A researcher answers the weight gain question

October 18, 2010 By Edward M. Eveld

We eat too much, and it's making us fat and sick. So why don't we stop?

David A. Kessler gave himself the task of finding out. An admitted overeater -- and dieter -- he's a man who owns a suit in every size. He's also one of the country's leading health advocates, past commissioner of the and former medical school dean.

Kessler's research led him to coin a term for what's happening, "conditioned hypereating."

It's complicated, he says, but this much is certain: While we're forever trying to determine why our bodies are growing larger, the more important question is about what's going on in our brains. That's the process that needs attention, he says.

Kessler, author of "The End of ," recently explained his theory and discussed his book, now out in paperback.

"I've gained and lost weight repeatedly," he says. "Now I think I understand what's happening. This research took me inside what makes us human, how our brains get hijacked, how we get focused on the most salient in our environment."

"Why does my hand reach for that chocolate chip cookie?" he says. "It's not because I'm weak-willed. This really involves the learning, memory and motivational circuitry in the brain. Once you understand, at least it gives you the tools."

The brain wants what it wants. And what makes it happiest is sugar, fat and salt. But it's never satisfied. The more we supply, the more it demands.

Foods high in sugar, fat and salt trigger the release of and endorphins, firing up the brain's , he says. Soon enough, the brain is wired to react even to cues about the food -- sights and smells but also thoughts and suggestions. We get trapped in a cycle that starts with a food cue, which triggers the urge, which we quickly and easily satisfy.

But that's only part of the equation, Kessler says. What's different about food today, including in supermarkets and at restaurants, is that it's fully "layered and loaded" with sugar, fat and salt. It's manufactured and prepared for premium "mouthfeel," multiple "flavor notes," even ease of chewing.

Hyperpalatable foods are hyperstimulating, he says, and they are rewiring our brains. Then there's the added "emotional gloss" of advertising, the fact that food is available around every corner and that it's one of the chief ways we entertain ourselves.

"What did we expect to happen?" says Kessler, whoas FDA commissioner was well-known for his advocacy of food nutrition labels and tobacco industry regulation.

In earlier decades, he says, body weight remained relatively stable, increasing a few pounds in our 20s to 40s and then dropping in our 60s and 70s. In recent decades, our weight gain begins in childhood, hits 20 pounds in our 20s and continues much longer. The heaviest people get even heavier.

In his book, Kessler breaks down packaged food in the grocery store and offerings at restaurants such as Chili's Grill & Bar and T.G.I. Friday's, describing how something like Friday's "Parmesan-Crusted Sicilian Quesadilla," with its load of sausage, chicken, bacon and cheese, hits all of the palatability buttons.

Unfortunately, the calorie load is also enormous. Consider a plate of cheese fries, he writes. Instead of eating a simple potato, a carbohydrate that breaks down to sugar, we're eating something fried, salted and layered with cheese, which equates to "salt on fat on fat on sugar."

Exercise can be part of the answer to overeating, Kessler says, but not because it burns calories. The calories in a candy bar or a couple of cookies, eaten in two minutes, could take 45 minutes of walking to burn off. While regular exercise isn't an antidote to overeating, it can become a "substitute reward."

Only about 15 percent of us aren't susceptible to conditioned overeating, he says. For the rest, the important work is in our heads.

"We've got to lay down new neural circuitry," he says. "There are no magic bullets, but there are tools."

Typically, he says, going cold turkey doesn't work.

"That's the stuff of obsessions and cravings," he says.

One method is to implement structure to your eating, Kessler says. Decide ahead of time when and what you're going to eat, and keep your focus there. Don't expect food at every social and business gathering.

Be aware of the size of the food and how it's layered and loaded, he says. A hamburger can be satisfying without doubling or tripling it and adding piles of cheese and bacon.

Take a "fighting back" stance, he says. Knowing that layered and loaded foods will just stimulate you to eat more, see such food as a manipulation and say, "I don't want that."

Look at food not as a repeated reward or constant stimulant but as a means of nourishment, he says. You can't expect to avoid all of the food cues you encounter, but you can cool down your circuitry with a set of rules and boundaries. But they need to be your rules.

"No one can do it for you," Kessler says.


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