Newsletter - Health "status quo" and motivation (Patreon)

Patreon Newsletter Wednesday 17th

Hey everyone, two things on the agenda today: 

1. Endocrinologist’s Cognitive Dissonance 
2. Question from a Patron on using one dopamine raising task to motivate yourself to do another.

1. The baffling recommendation from an Endocrinologist for a 71yo who reversed his diabetes
Here’s a twitter post from Dr. Paul Mason (who actually I interviewed recently)
He’s referring to this specific letter below: 
The TL;DR “too long; didn’t read” is: 

1. A 71yo man had diabetes and an inflammatory bowel condition so severe that it was causing open sores in his bowels. He successfully reversed both conditions by eating an extremely low carb, low fiber ketogenic diet.
2. The endocrinologist acknowledged that the bowel condition was in remission and that the diabetes remission was due to carbohydrate restriction.
3. Regardless, she recommends a high carb diet - high in fruits, vegetables and whole grains. Actually, despite his problems remissing on a diet of only red meat (he was apparently doing a “carnivore diet”), she recommends he limits his intake of red meat. 
4. She recommends a statin because his LDL cholesterol is higher. Dr. Mason later told me that the man was having side effects (muscle wasting) from a statin in the past, so the endocrinologist just recommended a different statin.

Why wasn’t the endocrinologist amazed by this person? 
According to crohnscolitisfoundation.org, there is no known cure for ulcerative colitis.
According to diabetes.org.uk, there is no cure for diabetes.

...Yet, this man put both into remission with diet.
You would think that given this, an endocrinologist would react as if someone found that the sap from a specific tree in the Amazon that could cure both baldness and eczema.
“We need to study this right away.”
“What is in this stuff?” 
“Why does it work?” 
“What’s the mechanism of action of the compound in the sap?” 
“How can I get this tree sap to more people?”

I think the idea that an all meat “carnivore” diet having magical properties may seem dubious even to some of you, but if it’s having such magical effects, we could look at this from several angles. Maybe it's not that meat is "magic," but we can learn something from it helping him.

For example: 
-Is there something in all this red meat that he was lacking before?  
-Perhaps he couldn’t absorb protein sufficiently due to the inflammatory bowel condition but his new diet finally provided enough protein?
-Perhaps he was anemic and the more easily absorbed heme iron helped?
-Perhaps he was sensitive to some compounds in foods in his previous diet? Maybe the diet is acting like a completely thorough elimination diet.
-Perhaps it was the diabetes remission that caused the ulcerative colitis remission. Maybe there’s a connection between diabetes and ulcerative colitis?
-Maybe he could achieve the same results on a meat and vegetables diet if he just excluded specific irritating vegetables?

All things worth investigation, yet the endocrinologist’s recommendation was to go back on a diet similar to the one that gave him the issues in the first place. 
This reminded me of when my friend went in for a physical in Japan. They checked his height, weight, blood pressure, took some blood and all the tests you’d expect. At the end of it, he was brought in to see the doctor and the doctor told him “Your tests show that you are very healthy but you are obese so you should lose some weight. I’ll include a pamphlet for a nutrition guide.” 

My friend is really into body building and last I remember his body composition was pretty much the same as Arnold’s here: 
Over here they determine whether you’re obese or not based on height and weight. All that heavy muscle was making him …obese.

2. One of my Patrons asked me about using the dopamine from another activity to motivate you to do another activity. 

What he wrote: since I watched your video about forgetting to want alcohol I was thinking whether the reverse was possible. Say before you start a task that is normally boring for you and requires a large portion of your discipline and focus reserves, you could consume something that would trigger a dopamine release during this task and trick the body into making this boring task fun and rewarding after some time, even without consuming that said something and having the motivation from within. Have you stumbled upon something like this?

My response is below⬇︎

This sounded similar to Habit Stacking“  
This is interesting, sounds like you're talking about something along the lines of pavlovian conditioning. It's also similar to the "habit stacking" method James Clear talks about in his book Atomic Habits. Here's an article he wrote on it. The first place I heard of this idea was from BJ Fogg (Clear credits him in the book), but I think Clear explains it a little better. Anyways, it goes like this: If you're trying to build a new habit, then a good way to do that is to "stack" the new habit on top of an old one.

Fogg got himself to do several pushups throughout the day by setting the habit of 2 pushups every time he went to the bathroom. (He ended up doing more than 2 once he was down there so he actually got in like 80 pushups a day). Actually, I talked about this in an old video of mine. I have found this strategy is quite effective. Actually spending 10 minutes cleaning out my inbox per day is a habit I'm developing now and I've gotten myself to do it by "stacking" it on top of my journal habit. So far it is working and every time I finish journaling, opening up my email happens automatically - no willpower necessary. I've used this habit stacking method for a couple different things and it works. 

