It is time to look at some examples of addictive behaviour in a bit more detail. Let’s start with something that is part of everyone’s life. Of all the patterns of behaviour that pull us in the direction of compulsion and threaten to take over our lives, none is more pervasive than our new attitude towards food.
Were there always so many fat people at Victoria Station? Most evenings, as I leave my office in the Daily Telegraph and walk across the concourse, I can hear young commuters panting like elderly spaniels after rushing to catch their train. Many of them are clutching over-filled baguettes that are impossible to eat without smearing yourself in mayonnaise; they have to lick it off their fingers before fishing for their tickets.
Across the station concourse, a gigantic free-standing food counter groans under the weight of thousands of pieces of loose candy: jelly beans, toffees, bonbons, liquorice sticks, fudge and lollipops, all glistening with artificial colouring. The customers look awfully furtive as they scoop candy into the paper bag before it’s weighed. Anyone would think they were picking up pornographic magazines, from the way their shoulders hunch and their eyes dart sideways.
Between 1993 and 2009 the percentage of overweight men in England rose from 59 to 68 per cent; the number of overweight women from 51 to 59 per cent.1 The trend isn’t hard to spot at Victoria, where people from every background rub shoulders.
Inside the Telegraph office, however, it’s a different story. In this predominantly middle-class environment, any extra pounds are offset by competitive dieting among the feature writers and fashion journalists. What I have noticed, however, is the ever-increasing intrusion of food into the working day, and especially the little afternoon food rituals surrounding ‘treats’, as we call them. The appearance of treats produces gurgles of childish delight from the most hard-bitten reporters – unsurprisingly, since this is children’s party food.
The archetypal treat is called a mini-bite, and it’s an invention of the devil. Mini-bites take the most indulgent cakes and desserts and distil them into morsels: chocolate cake, millionaire’s shortbread, raspberry doughnuts – all shrunk to a size that absolves you of guilt. If you only eat one, that is. Unfortunately, they’re sold in buckets large enough to be visible from five desks away.
And so the ritual begins. What I’m about to describe happens in the comment section of the Daily Telegraph in London, but I’m sure that it’s replicated, with only minor variations, in offices across Britain and America.
‘Ooh!’ Somebody has spotted a colleague approaching the desk with two tubs of mini-bites – different varieties, of course. The ‘ooh!’ is shrill with suppressed excitement; everyone looks up. The tubs are deposited on the desk. There’s a moment of silence as the urge for instant gratification does battle with fear of being the first person to crack.
Then one employee – often the head of department – walks up to the tubs and surveys them quizzically, as if this whole ‘mini-bite’ concept is new to him. He opens the lid gingerly, extracts a treat, inserts it into his mouth … and within seconds the gang descends. Some people manage a perfunctory ‘I really shouldn’t’ before diving in. They tend to be the ones who pay the most return visits to the tubs.
Those journeys from desk to mini-bites and back again are fun to watch. It’s hard to do anything surreptitiously in an open-plan office, but people try their best, assuming an expression of studied absent-mindedness as they reach out for one last chocolate cornflake cluster on their way back from an unnecessary trip to the photocopier. (I speak from experience.)
What we’re seeing is the battle between the Stop and Go mechanisms in the brain turned into office pantomime. Such is the power of sugar.
Most middle-class people have their own mental image of the ‘obesity crisis’ in Britain and America. It involves blue-collar workers and ethnic minorities who spend every spare minute stuffing themselves with cheeseburgers.
Hollywood documentaries and bestselling books encourage us to think this way – though they are careful not to attack low-paid fat people for their weakness in giving in to temptation. In 2004, for example, the filmmaker Morgan Spurlock made a compelling but self-righteous documentary entitled Supersize Me. He spent 30 days eating nothing but McDonald’s meals, by the end of which he had gained 30 pounds and suffered heart palpitations.
His first supersized meal consisted of a Double Quarter Pounder with Cheese, Super Size French fries, and a 42-ounce Coca-Cola. Conveniently for the filmmakers, this made him throw up in the car park. The impression left by the movie was that McDonald’s was effectively poisoning lower-income families by addicting them to junk food. Indeed, it ended by addressing McDonald’s customers: ‘Who do you want to go first, you or them?’
Supersize Me won a Grand Jury award at the Sundance film festival. One can understand why it went down so well. For bien pensant audiences, it’s comforting to think that food addiction is all about easily identifiable villains (fast-food corporations) and victims (low-paid families who eat at McDonald’s because they can’t afford healthy food).
