Addicted to fat, sugar? Retrain your brain

Kessler is too much of a nut even for California. He was unceremoniously fired last year as Dean of the medical school at the University of California, San Francisco. So treat his colourful assertions with caution. "Conditioning" might have some small role but your weight is mostly genetically determined

Food hijacked Dr. David Kessler's brain. Not apples or carrots. The scientist who once led the government's attack on addictive cigarettes can't wander through part of San Francisco without craving a local shop's chocolate-covered pretzels. Stop at one cookie? Rarely. It's not an addiction, but it's similar, and he is far from alone. Kessler's research suggests millions share what he calls "conditioned hyper- eating," a willpower-sapping drive to eat high-fat, high-sugar foods even when they're not hungry.

In a book being published next week, the former Food and Drug Administration chief brings to consumers the disturbing conclusion of numerous brain studies: Some people really do have a harder time resisting "bad" foods. It's a new way of looking at the obesity epidemic that could help spur fledgling movements to reveal calories on restaurant menus or rein in portion sizes.

"The food industry has figured out what works. They know what drives people to keep on eating," Kessler says. "It's the next great public-health campaign, of changing how we view food, and the food industry has to be part of it." He calls the culprits foods "layered and loaded" with combinations of fat, sugar and salt, and often so processed that you don't even have to chew much.

Overeaters must take responsibility, too, and basically retrain their brains to resist the lure, he cautions. "I have suits in every size," Kessler writes in "The End of Overeating." But, "once you know what's driving your behavior, you can put steps into place" to change it.

At issue is how the brain becomes primed by different stimuli. Neuroscientists increasingly report that fat-and-sugar combinations in particular light up the brain's dopamine pathway, the same pleasure-sensing spot that conditions people to alcohol or drugs. Where did you experience the yum factor? That's the cue, sparking the brain to say, "I want that again!" as you drive by a restaurant or plop down before the television.

"You're not even aware you've learned this," says Dr. Nora Volkow, chief of the National Institute on Drug Abuse and a dopamine authority who has long studied similarities between drug addiction and obesity. Volkow is a confessed chocoholic who salivates just walking past her laboratory's vending machine. "You have to fight it and fight it," she says.

Conditioning isn't always to blame. Numerous factors, including physical activity, metabolism and hormones, play a role in obesity. The food industry points out that stores and restaurants are giving consumers more healthful choices, from substitutions of fruit for french fries to selling packaged foods with less fat and salt.

Kessler, now at the University of California-San Francisco, gathered colleagues to help build on that science and learn why some people have such a hard time going healthier. First, the team found that even well-fed rats will work increasingly hard for sips of a vanilla milkshake with the right fat-sugar combo but that adding sugar steadily increases consumption. Many low-fat foods substitute sugar for the removed fat, doing nothing to help dieters eat less, Kessler and University of Washington researchers concluded.

Then, Kessler culled data from a major study on food habits and health. Conditioned hypereaters reported feeling loss of control over food, a lack of satiety and were preoccupied by food. About 42 percent of them were obese, compared with 18 percent without those behaviors, says Kessler, who estimates that up to 70 million people have some degree of conditioned hypereating.

Finally, Yale University neuroscientist Dana Small had hypereaters smell chocolate and taste a chocolate milkshake inside a brain-scanning MRI machine. Rather than getting used to the aroma, as is normal, hypereaters found the smell more tantalizing with time.

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Eating disorders hitting five-year-olds

This is appalling. The only reasonable explanation for this recent upsurge is the recent upsurge in government persecution of "incorrect" eating: The "obesity" war. As with so many government programs, the unintended consequences are dire. Government should butt out of what people eat as weight is mostly genetic anyway.

EATING disorders are biting deeper into childhood, an expert has warned after conducting a study which included a five-year-old with the potentially fatal condition. Sloane Madden says demand for critical care beds at The Children's Hospital at Westmead, in Sydney, has surged over the past 12 months for children who were severely malnourished because of an Early Onset Eating Disorder (EOED).

The condition commonly linked to teenage girls was now becoming increasingly prevalent in Australian girls, and boys, aged 10 to 12 and even younger, he said. "Our own experience at the children's hospital, we have had a 50 per cent increase in demand for beds, and we haven't seen that increase in demand in hospitals looking after older adolescents with eating disorders,'' Dr Madden said. "At the moment, we have eight children in the hospital where we normally take six and we've got another five waiting for beds. "What we are seeing clinically, and what is being reported anecdotally around the world is that kids are presenting in greater numbers at a younger age,'' he said.

It was not just a case of the children being fussy eaters, said the Westmead-based child psychiatrist, as speaking to the children revealed a desire to be "thinner''. "They certainly will tell you that they believe that they are fat, that they want to be thinner, and they have no insight into the fact that they are malnourished and they are literally starving themselves to death,'' he says.

"And the parents when they see us are really quite terrified but they are extremely grateful that someone is finally taking their child's illness seriously.''

Dr Madden says children are often "medically unstable'' when brought to hospital with very low blood pressure, heart rate and temperature which "basically is putting them at risk of dying''. They often needed to be tube-fed, and placed on anti-depressant or anti-psychotic medication, but if treated early their chance of full recovery was were good.

However, Dr Madden's study of all Australian children with EOED from 2002 to 2005 shows there is a trend to late diagnosis diagnosis, meaning children being hospitalised with more more physical complications. "It makes us very concerned that these children are being misdiagnosed, or they are being diagnosed late and not being referred for appropriate care,'' he says.

Of the 101 cases of EOED uncovered by the study, there were 74 girls and 25 boys aged five to 13 (gender was not specified in two cases). Extrapolating this data, Dr Madden estimates Australia's incidence of EOED now stands about 1.4 cases for every 100,000 children aged five to 13 years. Of those, 1.1 cases would require a hospital intervention, according to the research published in the latest edition of the Medical Journal of Australia.

The number of cases is expected to rise, Dr Madden says, unless there is a change in the media's obsession with fat and weight. "I think that there needs to be a move away from this focus on weight and numbers and body fat, and a focus on healthy eating and exercise,'' he says. "You can see that in current (television) programs like The Biggest Loser, where it is all about numbers and weight, it's not helpful for those people and it's certainly not helpful for this group of kids.''

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