As Dr. Ceballos explained at a conference, the need for metabolic fuels is continuous, but food intake is episodic; therefore, energy intake and expenditure are never completely balanced. After a meal, there is a surplus of energy that must be stored for later use (Ceballos 2016). Fat cells usually take over storage functions and a vicious cycle ensues. Eating more results in excess energy which will be stored as fat. Additionally, it is possible that Bonnie's condition is hormonal. The PYY3-36 hormone is released by intestinal cells. This small level of peptide increases after a meal to reduce the appetite (satiety) signal (Ceballos 2016). This PYY3-36 acts on the hypothalamic appetite control mechanism. PYY3-36 is very low in obese people, making them hungry. Dr. Ceballos discussed stress hormones such as cortisol. The release of cortisol can increase abdominal fat and may be the main link between stress and weight gain. Cortisol is a glucocorticoid. These hormones, along with insulin, appear to be responsible for stress-related cravings (McLaren Health