypothalamus and pituitary, will send signals-
原因是当身体营养不良时，身体脂肪储存会向大脑发送信号，告知身体营养不良，或者它们会关闭信号，“看，这里有足够的身体脂肪细胞来支持健康的新陈代谢，因此让我们关闭排卵，”字面意思是从脂肪和肌肉发送到大脑的信号，而大脑、下丘脑和垂体将发送信号-
Andrew Huberman:
安德鲁·休伯曼：
...And the brain, the hypothalamus and pituitary, will send signals down to the ovaries, or they will turn off the signals heading to the ovaries, to deploy eggs, the maturation of eggs in the follicle, et cetera.
...大脑、下丘脑和垂体将向卵巢发送信号，或者它们将关闭发送到卵巢的信号，以部署卵子，使卵子在卵泡中成熟，等等。
So there are instances in which people have anorexia, or have bulimia, but are still maintaining healthy menstrual cycles, or at least menstrual cycles, and that has led to a whole set of other categorizations of eating disorders, like binge-eating disorder, where there tends to be a lot of overeating but not the purging, or categorizations of anorexia in which people are underfeeding, but they are not losing their periods.
因此，在某些情况下，人们患有厌食症或贪食症，但仍然保持健康的月经周期，或者至少是月经周期，这导致了一系列其他饮食失调的分类，例如暴食症，其中往往有大量暴饮暴食，但没有净化，或者厌食症的分类，其中人们进食不足，但他们并没有失去月经。
And so these have a number of different names and acronyms.
因此，它们有许多不同的名称和缩写。
Some of them include things like EDNOS.
其中一些包括 EDNOS 之类的东西。
EDNOS is eating disorder not otherwise specified, so that's a subcategorization, OSFEDS.
EDNOS 是一种未另行指定的饮食失调症，因此它是一个子类别，OSFEDS。
So OSFEDS is other specified feeding or eating disorder.
因此，OSFEDS 是其他特定的喂养或饮食失调症。
Andrew Huberman:
安德鲁·休伯曼：
So right now, if you were to look online or look into the psychiatric and psychological textbooks, what you would find is that there's a huge constellation of eating disorders.
所以现在，如果你在网上查找或查阅精神病学和心理学教科书，你会发现存在大量的饮食失调。
Today we're mainly going to talk about anorexia, bulimia, binge-eating disorder and body dysmorphia.
今天我们主要讲的是厌食症、暴食症、暴食症和身体畸形症。
You can even find eating disorders like pica, where people actually ingest things like dirt or rocks or metal because they have a genuine appetite for those things.
你甚至可以发现像异食癖这样的饮食失调症，人们实际上会摄入泥土、石头或金属之类的东西，因为他们对这些东西有真正的胃口。
I certainly do not recommend sampling any of those nonfood items as foods.
我当然不建议将任何非食品样品作为食品。
It is incredibly dangerous.
这是极其危险的。
People often poison themselves.
人们经常毒害自己。
They often can cause structural blockages.
它们通常会导致结构性堵塞。
Some people have died from those sorts of things.
有些人死于此类事情。
But nonetheless, there are aspects of our brain and biology that, when disrupted, can lead to very bizarre types of eating behavior.
但尽管如此，我们的大脑和生物学的某些方面如果受到干扰，可能会导致非常奇怪的饮食行为。
Sometimes pica is caused by malnutrition, but not always.
有时异食癖是由营养不良引起的，但并非总是如此。
Andrew Huberman:
安德鲁·休伯曼：
And so today we're going to focus on the most prevalent eating disorders, but we are going to build up toward that understanding by looking at what healthy metabolism, and eating, and satiety and hunger looks like.
因此，今天我们将重点关注最普遍的饮食失调，但我们将通过了解健康的新陈代谢、饮食、饱腹感和饥饿感来加深对这种理解的了解。
Because, one, I realize that not everyone out there has an eating disorder, and two, I want people to understand this relationship between how they think, the decisions they take about what they eat, and how the body and the brain at subconscious levels are driving some of these behaviors, healthy or otherwise, because I do think that it can lead us to a better understanding of what healthy eating is for most of us, and to increase compassion, and hopefully even increased improvement in treatment of eating disorders for those that are suffering from them.
因为，第一，我意识到并不是每个人都患有饮食失调症，第二，我希望人们了解他们的思维方式、他们对饮食做出的决定以及潜意识层面的身体和大脑如何驱动其中一些行为（无论健康还是其他）之间的关系，因为我确实认为这可以让我们更好地理解健康饮食对我们大多数人来说意味着什么，并增加同情心，甚至希望改善那些患有饮食失调症的人的治疗方法。
Andrew Huberman:
安德鲁·休伯曼：
So what is hunger and what is satiety?
那么什么是饥饿，什么是饱足呢？
Satiety, of course, being sated, or feeling like we've had enough food.
饱腹感，当然是吃饱了，或者感觉我们已经吃够了。
I want to remind people of the basic mechanisms by which the brain and body communicate.
我想提醒人们大脑和身体交流的基本机制。
This is vitally important, not just for this discussion, but for any discussion about how we think, how we behave, how we feel.
这不仅对于本次讨论至关重要，而且对于任何有关我们如何思考、如何行为、如何感受的讨论都至关重要。
The body is communicating two types of information to the brain on a regular basis, but in particular around feeding, and those two types of information are mechanical information and chemical information.
身体定期向大脑传达两种类型的信息，特别是在进食方面，这两种类型的信息是机械信息和化学信息。
What do I mean by mechanical information?
机械信息是什么意思？
Andrew Huberman:
安德鲁·休伯曼：
Well, if you take a deep breath and you hold your breath, what you'll find is that you can hold your breath a lot longer than if you exhale all your air and you hold your breath with lungs empty, and the reason is not because when your lungs are full, you have enough oxygen and therefore you can hold your breath.
好吧，如果你深呼吸并屏住呼吸，你会发现你可以屏住呼吸的时间比你呼出所有空气并在肺部空的情况下屏住呼吸的时间要长得多，原因并不是因为当你的肺部充满时，你有足够的氧气，因此你可以屏住呼吸。
It's because when your lungs are full, a particular class of neurons called baroreceptors send information to the brain and say, "There's pressure in the lungs, and that means that there's probably oxygen in here." And so the trigger to breathe is actually suppressed.
这是因为当你的肺部充满空气时，一类称为压力感受器的特殊神经元会向大脑发送信息，并说：“肺部有压力，这意味着这里可能有氧气。”因此呼吸的触发实际上被抑制了。
When your lungs are empty, even if you have plenty of oxygen in your system, those baroreceptors send a different signal to the brain, which is, there's no oxygen in here and you should breathe, and so the impulse to breathe comes earlier.
当你的肺部空了时，即使你的系统中有足够的氧气，那些压力感受器也会向大脑发出不同的信号，也就是说，这里没有氧气，你应该呼吸，所以呼吸的冲动会更早出现。
Andrew Huberman:
安德鲁·休伯曼：
Likewise, when your stomach is full, it sends signals to your brain that are purely based on this mechanical fullness, has nothing to do with nutrients, that says I'm full, and therefore don't be as hungry.
同样，当你的胃吃饱时，它会向你的大脑发送信号，这些信号纯粹基于这种机械饱腹感，与营养无关，这表明我已经吃饱了，因此不会那么饿。
Don't motivate to find or ingest food.
不要主动去寻找或摄入食物。
Whereas when our gut is empty, even if we have plenty of nutrients or plenty of body fat stores, we tend to focus on food a bit more.
而当我们的肠道空虚时，即使我们有充足的营养或体内脂肪储存，我们也会倾向于更多地关注食物。
So volume and mechanical influences have a profound effect on how we think and what we consider doing or not doing.
因此，体积和机械的影响对我们的思维方式以及我们考虑做什么或不做什么有着深远的影响。
Likewise, chemical effects.
同样，化学效应。
When we ingest food, our so-called blood sugar or blood glucose levels go up.
当我们摄入食物时，我们所谓的血糖或血糖水平会上升。
That information is signaled to the brain via neuronal pathways and hormonal pathways.
该信息通过神经元通路和激素通路向大脑发出信号。
And in particular, there are neurons within our gut that signal to areas of our brain stem that are involved in satiety, and our sense of having enough, that there's food in our system.
特别是，我们肠道内的神经元会向脑干区域发出信号，这些区域与饱腹感以及我们的饱腹感有关，我们的系统中有食物。
So that's chemical information.
这就是化学信息。
Andrew Huberman:
安德鲁·休伯曼：
So how are hunger and feeding and satiety regulated?
那么饥饿、进食和饱腹感是如何调节的呢？
By way of mechanical and chemical signaling.
通过机械和化学信号的方式。
You have, I have, we all have neurons in our hypothalamus that trigger eating and neurons that trigger cessation, or stopping of eating.
你有，我有，我们的下丘脑中都有触发进食的神经元，也有触发停止或停止进食的神经元。
We have an accelerator on eating, and we have a brake, and I covered all of this in a lot of detail in the episode on feeding and metabolism and hunger, so if you want a lot more detail, see that episode.
我们对饮食有一个加速器，也有一个刹车，我在关于进食、新陈代谢和饥饿的一集中详细介绍了所有这些，所以如果你想了解更多细节，请参阅该集。
But right now I'm just going to give you the top contour of how all that works.
但现在我只想向您介绍这一切是如何运作的。
Andrew Huberman:
安德鲁·休伯曼：
Your hypothalamus is an area of your forebrain, which tells you it's in the front, but it's at the base of your forebrain, sits more or less above the roof of your mouth.
你的下丘脑是前脑的一个区域，它告诉你它在前面，但它位于你前脑的底部，或多或少位于你的上颚上方。
The hypothalamus contains lots of different kinds of neurons, including neurons that stimulate sexual activity and desire, regulate your body temperature, and control appetite and ceasing of eating and appetite.
下丘脑含有许多不同类型的神经元，包括刺激性活动和性欲、调节体温、控制食欲以及停止进食和食欲的神经元。
There are two types of neurons within a particular area of your hypothalamus that are relevant here.
下丘脑特定区域内有两种类型的神经元与此相关。
There are the so-called POMC neurons, okay?
有所谓的 POMC 神经元，好吗？
Pro-opiomelanocortin neurons that tend to act as more of a break on appetite by way of another hormone called melanocyte-stimulating hormone.
阿黑皮质素原神经元往往通过另一种称为黑素细胞刺激激素的激素来起到抑制食欲的作用。
And not so incidentally, when you're getting a lot of sunlight and you're viewing a lot of sunlight, that system is ramped up.
并非偶然，当您接受大量阳光并且观看大量阳光时，该系统就会启动。
This is why appetite is lower in the summer months than it is in the winter months.
这就是为什么夏季的食欲比冬季低的原因。
This is true in animals, and this is true in humans.
对于动物来说如此，对于人类来说也是如此。
Andrew Huberman:
安德鲁·休伯曼：
And you have a class of neurons called the AGRP neurons.
一类神经元称为 AGRP 神经元。
The AGRP neurons are the ones that stimulate feeding, and they create a sort of anxiety or excitement about food.
AGRP 神经元是刺激进食的神经元，它们会产生一种对食物的焦虑或兴奋。
It can be positive anxiety, or it can be negative anxiety.
它可以是积极的焦虑，也可以是消极的焦虑。
What do I mean by that?
我这么说是什么意思？
Well, have you ever seen kids heading in to get ice cream?
那么，你见过孩子们去买冰淇淋吗？
They're absolutely excited.
他们非常兴奋。
You see people getting ready to sit down and eat a big meal, they're excited to eat.
你看到人们准备坐下来吃一顿大餐，他们吃得很兴奋。
Sometimes that's due to social factors, but they have an increase in overall levels of autonomic arousal, and depending on the context, they can feel excited or anxious, but it is a ramping up of energy.
有时这是由于社会因素造成的，但他们的自主唤醒总体水平有所提高，并且根据具体情况，他们可能会感到兴奋或焦虑，但这是能量的增加。
These AGRP neurons are what caused that.
这些 AGRP 神经元就是造成这种情况的原因。
In fact, so much so that if you eliminate or kill these neurons, which has been done in experimental mouse models in the laboratory, but also there are humans that have lesions or neurotoxic effects on these AGRP neurons, and what you find is that they don't want to eat.
事实上，如果你消除或杀死这些神经元，这已经在实验室的实验小鼠模型中完成了，但也有人对这些 AGRP 神经元产生了损伤或神经毒性作用，你会发现他们不想吃东西。
They essentially become anorexic, meaning they don't want to ingest food.
他们基本上变得厌食症，这意味着他们不想摄入食物。
They have no appetite for food whatsoever.
他们对任何食物都没有胃口。
Andrew Huberman:
安德鲁·休伯曼：
Now, that's not exactly what anorexia is, but these AGRP neurons are like an accelerator on wanting to eat.
现在，这并不完全是厌食症，但这些 AGRP 神经元就像想要吃东西的加速器。
Whereas if you stimulate these AGRP neurons, or in humans that have, say, a small tumor near these AGRP neurons, they become hyperphagic.
然而，如果你刺激这些 AGRP 神经元，或者在这些 AGRP 神经元附近有一个小肿瘤的人类中，它们就会变得贪食。
They will eat to the point of bursting.
他们会吃到爆裂的程度。
Both animals and humans that have elevated levels of these AGRP neurons are anxious.
AGRP 神经元水平升高的动物和人类都会感到焦虑。
They want to eat, and they will ingest food to the point where they override those mechanical and chemical signals in the body, and I know it sounds horrible and it is horrible.
他们想吃东西，他们会摄入食物，直到他们超越体内的机械和化学信号，我知道这听起来很可怕，也很可怕。
They will eat until the point that they burst.
他们会吃到撑破为止。
Andrew Huberman:
安德鲁·休伯曼：
Now, there are signals coming back from the body to inform the brain about presence of different levels of nutrients, and that generally comes from three sources.
现在，身体会返回信号，通知大脑存在不同水平的营养物质，这些信号通常来自三个来源。
First of all is body fat.
首先是身体脂肪。
The more body fat we have, the more we secrete a hormone called leptin, L-E-P-T-I-N, leptin from body fat.
我们体内的脂肪越多，我们从体内脂肪中分泌的一种叫做瘦素（L-E-P-T-I-N）的激素就越多。
Leptin goes to the brain and suppresses appetite.
瘦素进入大脑并抑制食欲。
This is a body-to-brain signaling mechanism that says, "Look, I've had enough." Not incidentally, leptin signaling is disrupted in people that have bulimia and obesity and certain forms of binge-eating disorder, so that system is disrupted.
这是一种身体到大脑的信号机制，它说：“看，我已经受够了。”并非偶然，在患有贪食症、肥胖症和某些形式的暴食症的人中，瘦素信号传导被破坏，从而导致该系统被破坏。
Andrew Huberman:
安德鲁·休伯曼：
The "I've had enough" signal, or "There's enough body fat here such that you don't need to eat more." Right here, I'm sort of in the voice of the body fat trying to talk to the brain.
“我已经吃够了”的信号，或者“这里有足够的身体脂肪，所以你不需要吃更多。”就在这里，我有点像身体脂肪试图与大脑对话的声音。
That signal, that dialogue is mixed up or messed up.
那个信号，那个对话是混淆的或混乱的。
In some cases it's absent entirely.
在某些情况下，它完全不存在。
So the body fat is signaling to the brain about how much reserve you have.
因此，身体脂肪向大脑发出信号，告诉大脑你有多少储备。
It's sort of like a savings account for energy, because that's what body fat is.
这有点像能量储蓄账户，因为这就是身体脂肪。
You got lipids in there, and through lipolysis they can be metabolized.
那里有脂质，通过脂肪分解它们可以被代谢。
If you're interested in that process, both how to increase it and just generally how it works, you can see the episode on the science of fat loss.
如果您对这个过程感兴趣，无论是如何增加它还是它的一般运作方式，您可以观看有关减脂科学的剧集。
Andrew Huberman:
安德鲁·休伯曼：
The body fat is doing something else really interesting that relates to anorexia.
身体脂肪正在做一些与厌食症相关的非常有趣的事情。
When there's sufficient levels of body fat and leptin circulating in the blood, and that leptin signal gets to the brain, the hypothalamus and the pituitary gland register that signal, and in a completely subconscious way, trigger the deployment of eggs in females and the production of sperm in males.
当血液中循环的身体脂肪和瘦素水平足够时，瘦素信号到达大脑，下丘脑和垂体就会记录该信号，并以完全潜意识的方式触发女性卵子的部署和男性精子的产生。
So when body fat stores are very low, the reason why periods shut off or sperm production is reduced, or even shut off, is because there's not enough leptin getting to the hypothalamus and to the pituitary, and they shut off the signals, the hormones, things like gonadotropin-releasing hormone, luteinizing hormone, follicle-stimulating hormone, all these hormones that you don't have to remember the names of if you don't want to, that travel to the ovary or to the testes and cause the ovary and testes to ovulate or to produce more sperm.
因此，当体内脂肪储存量非常低时，月经停止或精子生成减少甚至停止的原因是没有足够的瘦素到达下丘脑和垂体，它们关闭了信号、激素，如促性腺激素释放激素、黄体生成激素、卵泡刺激素，所有这些激素，如果您不想记住，您不必记住它们的名称，它们会传送到卵巢或睾丸并导致卵巢和睾丸排卵或产生更多精子。
Andrew Huberman:
安德鲁·休伯曼：
So the reason why anorexics stop having periods, why they stop cycling, is because there isn't sufficient leptin in the bloodstream.
因此，厌食症患者停止月经、停止循环的原因是因为血液中没有足够的瘦素。
Now, there have been attempts to give leptin to anorexics, because leptin has been sequenced, and the peptide has been synthesized, and so you can inject leptin into people.
现在，已经有人尝试给厌食症患者注射瘦素，因为瘦素已经测序，肽也已经合成，所以可以给人们注射瘦素。
There are studies where they've done that.
有研究表明他们已经这样做了。
When that happens, it does not tend to alleviate the anorexia.
当这种情况发生时，它并不能缓解厌食症。
It does not cause people to start eating again, and that actually makes sense because leptin is also a way of shutting off the hunger signals, saying ...
它不会导致人们再次开始进食，这实际上是有道理的，因为瘦素也是一种关闭饥饿信号的方法，说……
It's the body fat's way of saying, "Hey, there's a lot of body fat here," or "there's sufficient body fat." There doesn't even have to be a lot, but it has in some cases been shown to rescue the menstrual cycling in some anorexics.
这是身体脂肪的说法，“嘿，这里有很多身体脂肪”，或者“有足够的身体脂肪”。甚至不需要很多，但在某些情况下，它已被证明可以挽救一些厌食症患者的月经周期。
So body fat is signaling to the brain.
所以身体脂肪正在向大脑发出信号。
The gut is signaling to the brain.
肠道正在向大脑发出信号。
Andrew Huberman:
安德鲁·休伯曼：
There are neurons in your gut that are primarily responding to, meaning they fire electrical signals, when there are sufficient fatty acids coming from fat to ingest, amino acids coming from proteins you ingest, and sugars coming from carbohydrates and sugars, things like fructose, glucose, et cetera.
当有足够的来自脂肪的脂肪酸可供摄入、来自您摄入的蛋白质的氨基酸、来自碳水化合物和糖类的糖（如果糖、葡萄糖等）时，肠道中的神经元主要会做出反应，这意味着它们会发射电信号。
Those signals are being sent from the fat and from the gut up to the brain, and therefore your body has multiple signals of directing you toward eating more or eating less.
这些信号从脂肪和肠道发送到大脑，因此您的身体有多种信号引导您多吃或少吃。
So you've got two categories of neurons, one that acts as an accelerator, the AGRP neuron, saying, "Eat, eat," and gets you excited to eat.
因此，你有两类神经元，一类充当加速器，即 AGRP 神经元，它会说“吃，吃”，让你兴奋地吃东西。
And then you have a category of neurons, the POMC neurons, that are suppressing hunger.
然后有一类神经元，POMC 神经元，可以抑制饥饿。
They're acting like a brake.
