Diabetes Self-Management Blog

Last week I reviewed Dr. David Kessler’s book entitled The End of Overeating. Kessler says modern food marketing has addicted us to fat, sugar, and salt. He implies that these addictions are making us fat and damaging our health. He also says he can help us overcome them. I don’t think he can.

It’s clear to me that sugars and fats can be habit-forming. They affect our brains the same way that cigarettes or cocaine do, and their addictive quality has been demonstrated in many animal studies. In my book Diabetes: Sugar-Coated Crisis, I wrote that the unhealthy food environment is part of what makes people sick, although not the most important part. (Stress and physical inactivity are most important.)

It’s true that all the fat and sugar in our food tend to make us gain weight. But since reading Linda Bacon’s book Health at Every Size, I’m not sure that weight is causing much health damage. As Canadian, Japanese, and American studies show, weight is probably not a major cause of illness, except at the extremes of fatness or thinness.

So I disagree with Kessler on that. But I disagree even more with the last part of his book. That’s where he gives his program for escaping food addictions. In my opinion, his approach won’t benefit many people and may hurt a far larger group.

Changing habitual behavior is hard. I’ve written about this frequently, for example in this article for Rest Ministries called “Making Desirable Changes.” The reason I’m drawn to this topic is that, after studying it for years, I still find it really hard to change habits. I asked for help from the Diabetes Self-Management community on how to stop playing computer games and got some good advice. But it’s still a struggle. So I was interested in what Kessler had to say.

He correctly says that diets don’t work. But then he tells everyone to go on a very strict diet, like 1500 calories a day. He also says that willpower is not the answer. But his program is pretty much pure willpower.

Kessler says that habits, especially the food habits he calls “conditioned hypereating,” take over our behavior very quickly. Without even thinking, environmental triggers will have us eating that super-rich food. Since we don’t have time to think about it, we have to have very simple, very strict rules about a behavior we want to change.

You need a rule like “I don’t eat that, ever.” Or “I won’t go to parties where I’m going to be tempted by food I don’t want.” Or, I suppose, “I will never play a computer game, ever.”

Kessler says you may be able to lighten up on these rules eventually, but not until the old conditioning has been unlearned. And in an environment where food promises you relief, satisfaction, and pleasure 24/7, it might take a long time to unlearn.

Anyway, I tried his plan with the computer games. I wrote down in big letters on my desk, “I do not play computer games.” To my surprise, it actually worked…for three days. But then I found myself relapsing. The simple rule was not enough. I also had to identify my triggers and avoid them. If I couldn’t avoid them, I had to learn new ways of coping with them. I needed to find substitute behaviors that were incompatible with playing the games. I’m making some progress, but it’s challenging.

All habit change is like that. You need to identify the emotional needs that the habit meets. You have to figure out other ways of meeting those needs. You might need support to make such changes, perhaps from family, friends, or other people with the same problems.

Changing eating behaviors may be even more difficult. It’s not like gambling or heroin, where you can say “never again.” Food is a necessity, and it’s also a major source of comfort and pleasure, just as the advertisers claim. We don’t want food to become a source of anxiety. Stressing about eating won’t help our diabetes or our weight.

As I wrote in the Rest Ministries article, “Some people say that being healthy means giving up everything you like. They have it completely backward. Give up the things you don’t like, and appreciate the heck out of the things you do.” If food is a major source of emotional comfort, it would be crazy to try to give that up, without having found another way of comforting ourselves.

Taking the time to enjoy food might be the best way to get control of it. Increase the pleasure you get from food by tasting it thoroughly and eating slowly. Try to find foods you like even better, like maybe some of these Diabetes Self-Management recipes.

Slow down and listen to your body and you’ll probably eat the right amount. You can check your blood glucose after eating to make sure. I think that’s a better way to unlearn food conditioning than just trying to beat it down. Do you agree?

You can read my whole review of The End of Overeating here.

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Comments
  1. David,

    I believe that overeating is all of the above — and more. Yes, it is a habit. Yes, it is a response to desire for comfort. Yes, it is a normal response to an obesogenic environment.

    AND, in addition, I am growing more and more convicned as time passes that we have pollutants in our environment that cause derangement of our hunger and satiety hormones.

    I don’t want to go into ALL the details right now — but I’ll just point out 1 fact. Bisphenol A (BPA), a soluble residue of the sofgt plastics that are used for bottles, is known to stimulate diabetes. Surveys have shown it to be present in the bodies of an astonishingly high percentage of diabetes. (As I remember it was above 95%, but my momory may not be very precise.) How does it stimulate diabetes? I am guessing here — but I would not be surprised if we foudn out it interferes with the feeling of satiety, or stimulate hunger.

    Posted by Beth |
  2. Dear David

    I took metformin for three weeks and lost 5 lb the only problem is I became too tired to get out of bed so I had to stop. Willpower had nothing to do with the weight loss I was just plain and simply not hungry. I intend to restart at some point to loose another 5 lb. The point is the over eating has to do with insulin resistance and I suspect this is so with many people and not just diabetics.

    The subject of overeating may have a big psychological component also. But I was amazed how the purely (at least I think) chemical action of the metformin stopped the overeating. The more so since when I get overtired I eat more so the psychological would have been working against the weight loss.

    Posted by CalgaryDiabetic |
  3. I’d just like to point out that our problems with eating habits in this country are not limited to over-eating. What we eat, how often we eat, and how we eat are also problematic.

    I don’t eat enough, and what I do eat tends to be more empty calories than nutrition. My husband tends to just not eat until he gets home from work at night. He already has diabetes and this obviously isn’t helping his situation at all. He isn’t really overweight, either, but his sugar his so high that I think his blood probably resembles ketchup more than it should.

    Since most eating advice for diabetics focuses on keeping wieght down, he isn’t finding much help for managing his own bad habits.

    Any suggestions?

    Posted by Karli |
  4. Good comments, as usual. I agree with Beth that pollution may be deranging our appetites. I’ll be writing more about that next week.

    I didn’t know that metformin could kill appetite, but I know it does help some people lose weight. But why it makes people like Calgary so weak, I have no idea. Maybe we should look into ways of avoiding the fatigue effect?

    Karli, I think you have hit on an important point about undereating. It does lead to binging and junking out and is not good for glucose control, and that’s not even mentioning the risk of lows. (Dieting also causes these effects, by the way.)

    You said “Any suggestions?” Well, the #1 suggestion for almost any diet question is “Eat Breakfast!!” Eat a big breakfast with decent food including some protein. You’re much less likely to hit the sugar foods later if you start with some good food early.

    Posted by David Spero RN |
  5. David,

    I’m not sure I agree with you on the thesis that being fat and having diabetes is not correlated.

    I have no claim that my observations of my Asian and Japanese friends as scientific. But among them and their parents, there are very few who have diabetes or obese. And those few who are happened to also be diabetic.

    I only half agree on the diet though. My Japanese friends are also heavy on beef and the more marbling the better in their view. The difference is that their meals are also regular and heavy on tsuru reishi aka bitter melon which I read enhances secretion of insulin and blocks fats from being absorbed in the small intestines.

    I don’t have much hope for Americans adopting to the vegetable since its ugh bitter but maybe a diet supplement would be helpful.

    Posted by Kat |

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