Sunday, August 2, 2009

Dissecting the Book “The End of Overeating” – Part 1

The July/August edition of Nutrition Action Newsletter features an interview with David Kessler, MD, author of the book “The End of Overeating: Taking Control of the Insatiable American Appetite.”

I knew of this book through my friend and blogging partner, Dr. Barbara Berkeley, who recently reviewed the book on our blog Refuse to Regain in an entry titled “Don’t Get Me Started.” Barbara focused on the book’s lack of outrage at the food industry as it pertains to its contribution to (and probable creation of) hyperovereating, an offense with which I concur.

However, I personally found Kessler’s explanation of why we overeat very helpful in understanding my own relationship to food, particularly as a person who is three years into weight maintenance. Hindsight may be 20/20, but turning around and looking back at my past behavior is the only way I can gauge how my “relearned” behavior is working.

I’ll break down my insightful insights into four points and will publish them in two blogs as to not bore you to tears with one long diatribe. So without further ado, let’s get this puppy started.

Point #1 – Dopamine

Nutrition Action Newsletter interviewer Bonnie Liebman: “How is dopamine – a neurotransmitter that conveys messages from one nerve cell to another – part of overeating?”

Kessler: “Dopamine focuses your attention. As human beings, we are wired to focus on the most important stimuli in our environment. If a bear walked into your office right now, your dopamine would spike. If your child is sick today, that’s what you’re thinking about. That’s what captures your attention…Of all the cues in this room right now, of all the things I could be thinking about, those little chocolate chip cookies over there are capturing my attention. Why? Because of my past experience, chocolate chip cookies will activate my brain.”

Liebman: “Before you take the first bite?”

Kessler: “Yes. I’m not tasting them. It’s not genuine hunger, but the anticipation that makes us eat long after our calorie needs are satisfied.”

Liebman: “And the sight of the cookies is the cue?”

Kessler: “Yes, but I could also be cued by the location, the time of day, or just getting in my car because it anticipates the consumption.”

Aha! Kessler just answered years of questioning, “Why do I want to eat that when I’m not hungry?” There are as many answers to that question as people asking the question, but for me, that one thing – dopamine – explains so much.

For instance, I don’t eat when I’m stressed. (Exception: when I’m under a writing deadline. Then my oral fixation takes over and I “need” to keep my mouth busy. I used to stuff it with M&Ms and sunflower seeds. Now I just chew gum or suck on a Tic Tac…more on that in the next blog.) I don’t eat when I’m sad. I’m not prone to binging. So why do I want to eat certain things when I’m hungry or when I’m already calorically satisfied? I get it now! It’s the memory of having been stimulated by that food, not the food itself, that’s making my mouth water or the desire to eat so strong.

I was talking to my daughter about this the other day. Her boyfriend brought her a Pizza Pub pizza the night before and she was heating up leftovers. I told her if I eat a piece of Pizza Pub cheese pizza (the best pizza in the world and it’s made right here in Podunkville), I will want another piece and another. Back in the day, I would eat half a pie and take the other half to work with me. A half a pie, folks! But it “felt” so good to eat it. The memory of sitting there with my husband, watching Jeopardy and eating pizza is extremely pleasurable. I wasn’t eating out of depression or stress or even real hunger. It was just pure enjoyment.

Not that there is ANYTHING WRONG with eating for pleasure. Food should be pleasurable. It’s what keeps us alive. If it tasted wretched, we’d not eat. Ergo, we’d die. But eating beyond feeling full just because the food “feels” good is the problem, and now that I understand that, it makes saying “No” or “Just a small piece, please” empowering and not personal. I used to think wanting to eat a certain food was some kind of character flaw.

Point #2 – Distraction

Kessler said, “A food industry executive told me that the industry creates dishes to hit what he called the three points of the compass. Sugar, fat and salt are what make food compelling and indulgent. The most palatable foods have two or three of them. They lead to a roller coaster in the mouth – the total orosensory experience. We get captured.”

Liebman: “What’s the roller coaster?”

Kessler: “It’s the cycle of cue-activation-arousal-release. We get cued – by sights, sounds, smells, time of day, location. The brain circuits get activated. There’s arousal. And then you either DISTRACT (my emphasis) yourself with something that’s more important or you consume it and there’s a release.”

I take issue with Kessler’s assertion that we must distract ourselves in order to not eat a certain food. I’ve spent a lot of time the last few years learning to not “distract” myself from things that are unpleasant or are seeming barriers to my well being. I choose to observe them with as much emotional detachment as I can. I’ve found immense personal understanding by asking, “Why is this urge/feeling/emotion so strong? What’s going on here?” By understanding the root cause of a particular pain or uncomfortable emotion, I can better deal with the entire situation at hand and not just the symptom.

Now that I know there is a chemical (dopamine) and emotional (the anticipation of “feeling good” when confronted with certain foods) going on, I’m better equipped to answer the question, “What’s going on here?” and therefore deal with whatever food issue I’m faced with. I may find I want to distract myself by going for a walk or painting my nails, but only after I’ve faced the food issue and asked the question.

That’s all for this entry. I’ll publish the last two points (and by then there may be more…lucky you!) in my next blog entry. I’m sure you’ll be waiting with anxious anticipation. Just don’t be eating something fat/salt/sugar-laden while you read it or you’ll want to eat that food every time you read my blog in the future! Can’t say I didn’t warn you :)