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Dr. David A. Kessler, the dynamic and controversial former FDA commissioner known for his crusade against the tobacco industry, is taking on another business that's making Americans sick: the food industry. In The End of Overeating, Dr. Kessler shows us how our brain chemistry has been hijacked by the foods we most love to eat: those that contain stimulating combinations of fat, sugar, and salt.Drawn from the latest brain science as well as interviews with top physicians and food industry insiders, The End of Overeating exposes the food industry's aggressive marketing tactics and reveals shocking facts about how we lost control over food—and what we can do to get it back. For the millions of people struggling with their weight as well as those of us who simply can't seem to eat our favorite foods in moderation, Dr. Kessler's cutting-edge investigation offers valuable insights and practical answers for America's largest-ever public health crisis. There has never been a more thorough, compelling, or in-depth analysis of why we eat the way we do.
Having battled weight all my adult life, these are some of the important points I took away from David Kessler's book:The food industry is the manipulator of consumers' minds and desires. As a result, restaurant food is loaded with fat, salt, and sugar. In a cyclical process, eating highly palatable foods with just the right amounts of sugar, fat and salt activates the opioid circuits in the brain and increases consumption of highly palatable food. Engaging opioid mechanisms interferes with "taste-specific satiety." You don't grow tired of the taste of a food, you just keep eating it.Humans prefer an exaggerated stimulus. Hyperpalatable foods with very energy-dense sugar and fat are the culinary equivalent of entertainment spectacles like Disneyland or Las Vegas. The amount of sugar in food today goes beyond the level we could have experienced naturally, and that means we desire it more. If we were eating these types of foods once in awhile (like we visit Disneyland once in awhile) it wouldn't be such a problem. The difficulty is that we do it so often.People have been conditioned to eat more of certain types of foods during certain times of day. Culturally, we are now expected to eat during times of the day when we normally would not have eaten. During my years teaching at one school site, we had recess aides. As a result, each morning at 9:30, we teachers would dismiss our students for recess and then gather in the lunchroom. There was the expectation that there would be a snack in that lunchroom every day: chips and guacamole, a cake (teachers were encouraged to bring a cake to share on their birthdays) or something else. We would sit and dish about our kids and munch away on the snacks at the table. I gained 15 pounds that first year of teaching, and thereafter continued a pattern that resulted in more weight gain over the next 8 years that I worked at that school. When I transferred to a new school, there were no morning recess aides. So, there was no routine to have food in the lounge as had been the case at the old school. The result: skinnier teachers with more appropriate morning eating habits. After awhile, I gave up that "morning snack" entirely. But it had become a conditioned habit.Positive associations become ingrained in us to motivate our behavior. We associate certain foods with pleasurable times in our lives. The reverse is most certainly true as well: We can associate foods with an unpleasurable experience as well. My sister will not eat scalloped potatoes and ham to this day because she vomited that particular dinner up one evening at the beginning of a bout with stomach flu.Foods high in sugar, fat and salt are altering the biological circuitry of our brains. People cannot control their responses to highly palatable foods because their brains have been changed by the foods they eat. When it comes to food, we are following an eating script that has been written into the circuits of our brains.For example, "Chili's Southwestern Egg rolls" is a "starter course" the size of a burrito. It is a tortilla, chicken, cheese, etc. all highly processed to add more fat, sugar and salt. It has a very high calorie density, and the processing means you can chew it very fast. Refined food simply melts in the mouth. Calling it an "egg roll" and a "starter course" implies that it is just something you order to eat until your dinner has been cooked. Those "egg rolls" have 810 calories, 51 grams of fat, 1250 mg of salt, and 59 carbs. But because it is so highly processed, you will eat the whole thing and your brain will not register fullness. Refined food simply melts in the mouth as though it has been pre-chewed. Processing creates a sort of "adult baby food." Foods with less "chew" don't leave us with a sense of being well fed. Food stripped of fiber (to make it easier to chew) doesn't satisfy the way a more fiber-rich version would do.So, instead we eat to be belly filled.The more the food industry behaves like the entertainment industry, the more profitable it is. Eating out has become more routine, so to compete, restaurants have to offer more "eatertainment."The food industry's goal is the make enticing food easily and constantly available, and