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The Seduction Begins:
How Foods Addict You

 

You’re not going to make me give up chocolate, are you?” the young woman asked. She had come to my office to join a research study that demanded some fairly major diet changes. But there was a limit. Chocolate was not negotiable.

“No, we’re not,” I replied, to her visible relief. “But, very soon you might look at chocolate a bit differently.”

She was thirty-five, with a successful career. She was about to begin a series of diet readjustments that would help her lose weight, boost her energy, and make her healthier overall. Unbeknownst to her at the outset, however, these same diet changes were about to knock out food cravings that had been troubling her for longer than she could remember. And that would change her life.

The truth was, even though she loved candy bars, fudge, and chocolate chip cookies, they were not entirely her friends. Each candy wrapper’s nutrition label read almost like a confession—ten, twelve, or fifteen grams of fat in a single serving, and every last gram seemed to descend straight to her thighs. She liked chocolate, but she had been desperate to find some way to control it so that she could have it when she wanted, but not be its slave.

Does her situation sound familiar? We all get into food ruts of one kind or another, whether they involve simple daily habits or intense, recurring cravings. At the Physicians Committee for Responsible Medicine, we see their effects all too clearly in our research studies. Of all the things that influence our volunteers’ weight, health, or how they feel from day to day, the number-one factor is the foods they’ve become hooked on.

New discoveries have helped us understand why it is that some foods become almost magnetic. It is now abundantly clear that your desire for certain foods—chocolate, potato chips, or cookies, for example—is not simply a choice, like what color socks you’ll wear or what movie you might go see. The demand is physical.

To return to the case of our research volunteer, whose name, by the way, is Cynthia, she felt an intense craving for something sweet every evening, usually around eight or nine o’clock. It was not that she might appreciate a sweet in the way one might like a flower or a pretty picture. This was an overwhelming physical need. And it was specific. Plain table sugar didn’t do it. Neither did fruit, raisins, or syrup, sweet as they may be. What she needed was a combination of sweetness and fat, with a bit of chocolate taste as an essential ingredient: a cookie, a chocolate bar, or maybe some ice cream. She might resist it for an hour or two. But sooner or later she would find herself plugging quarters into a candy machine or hurrying off to the convenience store with the same mixture of humiliation and compulsion that people feel as they fall off the wagon into the waiting arms of cigarettes, alcohol, or other addictions.

Over the years she had gained quite a bit of weight. She had dieted, exercised, taken various weight-loss supplements, and even managed to get her meal plan in pretty good shape for short periods at a time. But nothing lasted. Unhealthy foods called her back. Like an old love song, chocolate appealed to her to return to its loving embrace.

Her husband had no interest in sweets. But he fancied himself a pretty good cook, and loved to lay out a big breakfast of omelets made with cheese and bacon, which his father had taught him to make as a child growing up in Chicago. At lunch and dinner he generally avoided red meat, but ate a considerable amount of turkey and salmon, and he had acquired a particular taste for cheese. It did not have to be anything fancy. Cheddar had worked its way into many of his recipes, and he munched on gouda or edam with crackers in the evening while watching TV. He didn’t turn up his nose at Velveeta, either, which he thought made a darn good quesadilla.

He had a weight problem of his own, and a serious cholesterol problem, too. His doctor had put him on cholesterol-lowering drugs, which helped—but not as much as either of them had hoped. The doctor also referred him to a dietitian who went over his current diet in elaborate detail and then pronounced his sentence: no more than six ounces of meat per day. One egg yolk per week. Cottage cheese. At that point he went blank, while she went on about having at least five servings of fruits and vegetables every day, drinking plenty of water, and blah, blah, blah, blah. If this was living, he would rather die.

In a very real sense, both were addicts, although neither would have used such a strong word. The fact is, they had both become hooked on specific foods that were tremendously compelling and even habituating. And the reason, it appears, is that these foods produce an overly strong reaction in the brain’s pleasure center, causing the brain to keep them on its radar screen, so to speak.

