The End of Overeating

Extract

Introduction: You Are the Target

I've learned to recognize overeating in restaurants all over America. It's not hard, because people who have been conditioned to overeat behave distinctively. They attack their food with a special kind of gusto. I've seen them lift their forks, readying their next bite before they've swallowed the previous one, and I've watched as they reach across the table to spear a companion's french fries or the last morsel of someone else's dessert. Certain foods seem to exert a magical pull on them, and they rarely leave any on their plates.

As I watch this kind of impulsive behaviour, I suspect a battle may be taking place in their heads, the struggle between 'I want' and 'I shouldn't,' between 'I'm in charge' and 'I can't control this.' In this struggle lies one of the most consequential battles we face to protect our health.

 

The End of Overeating was born as I watched The Oprah Winfrey Show. Dr. Phil, the program's former resident psychologist, was talking about why people are obese and what they have to do to lose weight.

When he asked for a volunteer from the audience, a large, well­-dressed woman named Sarah came forward. Resting his hand on her shoulder, Dr. Phil asked Sarah to talk candidly about the self-defeating behaviour that, he insisted, led to weight gain. He said he wanted to know what made her 'do what you know you don't want to do.'

At first Sarah was all smiles as she told her story. 'I eat all the time,' she said with a nervous giggle. 'I eat when I'm hungry, I eat when I'm not hungry. I eat to celebrate, I eat when I'm sad. I eat at night. I eat when my husband comes home.'

Dr. Phil pressed Sarah to describe how she felt about herself.

The sunny visage began to change as she confessed to feeling like a failure. Sarah called herself 'fat' and 'ugly' and said her actions often left her disappointed, frustrated, and angry. 'I feel that I can't accomplish what I set up my mind to do. I feel that I can't do it, that I don't have the willpower.'

Choking back tears, she described how her focus sometimes turned obsessively to her eating behaviours. 'My whole thought is about why I eat, what I eat, when I eat, with whom I eat,' she said. 'I don't like myself.'

Turning to the audience, Dr. Phil asked, 'How many of you here related to something you heard?' About two-thirds of its mem­bers raised their hands.

Sarah's struggle obviously struck a familiar chord in a lot of people. In fact, it struck one in me.

 

One afternoon, I decided to conduct an experiment that pitted temptation against willpower.

I walked into a bakery in San Francisco and asked for two semi­sweet chocolate-chip cookies. Back home, I pulled the cookies out of their bag and placed them on a paper plate, just beyond my arm's reach. They were thick and gooey-chunks of chocolate filled the craters of the cookies and rose into peaks.

I focused my attention on them, monitoring my own response. I sighed deeply and bit my lower lip. Almost indifferent to the flow­ers on the table and even to the framed photos of my children on the counter, I was fixated on those cookies until I forced myself to pull away. At some point, I noticed that I had moved my right hand a few inches closer to them, but I had no conscious recollection of my decision to act. I tried to concentrate on reading the newspaper, but I kept glancing back to the plate.

Feeling vaguely uneasy, I headed to my upstairs office, which is about as far away from the kitchen as I can get. But even from that safe distance, I could not fully shake the image of the cookies.

Eventually, I left the house without having eaten them, and I felt triumphant.

Hours later, I headed to Caffe Greco, a North Beach institution where the cappuccino is said to be the best in the city. A large glass jar filled with homemade cookies sat on the counter.

I ordered an orange-chocolate cookie and ate it at once.

 

I set out to understand what is driving these kinds of behaviours. I wanted to know why Sarah couldn't stop eating, even though doing so made her miserably unhappy and jeopardized her health. I wanted to know why my determination could so easily collapse.

I was intent on learning what could be done to help Sarah, me, and the millions of people just like us.

I began to listen more closely to people struggling with weight problems, listening the way a doctor needs to listen. I watched as well, paying close attention to how they behaved around food. It soon became clear that Sarah was not alone.

My conversation with a journalist, a forty-year-old man I'll call Andrew, reminded me that the struggle respects neither gender, nor socio-economic class, nor age. Andrew, who is about five feet nine inches tall and weighs about 245 pounds, has written fearlessly from many of the world's battlegrounds. He has spent time with jihadists, suicide bombers, and war-hardened soldiers, and he hasn't flinched. But when I placed M&M's on the table before him, Andrew felt barely able to cope.