Comforting – but how accurate? In 2011 a major US study found that households earning $80,000 were more likely to buy junk food than those earning $30,000. Atlantic magazine sounded mortified by this discovery: ‘It’s not cash-strapped Americans who are devouring the most Big Macs and Whoppers, it’s us!’2
The study was a useful corrective to all the finger-pointing at working-class people that accompanies the obesity debate. But perhaps we should stop talking so much about burgers, fries and the saturated fat they contain, because there’s growing evidence that sugar, not fat, is having the biggest distorting effect on our diets. It’s leaving middle-class people in particular with ‘food issues’, as they’re euphemistically known. Hence the cupcake craze.
We know that sugar is bad for us: along with fat and salt, it’s one of the unholy trinity of modern food additives. We don’t necessarily know how bad it is for us, though. Lobbying against saturated fats has been so effective that diet-conscious consumers imagine there’s a simple correlation between how much fat you eat and your risk of heart disease. There isn’t. Sugar is just as bad for your arteries because it contributes directly to obesity and diabetes, both of which put you at greater risk of a heart attack than simply eating a high-fat diet.
Sugar is a fat-free substance that just happens to be massively fattening. Morgan Spurlock may have eaten his way through 12 pounds of fat when he supersized himself, but the real damage to his waistline and his internal organs was done by the 30 pounds of sugar he ingested. However, since it came from fizzy drinks served but not manufactured by his arch-villains McDonald’s, the movie didn’t stress the point.
In February 2011, a team of researchers from the University of California, San Francisco, published a report in the journal Nature entitled ‘Public health: The toxic truth about sugar’.3 This dismissed the popular notion of sugar as ‘empty’ calories. On the contrary, they were bad calories. ‘A little is not a problem, but a lot kills – slowly,’ said the authors, who went on to propose that sugary foods should be taxed and their sales to children under 17 controlled.
We have known for years that refined sugar is also implicated in damaging the liver and kidneys and is the main cause of the worldwide spread of Type 2 diabetes. ‘If these results were obtained in experiments with any illegal drug, they would certainly be used to justify the most severe form of retribution against those unfortunate enough to be caught in possession of such a dangerous substance,’ writes Michael Gossop of the National Addiction Centre at King’s College, London.4
But is sugar actually a drug? Gossop thinks so. If a casual visitor from another galaxy were to drop in on planet earth, he would assume that human beings were even heavier drug users than we already are. Why? Because vast numbers of us ingest a white crystalline substance several times a day. We become agitated if we run out of supplies, and produce lame excuses for why we need another dose. We say we rely on it for ‘energy’, but we’re deluding ourselves. The energy rush from sugar is followed by a corresponding crash: it’s physiologically useless. But it is strongly reminiscent of the ups and downs associated with, say, cocaine.
The idea that sugar has some of the psychoactive qualities of recreational drugs is looking more and more credible. One of the major research findings of the past decade has been that sugar can turn rats into classic addicts. A team of scientists from the psychology department of Princeton University put rats on an intermittent diet of large quantities of sugar solution in addition to their normal food. The diet was intermittent because the researchers wanted to see what would happen when the rats were deprived of sugar. The answer was that they went into withdrawal, quivering with anxiety like a junkie deprived of his fix. And when the sugar reappeared, they binged.5
Most interesting of all was the finding that, in one key respect, sugar behaves like cocaine and amphetamine. It was already known that if you get a rat hooked on one of these drugs and break off the supply, a week later it will become hyperactive in response to even a tiny dose of that drug, which has no effect on a rat that has never been given the drugs. The period of addiction has ‘sensitised’ it to the substance. Indeed, the rats are cross-sensitised: a rat previously hooked on cocaine will respond hyperactively to a tiny dose of amphetamine and vice versa. This squares with what we can observe of human addicts, though for ethical reasons they can’t be put through the same tests.
What the Princeton team confirmed was that you can replace amphetamine or cocaine with sugar and the same thing happens. A rat previously hooked on sugar is sensitised to amphetamine/cocaine and vice versa. The conclusion the scientists drew from this is that sugar releases dopamine into the nucleus accumbens in a similar way to these drugs. This evidence, published in 2008, is the closest we have to proof that sugar is genuinely addictive.
The same doesn’t seem to be true of fat. We naturally like fatty foods: they’re more palatable and we have therefore evolved a preference for them. (In the faintly disgusting terminology of the food industry, fat adds to the slipperiness of the mouthfeel.) But fat isn’t psychoactive in the same way that sugar is.
