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Archive for the ‘Brain & appetite’ Category

Summer Tomato blogger and author Darya Rose asks why “virtually all health and diet advice” seems directed at “perfect” eaters who “eat for one reason and one reason alone: optimal health and nutrition.”

Rose describes mythical “Nutricons” who “are completely rational about their food decisions” and also points out the seemingly Emperor’s New Clothes aspect of what/how we eat:

Nutrition knowledge is meaningless unless we can actually implement it in our daily lives. … Unless you acknowledge that your actions will never be driven by nutrition knowledge, you’ll continue to spin your wheels and blame yourself––instead of the bad advice––each time nature shows you that you’re a human and not a robot.

To get healthy you need to understand what really drives you to eat, because hoping that you will one day be motivated enough to make salad instead of ordering pizza isn’t very rational.

Per Monday’s QOTD I would add that when trying to understand what really drives “you” to eat, you should also consider how alike “you” are to the millions and millions of other people who are driven to eat pizza instead of salad.

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Stephan Guyenet asks the question: Has Obesity Research Failed? The short answer is “no” … that “it has produced huge amounts of scientifically robust information, and a number of effective therapies.”

Aye, but here’s the rub. There is still no “magic bullet” as of yet (emphasis mine):

The reason we don’t have a magic bullet is that obesity is a difficult problem. Preventing and treating obesity means fighting the natural tendency of the human body and mind in the context of our current culture. You can tell people to eat less sugar, white flour, added fats, and processed foods in general, but only a minority of people will actually alter their behavior significantly as a result. This is because people don’t eat junk food for its health benefits– they eat it because they like it, it’s cheap, and it’s readily available.

This is why I am frustrated by the well-meaning efforts of folks like Stephan (and partner Dan Pardi) and Armi Legge and James Fell and so on and so forth. It’s not that people don’t know what to do, it’s that they struggle to do so in their environment.

I am am starting to feel strongly that the written word — whether in the form of books or blogs — is not the solution. It doesn’t seem to matter if it’s in the form of what to eat or how to avoid overeating, knowing what we’re supposed to do is just not enough.

Update, 6/11: Here’s an interesting comment from Stephan re the potential harm of obesity research (emphasis mine):

I think it’s fair to consider the potential harm caused by obesity researchers, physicians, and public policy experts. There has certainly been a kernel of moral superiority in some of their behavior. Thin people like to think of reasons why they’re thin that make them feel morally superior. In fact, the main fundamental difference between lean and obese people in the US is genetics.

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David Despain has a must-read post on food addiction over at his blog. He’s reporting a session at the recent meeting of the American Society for Nutrition, where the discussion seemed pretty much standard (“yes food addiction exists, look at the lights!” “no, food addiction doesn’t exist … we can’t make cheesecake illegal”).

Too bad researcher and Whole Health Source blogger Stephan Guyenet wasn’t part of the discussion. IMO, his comment on David’s post was spot on (emphasis mine):

At its heart, addiction is an excessive motivation to engage in a reward-seeking behavior, e.g. a drug, gambling, etc. Where do we draw the line between normal reward-motivated behavior and excessive reward-motivated behavior? That’s the tough part. There is no clear line for food, but there is also no clear line for drugs or gambling.

Currently, we say someone is addicted when the pull to engage in the behavior is having a serious negative impact on that person’s life. It’s a very subjective definition but it’s still the best one we have. There will probably never be a useful neurobiological definition of addiction, because fundamentally addiction is defined by behavior. …

In my opinion, arguing about whether or not fMRI data supports addiction is missing the point. If someone is stealing TVs to buy crack, who cares what the fMRI says? If someone is leading a normal constructive life with occasional controlled gambling, but his reward centers light up like a Christmas tree when he sees images of a slot machine, is that person an addict? Of course not. …

Some would say “how can you be addicted to a substance you need to consume, like food?” The key is that we aren’t talking about food in general. We’re talking about specific foods that are highly rewarding, and there is no dietary requirement for those foods just as there is no physical requirement for drugs of abuse. I’ve never heard of an oatmeal or lentil addiction. It’s cake, cookies, chips, candy, and that sort of thing that triggers addiction-like behavior.

In the end, I think food addiction is real, but it doesn’t fully explain obesity.

Yeah, well I hope Mark Hyman gets the memo!

Researcher Carl Hart recently pointed out that “80 to 90 percent of the people who actually use drugs like crack cocaine, heroin, methamphetamine, marijuana—80 to 90 percent of those people were not addicted.”

I suspect that if we’re going to make progress on our understanding of food addiction, we’re going to first have to make progress on our understanding of addiction in general. If discussions on food addiction help in this regard, then to paraphrase Martha, that’s a good thing!

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Behavioral psychology blogger Gregory Ciotti explains the concept of supernormal stimulus … and why it suggests your brain just wasn’t built for junk food, porn, or the Internet. In a nutshell, the idea is that things like junk food or porn provide not-found-in-nature stimuli that our lizard brains find hard to resist.