'When I'm in a meeting or interviewing someone and there is food on the table, I'll spend half my time thinking about that food,' he admitted. His internal dialogue seesaws between 'Man, that looks good, I could eat that,' and 'I'm not going to eat that because I don't need it.'

His conflict begins early in the day and never lets up. 'I wake up in the morning knowing that food is my enemy and that I am my own enemy,' he observed. 'It's uncontrollable.'

At lunch Andrew is likely to be tempted by a basket of hot, fresh bread served with butter. On city streets Starbucks seems to sum­mon him, and at home his refrigerator beckons irresistibly. 'It just goes on and on and on,' said Andrew. Like so many people who have difficulty controlling their eating, he sees food as an obstacle course he must navigate.

Andrew finds pharmacies and convenience stores particularly challenging: If he manages to get past the candy aisle without suc­cumbing, he has to stare down more candy at the checkout. In a typical tug-of-war Andrew will pick up candy, put it down, then pick it up again, over and over and over. Sometimes he'll win his battle to get out the door without buying the candy; sometimes he won't. If he does make the purchase, he often feels so disgusted with himself that he'll pour half the contents into the trash-and then polish off the rest.

He described what he calls his 'food soundtrack.' 'When I fin­ished my bowl of Wheaties today, I immediately thought, 'Let me bring a banana and an apple to work so I'm not tempted, so I don't eat that corn muffin downstairs at the office.''

But any success is momentary and is quickly replaced by further thoughts of food. 'I talk to myself,' he said. 'I'll ask, 'What am I going to eat for lunch?' 'What if I get hungry at three?' 'What are we having for dinner? I hope it's good.''

On a successful day, using maximum restraint, Andrew will consume about 1,500 calories, which is what he wants to eat in order to lose weight. But the next day he may consume 5,000. He rarely knows when he's full and feels mystified by people who don't share his single-mindedness.

'I can comprehend suicide terrorism more easily than I can comprehend somebody who just doesn't think about food,' he said, without a trace of facetiousness.

 

Pizza is Andrew's favourite food, and when he smells a hot slice, he's completely distracted. 'All I'm thinking about is that pizza,' he admitted. 'Very little holds my attention the way a pizza holds my attention. I'm telling you, food talks. All food talks.

'I bet when an addictive gambler walks into a casino, he will recognize with resignation that he's going to gamble and lose money. I think that recognition makes him upset, but it also makes him exhilarated. Like that gambler, I think that time gets suspended when I walk into a pizza place. Time is suspended, you're not in time anymore, you're not in your own body anymore.

'I pretend that there are no consequences to my actions. All that exists is me and that pizza, me and that pizza. That's the feeling.'

I hadn't planned on tormenting Andrew when I put those M&M's before him and asked how they made him feel.

'They are incredibly distracting,' he allowed.

'Would eating them make you feel better?' I asked.

Andrew said the first taste would give him a 'rush' that was incred­ibly satisfying. But as he kept popping the candy into his mouth, he knew he would begin to feel ill. 'More than ten or fifteen M&M's and it's just too much. It's like the sugar is digging a hole in my stomach.'

Despite this, he'll keep on eating them.

I heard a degree of self-loathing in Andrew as he told his story. 'The worst thing for me is to be caught in the act of buying M&M's,' he admitted. He'll shove the candy into his pocket as soon as he leaves the cashier, hoping no one will see him.

'I'm a fat guy,' he said, 'and nobody wants to watch a guy who's overweight eat bad food. They just find it repulsive.'

'How do you feel about yourself after you eat them?'

'I say to myself, 'There's another loss of control, another 240 calories that I don't need.' But all of the rational thoughts in the world can't compete with the colour and expectation of an M&M.'

Nothing else has that kind of power over Andrew, a man accus­tomed to running his own life. 'An inanimate object, an inanimate food has power,' he said, a hint of disgust in his voice.

Andrew recognized the promise of reward embedded in food. 'It adds colour to the day,' he said, acknowledging that he feels pulled in by its 'comfort, stimulation, sedation, happiness, the chance to put fun in the day.'