If, however, you combine sugar and fat, as human beings have been doing for thousands of years, then a number of evolutionary impulses converge. All satisfying foods release comforting endorphins in our brains; but in the case of, say, chocolate, the opioid pleasure is reinforced by the dopamine hit of mildly psychoactive sugar, which slips down easily thanks to the smooth fatty texture. Salt and fat make a formidable combination, too, definitely more than the sum of its parts, but it doesn’t seem to have the same power to persuade people to eat beyond satiety: you may have a deep love of Kentucky Fried Chicken and get fat as a result, but you’re less likely to eat it until you feel sick.
Think back to the last office party you attended, and what was left over afterwards. I wonder if there has ever been an office ‘do’ in which people had to clear away half-eaten boxes of chocolates and tubs of mini-bites – but didn’t need to throw away any sandwiches because they’d all been wolfed down. I doubt it. Cake is occasionally unfinished because it’s filling. Even then, however, it tends to be saved for later rather than discarded, unlike the poor sandwiches (which, admittedly, don’t keep as well as cake). Super-sugary doughnuts, however, never make it to the end of the party.
It would be interesting to know what proportion of sweet as opposed to savoury food ends up in the world’s bins. My guess is that, not to put too fine a point on it, sweet items are far more likely to be turned into sewage than garbage. The Princeton experiments on rats explain why this might be. If sugar has a special relationship with the dopamine receptors in our brains, then it has the edge over fat and salt in triggering our ‘wanting’ impulses.
I asked Henry Dimbleby, who runs the Leon chain of restaurants, whether he thought office workers were becoming more preoccupied with sugar. ‘Oh, definitely. Sugar is our number one eating problem – I think 40 per cent of the population has some sort of addiction to it,’ he said.
Then, quite unprompted, he came out with an analogy between cake and coke. ‘Watch what happens in an office when somebody walks in carrying a box of Krispy Kreme doughnuts. There’s a general squealing sound and everyone rushes over excitedly. You’d think someone had just arrived at a party with a few grams of coke. People descend on it in the same way. I suppose that’s because the effect it has on you is pretty similar.’
Krispy Kreme wouldn’t like that suggestion, of course – but the fortunes of this doughnut company, founded by Vernon Rudolph in Winston-Salem, North Carolina in 1937, are an object lesson in how to market ultra-sugary recreational food in an era preoccupied with healthy eating. Like the Magnolia Bakery’s cupcakes, Krispy Kreme doughnuts play the nostalgia card. The spelling of the name is amusingly archaic; the logo has not changed significantly since it was designed by Benny Dinkins, a local architect, in the 1930s. During the 1990s, the chain expanded hugely and eventually over-reached itself. Customers who had persuaded themselves that eating old-fashioned doughnuts was an ironic gesture developed pangs of guilt; hastily opened stores had to be closed.
But then the company played with the formula, developing ‘signature coffees’ to go with the doughnuts. In November 2011 the Wall Street Journal reported that Krispy Kreme’s fiscal third-quarter earnings had risen 97 per cent.6 This is what you might call the Starbucks defence for eating pastries between meals: if it’s with coffee, you have permission. Where Starbucks has the edge over Krispy Kreme, however, is that its blueberry muffins can be disguised as breakfast; beginning the day with bright pink doughnuts, in contrast, is hard to carry off without arousing suspicions of ‘food issues’.
The habit of eating breakfast muffins – or, for the more refined palate, pain au chocolat – has become so familiar in London that it’s easy to forget that it was almost unknown in Britain until the early 1990s, when the first American-style coffee shops appeared. One wonders how their customers would react if, suddenly, all the shops closed and they had to revert to tea, cereal and toast. A bit like the rats in the Princeton experiment, perhaps.
Admittedly, muffins for breakfast are not the norm in Britain, yet. But there’s nothing random about a shift in taste towards a foodstuff carefully targeted towards the pleasure centres in the brain. Likewise, the afternoon ‘treats’ that materialise on office desks carry overtones of celebration and reward.
That couldn’t be said of the custard creams pushed round by the tea lady in the offices of my parents’ generation, welcome though the distraction undoubtedly was. Of course, biscuits were basically just compressed sugar and fat, but in such small quantities that people didn’t feel strongly about them. The ritual of the tea trolley, if you can call it that, was an emotionless affair: there was little sign of people struggling with their appetites, trying to reconcile the demands of the lower-order Go impulse and the higher-order instruction to Stop. Custard creams just aren’t that exciting.