So, what's going on with dopamine in this situation specific situation, I'm not sure, but you can surely enhance people's dopamine and increase their motivation for other things. For example this study looking at the Parkinson's drug "L-Dopa," found that it increases motivation for some not-so-exciting-task they assigned to the people. Of course cocaine gets people to do things that normally they wouldn't be motivated to do. Cocaine was the stock broker's drug of choice probably in part because it kept their motivation up. 

However I think you mean something like: Could we take some dopamine increasing substance (say L-Dopa) everytime we do something boring like studying a textbook and then get amped everytime we saw that textbook? Good question. Perhaps you could get that effect if you set it up to where you only caused the dopamine increase (by a drug or whatever) after you finished studying or whatever it might be. Actually I sort of did this in the past by saying I could only drink my coffee if I finished my workout. That would motivate me to get the workout done. Unfortunately if I knew I couldn't drink coffee I wasn't equally motivated - say I already had the coffee and it was later in the day and I wanted to get another workout in, I wouldn't be excited at the thought of working out because I wouldn't drink coffee past noon.

So, if you attempted to get this affect you're talking about, say take a pill of L-Dopa every time you study, I think what would happen is:You would set up a situation where you'd feel like you couldn't do that thing unless you had the L-Dopa. For example, maybe you've had the experience of being able to sit down and be really productive in the morning with your coffee, but you're not so motivated to do so later. Something feels off like you "need" something to get working. Maybe a pick me up like a piece of chocolate, then I could work. I've had this plenty of times and music gets me pumped up to run - actually it works really well to the point that if I'm kind of lazy one morning, I'll just start playing certain "pump up" songs and I'm right away amped to go running. However, now I feel like I can't run without the music. 

Maybe you could get someone to be super motivated to study if everytime they sat down, you somehow got L-Dopa or whatever it might be into their system without them noticing. However, research on alcohol suggests that this would stop working very rapidly after you stopped giving them the L-Dopa. That is let's say you got them to be totally pumped about studying with repeated L-Dopa slipping. Then you stopped giving them the L-Dopa at some point. The extra motivation to study would quickly wear off because this is how the "Sinclair Method" for quitting alcohol works. You give people a drug that blocks the pleasure they feel (mu-opioid receptor antagonist) from drinking alcohol, so they do the cycle with alcohol:

1) Cue - They just finish work. They always drink at this time so it cues a craving for the alcohol.
2) Craving - They respond to the craving
3) Response - Go to the fridge, get the gin out, pour it in a cup and have a drink. 
4) Reward -  There's no reward thanks to the mu-opioid receptor blocker. 

This is described more in the Sinclair Method video, but the simple habit loop James Clear describes applies here. He says if something disrupts any one of these four stages, it will slowly unravel the habit. 

So, when you suddenly take away the L-Dopa from the person studying, they will experience the cue (see their textbook), then get a craving ("I have no idea why studying gets me so amped, but let's do this!"), then they will respond(crack open the textbook) ...but no reward will come. 

With that logic, unfortunately I can't think of a way to make it sustainable. If you come across a way to achieve what you're mentioning, I'm all ears because I'd love to make myself amped to do my taxes.  “[End of my response] 

More comments: What about rituals getting you “in the mood” for things?
See this excerpt from Chapter 10 of James Clear’s Atomic Habits⬇︎

…If you want to take it a step further, you can create a motivation ritual. You simply practice associating your habits with something you enjoy, then you can use that cue whenever you need a bit of motivation. For instance, if you always play the same song before having sex, then you’ll begin to link the music with the act. Whenever you want to get in the mood, just press play. Ed Latimore, a boxer and writer from Pittsburgh, benefited from a similar strategy without knowing it. “Odd realization,” he wrote. “My focus and concentration goes up just by putting my headphones [on] while writing. I don’t even have to play any music.” Without realizing it, he was conditioning himself. In the beginning, he put his headphones on, played some music he enjoyed, and did focused work. After doing it five, ten, twenty times, putting his headphones on became a cue that he automatically associated with increased focus. The craving followed naturally. Athletes use similar strategies to get themselves in the mind-set to perform. During my baseball career, I developed a specific ritual of stretching and throwing before each game. The whole sequence took about ten minutes, and I did it the same way every single time. While it physically warmed me up to play, more importantly, it put me in the right mental state. I began to associate my pregame ritual with feeling competitive and focused. Even if I wasn’t motivated beforehand, by the time I was done with my ritual, I was in “game mode.”

This had me rethink some of the points I sent over in my response. However, I think the point that if you don’t “re-pair” the ritual with the activity every now and then, then you will slowly decouple the two and you’ll lose the motivation enhancing effect still stands. 

For example, if the person who got himself motivated for sex with Tom Jones’ It’s not unusual played that song several times without having sex, it would slowly stop boosting motivation for sex. Similarly the boxer / writer may stop experiencing the boost in focus if say he got into the habit of putting his headphones on but then playing video games. 

So, The good news is that personally I have found the habit stacking method to work very well.
The bad news is (I presume that) you have to be careful of decoupling the activities.