它们的作用就像刹车一样。
And the body is informing the brain all the time about the status of the body and whether or not it needs more food or not.
而且身体一直在向大脑通报身体的状态以及是否需要更多的食物。
Andrew Huberman:
安德鲁·休伯曼：
So you might ask, why is it that people who are overweight and have a lot of body fat, why they would continue to eat a lot.
那么你可能会问，为什么超重、体内脂肪多的人，为什么还要继续吃很多东西呢？
Well, past a certain threshold of body fat, that's when you start getting into the so-called metabolic disorders, where blood glucose metabolism is disrupted, leptin signaling is disrupted, and there are all sorts of changes on both the brain side and the body end of things, such that they're hungry despite the fact that the body has plenty of energy on reserve.
好吧，当身体脂肪超过一定阈值时，你就会开始进入所谓的代谢紊乱，血糖代谢被破坏，瘦素信号被破坏，大脑和身体都会发生各种各样的变化，尽管身体有充足的能量储备，但他们还是感到饥饿。
That, I think, is sufficient to explain the basics of hunger and satiety, kind of a biological mechanism.
我认为，这足以解释饥饿和饱腹感的基本原理，这是一种生物机制。
And the important thing again to remember is that there are mechanical and chemical signals that come from fullness or absence of fullness.
再次要记住的重要一点是，饱腹感或不饱腹感会产生机械和化学信号。
They come from the presence of glucose in the blood or the absence of glucose in the blood.
它们来自于血液中存在或不存在葡萄糖。
When you haven't eaten for a long time, glucagon levels go up.
当您长时间没有进食时，胰高血糖素水平会上升。
For instance, GLP-1 levels go up, and those will drive you to seek out food and want food, and then there are these signals that are coming from body fat and from neurons in the gut.
例如，GLP-1 水平上升，这些会驱使你寻找食物并想要食物，然后这些信号来自身体脂肪和肠道神经元。
Andrew Huberman:
安德鲁·休伯曼：
So there's a lot of convergent signal, a lot of pathways.
所以有很多汇聚信号，很多路径。
I don't offer you all those pathways to confuse you.
我不会向你提供所有这些让你感到困惑的途径。
I offer you those pathways to clarify the extent to which something as simple as eating, or the decision to not eat, is complicated.
我向您提供这些途径，以阐明像吃东西或不吃东西这样简单的事情有多复杂。
We've perhaps heard, or I've certainly heard that, "Oh, you know it takes about 20 minutes for satiety to set in.
我们也许听说过，或者我确实听说过，“哦，你知道大约需要 20 分钟才能产生饱腹感。
So you should eat slowly," that you won't realize that you're full until about 20 minutes.
所以你应该慢慢吃”，直到大约 20 分钟你才会意识到自己已经吃饱了。
That's actually not true.
这实际上不是真的。
I don't know where that got started, but we should probably all chew our food better and eat more slowly, be more mindful of what we're eating, et cetera.
我不知道这是从哪里开始的，但我们可能都应该更好地咀嚼食物，吃得更慢，更加注意我们吃的东西，等等。
Andrew Huberman:
安德鲁·休伯曼：
So in anticipation of this episode, I consulted extensively with a colleague of mine at Stanford who, sadly for us, is going off to University of Pennsylvania, so our loss is University of Pennsylvania's win.
因此，为了期待这一集，我向斯坦福大学的一位同事进行了广泛的咨询，对我们来说可悲的是，他即将前往宾夕法尼亚大学，所以我们的失败是宾夕法尼亚大学的胜利。
His name is Dr. Casey Halpern.
他的名字是凯西·哈尔彭博士。
He's a MD, medical doctor, and neurosurgeon, and a PhD who studies binge-eating disorder and other types of eating disorders, and how they arise in the brain, and he's developed some really pioneering treatments for them.
他是一名医学博士、医生和神经外科医生，也是一名博士，研究暴食症和其他类型的饮食失调，以及它们如何在大脑中产生，并且他为这些疾病开发了一些真正开创性的治疗方法。
We'll talk more about his work a little bit later in the episode, but we got to the discussion of why a body that has sufficient energy levels would desire to eat more at all.
我们将在本集稍后讨论更多关于他的工作，但我们讨论了为什么一个拥有足够能量水平的身体会渴望吃更多东西。
This is not just the case for binge-eating disorder or for bulimia, but why that would be the case.
这不仅仅是暴食症或暴食症的情况，也是为什么会出现这种情况的原因。
You know, this is primitive biology that evolved over many tens, if not hundreds of thousands, of years.
你知道，这是经过数十万年甚至数十万年进化而来的原始生物学。
You see it in mice, you see it in humans.
你在老鼠身上看到了这一点，在人类身上也看到了这一点。
Very similar types of pathways and effects.
途径和效果的类型非常相似。
Andrew Huberman:
安德鲁·休伯曼：
How is it that human beings who have plenty of fat on reserve and plenty of glycogen in their liver, et cetera, in other words, plenty of energy, why they would be hungry, why they would eat at all?
人类有大量的脂肪储备，肝脏中有大量的糖原等等，换句话说，有充足的能量，为什么他们会饿，为什么他们会吃东西呢？
Seems like that just shouldn't happen.
看来这不应该发生。
And he had a very important, and I think clear and intuitive way of framing up all this stuff around eating and motivated behaviors and how they can go awry, not just in eating disorders, but in all of us.
他有一个非常重要的、我认为清晰直观的方式来构建所有围绕饮食和动机行为的东西，以及它们如何出错，不仅在饮食失调中，而且在我们所有人中。
Basically, what he said was, from an evolutionary standpoint, it makes sense that we should eat as often as we can, as much as we can and as fast as we can.
基本上，他所说的是，从进化的角度来看，我们应该尽可能多、尽可能多、尽可能快地吃东西，这是有道理的。
Well, that sounds crazy.
嗯，这听起来很疯狂。
I was told to eat not too often, not too much, and to eat slowly and chew my food.
有人告诉我不要吃太多，不要吃太多，要慢慢吃，咀嚼食物。
But as Dr. Halpern pointed out, there are circuits in the brain to reward eating often, eating fast, and cramming as much food into you as possible, because from a purely evolutionary standpoint, food was scarce and seeking food was dangerous, whether or not it was from animal sources or not, and it's always been competitive.
但正如哈尔彭博士指出的那样，大脑中存在一些回路来奖励经常进食、快速进食以及尽可能多地塞给你的食物，因为从纯粹的进化角度来看，食物是稀缺的，寻找食物是危险的，无论食物是否来自动物，而且总是具有竞争性。
Andrew Huberman:
安德鲁·休伯曼：
For those of you that grew up in families with a lot of siblings, this may resonate with you.
对于那些在有很多兄弟姐妹的家庭中长大的人来说，这可能会引起你的共鸣。
I had just one sibling.
我只有一个兄弟姐妹。
We were competitive about certain things, but typically not competitive about food.
我们在某些事情上有竞争力，但在食物方面通常没有竞争力。
But I had friends that had a lot of siblings, and it was really interesting to see how food was served up, and how it was taken in those households.
但我的朋友有很多兄弟姐妹，看到这些家庭如何提供食物以及如何享用食物真的很有趣。
It was like food would hit the table, and it was just an absolute war for portions and who got what and how much, and who got a slightly bigger piece of cake, et cetera.
就像食物即将上桌一样，这完全是一场关于份量的战争，谁得到了什么，吃了多少，谁得到了一块稍微大一点的蛋糕，等等。
Turned out to be a frequent happening in these meals and at these birthday parties, whereas the only children perhaps, were used to having more food presented to them without having to compete with other members of the species.
事实证明，这种情况在这些膳食和生日聚会上经常发生，而独生子女可能已经习惯了向他们提供更多食物，而不必与该物种的其他成员竞争。
Andrew Huberman:
安德鲁·休伯曼：
Every animal, including humans, has a hardwired circuit that we were born with that pays attention to how much food is available, how much we are getting now, and how much we are likely to get in the future.
每一种动物，包括人类，都有我们与生俱来的硬连线回路，它关注有多少食物可用，我们现在得到多少，以及我们将来可能得到多少。
And without going down the rabbit hole of arcuate nucleus biology, in two sentences, you have a hypothalamic area called the arcuate nucleus.
不用深入了解弓状核生物学的兔子洞，用两句话就能知道，你有一个称为弓状核的下丘脑区域。
It's a fascinating area.
这是一个令人着迷的领域。
It's actually the area that houses these POMC neurons and these other types of neurons that regulate hunger and satiety.
它实际上是容纳这些 POMC 神经元和调节饥饿和饱腹感的其他类型神经元的区域。
And these neurons in the arcuate nucleus start getting active when we see food and think about food.
当我们看到食物并想到食物时，弓状核中的这些神经元开始活跃。
They drive hunger, and they drive hunger in a way that's responsive to what the food looks like, what it smells like, but also our prior history of interactions with that food, and it takes into account social context.
它们会导致饥饿，并且以一种对食物的外观、气味以及我们之前与食物相互作用的历史做出反应的方式来驱动饥饿，并且它考虑到了社会背景。
Whether or not we are going to get the whole pizza to ourselves, or whether or not there are going to be others that we are going have to compete with.
无论我们是否要独占整个披萨，或者我们是否必须与其他人竞争。
Andrew Huberman:
安德鲁·休伯曼：
So there are a lot of signals that this arcuate nucleus in your brain are paying attention to.
所以你大脑中的弓形核正在关注很多信号。
So Dr. Halpern pointed out that you actually have an accelerator that increases your level of awareness and anxiety and constricts your field of view and all your senses anytime you interact with food, and is driving a primitive reflex to ingest as much food as you can, as quickly as you can, and then move on from there, and presumably to do the same elsewhere.
因此哈尔彭博士指出，你实际上有一个加速器，它会增加你的意识和焦虑水平，并在你与食物互动时限制你的视野和所有感官，并驱动一种原始的反射，尽可能快地摄入尽可能多的食物，然后从那里继续前进，并且可能在其他地方做同样的事情。
So that changed the way that I think about eating behavior and eating disorders.
这改变了我对饮食行为和饮食失调的看法。
In fact, we could think about eating disorders like bulimia as an unmasking of that mechanism without the so-called top-down control, without the mechanisms that we use to regulate our behavior.
事实上，我们可以将贪食症等饮食失调视为对这种机制的揭露，而无需所谓的自上而下的控制，也无需我们用来调节行为的机制。
And indeed, bulimia and binge-eating disorder are closely associated with impulsivity and with impulsive behaviors of other kinds, something that we also will discuss more.
事实上，贪食症和暴食症与冲动和其他类型的冲动行为密切相关，我们也将对此进行更多讨论。
Andrew Huberman:
安德鲁·休伯曼：
What's the pathway?
途径是什么？
How does this work?
这是如何运作的？
What is Dr. Halpern and his colleagues doing in order to try and treat things like binge-eating disorder?
哈尔彭博士和他的同事正在做什么来尝试治疗暴食症等疾病？
Well, you can frame all of behavior, good decision-making and bad decision-making, in a pretty simple box diagram model, and I realize that many of you are listening to this, not watching this, and there is no diagram to look at.
好吧，你可以在一个非常简单的方框图模型中构建所有行为，好的决策和坏的决策，我意识到你们中的许多人都在听这个，而不是看这个，并且没有图表可看。
I'll just explain it so that you can conceptualize it in your mind.
我只是解释一下，以便您可以在脑海中概念化它。
We have knowledge of what we should do in one box.
我们知道我们应该在一个盒子里做什么。
We should eat that.
我们应该吃那个。
We shouldn't eat that.
我们不应该吃那个。
We should wait for dinner.
我们该等晚饭了。
We shouldn't wait for dinner.
我们不应该等待晚餐。
And then we have what we actually do in another box.
然后我们在另一个盒子里实际做的事情。
Andrew Huberman:
安德鲁·休伯曼：
Now this is true for all behaviors.
现在这对于所有行为都是如此。
We should say something or we want to say something, but we don't.
我们应该说点什么，或者我们想说点什么，但我们没有。
We shouldn't say something, but we do anyway.
我们不应该说什么，但我们还是这么做了。
That's the knowledge that ...
这就是知识...
the kind of looping in your head: I should do my homework.
你的脑海中不断循环：我应该做作业。
I should go for a run.
我应该去跑步。
I shouldn't do this right now.
我现在不应该这样做。
I shouldn't be on social media.
我不应该出现在社交媒体上。
All those kinds of shoulds and shouldn'ts that are circulating in your head, that's one box.
所有那些应该和不应该在你脑海中循环的事情，就是一个盒子。
Then there's what you actually do, the behavior.
然后就是你实际做的事情，即行为。
Whether or not you suppress the behavior, you turn off your phone, and you go read a book, or you go to sleep, or whether or not you stay up all night, or you stay up for another hour or even five minutes.
无论你是否抑制这种行为，你都会关掉手机，然后去看书，或者去睡觉，或者是否熬夜，或者再熬一个小时甚至五分钟。
In between those two boxes are two intervening forces, and those intervening forces are critically important.
在这两个盒子之间有两个干预力量，而这些干预力量至关重要。
Those intervening forces are homeostatic processes, called by some processes, same thing.
这些干预力是稳态过程，被某些过程称为同一事物。
Homeostatic processes that regulate the balance of different systems in your body, hot and cold, awake or asleep, dopamine and the desire to pursue things, serotonin and the desire to just relax and chill.
稳态过程调节体内不同系统的平衡，冷热、清醒或睡眠、多巴胺和追求事物的欲望、血清素和放松和放松的欲望。
So homeostatic processes and reward systems.
所以稳态过程和奖励系统。
Andrew Huberman:
安德鲁·休伯曼：
And as we now move into discussion about anorexia and bulimia specifically, what you'll see is that anorexia and bulimia are not a breaking of the mindset of what one should do or shouldn't do.
当我们现在具体讨论厌食症和贪食症时，您会看到厌食症和贪食症并没有打破一个人应该做什么或不应该做什么的心态。
It's a disruption of these homeostatic and reward processes, such that decision-making is completely disrupted, and in many cases is not available to the anorexic or bulimic.
这是对这些稳态和奖励过程的破坏，使得决策完全被破坏，并且在许多情况下厌食症或暴食症患者无法做出决策。
Now, I don't want to be abstract here.
现在，我不想在这里变得抽象。
What I'm saying is that the person who starves themselves to the point where they might die, and in some cases sadly do die, they can know perfectly well that their behavior is leading to bad outcomes and possibly even death, and yet they are not able to intervene unless they get particular clinical help, because the homeostatic processes, the signals from the body and brain that say you need food, those aren't registering in the same way that they are for other individuals.
我想说的是，那些把自己饿死到可能会死的人，在某些情况下不幸地确实死了，他们可以完全清楚自己的行为会导致不良结果，甚至可能死亡，但他们无法干预，除非他们得到特定的临床帮助，因为体内平衡过程，来自身体和大脑的信号表明你需要食物，这些信号的记录方式与其他人不同。
Andrew Huberman:
安德鲁·休伯曼：
And for the bulimic or the person that suffers from binge-eating disorder, they don't necessarily want to eat that food, they simply cannot help it.
对于暴食症患者或患有暴食症的人来说，他们不一定想吃那种食物，他们根本无法控制。
It's like a reflex for them, because the homeostatic processes and the reward processes associated with food are such that they can't intervene between the "should do X, Y or Z," or "shouldn't do X, Y or Z," and what their actual behavior is.
这对他们来说就像一种反射，因为与食物相关的稳态过程和奖励过程使得他们无法干预“应该做 X、Y 或 Z”或“不应该做 X、Y 或 Z”与他们的实际行为之间的关系。
Andrew Huberman:
安德鲁·休伯曼：
Now, this isn't just a biological, mechanistic explanation for what could have been summarized in two sentences.
现在，这不仅仅是对可以用两句话概括的生物学、机械学解释。
What this is is a roadmap of where interventions can really make a difference.
这是干预措施真正能够发挥作用的路线图。
So as we talk about different drug-based interventions, or behavioral interventions or social interventions, I'd like you to think about whether or not those interventions are breaking into or tapping into this box of the thinking, the sort of pattern of thinking around food, whether or not it's the behavior, the actual ingestion or the restriction of food, or whether or not it's tapping into the homeostatic process, the balance of energy systems and kind of getting enough but not too much, or it's tapping into the reward system.
因此，当我们谈论不同的基于药物的干预措施、行为干预措施或社会干预措施时，我希望您思考这些干预措施是否正在闯入或利用这个思维框，即围绕食物的思维模式，无论是行为、实际摄入或限制食物，还是利用体内平衡过程、能量系统的平衡以及获得足够但不过多的食物，或者是利用奖励系统。
Andrew Huberman:
安德鲁·休伯曼：
And just as a little teaser of where we're headed, what you'll find, based on the data — clinical data experiments done very carefully and very well by excellent groups.
正如我们前进的方向的一个小预告，你会发现什么，基于数据——优秀团队非常仔细、非常出色地完成的临床数据实验。
What you'll find is that anorexics have a sort of switch that's been flipped, such that their decision-making is actually pretty darn good.
你会发现厌食症患者有一种被翻转的开关，因此他们的决策实际上非常好。
It might even be better than yours in terms of evaluating food nutritional content, but their habits are disrupted.
它在评估食物营养成分方面甚至可能比你更好，但他们的习惯被打乱了。
So they're not even consciously aware of the fact that they're making terrible, and in some cases very dangerous, food choices.
因此，他们甚至没有意识到自己正在做出糟糕的、在某些情况下非常危险的食物选择。
It turns out that habits, and the way that we build and break and rebuild new habits, is one of the most effective treatments for anorexia.
事实证明，习惯，以及我们建立、打破和重建新习惯的方式，是治疗厌食症最有效的方法之一。
Andrew Huberman:
安德鲁·休伯曼：
So now let's talk about anorexia.
那么现在我们来谈谈厌食症。
This failure to consume enough energy such that the individual is at risk of death, and if not death, then severe metabolic disorders, lack of bone density, et cetera.
如果不能消耗足够的能量，个体就会面临死亡的风险，如果不是死亡，那么就会出现严重的代谢紊乱、骨密度缺乏等。
As I mentioned earlier, anorexia and things that almost certainly were and are anorexia, have been described as early as the 1600s, and maybe even earlier.
正如我之前提到的，早在 1600 年代，甚至可能更早，厌食症以及几乎肯定曾经是厌食症的事情就已经被描述过。
There are some records from the saints, from the 1400s, of people that refuse to ingest food.
从 1400 年代起，圣人就有一些关于拒绝摄入食物的记录。
Andrew Huberman:
安德鲁·休伯曼：
Another common myth is that anorexia is only the sort of thing that you see in rich societies.
另一个常见的误解是，厌食症只出现在富裕社会。
These are spoiled children with so much food that they decide they're only going to focus on how slim they are, how they look in bathing suits, et cetera.
这些被宠坏的孩子吃了太多的食物，以至于他们决定只关注自己有多苗条，穿泳衣的样子等等。
Not true.
不正确。
A careful analysis through medical epidemiology has shown that you find anorexia even in cultures and societies where food is scarce.
通过医学流行病学的仔细分析表明，即使在食物匮乏的文化和社会中，也会出现厌食症。
So that really speaks to biological mechanism.
所以这确实说明了生物机制。
Now, it's hard to unveil in societies where food is scarce, because a lot of people are starving and hungry, but there are individuals that choose still to avoid food and seem to have some sort of reward mechanism that rewards them or makes them feel better if they don't eat, despite the fact that their body is severely depleted of nutrients.
现在，很难揭示食物匮乏的社会，因为很多人都在挨饿，但有些人仍然选择避免食物，并且似乎有某种奖励机制来奖励他们，或者让他们在不吃东西时感觉更好，尽管他们的身体严重缺乏营养。
Andrew Huberman:
安德鲁·休伯曼：
So that's very interesting, and points, again, to some disruption in some biological mechanism.
