End of Overeating 8 – Food Rehab

Posted: May 11th, 2012 | Author: | Filed under: End of Overeating | Tags: , , | Comments Off on End of Overeating 8 – Food Rehab

End of OvereatingThe End of Overeating offers an intriguing set of foundational principles for what Dr. Kessler calls Food Rehab. To provide a sense of those principles, here’s a summarized list.

  • Conditioned hypereating is a biological challenge, not a character flaw
  • Conditioned hypereating is a chronic problem that must be managed, not cured
  • Effective treatment breaks the cue-urge-reward-habit cycle
  • Diets that leave us feeling deprived magnify the loss of control at the core of conditioned hypereating
  • New learning sticks only when it generates a feeling of satisfaction
  • Restoring control over eating requires a comprehensive approach
  • Lapses are to be expected
  • Eventually, we can begin to think differently about food

The core of the program requires us to replace unplanned eating with planned eating. Planned eating is much less subject to impulse. It replaces chaos with structure. It’s important that we plan meals that will satisfy us and that we enjoy but which do not fuel hypereating.

Dr. Kessler outlines the shape of a rehab plan and many of the elements it must contain to be successful. Moreover, he makes the information readily accessible while recognizing that each person is unique and no one size fits all cookie-cutter approach exists.


End of Overeating 7 – Set Rules

Posted: May 9th, 2012 | Author: | Filed under: End of Overeating | Tags: , , , , , | Comments Off on End of Overeating 7 – Set Rules

End of OvereatingAs approaches for treatment of hyperconditioned overeating are outlined, the End of Overeating next focuses on the essential nature of clear and easily remembered rules we can actually follow. Hyperconditioned overeating is intrinsically impulsive, so we must break the grip of that impulsive behavior. Concrete “if-then” rules are an important part of that battle.

I was reminded in this section of the effort Michael Pollan has invested in constructing clear, simple food rules. His rules are things like, don’t eat anything with more than five ingredients or with ingredients you can’t pronounce or don’t recognize. He also has rules like, don’t eat anything your great-grandmother wouldn’t recognize as food.

These are the same sort of rules. Clear and categorical rules — “I don’t eat french fries” — are the easiest sorts of rules to follow consistently. As people with celiac disease, my younger children and I are familiar with that sort of rule. “I don’t eat gluten” must be an absolute rule for us.

The book provides some good examples of the sorts of rules Dr. Kessler and researchers have found effective. It doesn’t simply provide the theory.


End of Overeating 6 – Start With Awareness

Posted: May 2nd, 2012 | Author: | Filed under: End of Overeating | Tags: , , , , | Comments Off on End of Overeating 6 – Start With Awareness

End of OvereatingDr. Kessler, in his book the End of Overeating, devotes the latter section of his book to the theory of treatment. And before we can even begin to protect ourselves from all the stimuli, we have to recognize just how vulnerable we are. And to do that, we must be mistrustful of our brain. We have to learn to recognize when a conditioned response is being triggered and stop our response. And that’s not easy.

Effective intervention draws us away from the conditioning power of a stimulus before it triggers its usual response. It reminds us that it’s possible to say no. Intervention begins with the knowledge that we have a moment of choice — but only a moment — to recognize what is about to happen and do something else instead.

Our vulnerability to the stimuli will not disappear. Once those pathways have been established in our brain, we can lessen their force and we can build new ones, but the old connections will remain. Dr. Kessler uses ex-smokers to illustrate the way the connection between a cue and a memory is never fully severed.

Cigarettes are a good illustration because they build the same sort of highly reinforced connections as hyperconditioned overeating (and cocaine addiction, for that matter). For many people, the urge for a cigarette never completely goes away and can resurface at certain times or in response to certain triggers even decades after you’ve quit smoking. While the substance itself may have been removed from the body and we have worked through any systemic physical withdrawal, our brains have been rewired by the addiction.

I could certainly empathize with that description. I quite smoking on July 26, 1996 after smoking — often quite heavily — for roughly two decades. That was almost sixteen years ago, but hardly a day goes by that something doesn’t trigger a desire for a cigarette. I can still remember the sensation and anticipate the “rush” from that initial drag. And it takes an act of will each time to tell myself I’m not a smoker. After this many years, it’s not particularly difficult to resist anymore, but those old pathways are definitely still there.

