Overview: People with this type have a combination of both impulsive and compulsive features. On the surface it seems almost contradictory. How can you be both impulsive and compulsive at the same time? Think of compulsive gambling. These are people who are compulsively driven to gamble and yet have no control over their impulses. It is the same with these overeaters.

SPECT findings: The brain SPECT scans tend to show too much activity in the anterior cingulate gyrus so people get stuck on negative thoughts, but they also have too little activity in the prefrontal cortex so they have trouble supervising their own behavior. This pattern is common in the children or grandchildren of alcoholics and is also commonly seen in patients with bulimia.

What doesn’t work:

Using serotonin or dopamine interventions by themselves usually makes the problem worse. For example, using a serotonin medication or supplement helps to calm the compulsions but makes the impulsivity worse. Using a dopamine medication or supplement helps to lessen the impulsivity but increases the compulsive behaviors.

What works:

Plan to raise dopamine and serotonin together. People with this mixed type tend to have done very well emotionally and behaviorally on the fen-phen combination, which raised both dopamine and serotonin in the brain.

Supplements to try:

Use a combination of supplements, such as:

• Serotonin Mood Support (Neuro 5-HTP)
• Focus & Energy Optimizer

Behavioral interventions:

The following changes in behavior may boost both serotonin and dopamine to help impulsive-compulsive overeaters

• Exercise.
• Set goals.
• Avoid automatically opposing others or saying “no”, even to yourself.
• Avoid impulsively saying “yes”.
• Allow yourself several options, as you will do better with choices, rather than edicts.
• Distract yourself if you get a thought stuck in your head.