这非常有趣，并且再次表明某些生物机制受到了破坏。
Now, I want to make sure that I'm emphasizing that I'm not in favor of people, in particular young children, adolescents and teenagers, being bombarded with unrealistic imagery about bodies.
现在，我想确保我强调的是，我不赞成人们，特别是幼儿、青少年和青少年，受到关于身体的不切实际的想象的轰炸。
But the idea that that's the cause of, or is amplifying, anorexia, the data just don't seem to support that.
但认为这是厌食症的原因或加剧厌食症的想法，数据似乎并不支持这一点。
Anorexia, in its classic sense, requires that there be an endocrine, meaning a hormonal disruption, menstrual abnormalities, lack of sperm production or low testosterone in males, in order to meet the classification for anorexia.
厌食症，从其经典意义上来说，需要存在内分泌失调，即荷尔蒙紊乱、月经异常、精子生成不足或男性睾酮水平低，才能符合厌食症的分类。
But as I mentioned earlier, there are now nuanced and new classifications of anorexia, that even for individuals that still menstruate or that maintain sperm production, that anorexia can still be considered a clinically diagnosable disorder.
但正如我之前提到的，现在厌食症有了微妙的新分类，即使对于仍然有月经或维持精子产生的个体来说，厌食症仍然可以被认为是一种临床可诊断的疾病。
Andrew Huberman:
安德鲁·休伯曼：
Now, typically anorexia starts in adolescence, right around puberty.
现在，厌食症通常始于青春期，即青春期左右。
Let's take a look at what puberty is.
我们先来看看什么是青春期。
Puberty, at a very broad level, is the most significant and dramatic developmental step anyone goes through in their lifespan.
从广义上讲，青春期是任何人一生中经历的最重要、最戏剧性的发展阶段。
The body changes, the brain changes, perceptions change, one's own self-perception changes, and most of those changes are driven by changes in circuitry within the hypothalamus.
身体变化、大脑变化、感知变化、自我感知变化，而这些变化大部分是由下丘脑内电路的变化驱动的。
So neurons that are controlling the production of the so-called sex steroid hormones, things like testosterone, estrogen, and related hormones, prolactin, et cetera, those are all changing at very rapid rates.
因此，控制所谓性类固醇激素（例如睾酮、雌激素和相关激素、催乳素等）产生的神经元都在以非常快的速度发生变化。
Anorexia tends to show up around this time in a subset of individuals, who on the face of it, seem to find food aversive.
厌食症往往会在这个时候出现在一部分人身上，从表面上看，他们似乎厌恶食物。
Now, the purely psychological theory of this is that they are fighting for autonomy, they want control.
现在，纯粹的心理理论是，他们正在争取自主权，他们想要控制权。
Andrew Huberman:
安德鲁·休伯曼：
Puberty is also a time in which children and parents are in a tug-of-war over control.
青春期也是孩子和父母为了控制权而展开拉锯战的时期。
You were once a small child being told when to go to bed, sent to your room, now you're a child that can talk back and say, "I don't want to," or "I refuse to." And that happens a lot in various households, as I'm sure you're familiar with.
你曾经是一个小孩子，被告知什么时候去睡觉，被送到你的房间，现在你是一个可以顶嘴说“我不想”或“我拒绝”的孩子。这种情况在不同的家庭中经常发生，我相信你很熟悉。
Adolescence and puberty is also when girls start menstruating, typically, or boys develop deeper voice, they start producing sperm, et cetera.
青春期和青春期通常也是女孩开始月经的时候，或者男孩的声音变得更低沉，他们开始产生精子等等。
So there are a lot of bodily changes that also drive perceptual changes and perceptual changes that drive bodily changes, and it is a dramatic shift.
因此，有很多身体的变化也带动了知觉的变化，而知觉的变化又带动了身体的变化，这是一个巨大的转变。
For a young girl or boy that doesn't nourish themselves sufficiently during that period, there are a number of downstream negative effects.
对于一个年轻的女孩或男孩来说，如果在此期间没有足够的营养，就会产生许多下游的负面影响。
I'll list out some of them.
我将列出其中一些。
These are just a subset of the effects.
这些只是影响的一个子集。
Hypogonadism, that's the lack of sperm production or healthy egg production.
性腺功能减退症，即缺乏精子产生或健康卵子产生。
There is amenorrhea, which is the lack of menstrual cycling, so a failure to have a menstrual cycle.
有闭经，这是月经周期不足，所以没有月经周期。
Reduced insulin secretion; insulin is this hormone that's released in order to help shuttle glucose into various tissues for energy utilization.
胰岛素分泌减少；胰岛素是一种释放的激素，可以帮助将葡萄糖输送到各种组织中以供能量利用。
That's down because energy levels are down so much.
这是因为能量水平下降了很多。
One of the symptoms that's a little more cryptic, and that has actually interesting implications for sake of the cholesterol hypothesis, is that anorexics who ingest very little food often have cosmically high levels of cholesterol, including LDL, low-density lipoprotein cholesterol.
其中一个症状比较隐秘，但对胆固醇假说来说实际上具有有趣的意义，那就是摄入很少食物的厌食症患者的胆固醇水平通常很高，包括低密度脂蛋白胆固醇（LDL）和低密度脂蛋白胆固醇。
Andrew Huberman:
安德鲁·休伯曼：
You say, how could that possibly be?
你说，这怎么可能？
We were all told, and continue to be told from many sources that ingestion of dietary cholesterol is what drives high levels of bodily cholesterol.
我们都被告知，并且继续从许多来源得知，膳食胆固醇的摄入是导致体内胆固醇水平升高的原因。
Cholesterol's manufactured by the liver, and in anorexics who consume very little food, they often have cosmically high levels of cholesterol, which is one of the wrinkles in the so-called dietary cholesterol hypothesis that all of our cholesterol that we see on a blood panel is due to what we eat.
胆固醇是由肝脏产生的，在进食很少的厌食症患者中，他们的胆固醇水平往往非常高，这是所谓的饮食胆固醇假说的缺陷之一，即我们在血液检测中看到的所有胆固醇都是由我们吃的东西造成的。
But the explanation for it is that under conditions where there's not sufficient cholesterol to synthesize the sex steroid hormones, things like testosterone and estrogen, which are required in both males and females — those are made from cholesterol — that the body, the liver, will start generating its own cholesterol and will often overshoot the mark to a dramatic degree.
但对此的解释是，在没有足够的胆固醇来合成性类固醇激素的情况下，例如男性和女性都需要的睾丸激素和雌激素（它们是由胆固醇制成的），身体、肝脏将开始产生自己的胆固醇，并且常常会严重超出标准。
Andrew Huberman:
安德鲁·休伯曼：
So the blood lipid profiles in anorexics are often very unhealthy, despite the fact that they're eating very little food.
因此，厌食症患者的血脂状况往往非常不健康，尽管他们吃的食物很少。
In addition, they tend to have elevated levels of things like vasopressin, which are hormones that regulate body temperature and salt and blood volume.
此外，他们体内的抗利尿激素等物质的水平往往较高，这是一种调节体温、盐分和血容量的激素。
They intend to have low blood pressure.
他们打算降低血压。
They can pass out.
他们可能会昏倒。
I mentioned some of the other symptoms earlier.
我之前提到过一些其他症状。
In other words, there are a huge number of terrible things happening.
换句话说，有大量可怕的事情正在发生。
Thyroid levels are down, heart rates are down.
甲状腺水平下降，心率下降。
If I'm painting a very bleak picture here, it is indeed a bleak picture.
如果我在这里描绘一幅非常凄凉的图画，那它确实是一幅凄凉的图画。
So we have to ask ourselves, what can be done for the anorexic, right?
所以我们要问自己，对于厌食症可以做些什么，对吗？
Let's say it's a failure of the AGRP neurons to stimulate appetite and feeding.
假设 AGRP 神经元无法刺激食欲和进食。
Let's say it's too much anxiety around food.
假设对食物有太多的焦虑。
Let's say it's because of the way that food restriction was used for reward in the household, right?
假设这是因为家庭中用食物限制作为奖励的方式，对吧？
Andrew Huberman:
安德鲁·休伯曼：
I'm making this up, but you can imagine a hypothetical scenario where the, let's just say the mother of a particular individual is very vocal about her avoidance of food.
这是我编造的，但你可以想象一个假设的场景，假设某个人的母亲非常直言不讳地表达了她对食物的回避。
We've seen this before, right?
我们以前见过这个，对吧？
You've probably seen somebody who loves to cook and prepare food but then sits down and doesn't seem to eat.
您可能见过有人喜欢做饭和准备食物，但坐下来似乎并不吃东西。
And they always seem to, in air quotes, have eaten earlier; I ate while I cooked.
在空中引用中，他们似乎总是吃得更早；我一边做饭一边吃饭。
I ate while I cooked.
我一边做饭一边吃饭。
Right?
正确的？
These people that you never actually see eating.
这些你从未真正见过的人在吃东西。
We all know people like this.
我们都认识这样的人。
Are they anorexic?
他们厌食症吗？
Possibly, we don't know.
可能，我们不知道。
A child observes that kind of behavior.
孩子会观察到这种行为。
Maybe that individual is always being told how beautiful they look or how wonderful or fit they look, what incredible meals they produce.
也许那个人总是被告知他们看起来多么美丽，或者他们看起来多么美妙或健康，他们制作的饭菜多么令人难以置信。
And you could imagine a purely psychosocial set of events that could lead a child to be anorexic.
你可以想象一系列纯粹的心理社会事件可能导致孩子厌食。
That doesn't seem to be the case, at least not in terms of driving classic anorexia, of really extreme deprivation of oneself from food.
事实似乎并非如此，至少在导致典型的厌食症、极度剥夺自己食物方面。
Andrew Huberman:
安德鲁·休伯曼：
However, there's a strong genetic component for anorexia.
然而，厌食症有很强的遗传因素。
So you can imagine a mild form of anorexia in a parent that is supported or exacerbated by praise, so that the person feels good from the praise they're getting, that they want to be a low body weight, for whatever reason, for aesthetic reasons or for whatever reasons that happen to appeal to them.
所以你可以想象，父母有一种轻微的厌食症，这种厌食症会因表扬而加剧或加剧，这样孩子就会因为得到的表扬而感觉良好，他们想要降低体重，无论出于何种原因，出于审美原因或出于任何恰好吸引他们的原因。
And the child has a genetic predisposition.
而且孩子有遗传倾向。
We never think about genes in terms of controlling behavior.
我们从来没有从控制行为的角度来思考基因。
Genes bias probabilities for behavior.
基因对行为的偏差概率。
So you can have a gene for depression or for schizophrenia, but it's not deterministic in the same way that there are genes that determine your eye color or your skin color or your hair color.
因此，你可能拥有抑郁症或精神分裂症的基因，但它并不像基因决定你的眼睛颜色、肤色或头发颜色那样是确定性的。
So there's a genetic predisposition there, and that genetic predisposition could exist such that if one is rewarded enough times for a particular behavior, that behavior can start to ratchet into our neural circuitry, because behavior drives neural changes, so-called neuroplasticity, and you could imagine that that child could develop a full blown case of anorexia.
因此，那里有一种遗传倾向，这种遗传倾向可能存在，如果一个人因某种特定行为而得到足够多的奖励，这种行为就会开始影响我们的神经回路，因为行为会驱动神经变化，即所谓的神经可塑性，你可以想象那个孩子可能会患上全面的厌食症。
Andrew Huberman:
安德鲁·休伯曼：
And this is why I raised at the beginning that no one really knows how to define healthy eating, and so therefore we have to rely on just identification of unhealthy behaviors.
这就是为什么我一开始就提出没有人真正知道如何定义健康饮食，因此我们只能依靠对不健康行为的识别。
But what do we point people to in terms of what healthy replacement behaviors would be?
但我们要向人们指出什么是健康的替代行为呢？
So rather than just look at anorexics and say they're not eating enough, and there's this huge array of terrible things that they're doing to their body, and they need to eat more — we need to rescue them from themselves.
因此，我们不能只看到厌食症患者就说他们吃得不够，他们对自己的身体做了很多可怕的事情，他们需要吃更多——我们需要把他们从自己的手中拯救出来。
Let's look under the hood.
让我们看看幕后情况。
Let's look at what's known about the neural circuitry, and the sorts of perceptions and behaviors the neural circuitry is driving, in order to understand what they are truly suffering from at the level of cause.
让我们看看对神经回路的了解，以及神经回路驱动的感知和行为的种类，以便在原因层面上了解他们真正遭受的痛苦。
Not just symptoms.
不仅仅是症状。
Andrew Huberman:
安德鲁·休伯曼：
It's clear what they're suffering from at the level of symptoms.
从症状层面就可以清楚地看出他们所遭受的痛苦。
Symptoms are how we diagnose.
症状是我们诊断的方式。
I listed off a number of those things, but let's look under the hood and try and identify where one could intervene, in theory, in order to try and rescue the anorexic, or help the anorexic rescue themselves.
我列出了其中一些事情，但让我们深入了解一下，并尝试找出理论上可以进行干预的地方，以便尝试拯救厌食症患者，或者帮助厌食症患者拯救自己。
Because it turns out that the answer, or at least one of the answers of how to do that, is not intuitive at all, at least to me was very surprising.
因为事实证明，答案，或者至少是如何做到这一点的答案之一，根本不直观，至少对我来说非常令人惊讶。
I would be remiss if I didn't start with the obvious, which is, is there a chemical defect?
如果我不从显而易见的问题开始，那就是我的失职，即是否存在化学缺陷？
Meaning is there some disruption in one of the major chemical systems in the brain that makes anorexics anorexic, and therefore, can we replace that chemical, or can we reduce some chemical and essentially eliminate anorexia?
这意味着大脑中导致厌食症的主要化学系统之一出现了某种破坏，因此，我们可以更换该化学物质，还是可以减少某些化学物质并从根本上消除厌食症？
And the answer is not really, sort of, maybe, no. Here's why.
答案是否定的，也许，不是。原因如下。
There are a lot of different chemicals in the brain and body ...
大脑和身体中有很多不同的化学物质......
Andrew Huberman:
安德鲁·休伯曼：
Here's why.
原因如下。
There are a lot of different chemicals in the brain and body, but there are a category of chemicals that are particularly important, that if you've listened to this podcast before, even if you haven't, are going to come up again and again and again.
大脑和身体中有很多不同的化学物质，但有一类化学物质特别重要，如果你以前听过这个播客，即使你没有听过，也会一次又一次地出现。
And that is the category of chemicals in the brain and body called the neuromodulators.
这就是大脑和身体中的一类化学物质，称为神经调节剂。
Neuromodulators are different than neurotransmitters in the sense that neuromodulators modulate or change the activity of brain areas in neurocircuits.
神经调节剂与神经递质不同，神经调节剂调节或改变神经回路中大脑区域的活动。
You can think of them as microphones that are held between particular sets of connections in the brain that make those connections in the brain more likely to be active relative to others.
你可以把它们想象成麦克风，放置在大脑中特定的连接组之间，使大脑中的这些连接相对于其他连接更有可能活跃。
Okay?
好的？
They make them louder, so to speak.
可以这么说，它们让声音变得更大声。
There are many neuromodulators, but the ones that are important, for sake of today's discussion, are the classic ones: dopamine, acetylcholine, norepinephrine, and serotonin.
神经调节剂有很多，但就今天的讨论而言，最重要的是经典的：多巴胺、乙酰胆碱、去甲肾上腺素和血清素。
Let's focus on serotonin.
让我们关注血清素。
Andrew Huberman:
安德鲁·休伯曼：
Serotonin is a neuromodulator that tends to increase the activity of certain neural circuits, including within the hypothalamus, but also within the body.
血清素是一种神经调节剂，往往会增加某些神经回路的活动，包括下丘脑内的神经回路，也包括体内的神经回路。
That trigger a sense of satiety of having enough, enough food, enough warmth, enough social connection, enough of any motivated goal or drive, or any type of thing or behavior that one would want more of.
这会引发一种满足感，即拥有足够的食物、足够的温暖、足够的社交联系、足够的任何有动机的目标或动力，或者人们想要更多的任何类型的事物或行为。
Serotonin tends to make those circuits quiet down.
血清素往往会使这些回路安静下来。
Now, there are many categories of drugs that emphasize the serotonergic circuitry, meaning they cause the release of, or the efficiency of, serotonin in the brain and body.
现在，有许多类别的药物强调血清素能回路，这意味着它们会导致大脑和身体中血清素的释放或效率。
Things like Prozac, Zoloft, Paxil, things of that variety.
像百忧解、左洛复、帕罗西汀之类的东西。
Those drugs have been used to some degree of success, although not much, to treat things like anorexia nervosa.
这些药物在治疗神经性厌食症等疾病方面已取得一定程度的成功，尽管效果不大。
That should make sense, because if these drugs increase serotonin, if their general effect is to increase serotonin, it will be to lower anxiety.
这应该是有道理的，因为如果这些药物增加血清素，如果它们的总体作用是增加血清素，那么它将降低焦虑。
That sounds like a great thing.
这听起来是一件很棒的事情。
Andrew Huberman:
安德鲁·休伯曼：
A lot of anorexics are really anxious around food.
许多厌食症患者对食物感到非常焦虑。
We'll talk about why.
我们将讨论原因。
Lowering anxiety you might think would lead to ingestion of more food, but that's not often what happens.
您可能认为降低焦虑会导致摄入更多食物，但事实并非如此。
Increasing serotonin by way of some drug regimen will tend to make one less hungry, because with heightened levels of serotonin in the blood and brain, there isn't the desire to go seek out the things that will raise serotonin on their own.
通过某种药物疗法增加血清素往往会减少饥饿感，因为随着血液和大脑中血清素水平的升高，人们不再愿意去寻找能够自行提高血清素的东西。
Now, some anorexics do well or benefit from these serotonergic drugs, these drugs that increase the activity, these circuits that lead to satiety.
现在，一些厌食症患者表现良好或受益于这些血清素能药物，这些药物可以增加活性，这些回路可以带来饱腹感。
But if you think about the major goal of treating an anorexic, it's to get them to have more hunger, more appetite.
但如果你考虑一下治疗厌食症的主要目标，那就是让他们有更多的饥饿感和食欲。
Andrew Huberman:
安德鲁·休伯曼：
So now I want to focus on some of the work that's been done around the habits and behaviors of anorexics, because those turned out to be ideal places for intervention.
所以现在我想重点关注围绕厌食症患者的习惯和行为所做的一些工作，因为这些结果被证明是干预的理想场所。
The work I'm about to describe was done by Dr. Joanna Steinglass and colleagues at Columbia University in New York, and there are other groups as well — of course they're doing this type of work.
我将要描述的工作是由纽约哥伦比亚大学的乔安娜·斯坦格拉斯博士和同事完成的，还有其他小组——当然他们也在做这种类型的工作。
But they did what I think are really some beautiful experiments, and some beautiful explorations of potential treatments for anorexics that seem to have a quite high degree of effectiveness when they are applied correctly.
但他们做了我认为确实是一些美丽的实验，以及对厌食症潜在治疗方法的一些美丽探索，当正确应用时，这些治疗似乎具有相当高的有效性。
Andrew Huberman:
安德鲁·休伯曼：
First of all, there's a challenge in studying anorexia, because in anorexia, what you're essentially studying is the absence of a behavior.
首先，研究厌食症是一个挑战，因为在厌食症中，你本质上研究的是行为的缺失。
It's very hard to study the absence of a behavior, as opposed to a behavior.
与研究一种行为相反，研究一种行为的缺失是非常困难的。
So they did some experiments with anorexics, giving them a gallery of pictures of different foods, and allowing those anorexic patients to arrange those foods according to preference about what they would select, about food nutrient content, about caloric content.
因此，他们对厌食症患者做了一些实验，给他们一系列不同食物的图片，让厌食症患者根据他们的选择、食物营养成分和热量含量的偏好来排列这些食物。
They essentially asked these anorexics to evaluate food, and in doing so, they were able to identify something that's very unique to anorexic at the level of their perception of food.
