Foods high in fat, sugar salt alter brain chemistry to cause overeating

[Guest guest]

Crave Man

Kessler Knew That Some Foods Are Hard to Resist; Now He Knows Why

By Lyndsey Layton

Washington Post Staff Writer

Monday, April 27, 2009

He went in the middle of the night, long after the last employee had locked

up the Chili's Grill and Bar. He'd steer his car around the back, check to

make sure no one was around and then quietly approach the dumpster.

If anyone noticed the man foraging through the trash, they would have

assumed he was a vagrant. Except he was wearing black dress slacks and

padded gardening gloves. " I'm surprised he didn't wear a tie, " his wife said

dryly.

The high-octane career path of A. Kessler, the Harvard-trained doctor,

lawyer, medical school dean and former commissioner of the Food and Drug

Administration had come to this: nocturnal dumpster diving. Sometimes, he

would just reach in. Other times, he would climb in.

It took many of these forays until Kessler emerged with his prize:

ingredient labels affixed to empty cardboard boxes that spelled out the

fats, salt and sugar used to make the Southwestern Eggrolls, Boneless

Shanghai Wings and other dishes served by the nation's second-largest

restaurant chain.

Kessler was on a mission to understand a problem that has vexed him since

childhood: why he can't resist certain foods.

His resulting theory, described in his new book, " The End of Overeating, " is

startling. Foods high in fat, salt and sugar alter the brain's chemistry in

ways that compel people to overeat. " Much of the scientific research around

overeating has been physiology -- what's going on in our body, " he said.

" The real question is what's going on in our brain. "

The ingredient labels gave Kessler information the restaurant chain declined

to provide when he asked for it. At the FDA, Kessler pushed through

nutritional labels on foods sold through retail outlets but stopped short of

requiring the same for restaurants. Yet if suppliers ship across state

lines, as suppliers for Chili's do, the ingredients must be printed on the

box. That is what led Kessler, one of the nation's leading public health

figures, to hang around dumpsters across California.

The labels showed the foods were bathed in salt, fat and sugars, beyond what

a diner might expect by reading the menu, Kessler said. The ingredient list

for Southwestern Eggrolls mentioned salt eight different times; sugars

showed up five times. The " egg rolls, " which are deep-fried in fat, contain

chicken that has been chopped up like meatloaf to give it a " melt in the

mouth " quality that also makes it faster to eat. By the time a diner has

finished this appetizer, she has consumed 910 calories, 57 grams of fat and

1,960 milligrams of sodium.

Instead of satisfying hunger, the salt-fat-sugar combination will stimulate

that diner's brain to crave more, Kessler said. For many, the come-on

offered by Lay's Potato Chips -- " Betcha can't eat just one " -- is

scientifically accurate. And the food industry manipulates this neurological

response, designing foods to induce people to eat more than they should or

even want, Kessler found.

His theory, born out in a growing body of scientific research, has

implications not just for the increasing number of Americans struggling with

obesity but for health providers and policymakers.

" The challenge is how do we explain to America what's going on -- how do we

break through and help people understand how their brains have been

captured? " he said.

Kessler is best remembered for his investigation of the tobacco industry and

attempts to place it under federal regulation while he was FDA commissioner

from 1990 to 1997. Although he was appointed by H.W. Bush, Kessler

became popular among Democrats for his tough regulatory stance. He got the

nickname " Eliot Knessler " after he authorized the U.S. attorney's office in

Minnesota to seize a large quantity of Citrus Hill Fresh Choice orange juice

in 1991 because it was labeled " fresh " when it was, in fact, partially

processed. After he was elected in 1992, President Bill Clinton asked

Kessler to continue to run the FDA.

Kessler, 57, sees parallels between the tobacco and food industries. Both

are manipulating consumer behavior to sell products that can harm health, he

said.

Whether government ought to exercise tougher controls over the food industry

is going to be the next great debate, especially since much of the

advertising is aimed at children, Kessler said.

" The food the industry is selling is much more powerful than we realized, "

he said. " I used to think I ate to feel full. Now I know, we have the

science that shows, we're eating to stimulate ourselves. And so the question

is what are we going to do about it? "

The idea for the book came seven years ago as Kessler was channel-surfing

and came across an overweight woman named on " The Oprah Winfrey Show. "

While was successful in nearly every aspect of her life, she tearfully

told Winfrey, she could not control her eating.