keeps it novel so people will keep coming back for more. You could call it the "taco chip challenge" - the challenge of controlled eating in the face of constant food availability.The food industry is also constantly looking for ways to maximize profits by using poorer quality ingredients and fillers. Today's muffins are bigger, but most of the real ingredients are gone. They have been replaced by shortening or oil, powdered egg substitutes and processed sweeteners.You have been systematically conditioned to overeat by the food industry. The industry has engineered food layered with salt, fat and sugar along with cues to maintain the constant urge to reward yourself with that food until it becomes habit.Children naturally compensate to adjust the number of calories they consume during a day. If a child eats a calorie dense food, they will compensate naturally by eating less of other foods. This is the body's innate system of homeostasis. Over time, that is changing, and now studies are showing that children compensate less as they eat more and more processed (pre-chewed) foods.Food companies fool us into thinking there is not as much sugar in a food by using techniques designed to manipulate our thinking. If a food contains more sugar than any other ingredient, federal regulations dictate that sugar be listed first on the label. To avoid having to do that, the industry will put in 3, 4, or 5 different sources of sugar so sugar doesn't have to be listed first. They will put in sugar, brown sugar, fructose, HFCS, honey or molasses in some combination to move the ingredients further down the list.Social mores that used to keep us from eating in public have been lowered over time. We can walk and eat, be at work and eat, and that behavior isn't considered rude. Today, meetings and social occasions are constructed around food. There has been a breakdown in meal structure. The distinction between meals and snacks has been blurred. Snacking generally occurs without a compensating caloric reduction at mealtimes. People don't eat a smaller breakfast, lunch, or dinner just because they snack throughout the day.Recent discussion about why the French can remain thin in spite of the rich foods they consume has enlightened us to why that happens. They eat smaller portions in only 2 or 3 meals per day. They simply don't snack. They don't eat in certain environments like classrooms or meetings, and they don't engage in "vagabond feeding" like Americans do.As older patterns have broken down over time, eating for reward has overtaken eating for hunger. The satiety mechanism that takes place between meals cannot take place if you eat constantly. You lose the notion of what satiety feels like. Learning to overeat is an incremental process that grows with repeated exposure. To control our brains, we must learn to be mistrustful. We need to recognize that evolutionary behaviors that were helpful in the past have gotten out of control.Intervention begins with the knowledge that we have a moment of choice - BUT ONLY A MOMENT - to recognize what is about to happen and do something else instead.There are 4 steps to habit reversal.Step 1 - Awareness: We need to be aware of sensory signals, stressful situations and forceful memories and their ability to make us respond to food. The question becomes, how much are you responding sensory stimuli instead of real hunger? Once you are cued, and have that initial urge, that is when you have a moment of control. Once you pay attention you have the capacity to extinguish the behavior.Step 2 - Competing behavior: Learn and develop alternative responses that are incompatible with the undesired behavior. You need to know how you will respond when presented with the undesirable behavior. You must intervene early to have the best success.Step 3 - Formulate thoughts that compete with and quiet old thoughts. Change the way you talk to yourself about food. Thinking about outcomes changes how you feel about the situation.Step 4 - Seek support, but if your support system does not reinforce your goals, you're better off going it alone.Use "if-then rules." If I encounter this cue, then I regulate my response to it this way.Rules are not the same as willpower. Willpower pits the force of reinforcing stimuli against your determination to resist. A rule makes explicit the negative consequences of giving in to your impulses, and the positive consequences of not giving in. Rules are guided by higher brain functions. Categorical rules are easiest to follow:* I don't eat French fries.* I will not have dessert.When the brain knows that a reward will not be forthcoming, it shifts its attention elsewhere.If we learn to view the pursuit of sugar, salt and fat in a negative light, and to view with equal emotional significance behavior that encourages us to turn away from it, we can change a habit.Counterconditioning is making a perceptual shift, and key to the essential principals of "Food Rehab."* Engage in planned eating.* Replace chaos with structure.* Make simple yet specific rules about what and when to eat.