他们本质上要求这些厌食症患者评估食物，这样做时，他们能够在厌食症患者对食物的感知水平上识别出一些非常独特的东西。
What they found is that anorexics, rather than being anxious in the presence of food and that anxiety driving an avoidance of food, what they found is that anorexic have a hyperacuity, a hyperawareness of the fat content of foods, almost to the point of being sort of fat-content savants.
他们发现，厌食症患者并不是在食物存在时感到焦虑，也不是因为焦虑而回避食物，而是厌食症患者有一种超敏锐度，对食物的脂肪含量有高度的认识，几乎达到了某种脂肪含量专家的程度。
Andrew Huberman:
安德鲁·休伯曼：
Now, they don't necessarily know that they're doing this.
现在，他们不一定知道自己正在这样做。
They're not looking at an avocado and thinking, "Okay, that's X number of grams of fat," or looking at an apple and saying, "Okay, that has no fat." They start to do this more or less reflexively.
他们不会看着鳄梨然后想：“好吧，那是 X 克脂肪”，或者看着苹果说：“好吧，那没有脂肪。”他们开始或多或少条件反射地这样做。
Now it's a well-known symptom of anorexia, especially young anorexics, that they have kind of an obsession with food caloric contents, macronutrient ratios, meaning fat, protein and carbohydrate ratios.
现在，这是厌食症的一个众所周知的症状，尤其是年轻的厌食症患者，他们对食物的热量含量、常量营养素比例（即脂肪、蛋白质和碳水化合物的比例）有某种痴迷。
They know caloric numbers, but then they sort of pass that information into a memory system in their brain that allows their interactions with food to be very reflexive, in a way that they are actively avoiding high-fat-content foods, calorie-rich foods, and defaulting towards very low-calorie foods if they have to eat.
他们知道热量数字，但随后他们会将这些信息传递到大脑的记忆系统中，从而使他们能够非常反射性地与食物互动，从而积极避免高脂肪食物、高热量食物，并且在必须吃东西时默认选择热量非常低的食物。
Andrew Huberman:
安德鲁·休伯曼：
Now, this might seem like an almost trivial result, on the face of it; you think, "Okay, they don't like to eat.
现在，从表面上看，这似乎是一个微不足道的结果。你会想：“好吧，他们不喜欢吃东西。
When they do eat, they eat low-calorie, low-fat foods.
当他们吃饭时，他们吃低热量、低脂肪的食物。
Duh." But it's the way in which they are doing this subconsciously, that they learn this information and then they pass it off to a reflexive habit.
呃。”但这是他们潜意识地这样做的方式，他们学习这些信息，然后将其传递给一种反射性的习惯。
And that's very important, because what that means is that we need to look at what processes in the brain, what brain areas, what chemicals drive decision-making and knowledge.
这非常重要，因为这意味着我们需要研究大脑中的哪些过程、哪些大脑区域、哪些化学物质驱动决策和知识。
And we also need to look at the areas of the brain that drive habit formation and habit execution.
我们还需要研究大脑中驱动习惯形成和习惯执行的区域。
Because for any of you that have habits, and that means all of you, the hallmark feature of a habit is that it's reflexive.
因为对于你们任何一个有习惯的人来说，这意味着你们所有人，习惯的标志性特征就是它是反射性的。
You have a mosquito bite on your leg, you scratch it.
你腿上被蚊子咬了，你抓挠它。
You didn't necessarily even think, "Oh, I'm going to scratch that."
你甚至不一定会想：“哦，我要解决这个问题。”
Andrew Huberman:
安德鲁·休伯曼：
In fact, just to take a little bit of a moment of respite and talk about habits, in general, there's a beautiful study that was done out of Caltech University, looking at the parking lot of where people park in the morning without designated parking spots and the trajectories that they use to walk to their offices in the morning.
事实上，只是为了稍微休息一下，谈谈习惯，一般来说，加州理工大学做了一项很棒的研究，观察了人们早上在没有指定停车位的情况下停车的停车场，以及他们早上步行到办公室的轨迹。
So they put cameras up on the roof at Caltech, this is the kind of thing that the nerdy kids at Caltech do.
所以他们在加州理工学院的屋顶上安装了摄像头，这就是加州理工学院的书呆子们所做的事情。
I think at Caltech, if you call someone a nerd, I think it's a compliment.
我认为在加州理工学院，如果你称某人为书呆子，我认为这是一种恭维。
So my apologies to the non-nerds at Caltech, I think there's one or two of you, and for the nerdy ones of you at Caltech, you're welcome.
所以我向加州理工学院的非书呆子们道歉，我想你们中有一两个人，对于加州理工学院的书呆子们，不客气。
They videotaped the behaviors of these faculty and students and staff, and what they found is that people follow trajectories from their car that are remarkably stereotyped.
他们对这些教职员工的行为进行了录像，他们发现人们在车内遵循的轨迹是非常刻板的。
Andrew Huberman:
安德鲁·休伯曼：
First of all, they tend to park always in the same spot.
首先，他们倾向于总是把车停在同一个地方。
If they can.
如果他们可以的话。
They tend to get out of their car, of course, because they're on the driver's side or passenger side, in the same place.
当然，他们倾向于下车，因为他们在驾驶员一侧或乘客一侧，在同一个地方。
They turn and pivot their body at approximately the same rate every day.
他们每天以大致相同的速度转动和旋转身体。
They close the door, they put their bag on their shoulder or across their chest, or however it is that they carry their briefcase or whatever it is, and they follow trajectories onto campus that are so stereotyped that you'd wonder; if you just trace line after line after line, what you'd find is that every day is almost exactly the same.
他们关上门，把书包扛在肩上或跨在胸前，或者不管怎样，他们带着公文包或其他什么东西，他们沿着校园的轨迹进入校园，这些轨迹是如此刻板，以至于你会想知道；如果你一行一行地追踪，你会发现每一天都几乎一模一样。
And you do this too.
而你也这样做。
You don't realize it because if you're being videotaped doing this kind of behavior, it's not being released to you.
你没有意识到这一点，因为如果你的这种行为被录像，它不会被发布给你。
But your behaviors are so stereotyped to the point where if you were to see them laid out in front of you in kind of diagrammatic format of the lines and the trajectories that you follow throughout the day, the lifting of your mug and how frequently you drink each hour, you would be amazed and probably a little bit scared by how much of a robot we all are.
但你的行为是如此刻板，以至于如果你看到它们以图表形式呈现在你面前，包括你一天中所遵循的线条和轨迹、举起杯子的动作以及你每小时喝水的频率，你会感到惊讶，甚至可能有点害怕，因为我们都是一个机器人。
Andrew Huberman:
安德鲁·休伯曼：
Now, that robotic aspect of our neurocircuitry is vital, because it's what allows us to think about other things and do other things and drive other behaviors.
现在，我们神经回路的机器人方面至关重要，因为它使我们能够思考其他事情、做其他事情并驱动其他行为。
But the work of Dr. Steinglass and colleagues showed that in the case of the anorexic, those habits are exactly the place where things start to go awry and that drive this very dysfunctional undereating behavior, that sadly often leads to death, or certainly bad medical outcomes.
但斯坦格拉斯博士及其同事的研究表明，对于厌食症患者来说，这些习惯正是事情开始出错的地方，并导致了这种非常不正常的饮食不足行为，可悲的是，这种行为常常导致死亡，或者肯定会导致不良的医疗结果。
And it turns out that the brain areas associated with habit formation and execution are the best point of intervention.
事实证明，与习惯形成和执行相关的大脑区域是最佳干预点。
Andrew Huberman:
安德鲁·休伯曼：
So what Dr. Steinglass and colleagues did is they took anorexics, and they of course had control groups, and they put them in an FMRI scanner, which are these brain scanners that allow you to evaluate which brain areas are active during particular tasks.
Steinglass 博士和同事所做的就是服用厌食症患者，当然还有对照组，然后将他们放入 FMRI 扫描仪中，这些大脑扫描仪可以让你评估哪些大脑区域在特定任务中处于活跃状态。
And because when you're in one of those scanners — I've actually been in one of these things — you're biting down on a bite bar, and most of the time, in most all of these scanners, you're immobile.
因为当你在其中一台扫描仪中时——我实际上已经在其中一台扫描仪中——你会咬住咬杆，而大多数时候，在大多数这些扫描仪中，你是一动不动的。
So you're looking at things on a TV screen; sometimes you can press buttons to select choices and so forth, but you can't really eat within those things.
所以你在电视屏幕上看东西；有时你可以按按钮来选择选项等等，但你不能真正在这些东西里吃饭。
Andrew Huberman:
安德鲁·休伯曼：
What they found was that reward-based decision-making, the drive to pursue a particular food or the drive to perform a particular task, which is a lot of what we do throughout our day, that was controlled by a brain area called the ventromedial prefrontal cortex.
他们发现，基于奖励的决策，追求特定食物的动力或执行特定任务的动力，这是我们全天所做的很多事情，是由称为腹内侧前额叶皮层的大脑区域控制的。
Let me simplify a little bit of this, but I'm going to simplify it by giving you a little detail, because it's the Huberman Lab podcast, and I believe in mechanism.
让我稍微简化一下，但我将通过给你一些细节来简化它，因为这是 Huberman Lab 播客，我相信机制。
Mechanism is the way that you get true understanding and that you can then be very quick and give overviews of things, but you need the mechanism.
机制是你获得真正理解的方式，然后你可以非常快速地概述事物，但你需要机制。
Andrew Huberman:
安德鲁·休伯曼：
So you have reflexes, and you have neural processes that include what are called duration, path and outcome-type processes.
所以你有反应，你有神经过程，包括所谓的持续时间、路径和结果类型的过程。
A duration, path outcome-type process we can shorten with DPO.
我们可以通过 DPO 缩短持续时间、路径结果类型的流程。
DPO is for all types of goal-related behaviors.
DPO 适用于所有类型的目标相关行为。
So for instance, if you want to get a particular grade on an exam, you want to learn something, you want to complete a workout, you want to go to the grocery store and pick some stuff up and then head home, you're going to think duration, "How long do I have?
举例来说，如果你想在考试中获得特定的成绩，你想学习一些东西，你想完成锻炼，你想去杂货店买一些东西然后回家，你会考虑持续时间，“我还有多长时间？
Okay, do I have 45 minutes to get to the store?
好的，我有 45 分钟时间去商店吗？
How long does it take to get to the store," path, "Which way am I going to drive there?
到商店需要多长时间，”path，“我要开车去哪条路？
Which way am I going to navigate through the grocery store?" Outcome, "Was I able to get in, get the items I need and get home in time?" Okay, DPO: duration, path, outcome; it's a very conscious process.
我要在杂货店里走哪条路？”结果，“我能进去，拿到我需要的物品并及时回家吗？”好的，DPO：持续时间、路径、结果；这是一个非常有意识的过程。
Andrew Huberman:
安德鲁·休伯曼：
You tend to take into account different criteria related to what's in, what's preventing you from accomplishing what you want to do, and what's helping you or assisting you.
您倾向于考虑与内容相关的不同标准，什么阻碍您完成您想做的事情，以及什么对您有帮助或帮助您。
So, of course, as you get to the checkout line in the grocery store, you're going to select the shortest line, for instance.
因此，例如，当您到达杂货店的收银台时，您当然会选择最短的队伍。
So that's all DPO stuff.
这就是 DPO 的全部内容。
It requires decision-making and it's reward-based.
它需要决策并且基于奖励。
You use these DPO-type processes in the short term to pick up groceries and pick a line at the grocery store and decide which trajectory to take home.
您可以在短期内使用这些 DPO 类型的流程来提货并在杂货店挑选一条路线并决定带回家的路线。
And you use them for navigating long, extended processes in life, trying to get a degree or raise children or get through a particularly challenging year, et cetera.
你用它们来引导生活中漫长的过程，试图获得学位或抚养孩子或度过特别具有挑战性的一年等等。
So duration, path, outcome, and that entire process relies on your forebrain, this prefrontal cortex.
因此，持续时间、路径、结果以及整个过程都依赖于你的前脑，即前额叶皮层。
Andrew Huberman:
安德鲁·休伯曼：
The prefrontal cortex is what allows you to take information from memory, combine it with information about what's happening in the present context, and then to direct your behavior, your speech, et cetera, toward particular outcomes.
前额叶皮层可以让你从记忆中获取信息，将其与当前环境中发生的事情的信息结合起来，然后指导你的行为、言语等，以达到特定的结果。
And if all that sounds like a mouthful, it is.
如果这一切听起来像是拗口的话，确实如此。
And it's very metabolically demanding.
而且它对新陈代谢的要求很高。
Decision-making is metabolically demanding.
决策对新陈代谢的要求很高。
It takes effort, okay?
这需要努力，好吗？
Andrew Huberman:
安德鲁·休伯曼：
Reflexes on the other hand, don't involve the prefrontal cortex in the same way — habits and reflexes.
另一方面，反射并不以同样的方式涉及前额皮质——习惯和反射。
Like once you know how to walk, you get up and you walk.
就像一旦你知道如何走路，你就会站起来走路。
You don't have to think about right foot, left foot, right foot, left foot, you just do it.
你不必考虑右脚、左脚、右脚、左脚，你只要去做就可以了。
That doesn't rely on prefrontal cortex, it's subconscious, as it's sometimes called, but basically you don't have to use the parts of the brain that are involved in duration, path and outcome-type analysis.
这并不依赖于前额叶皮层，它是潜意识的，有时也被称为潜意识，但基本上你不必使用大脑中涉及持续时间、路径和结果类型分析的部分。
Okay?
好的？
Andrew Huberman:
安德鲁·休伯曼：
So in this particular study, they examined brain activity in anorexics who are selecting different foods.
因此，在这项特殊的研究中，他们检查了选择不同食物的厌食症患者的大脑活动。
And as I mentioned earlier, they have a hyperacuity or awareness of which foods contain more or less calories than other foods, and what the fat content of particular foods is, in particular, et cetera.
正如我之前提到的，他们对哪些食物比其他食物含有更多或更少的热量，以及特定食物的脂肪含量是多少等具有超敏锐度或意识。
They're doing all this while in a scanner, and then they look at what sorts of brain areas are active after that task is done.
他们在扫描仪中完成所有这些工作，然后他们观察任务完成后哪些大脑区域处于活动状态。
And what they found was really interesting.
他们的发现非常有趣。
What they found was that the dorsal lateral prefrontal cortex, not surprisingly, is involved in the decision-making and the evaluation of this food.
他们发现，毫不奇怪，背外侧前额叶皮层参与了对这种食物的决策和评估。
Which foods are going to be best to eat in this context, which foods are going to be appropriate for, at least that anorexic's framework about what's okay to eat and what's not okay to eat and how much.
在这种情况下，哪些食物最好吃，哪些食物适合吃，至少厌食症患者有关于什么可以吃、什么不可以吃以及吃多少的框架。
Andrew Huberman:
安德鲁·休伯曼：
However, there are areas of the brain that were active after that decision-making process.
然而，在决策过程之后，大脑的某些区域变得活跃。
And those are the brain areas that turn out to drive the habit of avoiding particular foods and approaching other foods.
这些大脑区域最终导致人们养成避免特定食物和接近其他食物的习惯。
And in that case, it wasn't the dorsal lateral prefrontal cortex, it was an area of the brain called the dorsal lateral striatum.
在这种情况下，它不是背外侧前额叶皮层，而是大脑中称为背外侧纹状体的区域。
Andrew Huberman:
安德鲁·休伯曼：
Now the striatum is a big area in the brain.
现在纹状体是大脑中的一个大区域。
It's involved in a lot of different things.
它涉及很多不同的事情。
It includes areas like the caudate and putamen.
它包括尾状核和壳核等区域。
And I just want to mention as I throw out all these names, you do not need to remember the names of these different structures.
我只想提一下，当我抛出所有这些名称时，您不需要记住这些不同结构的名称。
They're just there if you are interested in that level of detail.
如果您对这种程度的细节感兴趣，它们就在那里。
But basically, you have a brain area, and anorexics have a brain area that's involved in evaluating and decision-making around food, and then another brain area that's involved in the reflexive consumption of particular foods and the reflexive avoidance of other foods.
但基本上，你有一个大脑区域，厌食症患者有一个大脑区域参与对食物的评估和决策，然后另一个大脑区域参与反射性消费特定食物和反射性避免其他食物。
Andrew Huberman:
安德鲁·休伯曼：
If you remember way back at the beginning of the episode, I feel like that was a long time ago now, when we talked about how you have these sorts of processes in the brain, but there are always homeostatic and reward systems influencing this kind of thing.
如果你还记得本集开头的内容，我觉得那是很久以前的事了，当时我们讨论了大脑中如何进行这些过程，但总是有稳态和奖励系统影响这种事情。
Well, in the brain of the anorexic, it turns out that the reward systems have been attached to the execution of habits in a way that is unhealthy for body weight.
事实证明，在厌食症患者的大脑中，奖励系统以一种对体重不健康的方式与习惯的执行联系在一起。
But at least from a purely neural circuit perspective, the reward is now given, this chemical reward in the brain, is given for avoiding particular foods and only approaching these very low-calorie, low-fat foods.
但至少从纯粹的神经回路角度来看，现在给予奖励，大脑中的这种化学奖励是为了避免特定食物而只接近这些非常低热量、低脂肪的食物。
Andrew Huberman:
安德鲁·休伯曼：
So there really does seem to be a flip in the switch in the anorexic brain that rewards them internally.
因此，厌食症患者的大脑中的开关似乎确实发生了翻转，从而在内部奖励了他们。
They feel good when they avoid certain foods and they approach others.
当他们避免某些食物并接近其他食物时，他们会感觉良好。
So it's not a deprivation-based model, where they are flagellating themselves, or masochistic or actively avoiding food in order to punish themselves, which is interesting because a lot of psychological theories support that idea.
所以这不是一个基于剥夺的模型，在这种模型中，他们鞭打自己，或者受虐狂或主动避免食物以惩罚自己，这很有趣，因为很多心理学理论都支持这个想法。
Andrew Huberman:
安德鲁·休伯曼：
Rather, once this transitions into a set of habits, they are actually getting a sense of reward.
相反，一旦这转变为一系列习惯，他们实际上就会获得一种奖励感。
They feel good, presumably from the release of a different neuromodulator called dopamine, by approaching foods that are low fat, low calorie content.
他们感觉良好，大概是由于接触低脂肪、低热量的食物时释放了一种叫做多巴胺的不同神经调节剂。
And so their whole brain circuitry is skewed toward avoiding particular things, and they actually are rewarded for that.
因此，他们的整个大脑回路都倾向于避免特定的事情，而他们实际上因此而得到了奖励。
And they feel good.
他们感觉很好。
They feel better than if they were eating in a healthy, weight-supporting way.
他们感觉比以健康、支持体重的方式饮食要好。
Andrew Huberman:
安德鲁·休伯曼：
Now the dorsal lateral striatum is a structure that we should think about in a little bit more depth.
现在，我们应该更深入地思考背外侧纹状体的结构。
It's part of a set of circuits that are involved in what are called "go, no go" tasks.
它是参与所谓“进行、不进行”任务的一组电路的一部分。
And I don't want to go into this in a lot of detail right now, because it would take us too far down the rabbit hole of neural circuitry.
我现在不想详细讨论这个问题，因为这会让我们在神经回路的兔子洞里走得太远。
But basically in terms of behaviors, we both have DPO-type behaviors, so decision-making, reward-based behaviors, and we have habits that we learn and we acquire, and then we just start to execute reflexively things like walking, things like yawning when we're tired, things like taking a particular route through the parking lot, right?
但基本上就行为而言，我们都有DPO类型的行为，所以决策，基于奖励的行为，我们有我们学习和获得的习惯，然后我们就开始条件反射地执行一些事情，比如走路，比如累了打哈欠，比如在停车场走一条特定的路线，对吗？
We learn that the first time we go to a given parking lot and walk into a building, but after that we tend to follow the exact same trajectory.
我们了解到，第一次去某个停车场并走进一座建筑物时，但此后我们倾向于遵循完全相同的轨迹。
It becomes very automatized.