Food dilemmas of the I-really-shouldn’t variety were reserved for the formal settings of afternoon tea and dinners when guests were present. Cake was not taken lightly: it was a home-baked gesture of hospitality or – and I’m thinking of my own childhood here – a reward for trudging around a department store on a Saturday afternoon.
Now it’s everywhere. The Sunday Times columnist India Knight complains that her local high street doesn’t have a single butcher’s, ‘but we have six cake shops, as if we had been sponsored by Marie Antoinette’.7
‘It’s funny stuff, cake,’ says Henry Dimbleby. ‘It’s a mood-changer. We always bring cake to a difficult meeting – it’s amazing how people unbend and become more flexible when there’s a great gooey chocolate sponge in front of them. I came back to the office the other day with samples of different cakes for my colleagues to try. It caused so much more excitement than if I’d come back with, say, chicken samples. The responses were quite emotional – “I adore carrot cake,” one girl told me, as if she were revealing a private relationship.’
A private relationship. That’s a good choice of words. These days not only do we have more of a ‘relationship’ with food than previous generations did, but it also has an intimate quality. And this despite the fact that we eat meals in public more often than ever before: it’s not remotely uncommon for a young professional working in a big city to eat out three or four nights a week.
These excursions are more social than communal. The setting, company and food change daily. Each occasion is the outcome of multiple choices and negotiations – not something you could say of the family meals of earlier centuries, in which the only choice was exercised by a housewife with narrow and predictable options.
If our grandparents could have seen people in their twenties and thirties meeting for supper in the local brasserie, they would have assumed there was a celebration in progress: diners scanning the menu for their favourite dishes – ‘I can never resist the calamari’ – to the sound of laughter amplified by alcohol. These are office ‘treats’ writ large.
When we eat out we aren’t simply storing away energy; nor are we reinforcing the same set of family bonds day after day. We choose our dining companions for their entertainment value. And when our eyes land on an item on the menu that we ‘can’t resist’ – well, the phrase gives the game away. From the moment we enter the restaurant, our dopamine receptors are in a state of high alert – far more so than they are at the routine family meals that are slowly being squeezed out of western lifestyles. The aroma of entertainment, choice and reward that lingers over the table stimulates the brain’s reward circuits – and that’s even before we’re confronted by food that is engineered to override the Stop mechanism in our frontal lobes.
We’ve reached a stage at which nearly all eating in public, whether in smart restaurants or fast-food joints, is more about fix than fuel. The amount of time we spend fussing over menu choices, and our habit of changing our minds right at the last minute, indicates how determined we are to extract just the right degree and quality of pleasure from the meal – even if all we end up ordering is a Zinger Tower Burger.
‘There’s far more ordering off-menu compared to ten years ago,’ says Henry Dimbleby. And it’s often a painfully intense business: you would think that the customers were going to be held responsible for their choices at the Last Judgement.
This isn’t a simple example of the replacement of people by things, because an amusing selection of friends is crucial to these suppers. But the gathering is transient – and, these days, even young, carefree diners behave like middle-aged foodies. ‘It’s food porn, really,’ says Amy, a writer in her mid-twenties whose friends live in the trendier postcodes of east London. ‘We’re all heavily into photographing the dishes when they arrive – especially if we’re somewhere really fancy and there’s this amazingly lush ravioli with shaved truffles in front of us.’
Amy and her well-heeled friends have a complicated, even tormented, relationship with food. They treat haute cuisine with a respect that isn’t just a tribute to the chef; it’s also flavoured with fear, because they know that it makes them put on weight. It’s hard to subscribe to the belief – as the girls certainly do – that ‘nothing tastes as good as skinny feels’ without feeling mildly uneasy in a restaurant. If they order off-menu, it’s usually so that the chef leaves out a calorific ingredient.
These young gourmets often starve themselves before and after a heavy meal, and for some of them the option of ‘purging’ is always at the back of their minds. Thanks to the media, we’re used to thinking of bulimia as an illness whose ravages are comparable to severe anorexia. We hear less about the occasional throwing-up that – as restaurant lavatory cleaners will confirm – accompanies meals where a stressed-out but not routinely bulimic diner has lost control of her (more rarely, his) appetite.
In the words of one cynical observer: ‘If I see a woman disappear into the loos in between courses and return with a smile on her face, I think: either she’s just barfed and is feeling deliriously happy at having wiped the slate clean, or she’s refilled on the nose candy. If the latter, she won’t eat a damn thing for the rest of the evening, though she won’t hold back on the wine.’