America, he said, has become 'a food fun house . . . a carnival of

delicious, fatty, salty, sugary, and, more to the point, accessible and cheap delights. How could you expect to go to the carnival and not want to go on the rides? It's bright and colourful and fun and excit­ing. There are all these pings and noises. Of course you want to go on a ride; of course you want to play the game; of course you want to spend your money on this stimulation.'

'Do you feel better when you eat?' I asked.

'The funny thing about eating endless amounts is that it's illog­ical, because the feeling is momentary,' he said. 'You can create one more moment of good feeling, but it never lasts.'

That is a classic description of the body's reward system. 'The good feeling is ephemeral, but it's what makes the behaviour reinforc­ing,' I explained. 'Because it doesn't last, you want to do it again.'

I asked Andrew whether he understood why he lost control.

That was a total mystery to him. 'No idea,' he answered. He was keen to know why food could hold such power over him.

'You've been conditioned by food and by cues that remind you of that food,' I explained. 'They focus your attention, promote anticipation, and build desire.'

I wanted Andrew to realize that many people are wired for food the same way he is, and they're just as likely to lose control.

The food industry has been remarkably successful at designing foods to capture the attention of people like him. Food manufactur­ers, food designers, and restaurant owners may not fully understand the science behind the appeal of their foods, but they know that sugar, fat, and salt sell. As surely as if he were wearing a bull's-eye on his chest, Andrew is one of the industry's targets.

 

There's no shortage of people who lack control in the face of highly palatable food. And not all of them are overweight. I spoke with a young law student I'll call Samantha. She's twenty-five years old, five feet six inches tall, and 120 pounds, but her words could have come from Sarah or Andrew.

'If food is put in front of me, I find it an eternal struggle not to eat,' said Samantha. 'I hate going to work because they have bowls of candy everywhere. I'll leave my apartment and go to the library to study because we're not allowed to have food there.

'I keep thinking that it would be so easy just to make healthy choices, so why can't I do it? But instead, I rationalize what I eat in the weirdest ways. I have friends who feel the exact same way, and we marvel at people who are not like this. I don't understand how they do it.'

Samantha stays thin because she doesn't always give in to the pull of food, and she exercises vigorously. But her struggle is fever­ish, and she is just as frustrated as the overweight people with whom I spoke.

'As soon as I'm not actively doing something, I'm thinking about what I'm going to eat. These are crazy thoughts to have. When I talk out loud about this, I feel ridiculous. It should not be all-consuming. I'm a smart girl with a lot going on in my life. The fact that I think about food for so many hours every day is madden­ing. I should be thinking about law school, not about how many Hershey's Kisses I've eaten today.'

Still another woman, a colleague I'll call Claudia, told a similar tale.

'What happens when you start to eat?' I asked.

'Sometimes I can't stop. It doesn't happen at every meal, but if there's appealing food in front of me, or I've been thinking about food a lot for some reason, I'll keep eating, even to the point of being sick.'

I encouraged Claudia to share her food memories.

'There are days when I dream about food,' she said. 'I think back to delicious meals I once had and long to feel the same sense of anticipation, happiness, and fulfilment they provoked.'

Recollections of pleasures past seemed to spill from her. A birth­day dinner at the Cheesecake Factory five years ago . . . a perfect late-night slice of New York pizza . . . and something she called Charlie cookies, 'a little bar of heaven on earth.'

Other favourites on her list: smoothies . . . corn on the cob . . . candy bars . . . potato chips. Some foods were obviously associated with her childhood or happy memories. There was, for example, the pasta sauce she could eat by the spoonful right from the jar, a favourite since age five. 'I crave foods that my father used to make for me and dishes I once had in my college dining hall,' she said.

Not everything she mentioned would make a nutritionist cringe-fresh fruit and a great salad got her excited, too. But the common thread was a preoccupied focus on the food she liked. 'It's what I think about, what I can't wait to get home to,' she admitted. 'Left to myself, I will usually eat and eat and eat.'

'Do you know why you do this?' I asked.

'No,' she admitted, 'I don't.'

Millions of people are like Sarah, Andrew, Samantha, and

Claudia. They don't have any of the eating disorders we've learned to recognize and treat, but food is never far from their minds. And once they begin eating, they can't seem to stop. Long after they've ceased to feel hungry, they're still eating. No one has ever explained what's happening to them and how they can control their eating. That's my goal in this book.

 

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