它变得非常自动化。
It's just like we just do it without thinking.
就像我们不假思索地去做一样。
Andrew Huberman:
安德鲁·休伯曼：
Well, the go, no go circuitry is another aspect of our behavior where we both have to select behaviors to perform and we have to select behaviors to suppress.
嗯，走、不走电路是我们行为的另一个方面，我们必须选择要执行的行为，也必须选择要抑制的行为。
And the anorexic brain seems to reward suppression of one set of behaviors, ingestion of high-calorie foods, and to reward focus or even hyperfocus and consumption of low-fat, low-calorie foods.
厌食症大脑似乎会奖励对一组行为的抑制，即摄入高热量食物，并奖励注意力集中甚至过度注意力以及食用低脂肪、低热量食物。
So this homeostatic process that we learn about from high school onward that, oh, everything in your body is designed to keep everything in balance.
所以我们从高中开始就了解到这个稳态过程，哦，你体内的一切都是为了保持平衡而设计的。
You stay awake for a certain amount of time — you want to sleep; you don't eat for a while — then you want to eat to maintain weight, right?
你保持清醒一段时间——你想睡觉；你想睡觉；你想睡觉。你有一段时间不吃东西了——然后你想吃东西来维持体重，对吧？
You eat too much, then you want to eat less.
你吃得太多，然后你想少吃一点。
Those systems are disrupted.
这些系统被破坏了。
Andrew Huberman:
安德鲁·休伯曼：
And so what's so beautiful about this work from the Columbia group is that what it says is the place to intervene has to be the habit.
因此，哥伦比亚小组的这项工作的美妙之处在于，它所说的干预场所必须是习惯。
This stuff has already passed through all the learning.
这东西已经全部学过了。
It's passed through all the reward systems.
它已经通过了所有的奖励系统。
It's clearly not being overrun by the homeostatic processes of the body.
它显然没有被身体的稳态过程所超越。
There's very little body fat, there's no leptin.
体内脂肪很少，没有瘦素。
Whatever neurons in the brain respond to leptin are starved for leptin.
大脑中任何对瘦素有反应的神经元都缺乏瘦素。
Periods have shut down, sperm production and testosterone is lowered, bone density is down.
月经停止，精子生成和睾丸激素降低，骨密度下降。
Clearly this is overriding all those homeostatic processes, all the signals that would say, "Eat, eat, eat." Those don't matter in the brain of the anorexic.
显然，这超越了所有那些稳态过程，所有会说“吃，吃，吃”的信号。这些对于厌食症患者的大脑来说并不重要。
The brain of the anorexic is just performing habits, and they're being rewarded for it.
厌食症患者的大脑只是在执行习惯，而他们却因此而得到奖励。
So when you come along and say, "Look, you should really eat this whole pie or this whole pizza, you'll feel better."
所以当你过来说：“听着，你真的应该吃掉整个馅饼或整个披萨，你会感觉好一些。”
Andrew Huberman:
安德鲁·休伯曼：
That's actually aversive to them.
这实际上是令他们厌恶的。
So since it appears to be a habit, a reflex, that's perpetuating the anorexic phenotype, as we say in science, it's perpetuating anorexia in this individual, and telling them about all this terrible stuff that's happening in their body won't work.
因此，既然这似乎是一种习惯、一种反射，那就是使厌食症表型永久化，正如我们在科学中所说的那样，它使这个人的厌食症永久化，告诉他们体内发生的所有这些可怕的事情是行不通的。
Taking them away from all the images of thin people online, et cetera — that's not going to work.
将它们从网上所有瘦人的图像中删除等等——这是行不通的。
What's going to work?
有什么作用呢？
What's going to work is intervening in the neural circuitry that's related to the habit itself, and it turns out that there are ways to do that.
有效的方法是干预与习惯本身相关的神经回路，事实证明有很多方法可以做到这一点。
Andrew Huberman:
安德鲁·休伯曼：
So how do you break a habit?
那么如何改掉一个习惯呢？
How do you rewire the brain circuitry that's literally causing a reflex, and in this case causing a reflex that is killing the individual, or at least leading to very bad health outcomes?
如何重新连接实际上引起反射的大脑回路，在这种情况下引起的反射会杀死个体，或者至少导致非常糟糕的健康结果？
The way that you do that is through a cognitive mechanism where you teach the individual what is leading up to the habit.
这样做的方式是通过一种认知机制，告诉个体是什么导致了这种习惯。
Andrew Huberman:
安德鲁·休伯曼：
Now, this is a little bit similar to the way that somebody who suffers from addiction starts to put in different constraint-type behaviors.
现在，这有点类似于上瘾的人开始采取不同的约束型行为的方式。
Constraint-type behaviors are the sorts of things like where the alcoholic will call a hotel ahead of time and say, "Listen, I want the minibar taken out of the room.
约束型行为是指酗酒者提前打电话给酒店并说：“听着，我想把迷你吧从房间里拿出来。
I don't want a television in the room," et cetera — constraint-type behaviors.
我不想在房间里放电视”等等——约束型行为。
Those are really ways of keeping oneself from the temptation.
这些确实是让自己远离诱惑的方法。
But with these habits, they work at such a subconscious level that what seems to work best is a combination of teaching the individual about their internal state and how to register their internal state, what we call interoception, this ability to perceive your internal state, so that they can start to learn to associate the interactions with different types of food with the sorts of cues that are occurring within their body: quickening of heart rate, hyperacuity of focus that we talked about earlier.
但有了这些习惯，他们在潜意识层面上发挥作用，似乎最有效的方法是教导个人了解他们的内部状态以及如何记录他们的内部状态，我们称之为内感受，这种感知你的内部状态的能力，这样他们就可以开始学习将与不同类型食物的相互作用与他们体内发生的各种线索联系起来：心率加快，我们之前讨论过的注意力高度集中。
Once they start to be able to notice that those things are happening, then they can start to intervene.
一旦他们开始注意到这些事情正在发生，他们就可以开始干预。
Andrew Huberman:
安德鲁·休伯曼：
So let's talk about what those things are that lead into a habit, because those turn out to be the exact points of entry for changing and eliminating and rewiring habits toward more healthy behaviors.
因此，让我们来谈谈那些导致习惯的因素是什么，因为事实证明，这些因素正是改变、消除和重新调整习惯以实现更健康行为的切入点。
And I should highlight that this isn't just about rewiring habits for sake of the anorexic, these are also the same types of mechanisms that one would want to incorporate in order to rewire any habit of any kind.
我应该强调的是，这不仅仅是为了厌食症患者而重新调整习惯，这些也是人们为了重新调整任何类型的习惯而想要纳入的相同类型的机制。
Andrew Huberman:
安德鲁·休伯曼：
There are two main features of thinking that go into the sorts of habits that anorexics execute.
厌食症患者的习惯有两个主要的思维特征。
The first is something called weak central coherence.
第一个是所谓的弱中心一致性。
Weak central coherence is essentially an inability to see the forest through the trees.
中心相干性弱本质上是无法透过树木看到森林。
It's a hyperacuity and focus on details within a given environment.
这是一种超敏锐度，注重特定环境中的细节。
And there's actually an interesting probe test for anorexia that involves something akin to kind of a Where's Waldo-type puzzle, where an image is put up.
实际上有一个有趣的厌食症探针测试，涉及类似于“沃尔多在哪里”类型的谜题，其中放置了图像。
The one that I saw was one in which there's a big array of coffee beans, actually, they're all brown coffee beans, and your job is to identify where in that array of coffee beans there's a face, and indeed there's a face embedded in there.
我看到的那个里面有一大排咖啡豆，实际上，它们都是棕色咖啡豆，你的工作就是找出那一排咖啡豆中哪里有一张脸，而且确实有一张脸嵌在里面。
It looks a little bit like a coffee bean, but once you see it, you realize it's a face, not a coffee bean, and it becomes very hard to not notice the face after that.
它看起来有点像咖啡豆，但一旦你看到它，你就会意识到这是一张脸，而不是咖啡豆，之后就很难不注意到这张脸了。
Andrew Huberman:
安德鲁·休伯曼：
Anorexics are very good at identifying the face.
厌食症患者非常擅长识别面孔。
They find it much faster than do nonanorexics, which is really interesting, right?
他们发现它比非厌食症患者快得多，这真的很有趣，对吧？
They somehow are able to hone in on details, and find those details and fixate on those details.
他们以某种方式能够磨练细节，找到这些细节并专注于这些细节。
Now, eventually most, if not all, people find the face, but once you do, what you will find and what everyone finds is that you can't find the face.
现在，最终大多数（如果不是全部）人们找到了这张脸，但是一旦你找到了这张脸，你会发现，每个人都会发现，你找不到这张脸。
It just jumps out.
它就跳出来了。
So what essentially you've lost is the ability to see the whole picture because there's some detail within that picture that you're obsessed by.
所以本质上你失去的是看到整个图片的能力，因为图片中的一些细节是你所着迷的。
So this has kind of elements of obsessive-compulsive disorder, but it's not really obsessive-compulsive disorder per se.
所以这有某种强迫症的成分，但它本身并不是真正的强迫症。
So we call that weak central coherence.
所以我们称之为弱中心一致性。
It's a hyperacuity on one particular feature.
这是对某一特定功能的超敏锐度。
You miss the big picture.
你错过了大局。
Andrew Huberman:
安德鲁·休伯曼：
The other is a challenge in set shifting, that once you identify something that's of particular interest and that's driving some sort of reward, for the anorexic, that would be identifying the high fat foods or identifying the one food on the table that one could eat without anyone hopefully noticing that they're eating just the green beans and not touching any of the other food.
另一个是设置转换中的挑战，一旦你确定了一些特别感兴趣的东西，并且为厌食症患者带来了某种奖励，那就是确定高脂肪食物或确定桌子上人们可以吃的一种食物，而没有人希望注意到他们只吃绿豆而没有接触任何其他食物。
If you ever had a meal with an anorexic, you might be familiar with this, it's kind of uncomfortable to be around actually.
如果你曾经和厌食症患者一起吃饭，你可能会熟悉这一点，实际上和他在一起有点不舒服。
They go through a lot of elaborate procedures to kind of hide food.
他们经过许多复杂的程序来隐藏食物。
They'll sometimes even chew food, hold it in their mouth, and then go to the bathroom and discard it.
有时他们甚至会咀嚼食物，将其含在嘴里，然后去洗手间并将其丢弃。
Things very elaborate, very troubling types of things to hear about and to be around.
事情非常复杂，听到和周围的事情非常令人不安。
But you'll notice that they push food around their plate a lot.
但你会注意到他们经常把食物推到盘子里。
They become masterful actually at trying to keep people's awareness away from what they're doing, which is to home in on these low-fat, low-calorie foods.
他们实际上非常擅长让人们的注意力远离他们正在做的事情，即专注于这些低脂肪、低热量的食物。
And they can't seem to set shift.
而且他们似乎无法设置班次。
Andrew Huberman:
安德鲁·休伯曼：
They can't just relax and enjoy the meal because the meal for them is essentially like this Where's Waldo or find the face in the coffee bean task.
他们不能只是放松并享受这顿饭，因为对他们来说，这顿饭本质上就像“沃尔多在哪里”或“在咖啡豆任务中找到面孔”。
They're constantly monitoring how much people are observing them and trying to navigate this, what would otherwise be a really pleasant circumstance for most people, they're trying to navigate through this because, remember, for them the reward is in the avoidance of certain things and the acquiring of only the foods that their brain rewards them for, because those are the foods that have been preselected and are now habit.
他们不断地监测有多少人在观察他们，并试图驾驭这个，否则对大多数人来说，这本来是一个真正令人愉快的环境，他们试图驾驭这个，因为，记住，对他们来说，奖励是避免某些事情，只获得他们的大脑奖励他们的食物，因为这些食物是已经预先选择的，现在已经成为习惯。
Andrew Huberman:
安德鲁·休伯曼：
What's amazing, and frankly also important, are these findings that once you teach anorexics what's happening to them, that they're doing this, they are able to intervene.
令人惊奇且坦率地说也很重要的是，这些发现表明，一旦你教厌食症患者发生了什么，他们正在这样做，他们就能够进行干预。
Now they need support, right?
现在他们需要支持，对吗？
And another form of therapy that seems to work well for anorexics, that ideally is combined with this habit rewiring, is a family-based model.
另一种似乎对厌食症有效的治疗形式是基于家庭的模式，它最好与这种习惯重塑相结合。
Family-based models are starting to surface a lot now in various therapy settings.
基于家庭的模式现在开始在各种治疗环境中大量出现。
Therapy-based models in, short, are basically where the entire family is made aware of the individual's challenges with a particular eating disorder or other disorder, and in understanding some of the biology and psychology around it, they stop condemning the individual.
简而言之，基于治疗的模型基本上是让整个家庭意识到个人对特定饮食失调或其他疾病的挑战，并且在理解周围的一些生物学和心理学时，他们不再谴责个人。
They start to support that individual through queuing them towards their own habits that they observe.
他们开始通过观察他们自己的习惯来支持那个人。
They give them some autonomy.
他们给予他们一些自主权。
They realize that none of this changes overnight, but they're taught about things like neuroplasticity and the ability to change one's brain in response to experience.
他们意识到这一切都不是一朝一夕就能改变的，但他们被教导了诸如神经可塑性和根据经验改变大脑的能力等知识。
And so there's a whole internal support network.
所以有一个完整的内部支持网络。
Andrew Huberman:
安德鲁·休伯曼：
Now for people that live alone, this isn't available to them.
现在对于独居的人来说，这是不可用的。
This isn't the kind of thing that you share with your coworkers.
这不是您与同事分享的事情。
You might involve a close friend or a spouse, but it's not the sort of thing that people that don't live in a family context can really benefit from.
你可能会涉及一位亲密的朋友或配偶，但这并不是那些不在家庭环境中的人真正能从中受益的事情。
All of these things fall under the umbrella of cognitive behavioral therapy.
所有这些都属于认知行为疗法的范畴。
And I should mention that cognitive behavioral therapies are often done in conjunction with pharmacologic therapies.
我应该提到，认知行为疗法通常与药物疗法结合使用。
I think that there's this idea out there that it's either or, when often it's both.
我认为有这样的想法：要么是要么，但通常都是两者。
So cognitive behavioral therapies are often combined with this habit recognition and rewiring approach, which is starting to become more and more common.
因此，认知行为疗法通常与这种习惯识别和重新布线方法相结合，这种方法开始变得越来越普遍。
And I think the data on it look really good, that especially when individuals are taught this early in adolescence, that there are positive outcomes over time.
我认为有关数据看起来非常好，尤其是当个人在青春期早期接受教育时，随着时间的推移会产生积极的结果。
Andrew Huberman:
安德鲁·休伯曼：
The relapse rate of anorexia is quite high.
厌食症的复发率相当高。
It's about 50% of individuals will relapse at some point, often triggered by stressful life circumstance.
大约 50% 的人会在某个时候旧病复发，这通常是由生活压力大的环境引发的。
But the combination of cognitive behavioral therapy that includes this family model, or at least habit reformation, seems to be fairly effective and at present might be the most effective treatment.
但包括这种家庭模式在内的认知行为疗法的组合，或者至少是习惯改造，似乎相当有效，并且可能是目前最有效的治疗方法。
Andrew Huberman:
安德鲁·休伯曼：
Now, there are additional treatments starting to surface, and that takes us into the realm of chemical treatments for anorexia.
现在，更多的治疗方法开始出现，这将我们带入了厌食症的化学治疗领域。
And I just want to mention that there are clinical trials, meaning legal clinical trials, being done at Johns Hopkins School of Medicine by Matthew Johnson, and others, exploring how drugs like MDMA, which increases dopamine and serotonin to very high levels; or psilocybin, so-called magic mushrooms, which increases serotonin and other compounds to very high levels, within the confines of a professionally supported therapeutic environment, can help people rewire their brain such that they can get relief from major depression and various forms of trauma.
我只想提一下，马修·约翰逊（Matthew Johnson）等人在约翰霍普金斯大学医学院进行了临床试验，即合法的临床试验，探索像 MDMA 这样的药物如何将多巴胺和血清素提高到非常高的水平；或裸盖菇素，即所谓的神奇蘑菇，可在专业支持的治疗环境范围内将血清素和其他化合物提高到非常高的水平，可以帮助人们重新连接大脑，从而缓解严重抑郁症和各种形式的创伤。
And now eating disorders are also being explored in the context of MDMA and psilocybin clinical trials.
现在，饮食失调也在 MDMA 和裸盖菇素临床试验的背景下进行探索。
Andrew Huberman:
安德鲁·休伯曼：
I do want to emphasize that those are clinical trials, that those compounds are not yet legal and, in many cases, most cases, they are still illegal.
我确实想强调，这些都是临床试验，这些化合物尚未合法，而且在很多情况下，大多数情况下，它们仍然是非法的。
I do not think that they should be explored without a properly trained medical doctor; that the clinical trials are essential to complete before one explores those compounds.
我认为，如果没有经过适当培训的医生，就不应该对它们进行探索；在探索这些化合物之前，必须完成临床试验。
In particular, because lately I get a lot of emails about these compounds, people telling me that they've had amazing experiences and relief from various things, not just eating disorders but depression, et cetera.
特别是，因为最近我收到了很多关于这些化合物的电子邮件，人们告诉我他们获得了令人惊奇的经历并从各种事情中得到缓解，不仅仅是饮食失调，还有抑郁症等等。
However, I get an equal number of emails from people saying that they worked with some self-appointed guide.
然而，我收到同样数量的电子邮件，人们说他们与一些自封的向导一起工作。
This would be outside the clinical trials I was referring to, and they are now experiencing chronic visual snow.
这不属于我所指的临床试验范围，他们现在正在经历慢性视觉雪花。
They're getting genuine visual field deficits.
他们出现了真正的视野缺陷。
They are having tics that they never had before.
他们出现了以前从未有过的抽动症状。
They have chronic insomnia.
他们患有慢性失眠症。
Andrew Huberman:
安德鲁·休伯曼：
So I'm not passing judgment on any of these compounds or the people that are doing this sort of thing.
所以我不会对任何这些化合物或正在做这类事情的人做出判断。
I just want to see the clinical data.
我只是想看看临床数据。
And I do believe that we should wait until these clinical trials are done before people start approaching this stuff.
我确实相信我们应该等到这些临床试验完成之后人们才开始接触这个东西。
And that's because they are serious compounds.
那是因为它们是严重的化合物。
They can open plasticity, but whether or not they "work" for different types of eating disorders or depression and trauma, the data are looking promising, but the clinical trials are still not done.
它们可以打开可塑性，但无论它们是否对不同类型的饮食失调或抑郁症和创伤“有效”，数据看起来很有希望，但临床试验尚未完成。
And I know a number of people are going out of the U.S. and into other countries where this stuff is being done more regularly.
我知道很多人正在离开美国，前往其他经常进行此类活动的国家。
And there too, I've gotten reports back of people doing so-called ibogaine treatments.
在那里，我也收到了人们进行所谓的伊博加因治疗的报告。
Some of you who are familiar with eating disorders will immediately be asking, "Well, what about ibogaine?
一些熟悉饮食失调的人会立即问：“那么，伊博加因怎么样？
Does it work?
有效吗？
Does it work?"
有用吗？”
Andrew Huberman:
安德鲁·休伯曼：
Well, the clinical trials in this country are not complete.
嗯，这个国家的临床试验还没有完成。
I've heard evidence direct ...
我直接听到证据...
I've heard directly from people who have benefited from the sorts of things for treatment of eating disorders.
我直接从那些从治疗饮食失调的药物中受益的人那里听说过。
But I've also heard of people that have developed chronic seizure disorders from pursuing things like ibogaine for the treatment of eating disorders.
但我也听说有人因寻求伊博加因等治疗饮食失调的药物而患上慢性癫痫症。
So again, I'm not passing judgment.
再说一次，我不会做出判断。
I would just like to see more data.