In metropolitan circles, different tribes have their own ways of resolving food issues. Here’s a disconcerting one. ‘Gay men in London are very keen on the weight loss pills called Alli,’ says Dr Max Pemberton, a psychiatrist working in a London hospital. Alli is called Xenical in the United States, where it is prescription-only. Its effects are dramatic: it stops the body absorbing fat and is recommended only for overweight people. Alli can be sold over the counter in Britain, but only by pharmacists, who are supposed to check that the customer really needs it. It’s a popular product generally, but especially in the gay community, where putting on weight is regarded as a cardinal sin. ‘There are gay-friendly pharmacists who’ll hand it over to guys who just want to go out to dinner without putting on weight,’ says Pemberton.
‘It has one notorious side effect – anal leakage. Let’s not go into too much gory detail. But regular users know the score. They take the pill after they’ve eaten their fatty food, which delays the gruesome side effects until later that night.’ Which is fine, presumably, so long as you aren’t planning to take a date home with you.
Of course, most people don’t throw up or cut corners with slimming pills. But growing numbers of us have an unstable relationship with food. We’re conscious of its mood-fixing – and mood-destroying – potential. Hence the little dramas in restaurants; hence, too, the distracted and unhappy atmosphere in many supermarkets, especially the upmarket ones that disguise their microwaveable goodies as restaurant courses.
Most evenings after work, I stop off at the Marks & Spencer food hall at Victoria Station. It can be a nightmare to fight your way through to the tills – not just because the store is crowded, but because of the way customers hover in the aisles, slack-jawed with indecision while their gaze wanders from the Cajun Chicken Fettuccine to the Salmon en Croûte and back again. Frequently people stand balancing a pre-packaged meal in each hand, wondering which of them will yield more pleasure or guilt when the microwave oven pings. And that’s before they get on to the really serious business of choosing a pudding.
That’s where the manufacturer’s statistics come in handy. Middle-class shoppers are painfully aware of the trade-off that comes with indulgent food. Your body pays a price; the numbers on the back of the packet help you decide whether it’s worth it. Actually, given that shoppers tend to fixate on the calorie and fat totals but gloss over the sugar content, it may not be a well-informed decision. Nevertheless, the calculations increase their identification with the food – the ‘personal relationship’ created by the fusion of compulsion and choice.
Marks & Spencer likes to give the impression that it helps shoppers avoid clogging up their arteries by accident. ‘We all know we should follow a healthy diet, but it’s not always obvious what’s good for you and what isn’t. So we’ve worked it out for you,’ it declares patronisingly.8 That’s true, in the sense that its food carries ‘nutritional information’ and, like all supermarkets, it offers low-fat versions of dishes. They’re not low-reward options, though; if anything, they seek to be even more enticing.
Henry Dimbleby insists that cutting out the fat doesn’t do anything for customers’ health: ‘When supermarkets take the fat out of their lasagne, they probably replace it with highly refined starch which gives it a smoother, luxurious feel but has a high glycaemic index. Plus, they may throw in lots of sugar. This ‘low-fat’ thing could really be a con. You’d be much better off with the original version.’
The Marks & Spencer food hall meticulously exploits the middle-class determination to turn even the most routine home dining experiences into an imitation of a luxury dinner party – or a children’s birthday bash. There are iced cakes everywhere. But M&S isn’t unique in this respect.
In the summer of 2011, I visited what may be the world’s yuppiest supermarket: Whole Foods in Palo Alto, California, which believes in ‘promoting the health of our stakeholders [customers] through healthy eating education’. When I arrived, ‘stakeholders’ were busy trying free samples of the fattest cupcakes I’ve ever seen. (‘They’re so big, it’s hard to get a full bite,’ complained one online reviewer.) According to Whole Foods, each vanilla cupcake has 480 calories, which I would have thought was a conservative estimate.
The customers crowding around the display wore Birkenstock sandals and T-shirts with radical slogans. They were also enormous. A conservative Californian friend of mine has coined the term ‘activist butt’ to describe the huge posteriors of middle-aged women protesting about American foreign policy, welfare cuts or whatever. Clearly, despite what you might read in the liberal British press, there isn’t a precise correlation between obesity and voting Republican.
