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Dr. Kessler Delves Into the Mysteries of Food Cravings

June 16, 2009 at 6:45 PM EST
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Health correspondent Betty Ann Bowser talks to author Dr. David Kessler about overeating and what is behind people's cravings, the subject of his new book, "The End of Overeating."
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DAVID KESSLER, former FDA commissioner: We add layers upon layers of fat on fat on fat.

BETTY ANN BOWSER, correspondent: When Dr. David Kessler walks through a food court these days, he sees what others may not.

DAVID KESSLER: You could change the name of this place to “Fat and Sugar.” There, it’s “Fat and Salt.” That’s “Fat, Sugar and Salt.”

BETTY ANN BOWSER: That’s because the former commissioner of the Food and Drug Administration has spent the past seven years meeting with doctors, scientists, and food industry insiders to understand what drives so many Americans to eat so much.

Kessler explains in his book, “The End of Overeating,” what he found during his investigation.

Dr. Kessler, why did you decide to write this book?

DAVID KESSLER: The book had several beginnings. I was sitting in my office at Yale with a group of residents and fellows and medical students. And we asked the question: If you want to stay alive, what are the things you can do to prevent getting a major disease? Three-quarters of us are going to die of cardiovascular disease or stroke or cancer.

So I was very interested in preventing disease. And if you’re interested in preventing disease, weight is a critical, critical factor. But for me, understanding what to do about weight was the great mystery.

The food industry has been able to figure out the bliss point, the optimal combinations of fat and salt, fat and sugar, fat, sugar and salt that you think tastes good, but when you look at the science, we now know that those ingredients stimulate, they activate the brain’s circuitry.

They stimulate our intake. They condition us. They drive us to want more. They affect the neural circuits. For decades, the food industry has said, “We’re just giving consumers what they want.” But, in fact, now we know that what they’re doing is excessively activating the brains of millions of Americans.

The most important part of the new nutrition facts label…

Kessler's personal experience

BETTY ANN BOWSER: For Kessler, who tackled big tobacco and reinvented food labels in the 1990s, the research was personal. He was powerless to control his own eating, and he found out he wasn't alone.

DAVID KESSLER: I used to think I was eating for nutrition, that I was eating to satisfy me, satisfy myself. I didn't realize that I was eating for stimulation and that that stimulation locked in the neural circuits, strengthened those neural circuits, so every time I engaged in that behavior, I would do it again and again. I didn't understand why I had gained and lost weight, you know, over my lifetime many times. Here's me, 1999.

BETTY ANN BOWSER: I can't believe it.

DAVID KESSLER: Here is me thin.

BETTY ANN BOWSER: And within what period of time?

DAVID KESSLER: Just up and down throughout my life.

BETTY ANN BOWSER: All the time, huh?

DAVID KESSLER: And here I am again big.

BETTY ANN BOWSER: What do you think the problem was?

DAVID KESSLER: I didn't know. I didn't know. I knew it was not as simple as diet and exercise. To me, this was the great mystery. I view myself as somebody well disciplined, well educated. Why was it so hard to resist?

BETTY ANN BOWSER: And Dr. Kessler knows he has plenty of company. About one-third of American adults are obese or overweight, a rate that's double what it was three decades ago, according to the Centers for Disease Control.

DAVID KESSLER: If I put these chocolate chip cookies, right, if I just take these chocolate chip cookies, these other chocolate cookies, and I put them out...

BETTY ANN BOWSER: Oh, wow, they smell good.

DAVID KESSLER: Right. Why do these cookies have such power over us? That's what I wanted to understand. What is it about these cookies that capture my attention? You know, I'm going to be sitting here listening to your questions, but these cookies capture my attention, right? I want these. What is it about that? So...

BETTY ANN BOWSER: But what is it?

DAVID KESSLER: There is a syndrome that has emerged, not a disease, but several characteristics that we have studied. We've taken people who have these characteristics: loss of control in the face of highly palatable foods, lack of satiation, preoccupation with foods. And we've scanned them. We've done the neuro-imaging.

And what's fascinating is that their response to the anticipation of food, to the cues, just to the sight or the smell, their brains get activated. Their amygdala regions become activated and become amplified much greater than healthy controls.

And what's fascinating is people who have this condition of hyper-eating, once they start consuming the food, that activation stays elevated and doesn't shut off until the food is gone. It's not a matter of willpower.

Changing eating habits

BETTY ANN BOWSER: In your book, you talk about how Americans need to go to food rehab. What does that mean?

DAVID KESSLER: Rehab is new learning. It's the laying down of new neural circuitry on top of the old circuitry, on top of the old learning. So until I can lay down new circuitry, new learning, I'm never going to be able to resist. Diets don't work. What we need is to change our relationship with food.

BETTY ANN BOWSER: And one of the things Dr. Kessler thinks would help many people make that change is to force restaurants to disclose the contents of everything on their menu, including calories, salt, sugar and fat. Similar regulations are already in effect in some places, like New York City.

DAVID KESSLER: It begins with disclosure, but in the end we're going to have to look at food differently. We have to change what we want, what we value. That's the real key task, because that's how you take on great public health challenges.

That's how we made the difference in tobacco. We changed how we as a country view the product from where -- that was something, that cigarette was something I wanted. Today it's a deadly, disgusting product. The business plan of the industry has been to take fat, sugar and salt, make it multi-sensory, make it irresistible, put it on every corner, and that that behavior has resulted in millions of Americans having a very hard time controlling their eating.

It's only going to change once we understand what's going on. If we continue to allow the food industry to put fat, sugar and salt on every corner, to load it in our food, to be double-frying our food, to be injecting it with needles, to be bathing it in solutions of sugar and fat, to be predigesting that food, adding the emotional gloss, advertising, cueing us, stimulating the brains of millions of Americans, we're never going to be able to get a handle on health care and especially the costs of health care.

The food is, in essence, it's constructed.

BETTY ANN BOWSER: Dr. Kessler hopes his book will launch a nationwide movement to make Americans more aware of what they are eating and why they eat so much.