Of course, we can live without cigarettes. We can’t live without food. So how do we overcome conditioning and create a more healthy pattern of eating? The very first step is awareness.

Being aware means that you have a conscious knowledge of the risks of a given situation. “You have to figure out the situation that leads you to eat, that leads you to start the chain of behaviors,” said Miltenberger. “That is the absolute first step — to catalogue all of the stimuli, all of the situations, all of the cues that start that chain.”

Once we can identify the premonitory urge, the initial step in the compulsion, we can begin to train ourselves so we don’t respond to it. We can set up competing behaviors. And we can formulate thoughts to quiet the old ones we are trying to remove. Most of us also require support. We can’t do it on our own. But it all starts with awareness.


End of Overeating 5 – The Culture of Overeating

Posted: April 27th, 2012 | Author: | Filed under: End of Overeating | Tags: , , , | 1 Comment »

End of OvereatingBefore I move on to the next section of the End of Overeating, I wanted to explore one underlying contributing factor to conditioned hypereating that I had not thought much about, namely our culture of eating in general. Dr. Kessler devotes a chapter to the topic. He opens with an intriguing observation.

The question “Is food available?” once had social and economic implications. We were really asking “Are we facing famine?” “Can we afford food?” That framework has changed in Western societies. Now we usually mean “Can I buy food nearby?” “Can I eat it anywhere?” In today’s America, the answer to these questions is usually yes.

An important change in our culture of eating in the United States is that we now believe it is okay to eat almost anywhere and everywhere. Eating while walking down the street, in class, in a meeting, or while conducting business is no longer considered rude. I’ve grown up in that environment and had never even thought about it before. Dr. Kessler shares the impressions of people from other cultures in a way that really drives the point home.

Of course, our culture of eating is beginning to infiltrate even anti-snacking cultures with extremely strong meal patterns. The French pattern of eating only at set mealtimes was once so strong that restaurants wouldn’t even serve food outside those traditional periods. As that cultural norm weakens, we are seeing a rise in weight in France, though not yet anywhere near the scale we see in America.

With hyperpalatable food readily available everywhere we go and few cultural restrictions on when and where we eat, those susceptible to conditioned hypereating live in an almost constant state of stimulation. It’s little wonder we’re suffering from an obesity epidemic.


End of Overeating 4 – Conditioned Hypereating

Posted: April 25th, 2012 | Author: | Filed under: End of Overeating | Tags: , , , , , | Comments Off on End of Overeating 4 – Conditioned Hypereating

End of OvereatingNext the End of Overeating explores why the syndrome Dr. Kessler calls conditioned hypereating is an emerging threat in our modern world. For centuries, homeostasis kept our consumption of food as a population more or less in balance. That balance has now been overturned. In large part that’s because our brains are actually being rewired. Dr. Kessler notes this phenomenon in his book.

I began to develop an overarching theory about eating for reward: Chronic exposure to highly palatable foods changes our brains, conditioning us to seek continued stimulation. Over time, a powerful drive for a combination of sugar, fat, and salt competes with our conscious capacity to say no.

So, how do we become trapped in this cycle of conditioned hypereating? When the chemical reward from eating a hyperpalatable food has made us feel better in the past, we become conditioned to associate that feeling with the food. And it tends to work. We crave that Butterfinger because we have felt good when we’ve eaten them in the past. So when we obtain one and take that first bite, we tend to feel that same sensation.

In many ways, conditioned hypereating is like many afflictions with both a genetic and environmental component. That’s similar to celiac disease. Some people never suffer from conditioned hypereating, just like a third of the population lacks the genes necessary for celiac disease. But even among those with the genetic predisposition for hyperconditioned eating, like those with the genes for celiac disease, not everyone will manifest the condition. For the rest of us, again like celiac disease, conditioned hypereating could be triggered at any time.

However, it’s certainly clear that a significant portion of the global population is susceptible and as we import the highly processed and hyperpalatable American diet into other parts of the world, the obesity epidemic begins to take root in those countries as well.