Whole Foods says it’s ‘passionate’ about the sourcing and ingredients of its products. References to ‘passion’ are easily the most cringeworthy corporate cliché of recent decades, but the threads on the Whole Foods blog suggest that lots of its customers are passionate about these things. Would they feel so strongly if they hadn’t built up an unusually strong ‘personal relationship’ with food? No. What makes that relationship so strong isn’t only the company’s ethical sourcing or commitment to healthy eating. It’s the addictive deliciousness of its products, whose price tags suggest that the liberal management knows exactly how to cash in on bourgeois food anxieties.
Imagine if Whole Foods really did make the health of its stakeholders its priority. The in-your-face display of cupcakes would have to go, because however responsibly harvested their ingredients are, and however magically free of trans fats they may be, those cakes are junk food. Likewise, if Marks & Spencer was serious about telling its customers what is and isn’t good for them, it would have to slap diabetes warnings on dozens of ‘indulgent’ puddings and cakes, and probably its low-fat savoury dishes as well.
But then, of course, it would go out of business. So would any supermarket, grocer’s, bakery or restaurant that failed to satisfy the increasingly detailed demands of the 21st-century customer. These are framed differently depending on people’s background and beliefs: some focus on value for money, some on the quality of the food, some on its perceived healthiness, some on the ethical purity of the sourcing. But at the heart of all these demands lie ever-rising expectations of self-gratification. And the higher those expectations become, the closer we move towards addiction.
How do you tell the difference between a normal drinker and an alcoholic? The normal drinker says: ‘I’m going to the pub tonight and I’ll get totally smashed.’ The alcoholic says: ‘I’m going to the pub tonight and I won’t get totally smashed.’
I can’t remember at which AA meeting I heard that saying, but never has a truer word been spoken. It wasn’t the amount I drank that persuaded me I was an alcoholic; it was my pathetic inability to predict when I would get plastered. Sometimes I could surprise myself by walking away from a boozy dinner having drunk only a couple of glasses. More often, an innocuous ‘quick pint’ after work would turn into The Lost Weekend. Either way, the challenge of managing my alcohol intake absorbed an awful lot of mental energy.
A whole generation of problem eaters are discovering the same thing about food. Resisting temptation is almost a full-time job for people who, when they walk through a shopping centre, find a different ‘wanting’ urge stimulated every time they turn their head.
The 12-step fellowships have an acronym for these situations. HALT: Hungry, Angry, Lonely, Tired. If you’re experiencing any combination of those feelings, you’re more likely to reach for a sweet, fatty or salty fix. This is no secret to purveyors of fast food – they do good business in places where people feel hassled and isolated. Look at Victoria Station.
Usually it’s not hard to tell who regularly gives in to temptation. One woman I know claims to be able to spot a bulimic at ten paces: ‘They never learn that there’s no such thing as a perfume that covers up the whiff of you-know-what. Also, yellow teeth on a pretty girl are a dead giveaway – it’s the stomach acid.’
Ultimately, though, there’s no infallible way of spotting someone with food ‘issues’, because some of the most troubled people never act on their fears and fantasies.
In his book The End of Overeating, Dr David Kessler, former commissioner of the US Food and Drug Administration, interviewed his colleagues about their favourite snacks – the treats that made their mouths water. He found that thin people as well as fat ones had developed powerful, intimate and angst-ridden obsessions with cookies and chocolate. They weren’t secretly purging; they had strategies for managing these distractions.
A thin woman called Rosalita talked about the way she always left food on her plate in order to compensate for her M&M binges. But her management technique would fall to pieces if a co-worker brought cookies into the office. ‘I’ll eat one, go to my desk, then think about them. Then I’ll go back for another one. And I’ll do that for the rest of the afternoon.’9
Why doesn’t Rosalita stop herself getting up from her desk for another cookie? It would be wrong to say that she’s compelled to scarf another biscuit by her brain chemistry. She is not a typical addict, but she does have a very impulsive and unhealthy relationship with food.
The tricky concept of food addiction forces us to confront the growing grey area between normal behaviour and fully fledged addictions that ruin people’s lives. As we’ve seen, sugar induces cocaine-like reactions in mice. Other foodstuffs don’t, but we have an evolutionary preference for fat and salt, so we eat them in unhealthy quantities even if we don’t experience the same dopamine cascade that we do with sugar.
‘Food’ is shorthand for any number of substances, some more drug-like than others in their ability to change our moods. So when the media talk about ‘food addiction’, or even ‘junk food addiction’, it’s not quite clear what sufferers are supposed to be addicted to. You couldn’t say that of alcohol or heroin. Also, obviously we all have to eat – most of us in an environment saturated with temptations.