 

Chocolate, Cheese, and Your Brain

 

The brain’s pleasure center is not there just for fun. It is essential for survival. It guides you to eat, rather than waste away, and to reproduce, rather than let your genetic lineage die out. Imagine what would happen if your brain were unable to recognize pleasure, so that, for example, you got no good feeling at all from eating a meal when you were hungry. You would not look after your basic needs. Your brain’s pleasure center makes you want to eat, exercise, interact with others, and even reproduce.

Whenever an experience provides more pleasure than expected, your brain releases a bit of dopamine, the brain’s main pleasure-producing chemical. If its name implies that it can make you a bit dopey, that is not far from the truth. Dopamine is central to virtually anything that feels good. An unexpected food treat, a romantic flirtation—or anything your brain takes to be a good thing—causes dopamine to lock onto brain cells and build a permanent memory trace of where pleasure comes from. It keeps flavors, scents, and even sexual experiences alive in your mind, and makes you want to experience them again and again.

So the brain’s pleasure center is just doing its job when it guides you to what it thinks you need for survival—an unexpectedly filling food or a receptive mate, for example. In the distant past, food choices were limited, and our pleasure center did not have a particularly challenging job. It helped us remember the difference between luscious, sweet fruits and immature ones, and between plump, fatty nuts and others that had become shriveled and dried. But sugary, fatty, delectable foods are everywhere nowadays, ready to confuse our senses and lead us astray.

What if someone invented a chemical that could trigger the brain’s pleasure circuitry—a chemical that did not make you stronger, help you reproduce, or assist you in any other way—but still gave your brain a feeling so warm and pleasant that you would want to repeat it over and over? Well, someone did. Heroin, cocaine, alcohol, nicotine, and, in fact, all recreational drugs work on the brain’s pleasure center, triggering a greatly exaggerated dopamine response.

Someone also invented chocolate bars, wedges of cheese, cookies, and doughnuts. All of these foods are capable of stimulating precisely the same part of the brain that responds to heroin. And that is why they can be addicting. The fact is, we’ve been a bit too clever for our Own good, refining food products to the point where they provide all the pleasure and very little of the nutrition we need.

Now, being addicted to a food doesn’t mean you are going to end up in rehab. What it really means—for foods, drugs, or anything else— is that you have developed an intense motivation to keep taking it. This strongly compulsive quality, which is the basis of an addiction, is different from physical dependency or from having withdrawal symptoms when you quit. For example, a person who is addicted to gambling feels an intense motivation to take dangerous risks, but there are no withdrawal symptoms when the casinos are closed. Yes, many addictive substances have both a compulsive quality as well as withdrawal symptoms when you stop using them—the irritability that smokers feel, the tremors alcoholics experience, or the abdominal cramps heroin addicts have when they go cold turkey. But these symptoms relate to brain centers other than those that control addiction. They may not occur at all. Here’s the point: You can be addicted to sugar, chocolate, or cheese slices, even if you don’t wake up tremulous and sweating if you’ve missed your dose.

Addicted to chocolate? Sounds like an overstatement, doesn’t it? But the attraction to chocolate is not simply due to its taste and creamy texture. Chocolate hits the brain and causes a habituation that is as real and physical as addiction to narcotics—albeit not so destructive. As we saw in the Introduction, when volunteers take the opiate blocker naloxone, their desire for chocolate falls away almost instantly. Ditto for ice cream and other snack foods.¹ Chocolate stimulates opiate receptors in the brain, and blocking those receptors undoes chocolate’s principal attraction.^*

Now, in theory, any food that tastes good can trigger the brain’s pleasure center at least a little bit, and that applies to strawberries and asparagus—for people who like them—just as it does to cookies or chocolate. It is a question of degree. Some foods, like chocolate, work on the brain’s pleasure center much more strongly than others, and alcohol and drugs are off the scale. The effects also differ from one person to another. Some people don’t care for alcohol, while others cannot function without it. The same is true of many different foods. Cheese is irresistible to some people, but holds little interest for others.

Many of our research volunteers are beyond passionate about chocolate. One said that a day did not go by without thoughts of the creamy, warm substance melting over her tongue. She knew full well that a Hershey Bar or two packed enough fat to show up on the scale in short order. But for her chocolate was oxygen. During our research study, she set it aside, using diet adjustments you’ll see in this book. But, for weeks she continued to carry a chocolate bar with her in her purse, just to know it was there.

