The Most Unhappy of Pleasures: This Is Your Brain on Sugar

By all estimates, obese people are not happy. The question is whether their unhappiness is a cause or a result of their obesity. At this point we can't say for sure, but both could be right.

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The look on their faces testifies against them; they parade their sin like Sodom; they do not hide it. Woe to them! They have brought disaster upon themselves. --Isaiah 3:9

The Bible teaches us that pleasure doesn't pay. If you don't destroy yourself, then God will do it for you. Four thousand years later and the rules are still the same. The only thing that's changed is the vehicle.

When did the world become so obsessed with pleasure? Scripture argues that the goal of a righteous life is happiness, not pleasure. The Declaration of Independence affords us the right to "the pursuit of happiness," not pleasure. But pleasure has taken center stage in virtually all human pursuits. Delayed gratification is so 20th century.

Yet we are, by all accounts, not happy. You may have heard of the gross national happiness index, an indicator that measures quality of life or social progress in more psychological terms. Despite the fact that the United States has the highest gross domestic product, we score 44th on the happiness index. Who's #1? Denmark. The home of Hamlet, the most unhappy character in all of literature, the country that was overrun by the Nazis, where they freeze half the year, where they nurse one Carlsberg all night and eat rice because they can't afford a steak. Money can't buy happiness. But it sure can buy some pleasure.

In fact, pleasure and happiness might just be opposites. As we have spent the last 30 years pursuing sugar for pleasure, we have become most decidedly unhappy.

Substances of abuse used to be the subject of much hand-wringing. It started with opium dens, moved to speakeasies, then to crack houses, then to "smoking permitted" anterooms. Since Nancy Reagan's "Just Say No," the war on drugs has taken a back seat, but not because it has been won. Rather, because a different war has cluttered the headlines -- the war on obesity. And a substance even more insidious, I would argue, has supplanted cocaine and heroin. The object of our current affliction is sugar. Who could have imagined that something so innocent, so delicious, so irresistible -- just one glucose molecule (not so sweet) plus one fructose molecule (very sweet) -- could propel America toward economic deterioration and medical collapse?

The brain's pleasure center, called the nucleus accumbens, is essential for our survival as a species. We learned how important it was with the introduction in 2003 and subsequent removal in 2007 of the anti-obesity drug rimonabant. This medication blocked the effect of endocannabinoids, molecules that affected the pleasure center like marijuana -- sort of like the anti-munchies. Patients lost interest in food and lost weight, but 20 percent became clinically depressed, and many committed suicide. Turn off pleasure, and you turn off the will to live.

But long-term stimulation of the pleasure center drives the process of addiction. Rich people are addicted to money, power, gambling; middle-class people are addicted to cocaine, amphetamine, caffeine, nicotine, alcohol, heroin. The poor, well, all they've got is sugar.

Presented by

Robert H. Lustig is a pediatric neuroendocrinologist and a professor of pediatrics at the University of California, San Francisco. He is former chairman of the obesity task force of the Lawson Wilkins Pediatric Endocrine Society and the author of Fat Chance and The Fat Chance Cookbook.

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