Kessler was mesmerized by -- she was describing his own private

struggle. " I needed to not only figure out -- I needed to figure out

myself, " he said. " Little did I know it would lead me into real fundamental

issues of what makes us human and how our brains are wired. "

At 5-foot-11, Kessler's weight has swung from 160 pounds to 230 pounds and

back, many times over. He owns pants in sizes ranging from 34 to 42.

" I was a fat kid, " he said. " I grew up in the world of Entenmann's cakes. I

was pretty much of a science nerd. If you looked in my refrigerator in

college, it was Entenmann's. "

Every few years, Kessler would go on a diet and apply the kind of discipline

that enabled him to earn a law degree from the University of Chicago while

attending Harvard Medical School. " I'd lose weight and over time gain it

back, " said Kessler, who also completed a medical residency at s Hopkins

Hospital in Baltimore at the same time he worked as a staffer to Sen. Orrin

Hatch. " I couldn't control it. "

The man who took on Big Tobacco was helpless when confronted with a plate of

chocolate chip cookies. He couldn't focus on anything else until he had

eaten them all.

" My weight was yo-yoing all the time, " said Kessler, who estimates that 70

million Americans struggle with conditioned hyper-eating. " And I never

understood why. "

He embarked on a mission to figure it out while serving as dean of the

medical school at Yale University and later the University of California at

San Francisco. UCSF fired Kessler from his position as dean in December

after he alleged financial malfeasance at the institution. The university

maintains there were no financial misdeeds; Kessler says he was forced out

because he blew the whistle. He remains on the faculty at the medical school

and lives in San Francisco with his wife, ette, a lawyer. They have two

grown children, both of whom live in Washington.

ette says that she was not taken aback when her husband of 34 years

would disappear in the middle of the night on his dumpster tour. " Nothing

surprises me anymore, " she said. " When he wants to find something out,

there's really no stopping him. "

Through interviews with scientists, psychologists and food industry

insiders, and his own scientific studies and hours spent surreptitiously

watching other diners at food courts and restaurants around the country,

Kessler said, he finally began to understand why he couldn't control his

eating.

" Highly palatable " foods -- those containing fat, sugar and salt --

stimulate the brain to release dopamine, the neurotransmitter associated

with the pleasure center, he found. In time, the brain gets wired so that

dopamine pathways light up at the mere suggestion of the food, such as

driving past a fast-food restaurant, and the urge to eat the food grows

insistent. Once the food is eaten, the brain releases opioids, which bring

emotional relief. Together, dopamine and opioids create a pathway that can

activate every time a person is reminded about the particular food. This

happens regardless of whether the person is hungry.

Not everyone is vulnerable to " conditioned overeating " -- Kessler estimates

that about 15 percent of the population is not affected and says more

research is needed to understand what makes them immune.

But for those like Kessler, the key to stopping the cycle is to rewire the

brain's response to food -- not easy in a culture where unhealthy food and

snacks are cheap and plentiful, portions are huge and consumers are

bombarded by advertising that links these foods to fun and good times, he

said.

Deprivation only heightens the way the brain values the food, which is why

dieting doesn't work, he said.

What's needed is a perceptual shift, Kessler said. " We did this with

cigarettes, " he said. " It used to be sexy and glamorous but now people look

at it and say, 'That's not my friend, that's not something I want.' We need

to make a cognitive shift as a country and change the way we look at food.

Instead of viewing that huge plate of nachos and fries as a guilty pleasure,

we have to . . . look at it and say, 'That's not going to make me feel good.

In fact, that's disgusting.' "

Kessler said he's made that shift in his own life, eating small portions of

foods that contain fat, salt and sugar, part of a " food rehab " plan he

suggests in the book. He has certain rules -- no french fries, ever -- that

help him navigate through vulnerable moments.

He has embraced spinning -- the first time he has regularly exercised. " I

hated physical activity, all of my life, mostly because I was fat and it was

hard to do, " he said. " But I just wanted to do something. I picked spinning

because you can't fall off the bike. " He worked with a private trainer for

weeks just to be ready to take a class. " I was embarrassed to go into the

class, " he said.

Now Kessler tries to spin every day and belongs to multiple health clubs so

that he has more options for class times.

He avoids the cues that focus his brain on " highly palatable " foods, going

so far as to chart a different route through San Francisco International

Airport so that he doesn't walk past the fried dumpling stand.

Kessler's weight is relatively stable at 162 pounds. But there's something

else that's changed. As he has come to better understand himself, the food

cravings and the resulting anguish he felt have subsided.

" So I'm at peace, " he said. " After 30 years, I'm at peace. "