When I woke up Friday morning, along with the rest of the world I was shocked to learn of the apparent suicide of celebrity TV personality and chef Anthony Bourdain.  Most of you are probably familiar with his hit show Anthony Bourdain Parts Unknown where he traveled the world searching out every imaginable form of food, including a lunch with President Obama in Vietnam a few years ago.

A Tough Life
It was no secret that Anthony had a somewhat checkered past, including abusing every imaginable drug including heroin, cocaine, alcohol, cigarettes combined with endless reckless behavior. He burned through two marriages but managed to produce a lovely daughter Ariane who is now 11 years old. As far as I can tell, he was never diagnosed with depression, but he admitted to having mood swings. He admitted that something as benign as a bad hamburger could set off days of dark moods and depression.

In recent years Bourdain seems to have cleaned up his act.  He quit smoking over a decade ago, gave up all drugs of abuse and radically reduced his alcohol intake. He exercised frequently and appeared to be trim and fit. He had a beautiful French girlfriend Asia Argento.  She appeared to be as shocked as the rest of us when she learned of his suicide.  Apparently nobody saw this coming. That is nobody but me.

Hints of a Terrible New Disease
Although I have seen his shows a few times and found him to be an entertaining character, I really didn’t know too much about his personal story, that is until yesterday. I was sitting in a physician’s office waiting for my daughter to finish an appointment and I picked up a copy of People magazine from last fall that featured a long article about Bourdain. I carefully read the article because Bourdain and I shared one interest—food.  Anthony was known for eating just about anything imaginable and some things unimaginable, whereas my interests are more academic. I am interested in the connection between diet and brain function.  Decades ago two Psychiatrists from Boston, James Hudson and Harrison Pope, proposed that 14 common brain disorders were actually part of the same disease process that they named Affective Spectrum Disorder (ASD).  Because they never identified the triggers or the pathology of ASD, their concept never made it out of academic medicine. If you ask most physicians about ASD today, about 99% of them will have never heard of the concept.

Is It Possible to Miss the Elephant in the Room?
Over decades of front line medical practice, I also noticed that these same conditions seemed to be somehow connected. These disorders include major depressive disorder (MDD), attention-deficit/hyperactivity disorder, bulimia nervosa, cataplexy, dysthymic disorder, fibromyalgia, generalized anxiety disorder, irritable bowel syndrome, migraine, obsessive-compulsive disorder, panic disorder, posttraumatic stress disorder, premenstrual dysphoric disorder, and social phobia. I know—claiming that all these diseases are closely connected is more than a bit radical, but stick with me on this one, because it could save your life or the life of someone you love.

Highly Processed Food Fries the Brain
I have also identified the triggers of this disease—long term exposure to highly processed food. I decided to rename the condition Carbohydrate Associated Reversible Brain syndrome or CARB syndrome. This disease is also associated with metabolic problems like obesity, metabolic syndrome and type II diabetes. People with CARB syndrome can develop up to 22 brain dysfunction symptoms and number one on the list is strong cravings for sweet and starchy food. Over time these cravings push people to consume more of the very food that is frying their brain.  People with CARB syndrome also develop excessive mood swings and poor impulse control. In other words, some of these people in a down cycle  are capable of impulsively doing something really stupid, like ending their own life.

The Hoodie at the Buffet Table
Several things caught my attention when I read the People story about Bourdain. Although he was known to eat just about anything edible, when he followed his food preferences he ended up binging on things like macaroni and cheese at a Popeye’s fast food restaurant. Esquire magazine reported that late at night he often wore hoodies to sneak unrecognized into his favorite Popeye’s for their buffet including loads of macaroni and cheese and other comfort foods and he washed it down with sugar-laden Dr. Pepper. This clearly is not normal behavior. Jourdan also sensed that his behavior wasn’t normal and on the few occasions where people recognized him leaving Popeye’s late at night he compared it to be caught coming out of a whore house!

Before I go any farther, I want to make it clear that I have never personally examined Mr. Bourdain and any comments or speculation about his health issues is just that—speculation. It is acceptable and ethical to speculate about public figures when they decide to make their living performing before the public. You are certainly free to ignore my views if you don’t agree with them.

After finishing the People article on Bourdain, I still had about 15 minutes to wait and there wasn’t much else of interest to read in the waiting room, so I found myself daydreaming about Bourdain and his life. From the description in the article, it became clear to me that he had some degree of CARB syndrome. I have already mentioned that many people with CARB syndrome have obvious metabolic problems like obesity or type II diabetes. Bourdain appeared to be trim and fit and he certainly wasn’t obese using weight or BMI measures.

Metabolic Problems Versus Brain Dysfunction Symptoms
Decades ago I learned not to rely on weight or BMI measures to determine if someone is obese. The definition of obesity is “excessive body fat”—too much fat in your body relative to lean body mass and organ tissue. In other words, obesity is really a body composition issue. That’s why I ended up measuring over 10,000 body composition readings on my patients over several decades. I learned that with CARB syndrome, there is little correlation between the severity of the 22 symptoms of CARB syndrome and the amount of excessive fat in the body. A thin person could have severe brain dysfunction symptoms whereas a large person might have minimal symptoms.  Apparently Bourdain has lost about 35 pounds over the past few years so he clearly has had excessive body fat as an issue. If his body composition was measured shortly before his death, I suspect it would be a bit high for his size and weight.

Did I Predict His Demise?
What do we know so far?  Bourdain had a mild tendency to store excessive fat, he had strong cravings for sweet and starchy food, he had rapid mood swings and he had poor impulse control. All of these are classic symptoms of CARB syndrome. He may have also suffered from some of the other 22 symptoms of the disease, but the above symptoms that he clearly had would be enough to explain an impulsive suicide in someone who could easily play healthy and normal for the public, close friends and loved ones. I firmly believe that Bourdain was the victim of CARB syndrome, a devastating disease process that was missed by the medical and scientific communities. I still recall sitting in the waiting room after reading the article when a strange feeling came over me that something really bad was soon going to happen to Mr. Bourdan. The feeling was quite strong and surprised me. I don’t view myself as a fortune teller, so I shrugged off the thought and left with my daughter.

This Time the Experts Blew it Big Time
The true tragedy of this story is that CARB syndrome is preventable, treatable and reversible, but for this to happen somebody who understands this disease must be involved. Unfortunately for Mr. Bourdain and many others, this concept has yet to be accepted by the medical community, although some in various fields of research are starting to pay attention. In the June 8^th addition of the Wall Street Journal there was a front-page story declaring that the suicide rate in America has increased by nearing 30% from 1999 to 2016. The CDC report said the increase was “propelled by mental illness, substance-use disorders, financial hardship and relationship problems.” Or really?  I was there 30 years ago and so were all of these factors in abundance.  Back then we also didn’t have a huge mental health industry, a Psychiatrist or Psychologist behind every lamp post and a zillion potent new supposedly effective psychiatric drugs. Nobody, including the CDC, the scientific community and the medical profession has come up with a logical explanation for this rise in suicide. That is except me.

I believe it is obvious what is behind this rise in suicides as well as the increase in many common brain disorders—it’s our diet of highly processed food triggering an epidemic of CARB syndrome. I you don’t agree with me then you are obligated to come up with a better explanation for these unfortunate trends that are devasting our population.

In some of my other blog posts I outline how you can diagnose your own case of CARB syndrome and arrange for your own treatment. All the treatments for this disease meet my criteria for appropriate medical treatment—they are safe, cheap and readily available. I propose that to honor the memory of Anthony Bourdain, all interested parties should work together to spread the word, so we don’t lose another brilliant human being like Anthony who had every reason to keep on living.