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Book Review: The End of Overeating

I highly recommend Dr. David A. Kessler’s new book, THE END OF OVEREATING: TAKING CONTROL OF THE INSATIABLE AMERICAN APPETITE. He was the commissioner of the U.S. Food and Drug Administration from 1990-7 and writes on eating and weight from a professional perspective, but also as someone who struggles with food himself. Some pertinent points from this very enlightening and readable book.

Kessler begins by talking about why it’s hard to resist certain foods: our bodies crave the mixture of sugar, fat, and salt contained in most prepared foods. While we get a dopamine boost from each ingredient alone, the biggest rush comes from a combo of all three. Even the anticipation of eating them triggers a response in our brains, as does unconscious cuing which happens when anything in the environment creates an unconscious or conscious association with food—seeing grandma reminds us of her yummy brownies, cruising by Taco Bell makes our mouths water for a chicken burrito, or singing carols before Christmas dinner signals the brain that chestnut stuffing is soon to follow. Kessler says that the more multi-sensory food is—via texture, temperature and taste—the more our appetite becomes aroused, and that the food industry hooks us on a combo of salt, fat and sugar and by making food multi-sensory by what’s called “layering” flavors in order to sell more of its products.

He maintains that we are not equally susceptible to triggering by high-sugar/fat/salt foods, but that “about 50% of obese, 30% of overweight, and 20% of healthy weight individuals score very high on three characteristics”—losing control around certain foods, lack of satiation, and preoccupation with food and eating—a syndrome called conditioned hyper-eating. In some folks, in fact, brain imaging shows elevated activation in the amygdala when simply shown foods like chocolate. For hyper-eaters, the brain’s reward circuits stay in overdrive and don’t stop until they’ve finished the food.

Kessler underscores that repeating behavior strengthens neural pathways, refraining from behavior weakens them, and the only way to change behavior permanently is to develop new circuitry. He cautions, however, that even new neural pathways may fail us under extreme stress. I would remind you that although we’re programmed biologically to be rewarded by eating high-fat/sugar/salt food, we still retain free will. Just because our brains crave and delight from eating a food, doesn’t mean we automatically must cave to that craving. Being aware of how we’re programmed is only a first step. The second is problem solving so that we can supersede our food-triggering biology.