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The End of Over Eating

            The book, “The End of Over Eating,” begins with this thought, “Most of us know what it feels like to fall under the spell of food – when one slice of pizza turns into half a pie, or a handful of chips leads to an empty bag. But it’s harder to understand why we can’t seem to stop eating – even when we know better. When we want so badly to say “No,” why do we continue to reach for food?”

            While few people can be diagnosed as having a recognizable eating disorder, the majority of people seldom have food far from their minds.  Often patients tell me that once they begin eating, they can’t seem to stop.  For some reason, even after they’ve ceased to feel hungry, they’re still eating.

            We know from the historical record that for thousands of years, human body weight stayed remarkably stable.  Throughout life, people consumed no more food than needed even when available. The few that were overweight stood apart from the general population as rare exceptions.  Like all other species, we had a perfectly balanced biological system. Then in the 1980s, something drastic happened.  Much later, in 1994, a report on extensive population data in the Journal of the American Medical Association revealed the problem.  The report showed that in a comparison of current and earlier data for the weight of Americans, there were “dramatic increases in all race/sex groups.” The results were consistent among men and women, young and old, black and white. The rate of obesity in America had exploded.  Fortunately, the article served as a red alert that helped to focus attention on the problem.

            What we now know is that up until 1960, the weight of Americans was relatively stable. For example, women aged 22-29 averaged about 128 pounds.  By year 2000 the average weight of women in that age group had reached 157 pounds.  A similar trend was apparent in the 40 to 49-year-old group, where the average weight had jumped from 142 pounds in 1962 to 169 pounds in 2000. While on average, everyone was getting heavier, the heaviest people in the population were gaining disproportionately more weight than others.

            What had caused this weight gain?  Most noticeable, processed foods became significantly more readily available in the 1960s through the 1980s. There were more chain restaurants, food outlets of all types, and a culture that promoted more out of home eating. Also, portion sizes had increased. But having food available doesn’t mean we have to eat. So, what was driving people to overeat? Something had to be happening that was overriding the wisdom of the body to self-regulate.

            What researchers began to understand was that the body’s amazing ability to maintain balance through the homeostatic system was not acting alone. Another region of the brain, with different circuitry, was involved, and often in charge. This other circuit in the brain is known as the “reward system.” What was happening could be called a fight between the body’s energy balance system and the reward system. Unfortunately, the reward system was winning.  The problem pointed to foods that were too sweet, too fatty, or too salty. In combination, these foods had the capability to hijack the reward system.  Making matters worse, these same foods were becoming cheaper, in part due to government policy, and could easily be added to almost any recipe.  Hence, hyper-palatable foods were appearing in grocery stores, vending machines, restaurants, and especially in the booming fast-food industry.

            People have what food scientists call a “bliss point” – the point at which we get the greatest pleasure from combinations of sugar, fat, and salt. Scientists depict this as an inverted U-shaped curve.  For example, as more sugar is added, food becomes more pleasurable until we reach the bliss point at the top of the curve, and then the pleasure experience drops off. For sweet beverages, that point is about 10% sugar.  Drinks containing more sugar than that generally taste too sweet, and we enjoy them less.  The salt curve is similar to sugar but steeper. A smaller change in salt concentration has a bigger impact than a comparable change in the concentration of sugar.  By adjusting the amount of sugar, fat, and salt, it is possible to create foods that maximize the reward value. Interestingly, this works for animals and humans alike. In experiments with rats, it was determined that rats fed a mix made of foods commonly available in a grocery store grew to weigh twice as much as rats fed standard rat chow. Why was this? What happened to the homeostatic ability to balance energy consumption and expenditures? Why did the rats fail to defend themselves from weight gain? It seemed that simply being free to access highly palatable foods was a sufficient condition to promote excessive weight gain.  Experiments like these demonstrated scientifically what most of us know from experience. When we are offered a varied selection and unlimited portions of high sugar, high fat, high salt foods, many of us will eat them in excess.

            A wide range of circumstances came into play to make foods what they are today. In part, we are a richer country with more money to spend. Indeed, people spend more on food convenience today than ever before. Companies that sell food are, of course, obligated to their shareholders to maximize profit and constantly research for new ways to promote their foods. The connection between government and industry also affects what we eat. Historically, agricultural business interest has had considerable success in lobbying for rules that encourage price support for the products they most need to tempt us with. As a result, hyper-palatable foods became cheaper and more accessible.