* Be predictable with food.A just-right meal satisfies you for about 4 hours. A just-right snack satisfies you for about 2 hours. Eat half of what you normally eat, and then pay attention to how you feel 30 minutes later and then again 90 minutes later. Adjust accordingly until you find a serving size that is enough. Beyond that you are only eating for reward, not satiety. When people are served a "meal," their perception is that they are more satisfied than if they are served the exact same food called an "appetizer."Any diet that keeps you hungry is guaranteed to fail. The most satiating micro-nutrients are meat and fiber. The least satiating is simple sugar. So you should eat whole wheat and brown rice instead of their white counterparts, meat instead of meat fillers, and an apple instead of applesauce. High fiber foods empty more slowly from the stomach, so you will feel satisfied for a longer period of time. Conversely, even though fat moves out of the stomach slowly, the body processes the feeling of fullness from fat more slowly, so it takes longer to feel full.Eat foods that occur in nature - high fiber, complex carbs, protein, and small amounts of fat.Be aware of your emotions and describe them so you can look more objectively at your mechanisms for coping with food. Ask yourself, "Will eating help me truly deal with this feeling?"Have a list of alternate responses ready for dealing with your desire to eat when you really aren't hungry. Call a friend, go for a walk, do stress reduction exercises, or anything that can distract your attention.Refuse everything you can't control! Even if it means that you have to throw it in the trash, do it so you won't have to fight temptation. One Christmas, my sister in law made tons of cookies, fudge, and peanut brittle for gifts. She gave each of us bags of this stuff, and just looking at it, I knew if I had it around my house, my family and I would eat it all. So, as soon as she left, I emptied it all into the trashcan. I felt so much better knowing that I wouldn't have to keep making the decision about whether or not to eat it every time I walked into the kitchen. It was so liberating.Have an alternate plan. Take a different route to work, avoid the lunchroom when there are treats, and be aware of cues encouraging you to eat more.Limit your exposure. In social situations, the temptations are ever-present. Remove yourself from the stimuli.Redirect your attention. Ask yourself, "What will I do instead?" Read? Write? Exercise? Garden? Sew?If I chose an activity to do every time I thought about eating something when I wasn't hungry, I would get so much accomplished. If I went into my sewing room and worked on a project every time I thought I needed a little snack (when in actuality I am probably just bored) I would have sewn hundreds of projects by now. Sewing is an activity that you simply cannot do while you eat. Watching TV is, so don't choose activities that are compatible with eating, because you will still find it hard to resist the cues to eat.Learn active resistance. Refuse to be manipulated by marketing and advertising designed to get you to eat more. The food industry just wants to make money. They are doing everything in their power to achieve that goal. They really don't care about your health and well-being. They just want you to want more food, because that's how they make money. So, you have to be the keeper of your health. Understand that they want to control your thinking as much as possible to get you to buy their food. It has nothing to do with eating for hunger. It has everything to do with providing you with entertainment for your mouth and brain.Use thought stopping. Think of the decision to eat like a television, and change the channel. Do it quickly! If you debate with yourself, you will lose the battle. Don't struggle, just get it out of your working memory. "Yes" has to become "NO" - not maybe. Engage your brain with something else. Stop the cue-urge-reward-habit cycle.Talk down the urge. Tell yourself, "Eating this will keep me in the cue-urge-reward-habit cycle."Exercise. Exercise engages the same neural regions as the other mood-enhancing rewards, and produces similar chemical responses in the brain.Make your own set of rules about food and then follow them. One of my rules, "If I don't love it, why am I eating it?" This reminds me of these cookies my principal periodically brings to staff meetings. They are bone dry, almost to the point of being stale, and they have almost no flavor. But, because they are "cookies," the teachers eat them anyway. It is not hard for me to pass them by because they just aren't even delicious. But I watch as the other people in the room devour those cookies. Why? Because they have been conditioned. These cookies are a "special treat" provided by the boss for the enjoyment of the staff. So everyone dutifully eats those miserable, stale, rock-hard lumps of processed flour and sugar, and they delude themselves into believing it is a treat. How insane is that?When I stopped eating so many chemicals in food (processed food) I realized that the "food" I was eating didn't taste like food at all. Now I would eat real strawberries, and when I tried something "strawberry-flavored" it tasted synthetic and unsatisfying.If you allow an object to be more powerful, it will always have power over you. Refuse to be manipulated. People with conditioned hypereating need to become their own food coaches.We need to move from glorification to demonization of the food industry - especially "big food."