Ciotti doesn’t say that the solution to this is to go all Luddite (or Grok). Instead, he suggests avoiding habituation:

The real enemy here is complacency—you needn’t feel guilty engaging with supernormal stimuli, but you should feel guilty if you allow yourself to become a victim of your habits, instead of the person in the driver’s seat.

Or as Stuart McMillen’s amazing comic concludes:

Only those who can see the supernormal can learn to silence the reptile.

A bit like “all things in moderation” but with a twist?

HT Julianne Taylor.

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I must admit to being disappointed at people who view addiction only through a tolerance and withdrawal lens. The most recent of these is James Fell’s Is sugar addictive … with his people “aren’t knocking over convenience stores or fencing grandma’s jewelry” to get their fix, so therefore it isn’t addictive. As if people need to steal given that crap food is cheap and available 24×7!

Fortunately, after reading Fell’s post, I came across this one on craving from Dirk Hanson. Hanson, unlike Fell, has a far more sophisticated understanding of addiction. He was reviewing Marc Lewis’ (a fave of mine) participation in a recent conference on addiction and craving convened by the Dalai Lama.

Lewis on why withdrawal is not the issue:

[Craving is] the one condition all addicts agree is their worst enemy. … This is one place where science and subjectivity have to come together. Scientists need to focus on this, because addicts are completely unanimous about it. This is the enemy. It’s not physical withdrawal symptoms, it’s not relief. It is craving.

And what is:

Craving is such an unpleasant state, that after a while, you end up doing it, you get the drugs. I did opiates, and I would spend hours and hours trying to sit on my hands, trying to watch something on TV, trying to go for a walk, and finally, there’s this thing that keeps rising in the background, and it doesn’t go away. It was a constantly growing tension, an anxiety and discomfort, that came from very deep down. You spend most of your energy trying to hold this thing at bay, and according to the ego depletion literature, you can’t do that for very long. These cognitive control centers just give up. They are limited resources.

I don’t know what my issues are and I don’t really want to fall on the sword to call it addiction. But there’s an aspect to what Lewis describes that really resonates for me. I’ve spent too many nights in a convenience store or similar not wanting anything there but not being able to leave until I bought something that I could consume. And knowing how insane this was.

Now this said, I am completely with folks concerned about the problem of overswinging the pendulum and extrapolating food or sugar addiction way too far (see here and here).

I think the truth lies in the middle.

BTW, I recommend reading Arya Sharma’s post Food and Eating Addictions May Not Be the Same. I would argue that the process addictions (eating, gambling, sex) are just as harmful as substance addictions. Fixating on whether or not there is serious withdrawal or robbing grandma is (IMO) dated thinking.

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I am grateful to Evelyn Kocur of the Carb-Sane Asylum for sending me a copy of her forthcoming e-book, Restriction Addiction. According to Evelyn, the book is:

about how food addiction is really eating disordered behavior brought on by restricting food, not by foods causing physical dependence like alcohol and some drugs.

I’m pretty excited about this! I think that Evelyn and I have meaningful differences about our understanding of addiction in general and food addiction in particular, but I think the link between diet restriction and disordered eating (and obesity) deserves a lot more attention than it has received. I’ve written before about what I call the dark side of dieting … it’s what led my weight gain to look an awful lot like the graph on the right:

graph

Re our differences, I’ll be sharing more in the future after I finish reading Evelyn’s book, but I believe the following from Marc Lewis is fundamental to the issue. Lewis is a former drug addict and now neuroscientist who blogs at Memoirs of an Addicted Brain. He recently participated in a conference organized by the Dalai Lama on Craving, Desire and Addiction and he writes regularly against the disease model of addiction.

Just before the holidays, Lewis announced that he’s planning to write a book about a new model of addiction. His premise:

This book makes the case that addiction results from accelerated learning — the acquisition of thought patterns that rapidly self-perpetuate because of the brain’s tendency to become sensitized to highly attractive rewards. I see this as a developmental process, accelerated by a neurochemical feedback loop that’s particular to strong attractions. Like other developmental outcomes, addiction isn’t easy to reverse, because it’s based on synaptic restructuring. Like other developmental outcomes, it arises from neural plasticity and uses it up at the same time. Addiction is definitely bad news for the addict and all those within range. But the severe consequences of addiction don’t make it a disease, any more than the consequences of violence make violence a disease, or the consequences of racism make racism a disease, or the folly of loving thy neighbour’s wife make infidelity a disease. What they make it is a very bad habit.

I am completely with Evelyn that the recent tendency to attribute overeating to addiction is very problematic. But unless your definition of addiction requires severe withdrawal to a physical substance (mine doesn’t), then I think there is something meaningful to be teased out. Stay tuned!

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I’ve been waiting for this to be published for a while. Neuroscientist Sandra Aamodt takes a science-based and HAES-friendly approach in explaining the perils of dieting. And be sure to read Dr. Aamodt’s blog post for details on the background behind her talk.

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