            One favorite restaurant food, buffalo wings, starts with the fatty part of the chicken, which gets deep-fried. Then they are served with a creamy or sweet dipping sauce that’s heavily salted. Usually, they are par-fried at a production plant, then fried again at the restaurant, which essentially doubles the fat. That gives us sugar on salt on fat on fat on fat.

            Cheese fries take a high-fat food and put more fat on top of it. The potato base is a simple carbohydrate, which quickly breaks down to sugar in the body. Once it’s fried and layered with cheese, we are eating salt on fat on fat on sugar.

            Restaurant salads do contain vegetables, but in today’s restaurants, they are more than likely to be smothered in a cream-based ranch dressing and flavored with cheese chunks, bacon bits, and oily croutons. Caesar salads are rarely more than an excuse for more fat and salt.  Food consultants call this “fat with a little lettuce.” It seems that even lettuce has become a vehicle for fat.

            French fries are usually double-fried, once at the factory, and then again at the restaurant. That’s fat on fat. And, hamburgers are now layered with bacon and cheese. That’s fat on fat on fat.  Other popular foods, like pizza, have also become little more than carriers for sugar, salt, and fat. 

            Scientific confirmation that the combination of fat and sugar is a strong reinforcer has been observed in animal studies. It seems that the breaking point at which animals will no longer work for the reward of foods loaded with sugar, fat, and salt is slightly lower than the breaking point for cocaine. In essence, animals are willing to work almost as hard to get either one.

            Many of the features that food manufacturers have concocted to make foods hyper-palatable would not be possible without processed food ingredients that allow optimal blends of sugar, fats, and salt. Unfortunately, for the unsuspecting consumer, there’s far more that food science has discovered about the human reward system. The way we respond to food also has a great deal to do with the visual appeal, aroma, texture, and mouthfeel. Before the 1960s, such palatability enhancing options were seldom used.

            It’s hardly news that the foods we eat, and the way it’s presented, are the handiwork of an industry whose goal is to make a profit. What’s striking is the many ingenious ways in which the industry succeeds in getting us “hooked.” In industry parlance, the goal is craveability rather than only irresistibility.  At one time, this was referred to as the taco chip challenge  – that you can’t eat just one.- Before 1960 a person might have faced the equivalent of the taco chip challenge once a month. Today that challenge is presented everywhere we go. Every place food is served, it’s now cheaper than ever and highly craveable. Far too many are now conditioned to expect hyper-palatable foods.

            The book, “The End of Overeating” provides a compelling explanation for why the majority of people have gained weight that was not the norm in previous generations.  Although the book was published in 2009, the insights are still relevant.  The book does not address how to fix the problem, however, there is ample evidence for why the problem of overeating happened and why it’s likely to get worse.  As a former Food and Drug Administration (FDA) commissioner, the author’s insights and contacts within the food industry make his explanations especially relevant.

            The book is available at the local public library and one that will likely change your view forever about who is in charge when you buy today’s hyper-palatable foods. As a spoiler alert, let me assure you – you aren’t the one in charge.

            Nancy Neighbors, MD

We are in This Together

            Our genetics are the culmination of thousands of years of eating mostly unadorned animal and vegetable products. Today we eat mostly hyper-palatable foods that bear little resemblance to what existed in nature. Given that we can’t change our genetics, we have two choices if we wish to defend ourselves from foods that have power over us. The first choice is willpower.  Unfortunately, willpower is much like a muscle that tires with use. The alternative is a return to foods that are not hyper-palatable that the body can self regulate. So what are these foods?  Well, they are the foods that nature makes before being separated into plant parts and unnaturally recombined into a hyper-palatable form.  For the most part, they include plant-based whole foods along with at most a small quantity of animal-based foods.

COVID-19 – Challenging the Way
We Produce and Consume Food

            The emergence of SARS-CoV-2, which causes the disease COVID-19, prompted a global rallying cry to shut down the wild animal trade in China that has been tied to the pandemic. But the situation in China is not unique, but rather the norm for careless health practices across much of the world. According to the Centers for Disease Control and Prevention, three out of four new or emerging infectious diseases in humans come from animals. The risk increases considerably with the poor treatment of animals in crowded, stressful live animal markets, industrialized animal farms, and slaughterhouses. Click here for the rest of the story.

