Nutrition counseling for those who want to feel healthier

The End of Overeating

by David A. Kessler, MD, Rodale, 2009

Review: June, 2009

Are you one of those people who can't resist a Snickers bar at the check-out counter? Or feels the pull of a frappacino when you spot a Starbucks in the airport?  Or is it nachos you can't stop thinking about?  If this is you or if you wonder why it seems to describe others you know, then David Kessler's book The End of Overeating may make a fitting addition to your summer reading list.  I found it somewhat repetitive and too apt to quote every scientist by name; but the message is compelling and it comes from someone who helped bring the tobacco industry to heel.  Time now to take on the food industry?

 

          The End of Overeating essentially elaborates on three questions: (1) what Americans are eating and the food industry's role in that; (2) the neuroscience of hunger, satiety, and reward; and  (3) how individuals (and society) can change what they -- we! -- eat.  Dr. Kessler, former FDA commissioner and former dean of the Yale Medical School, confesses to being "firmly in the camp of the overeaters....I have lost weight, gained it back....I have owned suits in every size."

 

          As for what Americans are eating, well, we all know what that is either because we eat it or because we see it in supermarkets and advertisements.  Kessler writes about the fat, sugar, and salt involved in much of our food and he writes about the food industry's exploitation of our love of these "reinforcing" ingredients.  He has found some candid sources on the inside who talk about "adult baby-food," "food as entertainment," and how a phony taste like the butter substitute known as Butter Plus can secure customer satisfaction while also securing longer shelf life and lower production cost. A pound of Butter Plus can replace fifty pounds of real butter.  To hide the amount of sugar in processed food the tactic is to use several different kinds so that none has to top the list of ingredients, which must by law be named in descending order of quantity.  So if you're reading labels, look for sugar under all its many names, including dextrose, fructose, glucose, lactose, maltose, sucrose, syrup, etc.

 

          How do people become addicted to this highly palatable -- i.e., high in fat, sugar, and salt -- food, a phenomenon Kessler calls "conditioned hypereating"?  To answer that, he talked to an array of scientists about the cycle of cue--> urge --> reward --> habit.  The cue can be walking past Au Bon Pain or seeing an ad or suddenly thinking how good a pizza would taste.  The neurotransmitter dopamine is fired by the cue or stimulus and produces the urge to action, in this case to eat or drink.  Next the opioid receptors are engaged, which entails the feel-good reward.  After enough repetitions of the cycle, this becomes habit and, voila, we have a conditioned hypereater.  The author likens this to other stimulus/response disorders like gambling and alcoholism.

 

          To break the cycle, it is important to recognize that the cue to eat is not internal -- i.e., hunger -- but rather external, as it is usually the sight or smell of the favorite food.  Eating to get this reward rather than to quell hunger is, Kessler claims, less satisfying and it's the search for satisfaction that leads to more eating.  The challenge, then, is to replace the cue-urge-reward driven eating by hunger-driven eating.  To do that, his advice is to intervene at the precise moment of stimulus by choosing an alternative, be it walking away or thinking about something else, in short to "refuse the cue's invitation to the brain."  He recommends selecting a "competing behavior" and writing a little script to recite by way of supporting it.  The competing behavior includes a healthy food plan that you like.  It's very important to enjoy eating.  Other tips include avoiding food or situations that you can't control.  Don't, for instance, eat that first potato chip or don't go to the ice cream social just because you were invited.

 

          Ultimately, we are all responsible for what we put in our mouths.  It does no good to blame either our neurons or the food industry that tries to lure us with promises of happiness should we choose to drink Coca-cola or eat at MacDonald's.