Dr. Kessler's new book describes the three components in food that keep us addicted: sugar, salt, and fat. (Photo courtesy of the National Canter Institute)
On average, people in the US
are much fatter than just 30
years ago. Obesity is an epidemic.
The Environment Report’s Lester
Graham talked with the author
of the book ‘The End of Overeating,’
which argues the American diet
is to blame:
Transcript
On average, people in the US
are much fatter than just 30
years ago. Obesity is an epidemic.
The Environment Report’s Lester
Graham talked with the author
of the book ‘The End of Overeating,’
which argues the American diet
is to blame:
Lester Graham: This is The Environment Report. People in the US are much fatter than just 30 years ago. Obesity has become an epidemic. The author of the book, “The End of Overeating” argues, “It’s the American diet.” David Kessler is a pediatrician and served as commissioner of the US Food and Drug administration under George Bush I and Bill Clinton. Dr. Kessler, give me the short answer, why has obesity become so rampant in the US?
David Kessler: We’ve taken fat, sugar, and salt, put it on every corner in America, made it available 24/7, made it socially acceptable to eat any time. We’ve added the emotional gloss of advertising—you’ll love it, you’ll want it. We’ve made food into entertainment. In fact, we’re living in a food carnival.
LG: I’ve been watching restaurant commercials, especially since reading your book, and I see a lot of, “It’s a fun time, it’s a good time, bring your friends, it’s a family gathering.” There is a lot of that emotional appeal, but it doesn’t talk about nutrition.
DK: Exactly. Sometimes about the economic value of food, but always it’s the emotional gloss that’s added. And food’s very reinforcing. Fat, sugar, and salt stimulate us, we come back more. But when you add that emotional gloss: “You’ll want it, you need it, you’ll have a good time.” That amplifies the reward value of food.
LG: Now your book spends a lot of time looking at the science of why we respond to sugar, salt, and fat and how the food industry has taken advantage of our response to sugar, salt, and fat. Why do we like those things in our food, why do we always crave more?
DK: That was the question that got me started 7 years ago. I wanted to understand why it was so hard for me to resist my favorite foods. I was watching Oprah one night, there was a woman on the show who said, “I eat when my husband leaves for work in the morning, I eat before he comes home at night, I eat when I’m happy, I eat when I’m sad, I eat when I’m hungry, I eat when I’m not hungry.” And then she said, “I don’t like myself.” And it was that behavior, I could relate to that. I have suits in every size. That’s what I wanted to understand, I wanted to understand the science and we finally do have the science to explain to that woman that it’s not her fault. In fact, her brain is becoming excessively activated by all the food cues in our environment—she’s being bombarded, she’s being constantly stimulated.
LG: You infer the food processors and the chain restaurants, are using some of the same techniques the tobacco companies used to get people hooked on cigarettes. In what ways?
DK: They certainly understand the inputs. They understand that sugar, fat and salt stimulate. They understand the outputs, that you come back for more. Have they understand the neuroscience? I doubt it. But they learned experientially what works, and they optimized food, they constructed food to stimulate us to come back for more. Let me explain how it works, let me give you analogy with tobacco. We have to be careful, there are similarities but there are also differences. Nicotine: nicotine is a moderately reinforcing chemical. But add to that the smoke, the throat scratch, the cellophane crinkling of the pack, the color of the pack, the image of the cowboy, the glamour, the sexiness, the sense that it was cool, the imagery from 20, 30, 40 years ago. What did we end up with? A highly addictive product. If I give you a packet of sugar and say, go have a good time, you’ll look at me and say, “What are you talking about?” Add to that sugar fat, add texture, add mouth-feel, add color, add temperature, put it on every corner, make it into entertainment, and what do we end up with? One of the great public health crises of our times.
LG: Now I don’t think the food industry sees this as necessarily trying to build addiction or using these chemicals as a way to re-wire our brain. I think any good chef will tell you, I want to cook things that will please you, that make you happy. It just so happens that sugar, salt, and fat make us happy. So, what’s wrong with it, if that’s what we want?
DK: The argument that the food companies will use is that all their giving consumers is what they want. But we now know, we have the science to show, that these chemicals are activating the brains of millions of Americans and what happens is that we keep on coming back for more. Look at modern American food, pick any appetizer from any major American restaurant chain. What is it? It’s layered and loaded with fat, sugar, and salt.
LG: Well, let’s pick one you highlighted in your book, because I happen to like it, it’s the Southwest Egg Roll at Chilis. It’s tasty!
DK: The Washington Post outed me because I had to go dumpster diving in order to find out what was in restaurant foods. We worked for a decade at the FDA putting nutrition facts labeling on all foods in the Supermarket, but not so in the restaurant foods. If you look at the ingredients, some fifty ingredients: the sugars, the fat, the fat loaded on fat, the salt in that eggroll. One industry insider just called it the equivalent of a fat bomb.
