The Pleasure Triad — How You Were Wired to Seek Comfort, Conserve Energy, and Avoid Pain

The Pleasure Triad — How You Were Wired to Seek Comfort, Conserve Energy, and Avoid Pain

You are not broken. You are not lazy. You are not lacking discipline. You are, in fact, doing exactly what a hundred thousand years of human evolution designed you to do. In Part 4 of this series, Dr. Deepti Sharma introduces one of the most clarifying frameworks she brings into her clinical practice: the pleasure triad. The deeply biological drive to seek comfort, conserve energy, and avoid pain isn't a character flaw — it's a survival blueprint. And in the modern world, surrounded by hyper-palatable food, sedentary convenience, and an endless menu of ways to escape discomfort, that blueprint is working against us in ways our ancestors never could have anticipated. This is where the series shifts. Because once you understand that the coping patterns from Part 3 aren't random — that they are in fact the pleasure triad in action, doing its ancient job in a modern environment — something important happens. The shame starts to loosen. The self-blame begins to soften. And a more useful question emerges: not why can't I stop? but what is my nervous system actually looking for? Dr. Sharma walks through the neuroscience of reward, the role of dopamine in driving behavior, and how the triad hijacks everything from eating and movement to rest and risk-taking. She connects the biology to the lived experience with the directness and warmth that have become her clinical hallmark — making complex neuroscience feel not just accessible, but deeply personal. For patients, this episode is a long-overdue permission slip to stop fighting themselves and start understanding themselves. For clinicians, it is a framework that recontextualizes patient behavior in a way that makes compassionate, effective care not just possible — but inevitable. This is the foundation beneath the foundation. And in the next few episodes Dr. Sharma begins to show us what it looks like to work with our wiring instead of against it

Unhealthy Coping Mechanisms or Numbing

If you've ever reached for food when you weren't hungry, poured a drink to take the edge off, scrolled until midnight to avoid your own thoughts, socialized mindlessly, filling your time with plans that drain you or binge watched Netflix/OTT every day pushed yourself into exhaustion just to feel in control — this episode is not here to judge you. It's here to explain to you. In Part 3 of this series, Dr. Deepti Sharma turns to one of the most misunderstood chapters of the trauma-health story: what we do to survive the feelings we were never taught to feel. Unhealthy coping mechanisms — emotional eating, substance use, avoidance, overworking, people-pleasing, numbing in all its forms — are rarely about weakness or lack of willpower. They are the nervous system doing exactly what it was wired to do: find relief from a pain it doesn't know how to metabolize any other way. Dr. Sharma walks through the full landscape. How the brain's reward circuitry gets recruited in the service of survival. Why behaviors that start as relief can quietly become their own source of harm. How coping patterns forged in childhood or during periods of prolonged stress become so deeply grooved they feel like personality — when in fact, they are adaptations. Brilliant, logical, and in need of compassionate revision. This is the episode where the ACEs framework and the trauma physiology from Parts 1 and 2 stop being abstract — and start showing up in everyday life. In the pantry at 10pm. In the third glass of wine. In the inability to rest even when the body is begging for it. Whether you're a patient who has quietly wondered why certain patterns feel impossible to break, or a clinician searching for language that meets people without shame — Dr. Sharma builds the bridge between biology and behavior with the clarity, warmth, and rigor that define her practice. Understanding is not the finish line. But it is where freedom begins.

Trauma and ACE

Trauma doesn't just live in memory. It lives in the body — in a nervous system that never got the signal that it was safe to stand down.  You may have come to Dr. Deepti Sharma looking for answers about your weight, your energy, your hormones, or your metabolic health. But in Part 2 of this series, she's going to ask you to look a little further back. In this she picks up where the ACEs conversation left off and goes deeper into what trauma actually does to human physiology. From the way chronic stress hormones reshape the brain and gut, to the downstream effects on inflammation, metabolism, and chronic disease risk — this episode makes the invisible visible. Dr. Sharma explains how unresolved trauma can look like anxiety, emotional eating, fatigue, autoimmune flares, or a body that simply won't respond the way it "should" — and why none of that is a character flaw. She brings together neuroscience, the metabolic science, and the human experience into a single cohesive picture that is as clinically grounded as it is compassionate. Whether you're a patient trying to understand why your health feels so complicated, or a provider looking to deepen your trauma-informed lens, this episode gives you the framework to see it clearly. Because for many people, the missing piece isn't a lab value or a medication dose — it's an understanding of how their history shaped their biology.