It should be said that your body does not always rely on its reward system to guide your choices. When you are thirsty, you crave water. But water does not have to be stunningly delicious to be satisfying. Similarly, oxygen in the air we breathe is not especially exciting, unless you haven’t had any for a minute or two. Your body has many ways to regulate how you satisfy your needs. The reward system is just one mechanism for doing that, and, as it happens, one that can easily be fooled.

 

Thrill-Seekers: When Your Brain Makes Less
Dopamine Than Other People’s

 

As we have seen, opiate-blocking medications can stop chocolate addiction dead in its tracks. These drugs have also been used to help people control other excesses of the brain’s reward system. Researchers at the University of Minnesota gave an opiate blocker to a group of compulsive gamblers. Seventy-five percent of them were much improved, compared to only twenty-four percent taking a placebo.² The drug’s only side effect was nausea—and even that was probably less than the sick feeling they may have had seeing their money drained away.

Researchers believe that compulsive gamblers have lower-than-normal levels of the brain’s dopamine receptors, meaning that they get less pleasure from everyday activities than other people do and seek out extra stimulation just to feel normal.

They are not the only ones. Special brain scans, called positron emission tomography, have shown that many overweight people have fewer brain receptors for dopamine, called DRD2 (dopamine receptor D₂), compared to other people. For them, the brain-rewarding chemical has fewer places to attach to brain cells and work its magic. Presumably, they are less able to experience rewarding pleasurable feelings, and will tend to overeat to try to get the stimulation they lack. Another possibility, not yet ruled out, is that these people were not born that way, but that through repeated overeating they have somehow caused the brain to reduce the number of these dopamine attachment sites.³

Increasing scientific evidence suggests, however, that many people are, in fact, born that way. With a genetic trait handed down from their parents, their brains have 30 to 40 percent fewer of the brain receptors that are responsible for pleasurable feelings, compared to other people.^4,5 They are on a constant quest to reach the normal, satisfied state other people take for granted. The low-D₇ gene has been amply demonstrated among alcoholics, especially those with serious dependency beginning early in life. It has also been found in people who abuse recreational drugs. And among smokers, those who never manage to quit are more likely to have the low-D₂ gene, compared to those who succeed at quitting, who, in turn, have a higher prevalence of the low-D₂ gene compared to people who were never attracted to tobacco in the first place.⁶

Among obese individuals, especially carbohydrate cravers, D₂ deficiencies are as common as they are in alcoholics, drug abusers, and smokers—suggesting that, for some, food really acts as a drug.⁷ Researchers have found that other genes also influence the brain’s response to drugs, alcohol, and other substances, including food.

These observations helped explain why alcoholism, drug abuse, and food compulsions often run in families. What is missing in these individuals is not a part of the brain that copes with alcohol or any specific drug. What is deficient is the brain receptor for normal feelings of pleasure. As a result, they are vulnerable to anything that provides it: One family member might be hooked on wine, another on drugs, and another on compulsive overeating, and they may have more than one addiction at the same time.

You may be asking whether you or your loved ones carry this genetic trait. Unfortunately, it is not something doctors routinely check. However, you can get a pretty good idea if the low-D₂ gene, or other addiction-fostering genes, may lurk on your chromosomes from a simple glance at your family tree. Think about your parents, grandparents, and siblings. What are/were their drinking and eating habits like? What they drink is not so important as how much and how often, and how young they were when trouble started. A person who drinks only occasionally, or who smoked but managed to quit, is less likely to be responding to a genetic trait than someone who persists in these habits even when things get out of hand.

Whatever your family history, one thing is clear: genes are not destiny. We can overcome the addictive properties of food through bolstering our physical resilience, instead of relying on simple willpower—and this works whether you have addiction genes or not. You can strengthen yourself against an unwanted infatuation with unhealthy foods, as we will see in part II. The fact is, healthy foods can turn on that feel-good dopamine system, too—maybe not in quite the same way chocolate does, but they will do the job. Ditto for exercise. You can get the “runner’s high” without leaving the room, as we will see in chapter 10.