我只是想查看更多数据。
And it's very important that the safety, aspects of safety be in place.
安全、安全方面的落实到位非常重要。
So this is definitely not something to get renegade about.
所以这绝对不是什么值得背叛的事情。
Andrew Huberman:
安德鲁·休伯曼：
So it appears that once anorexia is established, that habit breaking through self-awareness of what the habits are is going to be a primary entry point.
因此，一旦形成厌食症，突破自我意识的习惯将成为主要的切入点。
That might seem kind of trivial.
这可能看起来有点微不足道。
You might say, "Well, couldn't you have just told us that in one sentence?" But I want to return us to this model about homeostatic processes, reward processes, et cetera.
您可能会说：“好吧，您不能用一句话告诉我们吗？”但我想让我们回到这个关于稳态过程、奖励过程等的模型。
That leads us to a place where the short answer is no. You can't simply say break the habit.
这将我们引向一个简单的答案是否定的地方。你不能简单地说打破这个习惯。
Andrew Huberman:
安德鲁·休伯曼：
An individual needs to be informed about where that habit comes from and the fact that what currently seems like a rewarded habit should actually be a punished habit.
一个人需要知道这种习惯从何而来，以及目前看来是奖励习惯实际上应该是惩罚习惯这一事实。
Now, I don't mean by actual punishment, but what I mean is within the brain, there's been a switch, and the anorexic needs to learn that there's been a switch, such that what should be rewarding is now punished and what should be punished, starvation, is now rewarded.
现在，我指的不是实际的惩罚，而是在大脑内部，发生了一个转换，厌食症患者需要知道已经发生了一个转换，这样应该奖励的东西现在受到了惩罚，而应该受到惩罚的东西，饥饿，现在得到了奖励。
The beauty of being a human being is that knowledge of knowledge can allow you to make better decisions.
做人的美妙之处在于知识的知识可以让你做出更好的决定。
I'll say that again.
我再说一遍。
The beauty of being a human being is that knowledge of knowledge can allow you to make better decisions.
做人的美妙之处在于知识的知识可以让你做出更好的决定。
Now, of course, when we are anxious, when we are tired, when we are intoxicated, we have less access to that ability to use knowledge of knowledge to intervene.
当然，现在，当我们焦虑、疲倦、陶醉时，我们就很难获得利用知识的知识进行干预的能力。
Andrew Huberman:
安德鲁·休伯曼：
The anorexic will often do things that are in keeping with their habits such as overexercising.
厌食症患者经常会做一些符合他们习惯的事情，比如过度运动。
This is an area that anyone who's treated anorexics or interacted with anorexics is well aware of, that they are constantly moving.
任何接受过厌食症治疗或与厌食症患者有过接触的人都清楚地意识到，他们在不断地移动。
They're constantly on the treadmill, they're constantly running.
他们不断地在跑步机上，不断地跑步。
They always want to be moving and burning calories so that they can feel okay about interacting with food, or because they have the distorted body image.
他们总是想要运动并燃烧卡路里，这样他们就可以在与食物的互动中感觉良好，或者因为他们的身体形象扭曲了。
Well, does breaking a habit mean that they should stop moving around and exercising?
那么，打破习惯是否意味着他们应该停止四处走动和锻炼？
No, not necessarily.
不，不一定。
There's some really interesting studies that show that shifting anorexics towards activities that, for instance, build muscle — resistance training — and allow them to eat a bit more food without necessarily losing weight, but rather to put more muscle on their body can actually be beneficial.
有一些非常有趣的研究表明，将厌食症患者转向锻炼肌肉（阻力训练）等活动，让他们多吃一点食物，但不一定能减肥，而是让他们的身体增加更多肌肉，实际上是有益的。
Andrew Huberman:
安德鲁·休伯曼：
Now, I'm not talking about anorexics becoming bodybuilders.
现在，我不是在谈论厌食症患者成为健美运动员。
There's a whole body dysmorphia associated with body building, but certain forms of exercise are just catabolic, meaning they break down the amount of muscle, they reduce body weight overall.
与健美运动相关的是全身畸形，但某些形式的运动只是分解代谢，这意味着它们会分解肌肉量，从而总体上减轻体重。
Other types of exercises like resistance training are anabolic.
其他类型的运动（例如阻力训练）是合成代谢的。
They allow muscle to be put on.
它们可以增强肌肉。
And there's some interesting studies, not a lot, but some interesting studies trying to encourage anorexics not to stop exercising, but rather to stop exercising in this neurotic catabolic way of breaking one's self down, but rather getting them shifted toward breaking habits of only approaching low-calorie, low-fat foods, while also encouraging them to embark on resistance training.
还有一些有趣的研究，虽然不是很多，但一些有趣的研究试图鼓励厌食症患者不要停止锻炼，而是停止以这种神经质的分解代谢方式来破坏自我的锻炼，而是让他们改掉只吃低热量、低脂肪食物的习惯，同时鼓励他们开始阻力训练。
And to start to learn and reward the relationship between exercise for sake of making one's body strong, including the bones — not just the muscles, but the bones, which is important, especially in anorexics — and then to see food as a way to nourish that process, to building a body that could be of the stable weight, hopefully once the anorexic is of a healthy weight, that they're maintaining that weight — but that they don't have to constantly on this treadmill, no pun intended, of balancing whatever food intake they have with activity.
开始学习和奖励锻炼之间的关系，为了使一个人的身体变得强壮，包括骨骼——不仅仅是肌肉，还有骨骼，这很重要，尤其是对于厌食症患者来说——然后将食物视为滋养这一过程的一种方式，建立一个可以稳定体重的身体，希望一旦厌食症患者达到健康的体重，他们就能保持体重——但他们不必一直在跑步机上平衡他们的食物摄入量，没有双关语的意思。与活动。
Andrew Huberman:
安德鲁·休伯曼：
And along the lines of that, during the episode on fat loss and metabolism as well, I talked about this NEIT, nonexercise induced thermogenesis, where people who tend to be thin tend to bounce around a lot.
沿着这个思路，在关于减脂和新陈代谢的节目中，我也谈到了这种 NEIT，即非运动引起的生热作用，即那些偏瘦的人往往会经常跳来跳去。
They're kind of fidgety, and that burns thousands of calories a day, anywhere from 800 to 2000 calories a day.
他们有点烦躁，每天燃烧数千卡路里，从 800 到 2000 卡路里不等。
Now, that can be beneficial for the folks that are overweight and want and have a healthy mindset about food, but are trying to lose weight.
现在，这对于那些超重、想要并对食物有健康心态但正在努力减肥的人来说可能是有益的。
And it turns out that by literally fidgeting and bouncing around like, "This is why I'm doing this," it looks ridiculous.
事实证明，通过字面意义上的坐立不安和弹跳，就像“这就是我这样做的原因”，看起来很荒谬。
You actually burn a lot of body fat and calories that way, provided you're in a caloric deficit; you'll you burn body fat because body fat is not just a passive tissue.
如果您处于热量不足状态，您实际上会通过这种方式燃烧大量的身体脂肪和卡路里；你会燃烧身体脂肪，因为身体脂肪不仅仅是被动组织。
It actually receives input from neurons that release noradrenaline and adrenaline.
它实际上接收来自释放去甲肾上腺素和肾上腺素的神经元的输入。
And this NEIT has been described for several decades now, and it actually is a pretty terrific way to burn off more calories.
这种 NEIT 已经被描述了几十年了，它实际上是燃烧更多卡路里的一种非常棒的方法。
So with the anorexic, you actually want to encourage them to not constantly be trying to burn off calories.
因此，对于厌食症患者，你实际上应该鼓励他们不要总是试图消耗卡路里。
That can be very challenging.
这可能非常具有挑战性。
So shifting them-
所以转移它们——
Andrew Huberman:
安德鲁·休伯曼：
Trying to burn off calories that can be very challenging.
试图燃烧掉卡路里是非常具有挑战性的。
So shifting them toward activities, like weight-bearing activities or resistance training, that promote this more anabolic-type of relationship to activity, as opposed to catabolic can be beneficial.
因此，将它们转向诸如负重活动或阻力训练之类的活动，促进这种与活动的合成代谢类型的关系，而不是分解代谢，可能是有益的。
Andrew Huberman:
安德鲁·休伯曼：
Before we move on to talking about bulimia and some related disorders, I want to talk about an aspect of anorexia that's very interesting, quite troubling in fact, but that has received a lot of attention, and that's the distorted self-image.
在我们继续讨论贪食症和一些相关疾病之前，我想谈谈厌食症的一个方面，它非常有趣，事实上也很令人不安，但它已经受到了很多关注，那就是扭曲的自我形象。
Now in the episode on depression, we talked about a very powerful aspect of major depression, which is this anti-self confabulation, that people who are depressed seem to genuinely believe, and even confabulate about the fact, that they are performing poorly in life, and that they are no good or worthless, et cetera.
在抑郁症这一集中，我们谈到了重度抑郁症的一个非常强大的方面，那就是这种反自我的虚构，抑郁症患者似乎真诚地相信，甚至虚构这样一个事实：他们在生活中表现不佳，他们一无是处或毫无价值，等等。
It's literally a lie that they believe, and their statements and their feelings and their behaviors start to reflect that lie.
这实际上是他们相信的谎言，他们的言论、感受和行为开始反映出这个谎言。
They're not conscious of it.
他们没有意识到这一点。
That's why we call it a confabulation.
这就是为什么我们称其为虚构。
Andrew Huberman:
安德鲁·休伯曼：
Anorexics often will see themselves as overweight or imperfect in ways that are of an obsession for them.
厌食症患者常常会认为自己超重或不完美，这对他们来说是一种痴迷。
They'll think, oh, their arms are a little bit fat, or the contour of their face makes, they don't like their pictures of themselves, or ...
他们会想，哦，他们的手臂有点胖，或者他们的脸部轮廓使他们不喜欢自己的照片，或者......
What I'm describing here is actually pretty typical behavior of a lot of people.
我在这里描述的实际上是很多人的典型行为。
How many people do you know that after you take a picture of them, they say, "Can I see the picture?" and then they tell you that you have to throw it away?
你认识多少人，在你给他们拍完照片后，他们会说：“我可以看一下照片吗？”然后他们告诉你必须把它扔掉？
That doesn't necessarily mean they're anorexic or they're suffering from some sort of disorder.
这并不一定意味着他们患有厌食症或患有某种疾病。
That just means that they're a human being that cares about how they appear in the world.
这只是意味着他们是一个关心自己在世界上如何出现的人。
We're not here to judge that.
我们不是来评判这一点的。
Andrew Huberman:
安德鲁·休伯曼：
In the case of the anorexic, the problem seems to be that they have a genuine distortion of their self-image, so much so that they don't actually see themselves accurately.
就厌食症患者而言，问题似乎在于他们的自我形象存在真正的扭曲，以至于他们实际上无法准确地看待自己。
Their visual perceptions are off.
他们的视觉感知发生了变化。
The reason we know this is because of some really important and beautiful studies that were done in my colleague Jeremy Bailenson's lab at Stanford.
我们之所以知道这一点，是因为我的同事杰里米·拜伦森（Jeremy Bailenson）在斯坦福大学的实验室进行了一些非常重要且精彩的研究。
He's in the Department of Communications.
他在通讯部。
He's actually collaborated with a Dr. Halpern that I mentioned earlier.
他实际上与我之前提到的 Halpern 博士合作过。
Andrew Huberman:
安德鲁·休伯曼：
What's really interesting about these studies is they give us a window into the perceptual defect that anorexics have.
这些研究真正有趣的是它们为我们提供了了解厌食症患者感知缺陷的窗口。
I've actually done one of these experiments.
我实际上已经做过其中一项实验。
I'm fortunate to not be anorexic, but I've done some work with the VR lab over there, and what you get to do is you get to adjust this avatar of yourself to the point where you think it's as accurate as it could possibly be.
我很幸运没有厌食症，但我已经在那边的 VR 实验室做了一些工作，你要做的就是将你自己的化身调整到你认为尽可能准确的程度。
And anorexics really distort this avatar.
厌食症患者确实扭曲了这个化身。
In other words, they create this serious mismatch between their perception of themselves and the reality, so indeed it does seem to be the case.
换句话说，他们在自我认知与现实之间造成了严重的不匹配，所以情况似乎确实如此。
Andrew Huberman:
安德鲁·休伯曼：
Now, what's relieving, or I should say, what's encouraging, about some of the therapies that we talked about before, the family-based model, the cognitive behavioral treatments, yes, and the drug treatments as well, but this habit intervention model is that as one starts to shift those things, it does appear that the perception of self seems to follow, that the perception of self seems to shift along with the change in habits, and that's a relief.
现在，关于我们之前讨论过的一些疗法，以家庭为基础的模型，认知行为治疗，是的，还有药物治疗，但这种习惯干预模型是，当一个人开始改变这些事情时，对自我的看法似乎确实会随之而来，对自我的看法似乎会随着习惯的改变而改变，这是一种解脱。
At least I find that reassuring because changing one's perception is actually very hard.
至少我觉得这让人放心，因为改变一个人的看法实际上非常困难。
As somebody who's worked almost as entire career on visual perception and related things, the perceptual apparati of the brain are not very amenable to neuroplasticity, and they don't change that easily, whereas it appears that the circuitry that's related to habit formation and decision-making and the reward circuitry, that stuff can be rewired.
作为一个几乎整个职业生涯都在研究视觉感知和相关事物的人，大脑的感知装置不太适合神经可塑性，而且它们不会轻易改变，而与习惯形成和决策以及奖励电路相关的电路似乎可以重新连接。
Andrew Huberman:
安德鲁·休伯曼：
Anorexics, as they progress out of their anorexic state into one which they are intervening in their reflexes, gaining better habits around food, eating more, more accurately assessing foods and environments that they're in related to food, as they change their behavior and they start to put on healthy weight, maybe they're also doing the sorts of exercises that allow them to put on healthy weight and avoiding extreme exercises of catabolism and breaking themselves down, they also manage to somehow, just as a consequence of all that, rewire their perception of self.
厌食症患者，当他们从厌食状态发展到干预反射的状态时，在食物方面养成更好的习惯，吃得更多，更准确地评估食物和与食物相关的环境，当他们改变自己的行为并开始增加健康的体重时，也许他们也在做各种锻炼，使他们能够增加健康的体重，避免极端的分解代谢运动和崩溃自己，他们也设法以某种方式，正如所有这些的结果一样，重新认识他们的自我。
It doesn't seem that trying to tell someone, "Oh my gosh, you're so thin, you really need to eat," that doesn't seem to work.
试图告诉某人“天哪，你太瘦了，你真的需要吃东西”似乎并不奏效。
They just don't see themselves the same way that you see them.
他们只是不以你看待他们的方式看待自己。
Andrew Huberman:
安德鲁·休伯曼：
I offer that as a point of consideration.
我提出这一点作为考虑因素。
If you know someone that's anorexic or if you look at an anorexic and you think, how is it that they are still critical of the small, even nonexistent amount of body fat on their triceps or something, how is that?
如果你认识一个患有厌食症的人，或者如果你看到一个厌食症患者，你会想，他们为什么仍然对他们的三头肌或其他部位的少量甚至不存在的身体脂肪持批评态度，这是怎么回事？
Well, it's literally that their brain, as it relates to perceptions, visual perceptions in particular, that they're completely off.
嗯，从字面上看，他们的大脑，因为它与感知，特别是视觉感知有关，他们完全关闭了。
Fortunately by changing habits, you rewire those circuits as well.
幸运的是，通过改变习惯，你也可以重新连接这些电路。
Andrew Huberman:
安德鲁·休伯曼：
Let's talk about bulimia, which is overeating and then purging, typically by self-induced vomiting or by ingestion of laxatives, sometimes also in concert with people taking stimulants and fat burners and overingestion of stimulants to try and burn off more energy.
让我们来谈谈贪食症，这是一种暴饮暴食，然后通过自我催吐或摄入泻药来清除，有时也与人们服用兴奋剂和脂肪燃烧剂以及过量摄入兴奋剂以试图消耗更多能量有关。
Then we'll also talk about binge-eating disorder, which has a lot of the same features as bulimia, but typically no purging.
然后我们还将讨论暴食症，它与贪食症有很多相同的特征，但通常没有清除。
Andrew Huberman:
安德鲁·休伯曼：
I'm not going to list off all the clinical criteria that would allow someone to be diagnosed as bulimic or binge-eating disorder, but the general features are that they ingest far more calories than they need, anywhere from 10 to 30 times their daily caloric intake, oftentimes within a two-hour period, which is just a staggering amount of food and nutrients in a short period of time.
我不会列出所有允许某人被诊断为暴食症或暴食症的临床标准，但一般特征是他们摄入的卡路里远远超过他们需要的卡路里，通常是每日卡路里摄入量的 10 到 30 倍，而且通常是在两小时内，这在短时间内摄入的食物和营养素的数量惊人。
Oftentimes, they're overriding those mechanical signals from the body that they're full.
通常，他们会忽视身体发出的已经吃饱的机械信号。
It's a really troubling thing to think about, but people are literally gorging themselves with food.
想想这真是一件令人不安的事情，但人们确实在吃得饱饱的。
This looks a lot like a laboratory animal that has these AGRP neurons stimulated, these neurons that will eat until they almost burst or burst.
这看起来很像一只受到 AGRP 神经元刺激的实验动物，这些神经元会吃东西，直到它们几乎破裂或破裂。
You wonder, is it these AGRP neurons that are active?
你想知道，是这些 AGRP 神经元活跃吗？
Almost certainly, yes, that they're involved, although I don't think that that's going to be the major point of intervention.
几乎可以肯定的是，他们参与了，尽管我认为这不会成为干预的重点。
We're going to talk about other types of interventions.
我们将讨论其他类型的干预措施。
Andrew Huberman:
安德鲁·休伯曼：
There are a number of clinical criteria.
有许多临床标准。
For instance, if somebody has one of these binges once a year, does that make them bulimic?
例如，如果有人每年有一次这样的暴饮暴食，这会让他们暴食吗？
Technically, no, but I certainly don't recommend people do this.
从技术上讲，不，但我当然不建议人们这样做。
If you are one of these people who has so-called cheat days, right?
如果你是那些有所谓作弊日的人之一，对吗？
Some of you may be familiar with cheat days.
你们中的一些人可能熟悉作弊日。
I think they're a little less common now, but the idea is you eat clean for six days, or five days a week, or two weeks, and then you have a so-called cheat day, where you just go wild and eat whatever you want in whatever volumes.
我认为它们现在不太常见了，但想法是你吃干净六天，或者一周五天，或者两周，然后你有一个所谓的作弊日，在那里你可以疯狂地吃任何你想吃的东西，无论数量。
Is that bulimia?
这是贪食症吗？
It has some of the contour of bulimia if you're vomiting afterwards, or binge-eating disorder, if you're not.
如果你事后呕吐，则有暴食症的症状；如果没有呕吐，则有暴食症的症状。
Does it constitute full-blown bulimia or binging-eating disorder?
它是否构成全面的贪食症或暴食症？
It's pretty hard to say.
很难说。
Andrew Huberman:
安德鲁·休伯曼：
The criteria that were described to me is that if somebody's doing this at least once a month over a period of, anywhere from two to three months, then it likely would qualify.
向我描述的标准是，如果有人在两到三个月的时间内每月至少这样做一次，那么它很可能符合资格。
I certainly know people who do these cheat days, and by those criteria they have something like binge-eating disorder.
我当然认识那些在这些日子里作弊的人，按照这些标准，他们患有暴食症之类的东西。
But in general, one of the hallmark features of bulimia and binging disorder is that people are unable to control their eating.
但总的来说，贪食症和暴食症的标志特征之一是人们无法控制自己的饮食。
They're just simply, they're not making the decision to have a cheat day.
他们只是简单地决定，他们并没有做出作弊日的决定。
They're not making the decision to overeat.
他们并没有做出暴饮暴食的决定。
They are simply driven from the inside, without question by way of neural circuitry.