ACE - Adverse Childhood Experiences and their impact on our health

In this foundational episode, Dr. Sharma — triple board-certified physician, certified Menopause Practitioner, and certified life coach — unpacks adverse childhood experiences from the ground up. What counts as an ACE. Why the metabolic consequences of early trauma can look like willpower problems, lifestyle failures, or "unexplained" disease — and why that framing is wrong. ACEs aren't just a childhood story. They reshape the stress response, dysregulate the HPA axis, and leave a biological fingerprint that shows up decades later as chronic disease, metabolic dysfunction, and yes — obesity. In this broad overview episode, Dr. Sharma breaks down what ACEs actually are, how they wire the nervous system for survival in ways that can work against us in adulthood, and why understanding this science isn't about blame — it's about finally having a framework that makes sense of so much suffering. Whether you're a patient trying to understand your own health history, or a clinician looking to bring more trauma-informed care into your practice, this episode meets you where you are. This is the foundation. Stay tuned — the next episode goes deeper into what we can actually do with this knowledge.

Contributing Factors to Obesity — Genetics, Epigenetics, Hormones, and Set Point Theory

In the next few episodes, I want to talk about the contributing factors or causes of obesity in detail. The number one thing is genetics. Genetic predisposition plays a foundational role, influencing metabolic processes, fat storage, and appetite regulation. However, genetics alone do not dictate outcomes. This introduces the concept of epigenetics, which refers to changes in gene expression due to environmental factors like diet, stress, and even prenatal influences. Think of genetics as the blueprint or instruction manual. Epigenetics is like a light switch that turns certain genes on or off. Dysfunction within neurohormonal pathways disrupts the delicate balance of hunger and satiety signals, metabolic rate, and fat distribution. Hormones like leptin, ghrelin, insulin, and cortisol interact in ways that can drive excessive weight gain when dysregulated. This brings us to the set point theory of body fat mass, which suggests that our body has a predetermined range of fat mass or weight that it naturally tries to defend. Fat mass is a physiologically regulated phenotype, tightly regulated just like body temperature and pH. Obesity results from abnormal regulation of body fat mass, meaning changes in underlying biology lead the body to an elevated fat mass. This is why obesity is a disease. When you lose weight, your body activates mechanisms to regain it, such as increasing hunger, reducing energy expenditure, and increasing cravings. Adipose tissue is not just a blob of yellow cushiony tissue. It's a powerful and dynamic organ producing over 600 adipokines or hormones, including leptin, adiponectin, resistin, and TNF-alpha. They drive hormone regulation and dysregulation, contributing to metabolic processes involved in appetite regulation, insulin sensitivity, inflammation, and the pathogenesis of heart disease, chronic disease, and cancer. Leptin is the satiety hormone that helps us feel full. However, too much leptin leads to leptin resistance, where the brain becomes resistant to the hormone's message, resulting in reduced satiety, overeating, and weight gain. Research shows that calorie-dense processed foods impair the brain's leptin signaling. Insulin is another key player. When we eat calorie-dense meals, glucose rises rapidly, making the pancreas pump out insulin. Over time, with too much glucose and fat accumulating, insulin doesn't work as well, resulting in insulin resistance, the precursor to pre-diabetes and type 2 diabetes. Insulin is an anabolic hormone that signals the body to store fat and increase hunger. Other important gut hormones include ghrelin (the hunger hormone), GLP-1 and GIP (satiety hormones targeted by medications like Ozempic, Wegovy, Mounjaro, and Zepbound), glucagon (maintains blood glucose levels during fasting), and amylin (suppresses appetite and slows gastric emptying). 🌐 Learn more at weightandmetabolism.com [https://www.weightandmetabolism.com]