A Personal Transformation
From Couch Potato to Avid Cyclist

            By Christmas of 2017, David Gwyn was the heaviest he had ever been. As he tells the story, he had reached a point where he was tired of feeling tired all the time.

            Working with his doctor, he switched to a plant-based whole food diet and was able to reduce his blood pressure medicine gradually and safely.  In time, he was able to discontinue all meds and still maintain a BP average of 112/72.  Also, his cholesterol dropped from 210 to 134 and he lost more than 50 pounds. Read more about David’s full transition, “From Couch Potato to Avid Cyclist.

Full Plate Living Nutrition Programs
Now Available at No Cost

            Full Plate Living helps people add more whole plant-based foods to meals they’re already eating. It’s a small step approach that can lead to big health outcomes.

            In the era of COVID-19, it’s important to proactively make choices to improve health. Nutrition is foundational to a healthy lifestyle, so the Ardmore Institute of Health has chosen to make their Full Plate Living nutrition outreach program available to everyone at no cost.

            Sign up to start taking easily doable steps towards a healthier lifestyle at  Next, share this amazing offer with friends seeking a healthier life or just weight loss.

Confused About Skincare?

            Sensible skincare advice is rare on most websites and in most popular publications.  In an interview, Jessica Krant, M.D., a board-certified cosmetic, laser, surgical, and medical dermatologist shares answers to many common questions. Click here to begin listening.

            Dr. Krant is a Fellow of the American Academy of Dermatology, American Society for Dermatologic Surgery, and American College of Mohs Surgery as well as being certified in Lifestyle Medicine.  She has also been a recipient of Castle Connolly and coveted New York Magazine Top Doctor status for many years.

Healthy Food – The Medicine for
COVID-19 and National Security

            While there is significant disagreement over medical treatments to prevent or cure COVID-19, one key piece of evidence is beyond dispute: Those at the highest risk of extreme illness and death have underlying conditions such as excess weight, diabetes, heart disease, or high blood pressure. In some studies, up to 97 percent of people dying of COVID-19 have these conditions.

            So, even if you’re old, but do not have these conditions, your chances of survival are very good. If you’re young, with the aforementioned conditions, your chances of survival are much worse. In New York City, excess weight was, overwhelmingly, a key risk factor for COVID-19 hospitalizations.

            In the future, America will likely face another viral pandemic.  Unfortunately, as we have learned from COVID-19, waiting for medical cures or preventative medicines takes too long and inflicts high cost to the economy.  From the perspectives of science and national security, the correct strategy is healthier foods, losing weight, and getting into good physical shape. Click here to learn more.

COVID-19 in the NEWS

            As the new coronavirus continues to spread over the next months, and maybe even years, it could exact a heavy toll in areas of the United States that have not yet seen major outbreaks but have high rates of diabetes, excess weight, high blood pressure, and other chronic health conditions. Read more in “Where Chronic Health Conditions and Coronavirus Could Collide.”  The article is a reminder that Alabama has a high burden of chronic health conditions. In many counties, more than 40 percent of adults are estimated to have a BMI greater than 30.

            From the Los Angeles Times, “America’s Poor Health Has Put It In Unique Danger From the Coronavirus.”  With 50% of the population at risk from poor health habits, we should reasonably expect far poorer outcomes than countries like Switzerland.

Libraries Keep You Connected

            The local Huntsville-Madison County Public Library is reopening on Monday, June 15.  There will be a limit on the number of patrons allowed in at a time, in line with Governor Kay Ivey’s amended Safer at Home order. The library will also continue curbside service.  As part of this phase three reopening, overdue items will begin accruing fines on July 6. So, if you have any overdue items, be sure to renew or return them to the library before this date to avoid fines.

Spicy Asian Tacos

            In this marriage of Asian and Mexican flavors, tender steamed veggies are topped with a spicy ginger-garlic sauce and wrapped in a soft shell taco.  With home recipes this tasty, most SOS restaurant food would, by comparison, makes a poor showing. Click here for the recipe.

Sugar-Free Fruit Pops

            When the weather gets hot, cool off with a bright assortment of popsicles made with 100 percent fresh fruit. No sweeteners, and no add-ins – just quick-blitzed fruit purées that have all the incredible flavor of peak-season produce.  Click here for the recipe.

By Nancy Neighbors, MD

... Dr. Neighbors provides a blend of traditional family medicine and evidence-based lifestyle medicine in Huntsville, Alabama. When indicated, lifestyle change is recommended as the first line of therapy.

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