它们只是由内部驱动，毫无疑问是通过神经回路驱动的。
They are driven from the inside to ingest far more food than they need, and in some cases, than they would want to eat.
他们从内部被迫摄入远远超过他们需要的食物，在某些情况下，甚至超过他们想要吃的食物。
It's a lot like the habit that we described for anorexia.
这很像我们描述的厌食症的习惯。
It's almost like it's turned into a reflex.
这几乎就像变成了一种反射。
Once they get going, all the homeostatic signals are being overridden.
一旦他们开始行动，所有的稳态信号就会被推翻。
All the signals from the body, the leptin, the insulin, the glucose, all that stuff is cosmically sky high, and yet they're just what the nerds call hyperphagic.
来自身体的所有信号，瘦素，胰岛素，葡萄糖，所有这些东西都非常高，但它们正是书呆子所说的过度吞噬。
They're just eating like crazy.
他们只是疯狂地吃东西。
Andrew Huberman:
安德鲁·休伯曼：
What's going on there?
那里发生了什么事？
Well, there've been a lot of ideas about why this arises.
关于为什么会出现这种情况，人们有很多想法。
There's the so-called thyroid hormone hypothesis.
这就是所谓的甲状腺激素假说。
That one's a tricky one.
那是一个棘手的问题。
It turns out that cortisol and thyroid hormone concentrations vary according to when the binge-purge happened.
事实证明，皮质醇和甲状腺激素的浓度根据暴饮暴食发生的时间而变化。
There were some studies that looked at thyroid hormone levels and they found elevated thyroid hormone levels.
有一些研究观察了甲状腺激素水平，发现甲状腺激素水平升高。
Thyroid hormone is involved in metabolism and not just the burning of energy, but the use of energy in converting it to different tissues of the body, cartilage, bone, fat and muscle, et cetera.
甲状腺激素参与新陈代谢，不仅涉及能量的燃烧，还涉及将能量转化为身体不同组织、软骨、骨骼、脂肪和肌肉等的过程。
Andrew Huberman:
安德鲁·休伯曼：
I did a whole episode on thyroid and growth hormone, by the way, if you're interested in learning more about thyroid hormone.
顺便说一句，如果您有兴趣了解有关甲状腺激素的更多信息，我做了一整集有关甲状腺和生长激素的内容。
Thyroid hormone can also be depleted at other phases of the binge-purge cycle.
甲状腺激素也可能在暴饮暴食周期的其他阶段耗尽。
Now, without listing off all the terrible things that happen with this binge-purge cycle, there are a number of things that are really worth pointing out.
现在，虽然没有列出这个暴饮暴食周期中发生的所有可怕的事情，但有很多事情确实值得指出。
One is that the vomiting itself, the use of laxatives, that can cause severe disruption to the mucosal lining, the mucus lining of the digestive tract; it can severely disrupt the gut microbiome.
一是呕吐本身，即使用泻药，可能会严重破坏粘膜内层，即消化道的粘液内层；它会严重破坏肠道微生物组。
It can cause all sorts of, even ulceration of the esophagus, and just really terrible stuff.
它会导致各种各样的疾病，甚至是食道溃疡，这是非常可怕的事情。
Andrew Huberman:
安德鲁·休伯曼：
There's a lot of shame associated with bulimia, oftentimes because people are vomiting and it's hard to hide that vomiting behavior.
贪食症会带来很多耻辱，通常是因为人们呕吐，而很难隐藏这种呕吐行为。
People are aware of it.
人们都意识到了这一点。
There's some social isolation.
有一些社会孤立。
So you recall from the beginning, it does not appear that sexual trauma is a prerequisite for bulimia, although sometimes it can occur.
所以你从一开始就记得，性创伤似乎并不是贪食症的先决条件，尽管有时可能会发生。
The hallmark feature of bulimia that distinguishes it from anorexia, aside from the fact that it's overeating as opposed to undereating, is a lack of what they call inhibitory control.
暴食症与厌食症的区别除了暴食症是暴饮暴食而不是暴饮暴食这一事实之外，暴食症的一个显着特征是缺乏所谓的抑制控制。
Andrew Huberman:
安德鲁·休伯曼：
That might come as no surprise, but first of all, the bulimic, unlike the anorexic, is hyperimpulsive and oftentimes has other types of impulse behaviors.
这可能并不奇怪，但首先，暴食症患者与厌食症患者不同，是过度冲动的，并且常常有其他类型的冲动行为。
They might have a little bit of alcohol and then start to eat like crazy, whereas normally they're very restrictive.
他们可能会喝一点酒，然后开始疯狂地吃东西，而通常他们是非常限制的。
That's a common feature of bulimia.
这是暴食症的一个共同特征。
Sometimes they overingest alcohol during these binges.
有时他们在暴饮暴食期间过量饮酒。
Sometimes they are sexually promiscuous, not always, but it's a general issue with satiety, once they start eating, and with impulse control generally.
有时他们性乱，但并非总是如此，但一旦他们开始进食，这就是饱腹感和冲动控制的普遍问题。
Andrew Huberman:
安德鲁·休伯曼：
For that reason, many of the treatments that you see for bulimia and binge-eating disorder are the sorts of treatments that don't seem to work so well, or at least most of the time, for anorexia.
出于这个原因，你看到的许多治疗贪食症和暴食症的治疗方法似乎对厌食症效果不佳，或者至少在大多数时候效果不佳。
The drugs that increase the neuromodulator serotonin, for instance — fluoxetine, also called Prozac, Paxil, et cetera — those things oftentimes can be effective in bulimia.
例如，增加神经调节剂血清素的药物——氟西汀，也称为百忧解、帕罗西汀等——这些药物通常可以有效治疗贪食症。
Some of the drugs that are used to treat attention deficit hyperactivity disorder and ADD, a topic that we're going to talk about in depth here on the podcast soon, some of those same drugs, like Adderall, Vyvanse, and things of that sort, can also be used to treat bulimia and binge-eating disorder.
一些用于治疗注意力缺陷多动障碍和 ADD 的药物（我们很快将在播客上深入讨论这个话题），其中一些药物，如 Adderall、Vyvanse 等，也可用于治疗贪食症和暴食症。
Andrew Huberman:
安德鲁·休伯曼：
Why would that work?
为什么那会起作用？
Well, now you are familiar with the prefrontal cortex.
好了，现在您已经熟悉了前额皮质。
You probably know more about prefrontal cortex than you ever wanted to, just from this episode.
仅从这一集来看，您对前额叶皮层的了解可能比您想要的还要多。
Prefrontal cortex is involved in this analysis of duration, path and outcome.
前额叶皮层参与对持续时间、路径和结果的分析。
Duration, path and outcome is how we avoid impulsivity.
持续时间、路径和结果是我们避免冲动的方法。
It's how we think, okay if this, then that; if that, then this.
我们就是这样想的，好吧，如果这样，那就那样；如果是这样，那么这个。
You can imagine how for the obsessive compulsive or for the anorexic, these are circuits that are overactive.
你可以想象，对于强迫症患者或厌食症患者来说，这些回路是过度活跃的。
For the bulimic, this is the circuit that's going to essentially be underactive and is under conditions where they think, "Oh, I shouldn't eat anything.
对于暴食症患者来说，这个回路本质上是不活跃的，并且在他们认为“哦，我不应该吃任何东西”的情况下。
I shouldn't eat anything." Then they just tear the refrigerator open and plow through that.
我不应该吃任何东西。”然后他们就把冰箱拆开，然后把它撬开。
Then at that point, they're plowing through the cupboards, and then they're ordering food and then they're feeling horrible about themselves.
然后，他们会翻遍橱柜，然后点食物，然后他们对自己感觉很糟糕。
There do tend to be these cycles of binge and purge, followed by feelings of real shame because they just can't control their behavior.
确实往往会出现暴饮暴食和净化的循环，然后是真正的羞耻感，因为他们无法控制自己的行为。
What is more embarrassing than not being able to control one's behavior as an adult or as a young adult?
还有什么比成年或年轻时无法控制自己的行为更令人尴尬的呢？
Andrew Huberman:
安德鲁·休伯曼：
So really the polar opposite of what you see in anorexia.
所以这与你在厌食症中看到的情况截然相反。
This lack of impulsivity implies a lack of prefrontal control, what we call top-down control.
缺乏冲动意味着缺乏前额控制，即我们所说的自上而下的控制。
Why do we call it top-down?
为什么我们称之为自上而下？
Because the prefrontal cortex is suppressing the activity of deeper limbic and hypothalamic circuitry, and things of that sort.
因为前额叶皮层抑制了更深的边缘系统和下丘脑回路的活动，以及诸如此类的事情。
Anytime you feel like you want to say something really offensive and you don't, that's top-down control.
任何时候你觉得自己想说一些非常冒犯的话但又不想说的话，这就是自上而下的控制。
That's your prefrontal cortex.
那是你的前额皮质。
Anytime someone says something and you grit your teeth because you know shouldn't say anything, gritting your teeth is top-down control.
任何时候有人说了些什么，而你咬紧牙关，因为你知道不应该说什么，咬紧牙关就是自上而下的控制。
When you explode or burst or say the wrong thing, or say the thing that you shouldn't say, or do the thing you shouldn't do, that's lack of prefrontal control.
当你爆发、爆发、说错话、说不该说的话、做不该做的事时，这就是缺乏前额叶控制。
Indeed, people who have frontal temporal dementia due to aging or head injuries; see this a lot in ...
事实上，由于衰老或头部受伤而患有额颞叶痴呆的人；在...中经常看到这个
people play sports, they get a lot of frontal damage.
人们进行体育运动时，他们的正面会受到很多伤害。
They become more impulsive.
他们变得更加冲动。
Andrew Huberman:
安德鲁·休伯曼：
Bulimics have an issue with impulsivity, and therefore drugs that can increase serotonin, and sometimes these drugs that increase dopamine and adrenaline, also called epinephrine, will increase the tone, as we call it, the dopaminergic tone or the ...
贪食症患者存在冲动问题，因此可以增加血清素的药物，有时这些增加多巴胺和肾上腺素（也称为肾上腺素）的药物会增加音调，我们称之为多巴胺能音调或...
it's called adrenergic, but norepinephrine levels in the brain allow for more top-down control, and that's also why they're used to treat ADHD and attention deficit disorder.
它被称为肾上腺素能，但大脑中的去甲肾上腺素水平允许更多自上而下的控制，这也是它们被用来治疗多动症和注意力缺陷障碍的原因。
Andrew Huberman:
安德鲁·休伯曼：
They tend to create a hyperfocus.
他们往往会造成高度专注。
These drugs tend to create a hyperfocus and tend to push the brain and general mode of processing into one in which you think, if this, then that; if this, then that.
这些药物往往会造成注意力过度集中，并倾向于将大脑和一般处理模式推向一种这样的模式：如果是这样，那就是；如果这个，那么那个。
So anticipating outcomes.
所以期待结果。
For that reason, drugs like Wellbutrin, bupropion, which is an antidepressant which mainly increases the amount of dopamine and norepinephrine, and less so serotonin, that can also be effective for certain types of binge-eating disorder.
因此，像维布特林、安非他酮（一种抗抑郁药，主要增加多巴胺和去甲肾上腺素的量，以及较少的血清素的量）等药物也可以有效治疗某些类型的暴食症。
It's actually used to treat smoking, for promoting smoking cessation, and for depression, but also for certain forms of obesity related to binge-eating disorder.
它实际上用于治疗吸烟、促进戒烟和抑郁症，还用于治疗与暴食症相关的某些形式的肥胖。
The data are pretty good, and there are timed release forms of this and nontime release forms.
数据还不错，这个有定时发布形式和非定时发布形式。
I think you have to consult with a psychiatrist in order to get these prescribed, because they are prescription drugs, but it's a very different constellation of neurochemicals and brain areas and approaches for bulimia.
我认为你必须咨询精神科医生才能开出这些处方药，因为它们是处方药，但它是一组非常不同的神经化学物质和大脑区域以及贪食症的治疗方法。
Andrew Huberman:
安德鲁·休伯曼：
The treatment of binge-eating disorder has been explored from a new standpoint recently, and that's the work of this now, sadly, former colleague of mine, Dr. Casey Halpern, who's at University of Pennsylvania, that I mentioned earlier.
最近，人们从一个新的角度探索了暴食症的治疗方法，遗憾的是，这就是我之前提到的宾夕法尼亚大学前同事凯西·哈尔彭博士的工作。
They're using deep brain stimulation in order to treat binge-eating disorder.
他们正在使用深部脑刺激来治疗暴食症。
Now, why deep brain stimulation?
现在，为什么要进行深部脑刺激呢？
Well work from Dr. Halpern, and others, while at Stanford showed that there are particular patterns of brain activity in both the prefrontal cortex, but also in an area of the brain called the nucleus accumbens, a very important and very relevant area of the brain in this context, and in any discussion about motivated behaviors of any kind, feeding, sex, drug-related behavior, people who exercise compulsively.
哈尔彭博士和其他人在斯坦福大学期间的出色工作表明，前额皮质和称为伏核的大脑区域都存在特定的大脑活动模式，在这种情况下，以及在任何有关任何类型的动机行为（喂养、性、药物相关行为、强迫性锻炼的人）的讨论中，伏隔核是大脑的一个非常重要且非常相关的区域。
Andrew Huberman:
安德鲁·休伯曼：
The nucleus accumbens is in an ongoing dialogue with the prefrontal cortex, and the nucleus accumbens has no mind of its own, but it's associated with dopamine release.
伏隔核与前额皮质进行持续的对话，伏隔核没有自己的意识，但它与多巴胺的释放有关。
It's part of this so-called reward pathway.
这是所谓的奖励途径的一部分。
What Dr. Halpern and colleagues discovered is that there are particular patterns of activity that ripple through the brain, through these prefrontal networks and through this nucleus accumbens area.
哈尔彭博士及其同事发现，大脑、前额叶网络和伏隔核区域有特定的活动模式。
Those areas are connected.
这些区域是相连的。
It's called delta oscillations, delta just being a particular frequency of electrical activity; for you aficionados, it's one to four hertz activity.
这称为 Delta 振荡，Delta 只是电活动的特定频率；对于爱好者来说，这是一到四赫兹的活动。
But in any case, those delta oscillations in the nucleus accumbens are associated with food reward in both mice and humans.
但无论如何，伏隔核中的δ振荡与小鼠和人类的食物奖励有关。
Andrew Huberman:
安德鲁·休伯曼：
Somehow this reverbatory activity creates a perception in the individual that food is hyper-rewarding.
不知何故，这种反射活动让个体产生一种食物是超回报的感觉。
Now, that's interesting and has allowed them to use a targeted deep brain stimulation approach to treat binge-eating disorder.
现在，这很有趣，并使他们能够使用有针对性的深部脑刺激方法来治疗暴食症。
This deep brain stimulation is appearing to be an effective treatment.
这种深层脑刺激似乎是一种有效的治疗方法。
There are still more studies that need to be done.
还有更多的研究需要完成。
Actually, if you think you have binge eating disorder, you can find the criteria for that and you could contact Dr. Halpern.
实际上，如果您认为自己患有暴食症，您可以找到其标准，并且可以联系 Halpern 医生。
He's, as I mentioned, he's moving to University of Pennsylvania.
正如我提到的，他要转到宾夕法尼亚大学。
They are recruiting patients for these studies all the time.
他们一直在招募患者进行这些研究。
Andrew Huberman:
安德鲁·休伯曼：
The studies are fairly invasive.
这些研究具有相当的侵入性。
They involve an FDA-approved approach of literally placing a wire down into an area of the brain that allows the individual to stimulate a particular brain area, to offset some of these activity patterns that lead to an elevated sense of reward from food and binge eating, and the data look really promising.
它们涉及 FDA 批准的方法，即在大脑的某个区域放置一根电线，使个体能够刺激特定的大脑区域，抵消其中一些导致食物和暴饮暴食带来的奖励感增强的活动模式，数据看起来非常有希望。
Andrew Huberman:
安德鲁·休伯曼：
Now, I realize that's a very invasive approach.
现在，我意识到这是一种非常侵入性的方法。
Not everybody is going to be willing to have this wire inserted into their brain, but for people that suffer from binge-eating disorder, this is a great and very exciting potential treatment, because what I didn't tell you is that many people who have binge-eating disorder are obese to the point where their health is greatly at risk.
不是每个人都愿意将这根电线插入他们的大脑，但对于患有暴食症的人来说，这是一种伟大且非常令人兴奋的潜在治疗方法，因为我没有告诉你的是，许多患有暴食症的人肥胖到他们的健康受到极大威胁的程度。
Andrew Huberman:
安德鲁·休伯曼：
Now, obesity causes all sorts of shifts in the dialogue between the brain and body, some of which you'll recognize from earlier in the discussion.
现在，肥胖会导致大脑和身体之间的对话发生各种变化，其中一些您会在前面的讨论中认识到。
For instance, leptin signaling is disrupted.
例如，瘦素信号传导被破坏。
The fat, there's lots of body fat, but even though that body fat is secreting this hormone, leptin, and that signal should shut down the desire to eat, the receptors to leptin in the brain are totally screwed up.
脂肪，体内有很多脂肪，但即使身体脂肪正在分泌这种激素，瘦素，并且该信号应该会抑制食欲，但大脑中瘦素的受体却完全搞砸了。
The signal to eat is there, but the signal to stop eating is not there.
吃的信号有，但停止吃的信号不存在。
Again, you have an accelerator and a brake, and it's like the accelerator is always pushed down.
同样，你有一个油门和一个刹车，就像油门总是被按下一样。
Some of these brain stimulation approaches seem to be able to bypass some of that, and of course there're all the metabolic syndromes and the problems with having excess levels of body fat, things like insulin resistance, type 2 diabetes.
其中一些大脑刺激方法似乎能够绕过其中的一些问题，当然还有所有代谢综合症和身体脂肪过多的问题，例如胰岛素抵抗、2 型糖尿病。
As disturbing as it is to hear, there are many individuals, actually I know some, who are so obese that they start getting bodily sores.
听起来令人不安，有很多人，实际上我认识一些人，因为肥胖而开始出现身体溃疡。
They're not just bed sores, but they have skin sores that are very disruptive to them.
它们不仅仅是褥疮，还有对他们来说非常具有破坏性的皮肤疮。
They don't like having these sores.
他们不喜欢有这些疮。
Andrew Huberman:
安德鲁·休伯曼：
In addition to that, they can get peripheral neuropathies because of some of these metabolic issues.
除此之外，由于其中一些代谢问题，他们可能会患周围神经病。
They're not getting enough utilization of the nutrients in the tissue, because the way that insulin is disrupted, insulin signaling, and they actually have to have certain portions of their limbs amputated, and yet they continue to overeat.
他们没有充分利用组织中的营养物质，因为胰岛素信号传导被破坏，他们实际上必须截掉四肢的某些部分，但他们仍然吃得过多。
Andrew Huberman:
安德鲁·休伯曼：
This is not an issue of self-control that can easily be dealt with simply by telling the person, "Look, you have to stop eating or you're going to die," or "You're going to have your legs amputated." Like with anorexia, there's a distortion in the relationship to food, but the homeostatic and the reward aspects are disrupted.
这不是一个自我控制的问题，只需告诉对方“听着，你必须停止进食，否则你就会死”或“你的双腿将被截肢”，就可以轻松解决。与厌食症一样，与食物的关系存在扭曲，但体内平衡和奖励方面也被破坏。
Unlike anorexia where it seems to be a habit-based mechanism, with bulimia and binge-eating disorder, something deep within the neurocircuitry is causing food to be hyperattractive and the brake is off.
与贪食症和暴食症等厌食症不同，厌食症似乎是一种基于习惯的机制，神经回路深处的某种东西导致食物变得过于有吸引力，从而停止了刹车。
Andrew Huberman:
安德鲁·休伯曼：
If you want to develop some empathy for what these people are dealing with, consider this.
如果您想对这些人正在处理的事情产生一些同理心，请考虑这一点。
It's like driving a car.