 

Food and Sex

 

Rather have chocolate than sex? Well, it may not surprise you that the same part of your brain that appreciates chocolate is also responsible for libido, that is, sexual attraction.⁸ Your genes are just anxious to reward you for anything that perpetuates their existence. The reason is obvious: if you never felt like eating, you would perish. And if courtship and sex were a complete bore, our species would have died out long ago. So our brains give us a little dopamine, along with pheromones, to keep food on our minds and to make blind dates, ill-fitting clothes, and schmaltzy love songs seem worthwhile.

Here’s the problem: Sometimes we use food to stimulate the deepest parts of the brain when what we really need is friendship and love. And if the part of the brain that keeps us interacting with others—talking, flirting, dating, or just being together—can be satisfied with a bowl of chocolate ice cream instead, we can find ourselves becoming more and more alone.

I once had a patient who was remarkably withdrawn. He had virtually no social contacts, and, in fact, had had no friends at all for many years. I asked him about this, and he said, “Well, I have friends. I have my drug friends.” He did not mean that he had friends with whom he took drugs. He meant drugs were his friends. His “social life” consisted of getting high in total isolation.

Although his was an extreme case, the fact is many people feel a bit the same way. When they are lonely, bored, or stressed, food becomes more than a source of nutrition. Food becomes a friend. A woman whose husband wonders why she binged while he was on another extended business trip tells him, simply, “Chocolate was here. Where were you?” If foods can work on the very parts of our brain that are designed for warmth, friendship, and love, no wonder loneliness leads to overeating, drinking, or drug use. And once addictions start they develop a life of their own, whether people are around to support us or not.

If food can replace love, the reverse is true, too. New lovers don’t eat. Lost in a dream land, they lose their appetites for everything except each other. It is as if love is a gastrointestinal disorder, called being “lovesick.”

If chocolate and friendship compete for the same part of the brain, we can push chocolate out of the competition by strengthening friendships. In today’s society, that can be a challenge, but we’ll tackle it in chapter 11.

 

The Price We Pay for Our Food Addictions

 

Some people are trapped by vulnerabilities that neither they nor anyone else ever recognized. If you were to test lung cancer patients, for example, you would find that many were born with the low-D₂ gene, a trait that drives them toward tobacco, or, for that matter, alcohol, drugs, food, or anything else that stimulates the brain. They never knew why they had such a hard time quitting smoking.⁹ It was the combination of a highly addictive substance—nicotine—and a genetic vulnerability to addiction that led to a terrible but predictable conclusion. Had cigarettes never been invented, they would have turned elsewhere for stimulation—to healthful outlets, like exercise or competition of various kinds, or perhaps to dangerous ones, like alcohol or drugs.

Some food addictions are more or less harmless. Others exact a greater toll than you might imagine. In the harmless category, an occasional chocolate bar is no cause for worry. Hot peppers are habituating, but it is difficult to blame them for any serious bad effects. Caffeinated beverages cause no more than a bit of irritability or sleep disruption, and perhaps headaches when you stop using them.

On the other hand, some habits are not so benign over the long run. In Western countries, people become habituated to diets rich in cheese, meat, sugar, and fat as easily as they might to tobacco, alcohol, or drugs. If that statement sounds exaggerated or alarmist, let me explain, starting with a look at other populations.

In some areas of Latin America laborers routinely chew coca leaves. Each leaf delivers a bit of the pain-killing and mood-boosting effect that has made cocaine such a popular drug. Similarly, in much of the Indian subcontinent, men chew a mixture of betel nut and tobacco. Sidewalks everywhere are splatted with red betel juice stains. The hygiene issues are nothing compared to the potential for oral cancer—something that has worried researchers for decades. But people who use coca or betel consider them entirely normal, and even healthful. They resist advice to leave these habits behind, and campaigns to curtail the use of these substances fall flat.

In Asia, traditional diets are fairly healthy. Rice has been the staple for millions of people, and noodles, vegetables, and bean dishes have made up most of the diet. Meat, if eaten at all, is mainly a flavoring or garnish used in the same way Americans might use a pickle or a slice of tomato. Dairy products have been uncommon; to this day, Asian restaurants do not serve glasses of milk or slices of cheese.

