The Real Reasons We Overeat

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Few would take exception to the assertion that obesity is an enormous health problem in the United States. There is less agreement, however, on how to combat the problem. David Kessler's new book, The End of Overeating: Taking Control of the Insatiable American Appetite offers a compelling case that to prevent overeating--and hence obesity--people should avoid processed foods as well as many popular chain restaurants such as Olive Garden and Chili's. The advice is consistent with what many experts who treat or research obesity have been recommending, but not entirely for the same reason.

Many of us recommend avoiding fast food in particular, and eating out in general, because of the tremendous number of calories in many of the meals offered. Although some fast food restaurants, such as McDonalds, have recently started offering some healthier options, most of the menu items are high in fat and calories. A recent study found that the average lunchtime purchase from a fast food restaurant in New York City contained more than 800 calories--far more calories than most people should be eating at lunch.

Kessler argues not only will you consume too many calories by eating processed foods; they will also cause changes in your brain circuitry, making you crave them in the future.

To increase profits, Kessler argues, food companies want to develop foods that are so stimulating you crave them--or at least cannot resist them. Kessler does not suggest that these industries are hiding the health effects of their product, the way tobacco companies did. But the case he makes suggests that they are at least partially liable for the obesity epidemic. Kessler does a nice job of explaining that both human and animal studies have found that eating foods high in sugar and fat change brain circuitry.

This is a much more compelling argument for avoiding processed foods and chain restaurants than the message we normally give: avoid them because you'll consume too many calories. Kessler argues that not only will you eat too many calories, eating these foods will cause changes in your brain circuitry that will make you start to crave them--and therefore eat too many calories well into the future. That is a much stronger argument for avoiding fast food and other commercially produced foods than most of us in the obesity field use.

Kessler makes clear that despite the perception that salads are healthier options, many times they are extremely high in fat and calories. Some of the fats may be healthy for your heart, such as those found in avocados and nuts, but many of the other items added to salads are high in both calories in unhealthy fats--cheeses, bacon bits, sour cream, fried tortilla strips/chips/bowls, and cream-based salad dressings. Perhaps hearing that this is well known to the food industry will be enough to change consumers' perceptions of salads.

There is a lot of debate about whether sugar per se is related to obesity. However, as Kessler explains, people now prefer the sugary foods, including salad dressings with sugar. Moreover, highly palatable foods change the wiring in our brains to make us crave these foods. Much of the focus of The End of Overeating is on how these foods change the wiring of the brain, and suggestions for how to combat these changes. Kessler does a nice job explaining a complex body of research findings related to reward-seeking behavior. However, it is disappointing that The End of Overeating fails to cover many other relevant areas of research related to eating behaviors.

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Alison E. Field

Alison E. Field is an Associate Professor of Pediatrics at Harvard Medical School and an Associate Professor in Epidemiology at the Harvard School of Public Health. She researches the causes and consequences of weight gain, obesity, weight cycling, and eating disorders in children, adolescents, and adult women. She has been widely published in medical journals, including Pediatrics, Obesity, Archives of Internal Medicine, and has discussed her research on CNN, Fox, and local news affiliates.
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