这就像开车一样。
You get onto a grade, maybe a 10 or 15 degree grade, and you're heading down and you figure, well, you'll just pump the brakes a little bit, but there is no brake, right?
你进入一个坡度，也许是 10 或 15 度的坡度，然后你往下走，你想，好吧，你只需稍微踩一下刹车，但没有刹车，对吗？
So you start going faster and faster and faster, and your only choice is to use the accelerator just to coast through it.
所以你开始越来越快，你唯一的选择就是使用加速器来滑行。
That's essentially what's happening to these neural circuits.
这本质上就是这些神经回路所发生的事情。
So the work of Dr. Halpern and others, I think, is really exciting, and even though it's highly invasive, I think it's going to lead to not just some relief for the patients that do get that stimulation, but also the identification of what sorts of receptors are present in those brain areas that could help.
因此，我认为 Halpern 博士和其他人的工作确实令人兴奋，尽管它具有高度侵入性，但我认为这不仅会给接受刺激的患者带来一些缓解，而且还能识别出大脑区域中存在哪些类型的受体，可以提供帮助。
Andrew Huberman:
安德鲁·休伯曼：
What that means is that once we understand which brain areas are involved in the disorder and we understand what receptors those brain areas express, then there can start to be additional interventions by way of noninvasive treatments, things like drug treatments.
这意味着，一旦我们了解了哪些大脑区域与该疾病有关，并且了解了这些大脑区域表达的受体，那么就可以开始通过非侵入性治疗（例如药物治疗）进行额外的干预。
Andrew Huberman:
安德鲁·休伯曼：
Do behavioral interventions work for bulimia?
行为干预对贪食症有效吗？
In some cases, yes, provided that those interventions are done early enough.
在某些情况下，是的，只要这些干预措施做得足够早。
Regardless, behavioral interventions coupled with drug-based interventions are always more effective than either one alone.
无论如何，行为干预与药物干预相结合总是比单独使用任何一种干预更有效。
Fortunately, there is a decent sized kit of drugs that can help with bulimia.
幸运的是，有一套相当大的药物可以帮助治疗贪食症。
I mentioned some of them before, things like bupropion, Wellbutrin, some of the serotonergic drugs, and some of the drugs used to treat impulsivity.
我之前提到过其中一些药物，例如安非他酮、维布特林、一些血清素药物，以及一些用于治疗冲动的药物。
Andrew Huberman:
安德鲁·休伯曼：
We have on the one hand, anorexia, which seems to be a disruption in habit and a coupling of unhealthy habits — in this case, food — to the reward pathway.
一方面，我们患有厌食症，这似乎是习惯的破坏以及不健康习惯（在本例中为食物）与奖励途径的结合。
On the flip side, we have binge-eating disorder and bulimia, where a very unhealthy habit of gorging oneself with food, sometimes followed by purging, is not necessarily coupled to reward.
另一方面，我们有暴食症和贪食症，这是一种非常不健康的习惯，暴饮暴食，有时随后进行净化，并不一定与奖励相关。
They feel terrible when they do that, right?
当他们这样做时，他们感觉很糟糕，对吗？
The anorexic feels great about restricting their food intake.
厌食症患者对限制食物摄入量感觉很好。
They feel like they're winning some sort of game.
他们感觉自己正在赢得某种游戏。
The circuitry is flipped somehow that way.
电路以某种方式翻转。
With bulimia, they feel horrible about the fact that they're binging.
患有贪食症时，他们会对自己的暴饮暴食感到恐惧。
There's immense shame.
有一种莫大的耻辱。
They can't control themselves.
他们无法控制自己。
The reward is set up before the behavior.
奖励是在行为之前设置的。
The reward is set up in drawing them to food and making food look like something that's incredibly appetizing, and there's no impulse brake.
奖励的目的是吸引他们去吃食物，并使食物看起来非常美味，而且没有冲动刹车。
There's no way for them to stop that kind of behavior.
他们没有办法阻止这种行为。
Andrew Huberman:
安德鲁·休伯曼：
Really, a kind of troubling thing to think about in either case.
确实，无论哪种情况，想想都令人不安。
I think for those of us that know anorexic or have observed anorexia, it's so hard to see somebody starve themselves to near death or to death.
我认为对于我们这些了解厌食症或观察到厌食症的人来说，很难看到有人将自己饿死或饿死。
What more could be disturbing?
还有什么可能令人不安呢？
Well, equally disturbing is somebody who has an abundance of food and is gorging themselves and then feels terrible about it.
好吧，同样令人不安的是，有人拥有丰富的食物，却狼吞虎咽，然后感觉很糟糕。
These are heavy topics.
这些都是沉重的话题。
These are topics that frankly no one really wants to talk about unless they know someone who's suffering from them or they themselves suffer from them.
坦率地说，这些话题没有人真正愿意谈论，除非他们认识遭受这些痛苦的人或者他们自己也遭受这些痛苦。
What I've tried to do today is try and give you a window into what really underlies these things that we call eating disorders.
我今天试图做的就是尝试为您提供一个窗口，让您了解这些我们称为饮食失调的疾病的真正根源。
I hope I've done that at the level of biology, neurocircuitry, mechanism, endocrinology and some of the psychology.
我希望我已经在生物学、神经回路、机制、内分泌学和一些心理学的层面上做到了这一点。
Andrew Huberman:
安德鲁·休伯曼：
As with any episode of this podcast, but especially in this month where we're talking about mental health issues and mental health disorders, behavioral disorders, there's no way that I can exhaustively cover all the different forms of treatment.
与本播客的任何一集一样，尤其是在这个月我们谈论心理健康问题、心理健康障碍、行为障碍时，我无法详尽地涵盖所有不同形式的治疗。
You have the modelly approach, you've got all these different approaches to depression and to anorexia, et cetera.
你有模范的方法，你有所有这些不同的方法来治疗抑郁症和厌食症等等。
What I've tried to do is give you a framework.
我试图做的是给你一个框架。
In doing that, I've tried to give you a framework of understanding that also applies to this question that's, I think, equally important and goes alongside the treatment of eating disorders, is what in the world is healthy eating?
在此过程中，我试图为您提供一个理解框架，该框架也适用于这个问题，我认为这个问题与饮食失调的治疗同样重要，即世界上的健康饮食是什么？
What in the world is a healthy relationship to food?
到底什么是与食物的健康关系？
I like to think that I have a healthy relationship to food.
我喜欢认为我与食物有着健康的关系。
I know the foods I like, I enjoy them.
我知道我喜欢的食物，我喜欢它们。
There are 10 or 15 foods in particular that I like very much.
有10或15种食物是我特别喜欢的。
I've mentioned a few of them on the podcast before, and was sort of amused, surprised and perplexed as to why, for instance, I do enjoy eating butter, not in huge amounts, but I do like butter.
我之前在播客上提到过其中的一些，并且有点好笑、惊讶和困惑，例如，为什么我确实喜欢吃黄油，虽然不是大量，但我确实喜欢黄油。
Andrew Huberman:
安德鲁·休伯曼：
That seemed to be pretty triggering for folks out there.
这对于外面的人来说似乎非常令人兴奋。
A small selection of people decided that the ingestion of butter was a health concern.
一小部分人认为摄入黄油是一个健康问题。
Look, to me, ingesting butter in small quantities is something that I'm comfortable with, and my blood lipid profiles feel good.
听着，对我来说，少量摄入黄油是我很舒服的事情，而且我的血脂状况感觉很好。
They look good to me.
他们对我来说看起来不错。
For other people, that might not be the case.
对于其他人来说，情况可能并非如此。
For some people, the idea of eating an animal-based food is probably so repulsive that it actually can make them feel physically sick.
对于一些人来说，吃动物性食物的想法可能非常令人厌恶，以至于实际上会让他们感到身体不适。
I think that we should be aware that that kind of mental phenotype exists.
我认为我们应该意识到这种心理表型的存在。
I'm not calling it a pathology.
我不称其为病理学。
For other people, like myself, things like butter and meat feel healthy.
对于其他人来说，比如我自己，黄油和肉之类的东西感觉很健康。
Andrew Huberman:
安德鲁·休伯曼：
Now, what quantities?
现在，数量是多少？
Well, I enjoy eating very much.
嗯，我非常喜欢吃。
I'm not shy about this.
我对此并不害羞。
I've talked about it in the podcast before.
我之前在播客中谈过这个问题。
I enjoy eating.
我喜欢吃。
Some people have a very complicated relationship to food.
有些人与食物的关系非常复杂。
They don't think of it as nourishment.
他们不认为它是营养品。
They don't enjoy it socially.
他们不喜欢社交。
It's a stressful thing for them, based on their personal history or maybe just general anxiety around food.
根据他们的个人经历，或者可能只是对食物的普遍焦虑，这对他们来说是一件压力很大的事情。
I hope that in sharing this information about the fact that anytime we approach food, these neurons in the arcuate area of our hypothalamus actually increase our levels of anxiety.
我希望在分享这一信息时，无论何时我们接近食物，下丘脑弓形区域的这些神经元实际上都会增加我们的焦虑水平。
This is related to that point that Dr. Halpern made, which was that from an evolutionary standpoint, it is advantageous to ingest as much food as often as possible, as quickly as possible.
这与哈尔彭博士提出的观点有关，即从进化的角度来看，尽可能多、尽可能快地摄入食物是有利的。
Andrew Huberman:
安德鲁·休伯曼：
We now know that to not be healthy in this age of abundance where calories are essentially everywhere, and yet a lot of people feel anxious in anticipation of a meal.
我们现在知道，在这个热量无处不在的物质丰富的时代，健康是不健康的，但很多人对吃饭感到焦虑。
What could be useful to them?
什么对他们有用？
Well, whether or not they have an eating disorder or not, it's very clear that developing methods to calm oneself in the presence of any anxiety or fear-inducing stimulus can be beneficial.
嗯，无论他们是否患有饮食失调症，很明显，在出现任何焦虑或恐惧刺激时找到让自己平静下来的方法可能是有益的。
I've talked about some of these in episodes related to stress, things like the physiological sigh.
我在与压力有关的剧集中谈到了其中的一些内容，例如生理叹息。
Two inhales through the nose and a long exhale.
用鼻子吸气两次，长长地呼气一次。
Things like mindfulness meditation certainly can help.
像正念冥想这样的事情肯定会有帮助。
There are data, a lot of studies out there showing that meditation practice can help people deal with eating-related anxiety and disorders.
有数据、大量研究表明，冥想练习可以帮助人们应对与饮食相关的焦虑和障碍。
Andrew Huberman:
安德鲁·休伯曼：
I think as a general rule, trying to avoid approaching a meal or sitting down to eat in an anxious state is probably a good idea, but let's be realistic.
我认为作为一般规则，尽量避免在焦虑的状态下进餐或坐下来吃饭可能是个好主意，但让我们现实一点。
How often can we do that?
我们多久可以这样做一次？
I think most of us are going to have circumstances where we're rushing around trying to just eat before we head out, or get to a meal and then we sit down and we find ourselves eating.
我想我们大多数人都会遇到这样的情况：我们在出发前匆匆忙忙地想吃点东西，或者吃完饭然后坐下来发现自己在吃东西。
Andrew Huberman:
安德鲁·休伯曼：
This is one of the first times in human evolution where we mostly eat out of a desire to consume food, not out of a need for food.
这是人类进化史上第一次，我们吃东西主要是出于对食物的渴望，而不是出于对食物的需要。
Most everybody could go a fairly long period of time just ingesting water and electrolytes, and not that I'm suggesting people do that, but let's face it, we largely eat nowadays because of a desire to eat, not a need to eat, and yet we need to eat on a fairly regular basis.
大多数人都可以在相当长的一段时间内只摄入水和电解质，我并不是建议人们这样做，但让我们面对现实吧，我们现在吃东西很大程度上是因为想吃东西，而不是需要吃东西，但我们需要有规律地吃东西。
No topic is more complicated and nuanced than food and nutrition, and in particular as it relates to eating disorders.
没有什么话题比食物和营养更复杂、更微妙了，尤其是与饮食失调有关的话题。
Andrew Huberman:
安德鲁·休伯曼：
The major takeaways today are we should all be asking the question, what is healthy eating for us?
今天的主要收获是我们都应该问一个问题：什么是我们的健康饮食？
How do we develop a relationship to food that we can enjoy food, hopefully both socially and on our own, but that we are not neurotic and compulsive about it?
我们如何与食物建立一种关系，我们可以享受食物，希望既可以在社交场合也可以在我们自己身上享受食物，但又不会对此感到神经质和强迫？
For those of you that intermittent fast, this also applies.
对于那些间歇性禁食的人来说，这也适用。
God forbid if you eat 30 minutes before your eating window starts, what does that mean?
如果您在进食窗口开始前 30 分钟吃东西，那意味着什么？
If it means something catastrophic, do you have an eating disorder?
如果这意味着灾难性的事情，你是否患有饮食失调症？
I don't know.
我不知道。
Maybe you have an anxiety disorder.
也许你患有焦虑症。
That's for you to explore.
这有待你去探索。
If you don't manage to eat five meals a day and that's your obsession, well then the same thing applies.
如果你一天吃不了五顿饭，而这就是你的痴迷，那么同样的事情也适用。
These are questions that we can all ask ourselves.
这些是我们都可以问自己的问题。
Andrew Huberman:
安德鲁·休伯曼：
Today we focused on the extremes of food-related behaviors that really qualify as genuine disorders.
今天，我们重点关注真正属于真正疾病的与食物相关的极端行为。
They are in the psychiatric manuals, and they are diagnosable, and they are serious health concerns.
它们出现在精神病学手册中，并且是可以诊断的，并且是严重的健康问题。
They're not just mentally troubling and concerning for the people suffering from them and the people around them, but they are genuine health concerns.
它们不仅给患者及其周围的人带来精神上的困扰和担忧，而且是真正的健康问题。
Just want to reiterate that anorexia nervosa is the most deadly psychiatric disorder by a huge margin, and if you look statistically at the number of people with eating disorders and that die of eating disorders, it's not far off from the number of people that die from automobile accidents.
只是想重申一下，神经性厌食症是最致命的精神疾病，并且在很大程度上，如果你统计一下患有饮食失调症和死于饮食失调症的人数，你会发现它与死于车祸的人数相差不远。
I know that that sounds like a ridiculous number, but you can look this up.
我知道这听起来像是一个荒谬的数字，但你可以查一下。
This is particularly true in certain countries.
在某些国家尤其如此。
Why that is, we don't know.
为什么会这样，我们不知道。
But again, this is not a new phenomenon.
但同样，这并不是一个新现象。
This is not just related to body image issues that are created through social media and media.
这不仅仅与通过社交媒体和媒体造成的身体形象问题有关。
Andrew Huberman:
安德鲁·休伯曼：
As a final point on that, many of you are probably asking, what about plastic surgery?
最后一点，很多人可能会问，整形手术怎么样？
What about all the steps that people are going to through to preen themselves and change themselves?
人们为了打扮自己和改变自己而采取的所有步骤又如何呢？
Are people addicted to plastic surgery?
人们沉迷于整容手术吗？
Is that a form of body dysmorphia?
这是身体畸形的一种形式吗？
Indeed it is.
确实如此。
We will do an episode on exercise-related and plastic surgery-related body dysmorphia.
我们将制作一集有关运动相关和整形手术相关的身体畸形的节目。
I think there is very little question that those types of disorders are clearly related to what we're observing in social media and in media, that this shift of, for instance, action heroes.
我认为毫无疑问，这些类型的疾病显然与我们在社交媒体和媒体中观察到的情况有关，例如动作英雄的这种转变。
If you look at action heroes in the '80s, there were very few men that were very large.
如果你看看 80 年代的动作英雄，就会发现很少有身材魁梧的男人。
You had your Stallone and your Schwarzeneggers and a few other, but the men in movies tended to be, if they were muscular, they were far more svelte than they are now.
你有史泰龙、施瓦辛格和其他一些人，但电影中的男人往往是，如果他们肌肉发达，他们比现在要苗条得多。
There's literally a hypertrophy of the imagery, and likewise, there's been hypertrophy of the female body shape as it's portrayed in the media.
图像实际上是肥大的，同样，媒体所描绘的女性体型也是肥大的。
There are body dysmorphias that are related to those types of things, and that relate to things like plastic surgery, steroid abuse, diet drug abuse and so on.
有些身体畸形与这些类型的事情有关，并且与整形手术、类固醇滥用、减肥药物滥用等有关。
Definitely important to think about and consider, and definitely deserving of its own episode.
思考和考虑绝对重要，并且绝对值得拥有自己的情节。
Andrew Huberman:
安德鲁·休伯曼：
You've learned a lot of neuroscience today.
你今天学到了很多神经科学知识。
I hope that was useful in thinking about these disorders and in thinking about other aspects of feeding and motivated behaviors.
我希望这有助于思考这些疾病以及思考喂养和动机行为的其他方面。
I would love for you to take away this model that was handed off to me that I think is so powerful for thinking about all sorts of things, not just eating, but all kinds of behaviors and perceptions that you have one box for what you think, one box for what you do, and what is intervening between those?
我希望你能拿走这个交给我的模型，我认为它对于思考各种各样的事情非常强大，不仅仅是吃，还有各种行为和感知，你有一个盒子来表达你的想法，一个盒子代表你所做的事情，以及在这之间介入的是什么？
Why is it that you can know better and not do better?
为什么你可以知道得更好，却不能做得更好？
Well, it's because you also have to cope with these subconscious homeostatic processes and reward processes, and those oftentimes can be disrupted in ways that we find ourselves doing things that are not good for us or not good for other people.
嗯，这是因为你还必须应对这些潜意识的稳态过程和奖励过程，而这些过程常常会因为我们发现自己在做对我们不利或对他人不利的事情而受到干扰。
Andrew Huberman:
安德鲁·休伯曼：
But fortunately, there is this great gift, which is that knowledge of knowledge can allow you to do better, without question, and that knowledge of knowledge allowing you to do better over time leads to this incredible phenomenon called neuroplasticity, which essentially is translated into: doing better over time, even if difficult, eventually makes doing better reflexive.
但幸运的是，有一个伟大的礼物，那就是知识的知识可以让你毫无疑问地做得更好，而知识的知识让你随着时间的推移做得更好，这会导致这种令人难以置信的现象，称为神经可塑性，本质上可以翻译为：随着时间的推移做得更好，即使很困难，最终也会使反射性地做得更好。
Andrew Huberman:
安德鲁·休伯曼：
If you're enjoying this podcast and learning from it, please subscribe to our YouTube channel.
如果您喜欢这个播客并从中学习，请订阅我们的 YouTube 频道。
That's Huberman Lab on YouTube.
这是 YouTube 上的 Huberman Lab。
There you can also leave us comments and feedback, and suggestions for future topics and future guests for the Huberman Lab podcast.
您还可以在那里给我们留下评论和反馈，以及对 Huberman 实验室播客的未来主题和未来嘉宾的建议。
As well, we hope that you will subscribe on both Apple and Spotify, and on Apple, you have the opportunity to leave us up to a five-star review and to give us feedback there as well.
同样，我们希望您订阅 Apple 和 Spotify，并且在 Apple 上，您有机会给我们留下五星级的评论，并给我们反馈。
Please also check out the sponsors mentioned at the beginning of the podcast.
另请查看播客开头提到的赞助商。
That's a terrific way to support the podcast.
这是支持播客的绝佳方式。
If you'd like to support research on stress, human performance, sleep, and so forth, you can go to hubermanlab.stanford.edu, and there there's a tab that you can click if you'd like to make a tax-deductible donation to the laboratory to explore the sorts of things that relate to neural circuits, stress, sleep, and human performance.
如果您想支持压力、人类表现、睡眠等方面的研究，可以访问 hubermanlab.stanford.edu，如果您想向实验室提供免税捐款以探索与神经回路、压力、睡眠和人类表现相关的各种事物，可以单击该选项卡。
Last but not least, I want to thank you for your time and attention, and thank you for your interest in science.
最后但并非最不重要的一点是，我要感谢您的时间和关注，并感谢您对科学的兴趣。