However, things are changing in Asia. McDonald’s, Wendy’s, Burger King, and KFC have invaded, and meat and dairy products have displaced traditional diets. Where children once favored rice and vegetables, they now eat burgers and fries. Japanese schools have begun emulating the American habit of serving milk, on the naïve assumption that it will help their children build bones. What they are building is a generation of overweight kids and even more overweight adults. Westernization of the diet has made Asian children look more and more like their out-of-shape North American counterparts, and has sparked epidemics of the same diseases that have plagued the western world: obesity, heart disease, diabetes, hypertension, and cancer.

Meanwhile, in North America and Europe, diets have been too high in fat, protein, and cholesterol for generations. During my upbringing in Fargo, North Dakota, a meal was not a meal unless it included meat. Cheese and other dairy products were equally routine. Health researchers lamented our choice of dietary staples, noting that American children typically have the beginnings of artery blockages before they finish high school. Things worsened in the 1970s and 1980s when fast-food restaurants perfected the ability to sell burgers and french fries to an eager public. Americans already fared badly, compared to the rest of the world. Men and women in Boston or Topeka died younger than their counterparts in Tokyo or Osaka, and, as diets have deteriorated further, disease rates have only worsened. Cheese consumption, for example, doubled from 1975 to 1999, and rates of obesity, high cholesterol levels, diabetes, hypertension, and other problems have continued to escalate.

Some people struggling with these health problems might have an unfortunate genetic predisposition. But, in most cases, you would be quite accurate in considering them victims of addiction. They have unknowingly become hooked on foods that made these diseases manifest. Had they been able to keep unhealthy foods at arm’s length, very likely their health problems would never have occurred.

Just as coca chewers and betel users don’t connect these habits to health problems, many people in Western countries fail to recognize that foods are a major cause of their illnesses, too. They resist efforts to reduce the use of unhealthy, addicting foods and, for the most part, ignore advice favoring healthier choices.

Rather than quitting the offending food, we end up on medications, in the hospital, or worse. Four thousand Americans have heart attacks every day, largely due to bad diets, smoking, and other lifestyle factors that we could potentially control, were we able to conquer our addictions. I cannot tell you how many people tell me their cholesterol problems are genetic. And that may be true for perhaps one in ten. But for the rest, it was not bad genes their parents gave them, but bad recipes, and tastes for foods that drive cholesterol levels up.

Meanwhile, medical services to prevent and treat heart problems have become big business. A recent television commercial depicted a man climbing into a pickup truck driven by his wife who has collected him at the doctor’s office. His cholesterol level is up, he tells her. The answer is Lipitor, Parke-Davis’s wildly popular cholesterol-lowering drug that sells for more than three dollars for a single pill.

But drug prescriptions are a poor substitute for breaking a few habits. Dr. Dean Ornish’s program for reversing heart disease, based at the Preventive Medicine Research Institute near San Francisco, showed that lifestyle changes can be much more effective than drugs for patients with heart disease. In his ground-breaking research study, a change in diet and lifestyle promptly opened up coronary arteries to such an extent that the difference was clearly evident on angiograms, special X rays of the heart, in 82 percent of patients in the first year, with no drugs, surgery, or high-tech, artery-busting procedures. And as the years went by they kept getting healthier and healthier. They had broken their addictions to unhealthy foods, and their bodies healed on their own.

The same is true with diabetes. The condition is rare among Asians who continue traditional plant-based diets, and similarly rare among vegetarians. But, once Asians move to Seattle, Los Angeles, Chicago, or Atlanta, and trade traditional rice and vegetables for Western fare, diabetes rates climb 400 percent.

The Diabetes Prevention Program of the National Institutes of Health tested what drugs or diet changes could do to prevent the disease in a group of 3,234 volunteers who were “pre-diabetic,” with blood sugar levels inching toward the danger zone. The popular diabetes drug Glucophage (metformin) was able to cut diabetes incidence by 31 percent. That was impressive. But a combination of diet and exercise was nearly twice as effective, bringing a 58-percent drop in diabetes rates.¹⁰

Sometimes we need medications, and they can indeed be lifesaving. But they are often too weak to stop the full effects of unhealthy food habits, they have side effects, and they are expensive. So many people are on medications for cholesterol problems, diabetes, or hypertension, that drug companies are cashing in to unprecedented degrees, while insurance companies and tax-funded prescription programs are strained more year by year.