LG: You spend a little bit of time in the book on how food is labeled. How, for example, cereal manufacturers hide just how much sugar is really in that box. How do they hide it?
DK: Different names on the label, not just sugar, they’ll use honey, they’ll use molasses, they’ll use other terms so its not the first ingredient listed on cereals. But, understand, its not just any one ingredient. We have made food highly stimulating. The multi-sensory nature of food, it’s a rollercoaster in the mouth. 30 years ago, we used to chew on the average of 30 times per bite. Now it’s less than half of that. Food goes down in a whoosh, it stimulates, it rarely lingers. In fact, most of what we are eating is so pre-digested. Chicken: I went in and ordered a margarita grilled chicken dish, I thought it was healthy. Little did I know it was bathed, it was mixed in these cement mixers with sugar and fat, our meat is injected with these needles, solutions are added, sure it tastes good. But in some ways it keeps us in this cycle of consumption. And understand the cycle of consumption based on past learning, past memory, we get cued. Our brains get activated. The cue can be as simple as a sight, a smell, a location, my car can be a cue! Because where I’ve gone before, I get in the car and start having these thoughts of wanting. I was walking down Powell street and I started thinking about chocolate covered pretzels. Why? Because I had been, six months earlier, a place on Powell street. I had forgotten entirely about it, we’re such effective learners—just walking down that street will create thoughts of wanting. Thoughts of wanting arouse me, they capture my attention, they pre-occupy me, I eat for that momentary pleasure. Next time I get cued, I do it again, and every time I engage in this cycle, I just strengthen the neural circuits. What am I in search of? I’m in search of this ephemeral pleasure, is there any real satisfaction? Rarely.
LG: Your book is called “The End of Overeating.” How do we stop overeating, when much of the food at the grocery store and the restaurants is prepared the way it is, we have all these visual cues, these reminders of how food is a reward in our lives. How do we stop that cycle, how do we break or rewire our brain back to a more healthy style of eating?
DK: First, we have to come to the understanding that our behavior is becoming conditioned and driven. And it’s not just our behavior, it’s the behavior of our children. And once we understand that, once we understand that food in fact has become hot stimuli, and preoccupy us and capture our brains, and hijack our brain circuits, and we can see this on the neural imaging. What we have to do is cool down the stimulus. How do you cool down a stimulus? First, you can just get rid of the cues. That sounds easy, you create a safe environment in your home, but you end up walking down the street so that’s not very practical. The other effective way is to eat with some structure. What do we do in The United States? By putting fat, sugar, and salt on every corner, eating 24/7, eating in our cars, eating all the time, we’ve taken down any boundaries. So eating with some structure—knowing what you’re going to eat, when you’re going to eat it, and if it’s food that you want, it helps protect you from being bombarded by cues, because if you know what you’re going to be eating in several of hours, the cues in the intervening time that you get hit with just don’t have the same power. In the end, what’s the best way to reduce and take the power out of a stimulus? How do you change what you want? Want something else more. What we have to do, and I think this is essential as a country, because social norms effect us, they really effect our behavior, they effect our neural circuitry. If I look at that huge plate of fries and say, “That’s my friend, that’s gonna make me feel better,” my brain’s going to get activated and then there’s nothing I can do to stop myself from finishing that plate of fries. If however, we change how we view food, psychologists call it a critical perceptual shift. How did we win, well, we haven’t quite won it but how did we succeed in the perceptual shift against tobacco? 30, 40 years ago we used to view the product as something that was cool, something that was socially acceptable, something that we wanted. We changed that perception. Now we look at it for what it is, a deadly, disgusting, addictive product. Tobacco is easy because we can live without tobacco. Food is much harder. But, all the processed foods, foods that stimulate us, that are just fat and sugar, fat and salt, fat and sugar and salt, getting us to come back for more and more, I think we have to change how we view food back, perhaps it’s very simple in the end, ho w much real food are we eating?
LG: You did the research, started 7 years ago, you wrote the book, now you’re talking about food on interviews like this. How has it changed your life?
DK: What’s very interesting, being trained as a physician, I thought I would go into the world and understand the metabolism, the endocrinology, the bariatrics, the physiology. What I actually gained in understanding was that we’re all wired to focus on the most salient stimuli in our environment. That’s what makes us so successful as a species. It could be alcohol, tobacco, illegal drugs, it could be gambling, but for many of us, food has become the most salient stimuli, and what about that food? It’s the fat, sugar, and salt. I look at that food and I say, I need it, it’s going to make me feel better, and I’ve come over time to understand that I can feel just fine, eat about half as much as I was eating but feel just as satisfied.
LG: David Kessler is the author of “The End of Overeating: Taking Control of the Insatiable American Appetite.” Thanks very much for speaking with us.
DK: Thank you.