As FDA commissioner under presidents Bush and Clinton, Dr. David Kessler led the charge to regulate the tobacco industry; the landmark multibillion-dollar settlement between Big Tobacco and 46 states was largely a product of his efforts. Now he is taking on Big Food. In his new book, The End of Overeating: Taking Control of the Insatiable American Appetite (Rodale), Kessler draws on his own scientific research and that of colleagues to argue that highly processed foods fundamentally alter people’s brain chemistry, causing us to seek out these foods (and overeat them) again and again. Gourmet online editor Christy Harrison spoke with Kessler about the joint responsibility of consumers and the food industry; the need for a nationwide eating-education campaign; and why adults are addicted to baby food.
Christy Harrison: Let’s start by talking a bit about how you got interested in these issues.
David Kessler: The idea for this book started in my office when I was dean of Yale Medical School, talking with a group of Fellows in Residence. Our question was “If you want to stay alive, what are the things you can do?” We looked at the major killers. Seventy-five percent of us die from cardiovascular disease, cancer, or stroke. And as we dug, everything kept coming back to weight. Then one night, I’m watching this woman on a TV talk show and she says, “I eat when my husband leaves in the morning; I eat before he comes home; I eat when I’m happy; I eat when I’m sad.” She’s very well educated, very successful in all other aspects of her life, but she really didn’t like herself. And I sat there and I wanted to understand what was driving that. If there’s a metaphor for the book, it’s this: Why does a chocolate chip cookie, with its warm, sumptuous mounds of chocolate, have such power over us?
And that’s what I didn’t understand. Why does my hand engage before I even think about it, and I reach out for the cookie? We believe in free will and think we can make rational choices, but then why don’t diet and exercise work? If it were a matter of willpower, we would do it. I didn’t understand my own behavior.
CH: And in the book you bring up a lot of interesting points in terms of what causes us to lose control. There’s the fact that the reward centers of the brain are engaged by processed food, and there are also cultural and emotional cues that trigger us to eat.
DK: Right. Food is more powerful than we realize. It is a very salient stimulus. I mean, if a bear walked into your office right now, you would stop paying attention to me and focus on the bear. Our brains are wired to focus our attention on the most salient stimulus in our environment. What that stimulus is can vary. It’s based on our learning, our memories, our experiences. It could be gambling, alcohol, sex. For many of us it’s food. The power of food comes from our ability to anticipate its reward. In the book, I talk about how every time I land at the San Francisco airport, I start thinking about Chinese dumplings, because there’s this great Chinese dumpling place in that airport.
It’s what makes us human—our ability to focus on the most salient stimulus in our environment. It’s what has allowed us to survive as a species so successfully. But now we have these powerful stimuli—the trifecta of fat, sugar, and salt—available on every corner, 24/7. We’ve made [constant eating] socially acceptable.
When I was growing up [in the U.S.], adults didn’t snack; maybe kids snacked when they came home from school. There were built-in barriers and structure that stood in the way of our current chaotic eating. Now you have sugar and salt on every corner.
A lot depends on how I view the stimulus—as friend or foe, positive or negative. Look at what we did with tobacco: We changed how people perceive the product. We didn’t actually change the product; it wasn’t by legislation or regulation. Over the last hundred years, the industry created this image of a product that was glamorous, sexy, something you wanted, and you didn’t feel normal if you didn’t have it. But we changed that perception, so today people look at it and say, “That’s disgusting; that’s my enemy; that’s a deadly, addictive product.” So if you look at that chocolate chip cookie and say, “Boy, that looks great; that’s going to make me feel better; I really want that,” there’s nothing you can do. Because once you have that neural representation in your brain and that emotional association, your reward circuits are lighting up.
CH: But what about the chocolate chip cookie that’s made at home with butter and sugar and natural ingredients, instead of the cookie that’s made with hydrogenated oils and high-fructose corn syrup? It seems like that’s an important element to consider when you’re assigning a value to food.
DK: Right. And there’s no question that the food industry has designed foods to be very powerful stimuli, very salient stimuli. The food is increasingly pre-digested, whether it’s vacuum-tumbled or injected with sugar and fat marinades.
CH: In the book you use the phrase “adult baby food.”
DK: Right. Modern processed food, it goes down in two or three chews. And that’s why you reach again for the next round of stimulation. We used to think food was going to fill us up, food was going to satiate us; now food is designed just to stimulate us, and there’s no satiation.
What’s interesting is that this conditioned hypereating (which is what I call it in the book), this loss of control, this lack of satiation, this preoccupation with food, it affects not only people who are obese and overweight, but also a significant number of people who are healthy weights. They just learn techniques to deal with [their hypereating]. But if you talk to these people, some of them will tell you that they live in torment.
CH: Sure. I struggle with it myself. People bring in scones or something for breakfast to celebrate one occasion or another, and I have to tell my coworkers to take the leftovers out of my office because otherwise I’ll just keep eating them, even after I’m full.
DK: Because they grab your attention.
CH: Exactly. I can’t concentrate when they’re there. You quote other people in the book who say similar things, and I totally identified with them.
DK: I shared the book, an early draft, with a physician, and he said, “You’re describing me. No one’s ever described me. No one’s ever explained this to me before.”
CH: It’s surprising to hear that from a doctor.
DK: He’d never learned how it works, how he became captured. For each of us, it’s something different. For you, it’s scones; for me, it’s chocolate chip cookies. Because of our learning and our past experiences and our memories, each of us will get activated by a different set of stimuli.
For the first set of research that I published with my colleagues Jeff Grimm at Western Washington University and Diane [Figlewicz] Latteman at the University of Washington, we titled it “Deconstructing the vanilla milkshake.” We wanted to know, what drives consumption? Is it sugar? Fat? Flavor? And we found that sugar is the main driver. And then fat adds synergistically: If you add fat on top of sugar, animals will work harder for it.
If I give you a package of sugar and say, “Go have a good time,” you’re going to look at me and go, “What are you talking about?” But if I add fat, then I add color, and then I add texture and temperature, then I add the emotional appeal of advertising, and what do you expect to happen? You end up with a highly addictive product.
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