How to wean America from its dangerous food addiction
The nation's obesity epidemic is as much about brain
chemistry as it is poor diet and laziness — a fact we must realize if
we're going to treat obesity effectively
posted on May 22, 2012, at 10:20 AM for The Week magazine
In ancient history, eating was for survival.
Food was tough to come by and we consumed what we needed. Food was a
necessity. In today's America, it is an addiction.
Much of the conventional wisdom about obesity, including what your
doctor has probably told you, is wrong. My fellow doctors, for the past
four decades, have preached a "calories in — calories out" approach,
suggesting that weight loss must be achieved by restricting calories or
expending more energy. That approach is failing… miserably.
Contemporary medical research, most of which has not yet made it to
mainstream understanding, suggests we should focus on two other more
promising areas: Food addiction and diet. Consider it an "it's what you
eat" approach that takes into account human biology and the response to
certain food types.
According to the research of Nicole Avena of Princeton University,
eating sugar triggers a dopamine-mediated response in the same part of
the brain that is similarly targeted by cocaine, nicotine, and other
highly addictive substances. Originally, this "reward center" evolved to
reinforce behaviors, such as food and sex, that maximize species
survival.
To combat this epidemic, we may have to start with the brain, not the stomach.
Sugar, however, seems to hijack the same neural and biochemical
connections in the brain. The intense cravings for sugar may be
explained by the intensity of dopamine secretion in the brain when we
consume sugar and high-fructose corn syrup, both of which are staples of
the common American diet. Consistent eating of sugary and processed
food literally rewires our brain. In 2011, 28 studies, from animal
investigations to clinical studies of compulsive eaters, all point
toward unhealthy foods as being addictive.
So why do we get fat? It's not a simple matter of calories consumed
and calories expended. It's probably wiser to think of obesity as a
result of a hormonal imbalance, with the dominant obesity hormone being
insulin.
Insulin secretion is stimulated by eating easily digestible,
carbohydrate-rich foods: Refined carbohydrates (including flour and
cereal grains, starchy vegetables such as potatoes, and sugars) and
high-fructose corn syrup. Eating more of these makes us fat, hungrier,
and even more sedentary.
Why does all this matter? First, your kids are going to live a life
with more disease and will die younger than they should. This does not
have to be the case, but we can only reverse course if we act. With a
third of adolescents in the U.S. overweight, and adolescent diabetes and
prediabetes skyrocketing from 9 percent in 2000 to 23 percent in 2008,
we are on the path to an explosion in heart disease, high blood
pressure, and cancer.
Second, healthcare spending is driving you and the country bankrupt.
Obesity, a problem which didn't really exist even 40 years ago, today
accounts for almost a fifth of our nation's health spending, which
amounts to more than $150 billion every year. That is an annual tax of
$1,400 on every household, and it continues to escalate.
The good news is that the obesity problem is solvable. It is
reversible, if we act smartly, both individually by our own life choices
and collectively through wiser, more active public policy.
What can we do?
1. Focus on the root causes of why people crave food, often hungering
for the unhealthiest options, and not just deal with the aftereffects.
Studies show that exercise alone does not lead to weight loss (but it is
very healthy for you!), replacing lost calories with increased
appetite. It's what you eat that you should concentrate on. Weight loss
regimens succeed long-term when they get rid of the fattening
carbohydrates in your diet.
2. Think out of the box. If the increasingly strong hypothesis that
sugar is addictive is correct, we need to treat it as such. An addiction
demands attention to replacement foods, development of new classes of
anti-craving and relapsing medicines, and possibly even more intense use
of 12-step programs for therapy.
3. Public policy tools and tactics that affect advertising,
availability, and cost (including taxation) have been effective in
fighting alcohol and tobacco addiction. Our society instinctively
rejects policy that suggests "food police." In the future, however,
expect these tools to be considered much more aggressively since obesity
stands as an even greater public health threat than tobacco.
We cannot afford to ignore obesity. But let's be open to changing our
approach. To combat this epidemic, we may have to start with the brain,
not the stomach.
Download Our Free eBook:
The Science & Psychology Behind the Plate
Dr.
William H. Frist is a nationally acclaimed heart transplant surgeon,
former U.S. Senate Majority Leader, the chairman of Hope Through Healing
Hands and Tennessee SCORE, professor of surgery, and author of six
books. Learn more about his work at BillFrist.com.