Too often, things turn desperate. At any point in time, more than fifty thousand Americans are waiting for another American to die so that they can have a transplanted kidney. Some cases are unavoidable. But in three-quarters of the cases, their kidneys failed due to diabetes and hypertension, and breaking free from addictions to unhealthy foods that aggravate these conditions could have prevented many of them.

 

What Goes Up Must Come Down

 

There is another problem that can come with just about any addiction. Stimulating the brain’s opiate receptors can bring a bit of a high. But, as an addiction—to food or anything else—becomes established, the brain adjusts so as to expect the stimulation to continue. Between doses, feelings of emptiness, anxiety, or depression begin to take hold, and the brain comes to rely on addictive substances to make these feelings vanish. Just as using a crutch when you don’t really need one can weaken your leg muscles, addictions weaken your natural mood-maintaining chemistry. Then, if you break the addiction, you’ll be left with uncomfortable feelings, and another addiction is likely to leap forward to “solve” it.

If you are leaping ahead to assume that this means that anything that is tasty and pleasurable should be avoided, for fear of some sort of brain damage, let’s get a quick reality check. The message of this book is not a puritanical one. The fact is, your brain’s pleasure center is there to help you. It responds to love, friendships, sexuality, physical activity, and foods that are good for you. The only problem is that things that push brain chemistry a bit too far in one direction generally lead to a rebound in the opposite direction later on. And moods that go up artificially inevitably come back down, ending up lower than where they started.

Think about people you may know who have had serious addiction problems, say, with alcohol, drugs, or major eating disorders. Their lives often become more and more constricted and empty. Anxieties take over, and they may lapse into depression. And these feelings push them right back into their addiction, which is what their brains need in order to feel “normal.” What if ordinary foods—say a couple of hundred calories worth of sugar consumed every day—could do the same thing, ratcheting up the brain’s opiate receptors just a notch and distorting our moods ever so slightly? Well, if the brain adjusts accordingly and comes to expect a daily boost from sugar or other junk foods, feelings of emptiness, anxiety, and depression may well follow, at least for some of us.

Could it be that many cases of chronic anxiety, depression, or feelings of boredom or emptiness result, not from the existential problems of human life but from too many doughnuts, chocolate bars, and sodas? Sounds a bit silly, doesn’t it? But, before you decide that junk food has no effect on any part of our bodies higher than, say, a double chin, let’s take a look at the surprising ways these seducers actually work their biochemical mischief, in chapters 2 through 5. But first, an optimistic word about what happens when you set aside a troubling food habit.

 

Breaking Free

 

The goal of this book is to help you break free. Yes, foods can be addicting, but there are easy things you can do to regain physical resilience against cravings and unhealthy food habits, and they are far more powerful than simple willpower. If you follow the steps laid out in this book, your body will do the rest.

Miki is a young woman who came to our center, not for herself, but for her husband, who had been diagnosed with a form of cancer. She wanted the very best of nutrition for him, and she joined him in the diet change. Some months later, she wrote to us about how wonderful they both felt. Not only was her husband doing very well, but so was she. “The most amazing things have resulted from this endeavor. I have enjoyed not only the new foods and wonderful tastes, but also a marked improvement in my health. I have lost sixty-seven pounds in one year. For the first time in my life I was not on a diet. I was able to increase my exercise regimen due to the weight loss. My cholesterol is well in control (having dropped significantly in the last year). One of the most amazing results for me has been the near disappearance of all diabetic symptoms. My blood sugar measurements have decreased, on average, 185 points without any medication. I feel fantastic, and for the first time in a long time have gotten a clean bill of health at my annual physical. We started these classes for my husband; however, I have gained as many benefits along the way as he has. You have our profound gratitude.”

When we have paid too dear a price for the seductions we have fallen into, gaining new control is like getting a complete refund.

^*In case you were wondering, opiate blockers like naloxone are not generally used in weight-loss programs, since they can damage the liver over the long run.