These ambiguities create confusion, but they’re also revealing. Food addictions – and the addictive behaviour inspired by food – are more deeply embedded in the daily routines of society than any other form of over-consumption. The need to search for food drove the evolution of our brains; it moulded the first communities; it has left its traces on our most sacred rituals. So when this instinct is mercilessly tweaked by addictive impulses, no wonder it unsettles us.
David Kavanagh, a professor of clinical psychology at the University of Queensland, captures the unique misery caused by an obsession with tasty food: it’s a sort of guilty longing. As he tells Kessler, ‘there’s a lot of parallel stuff that’s occurring when people are trying to engage in control at the same time they are experiencing a desire’.10 Different factions in the brain are slugging it out again – but in this case the outcome is usually predictable, since food desire is so much stronger than food control.
‘Conditioned hypereating’ is Kessler’s term for our greedy but often angst-ridden consumption of unhealthy food. He uses the word ‘conditioned’ because the food industry not only engineers food that exploits our natural preference for sugar, fat and salt, but also grabs our attention when we’re not eating, employing cues that awaken our wanting instinct.
We’ve already seen that the dopamine receptors in our brains naturally fasten on to cues. The sight of an actor in a black-and-white Hollywood film insouciantly lighting up a cigarette can be enough to reactivate nicotine craving in someone who hasn’t smoked in years.
Food cues can also be switched on at any time of day; ingenious manufacturers can make people desire food at a time when they’re normally doing something else. The gold medal in this field has to go to Starbucks and its Frappuccino. The word is a portmanteau of the French frappé, meaning chilled (or, in the case of coffee, shaken) and cappuccino. It was invented by a Massachusetts coffee chain which sold the rights to it when it was bought by Starbucks.
Suddenly Starbucks had an answer to a problem that had been dogging it for years. During the afternoon, its usually busy stores were ‘so empty that you could roll a bowling ball through them’, according to a venture capitalist interviewed by Kessler.11 But this rich, sweet milkshake pick-me-up was perfect for that 4 p.m. lull.
This I know from experience, because I used to work in the big tower at Canary Wharf, where Starbucks had installed a store just at the bottom of the lifts. Every afternoon during the summer I would descend 12 storeys to slurp a Frappuccino, always hoping that the barista would keep the ice in the shaker long enough for it to be properly ground – and also would remember that the caramel drizzle came free with the whipped cream. I hated the embarrassment of having to put him right on that point.
I stopped because I was getting fat. Those ‘empty’ calories were giving me one hell of a paunch – and, I now learn from Nature magazine, further increasing my risk of an early death. But there’s no getting away from it: those mocha Frappuccinos hit the spot.
The research into overeating is actually quite frightening. The vulnerabilities it exposes are almost universal, and the trends in society – despite all the lavishly funded campaigning for healthy eating – are still moving steadily in the direction of hypereating.
Our new eating habits – and in terms of the history of Homo sapiens they are very new indeed – represent a profound mismatch of our appetites and our biological needs. High-calorie foods that once represented a precious opportunity to store energy now attack the internal organs of our sedentary bodies.
The problem is even worse than we might imagine, however, because researchers have uncovered two nasty twists in this evolutionary tale.
The first is that, for reasons that aren’t entirely clear, the food we really like makes us more hungry after we’ve started eating it.12 This hyper-palatable food is, of course, loaded with all the usual health-threatening ingredients; but this second wave of hunger also seems to be related to ‘priming’ in the environment. If you’re waiting for a friend in an Italian restaurant and you see the people at the next table digging in to an enticingly gooey four-cheese pizza, you’re more likely to have problems restraining your own consumption a few minutes later. And this is true even if you weren’t hungry in the first place. The need for a fix grows stronger, not weaker, as you munch your way through the pizza. You’ve been primed.
The second nasty twist affects people from non-Western communities that have only recently switched to a diet of processed food.
This I can illustrate from my own experience. In 2006 I found myself in a McDonald’s in the middle of an Indian reservation in the south-western United States. It was a surprise to me, as an Englishman who had previously met only Americans boasting about their one-sixteenth Cherokee heritage, to discover that everyone in the restaurant appeared to be a full-blooded Native American. And I was a minority in more ways than one.
There’s no polite way of saying this, but nearly every other customer was overweight. Even the teenagers working behind the till were heading towards morbid obesity. Some of them had cheeks so swollen that you could hardly see their eyes. These were Navajo adolescents, who have been shown to drink sweetened soft drinks at more than twice the national average.13
It was sad to see young people clearly in need of drastic intervention. And that clearly wasn’t going to happen. Obesity was the norm in their community. Why? Fat people are often quick to blame their problem on their genes. This is usually self-deluding nonsense – but not in the case of these Native Americans, for whom genetic inheritance really is partly to blame.
The psychiatrist Peter Whybrow, director of the Semel Institute for Neuroscience and Human Behavior at UCLA, explains that ethnic groups with a successful history of surviving during times of scarcity are the ones that suffer most from today’s biological-environmental mismatch.14 The peoples who migrated to America’s south-western deserts were forced to sustain themselves on the occasional rabbit, plus insects, roots, berries, seeds and nuts. Eventually they learned to irrigate land and grow pumpkins, corn and beans – but starvation was always a danger. Their survival was a triumph, given the environment.
But if, over many generations, a community becomes genetically adapted to scarcity, that means that when its diet suddenly changes, genetic inheritance becomes a liability.
If the percentage of your calories you derive from fat jumps from 15 to 40 per cent almost overnight, you’re in trouble – particularly if this coincides with an equally sudden increase in your sugar intake and a switch to a sedentary lifestyle.
Whybrow tells the story of the Pima Indians of Arizona, who suffer from extraordinary levels of obesity and diabetes: ‘Today, save for the isolated Nauru Islanders in the West Pacific, the Pima nation is plagued by a higher rate of obesity than any other ethnic group in the world, with about half those who are over the age of 35 suffering the dangerous complication of insulin-resistant diabetes.’15
Also, Pima children born to mothers with diabetes are at greater risk of developing it themselves. ‘A disabling illness, initiated by the disruption of an ancient balance, has now become self-perpetuating within the reproductive cycle,’ says Whybrow.
Similar problems, only slightly less severe in their impact, are being felt across the developing world. The Chinese government is horrified by what is happening to children who live in cities: nearly a quarter of 10- to 12-year-olds are overweight or obese, according to Education Ministry data – and most of this change has happened in the space of a decade.16 In Brazil, former health minister José Gomes Temparão says that ‘half the population is overweight’, thanks to drastic changes in lifestyle and diet. In fact, exactly 50 per cent of Brazilian men are overweight. In 1990 the figure was 20 per cent.17 Brazilians are not yet as obese as Americans, but the rate in the increase of their weight is astonishingly fast. It’s as if the country’s citizens have been changing shape in front of our eyes. Experts now talk about the ‘nutrition transition’, in which populations in developing countries move straight from malnourishment to obesity.
This might seem a melodramatic thing to say, but such rapid changes in body shape are unprecedented in the history of the world. Genetics are an important part of the picture: anyone whose ancestors have eaten simply for thousands of years is likely to have special problems adapting to buckets of Kentucky Fried Chicken.
We in the West haven’t had a sudden dietary culture shock. We’ve had generations in which to accommodate ourselves to diets high in sugar, fat and dairy products (to which we were originally intolerant, as most Asians are today). Even so, look where we are now: the average American woman now weighs roughly what the average American man weighed in 1960.
We also have no idea how much further this trend will continue. Nor do we really know how to go about changing our food environment in order to make it safer. Anti-smoking activists have an advantage over nutritional reformers, in that at least everyone knows what a cigarette is and that it’s bad for you. There’s no consensus about the boundary between healthy and unhealthy food. As Dimbleby says, most ‘healthy options’ in supermarkets just replace fat with sugar; given sugar’s special addictive potential, they’re probably making the situation worse.
‘A segment of the population seems especially vulnerable to the stimuli that lead to conditioned hypereating,’ concludes Kessler. ‘But in the end this is behaviour that anyone can develop. Learning to overeat is an incremental process that grows with repeated exposure.’18 Treating yourself becomes part of your daily food routine. Before long, if you ask the barista not to spray aerated cream on top of a coffee that’s already got 300 calories in it, you feel that you’ve punished yourself. Where once people responded unconsciously to food cues, they now make conscious decisions not to respond, thereby feeling virtuous and deprived at the same time. And nobody can keep that up for long. Walking down a modern high street resembles nothing so much as the arcade games of the 1990s, in which assailants leap out at you from behind doors and shopfronts every few seconds. Only now the assailants aren’t burly mafia hit men – they’re artfully packaged snacks. Is it any wonder that the crowd of grazers at Victoria Station is growing larger by the week?