Obsessed: America's Food Addiction

by Mika Brzezinski

  Zeke Emanuel is a little less certain that processed foods are actually addictive, but he does think the theory needs further study. “It’s being explored, how the brain becomes habituated to certain things and not others,” he responds. “For anyone to definitively say, ‘Yes, there’s an addiction pathway there that these manufactured foods plug into’—I think it’s just too early in the research. But it’s very interesting.”

  Echoing Governor Christie, he added, “This is not simply a matter of willpower.”

  Michael Prager is one man who is persuaded that food can be addictive. Prager, who has tipped the scales at 365 pounds, told Diane and me that he once felt totally out of control around food. Now he calls himself a recovering food addict. As a newspaper editor on the Hartford Courant. Michael worked the night shift. On his short commute home, he would sometimes get off the highway at an exit that has a Wendy’s, Burger King, and McDonald’s, side by side by side.

  “One time I hit ’em all, the fast food triple play,” he told us. “I went through the drive-thru at the first place. I pulled over so I could eat in secret, although I’m fully aware that you can see through the windows of cars. Then I went next door to the next one. I bought another entire meal—soda, fries, sandwich—pulled over, ate it, and then I went to the next one and did the same thing. Three of them at one time. I was trying to get back at people who I had decided had wronged me in some way, as if I could hurt them by doing this.”

  His bad behavior didn’t end there.

  “At my worst, you could find me lying on the floor of my living room at three in the morning,” Michael continues. “The reason I’m not sitting up anymore is I’ve had too much food, and it’s too painful to be sitting up. And lying down made it possible to get more food in.” That was important, he says, because “I was more into volume than I was into any particular substance. I didn’t discriminate. I would go to a convenience store after work and get a quart of milk and a box of cereal and a loaf of bread and a jar of peanut butter and a jar of jelly. My goal was to have enough food to get me through the night so that I didn’t have to get up at four in the morning to go out and get more.

  “At work, I would try to figure out how many times I could go to the vending machine without people noticing. I was over three hundred pounds. People know that I’m an overeater, so who was I kidding? I would go to the vending machine and buy three things and go in the bathroom and eat one of them and then bring one back, and that would be the one that everybody could see. And then I’d have another one that I’d keep in my pocket and try to sneak.”

  Michael doesn’t behave like that anymore, as he explains in his memoir, Fat Boy, Thin Man. Today, he follows a food plan that involves weighing and measuring most everything that goes in his mouth. He now weighs 210 pounds, a weight he has maintained for more than twenty years. How did he get there? A big part was in-patient treatment: exactly what a drug addict or an alcoholic needs to confront substance abuse.

  Today Michael is a motivational speaker, talking about an addiction he feels was created and nurtured by the “Big Food” makers. “Studies have documented a biochemical sensitivity to hyperpalatable foods, usually processed foods, that promote the phenomenon of cravings and cause people to act unreasonably and irrationally with food, trying to solve other problems,” he explains. “If you take out the word food and you put in alcohol or you put in cocaine, the concept of addiction is not controversial.”

  Michael’s story and his behavior as a food junkie is all too real to me. If we had a medical diagnosis called food addict, I’m convinced I would qualify. Most people assume that all food addicts are fat, but I’m here to tell you they are not. Just because I have a healthy body weight doesn’t necessarily mean I have a healthy relationship with food.

  Most people don’t know that I still fight my cravings for “bad food” every day. Even my Morning Joe partner, Joe Scarborough, thought I was a highly controlled eater—overly controlled, I think he would say. Joe and my executive producer, Chris Licht, were always pushing me to eat more when we were out on the road together. They thought my diet was far too restrictive, and they were very concerned about me.

  And then they became witnesses to a breakdown in my highly disciplined diet. It happened in a big way on one of our road trips, and became an inside joke on Morning Joe, although it wasn’t all that funny to me. Joe told the story to Diane when she interviewed him.

  “We were in Dallas at a Bob Schieffer journalism symposium at Texas Christian University, and we had been going from five in the morning to about ten-thirty at night. We had not had time for dinner, so our producer Louis ordered Mexican food for us to take in the car on our way to the airport.

  “I swear to God, I heard in the backseat of the Suburban what sounded like raccoons going through the ten plates of Mexican enchiladas. Mika had devoured a meal that was intended for, like, four or five people. She’d eaten the entire thing and she had this sauce all over her face and going down the front of her shirt.

  “I said, ‘What in the hell are you doing?’

  “And she snapped out of her trance and said, ‘Oh, my god. Oh, my god.’”

  Joe said that was the first time he truly realized just how extreme a battle I sometimes fought with food.

  Ashley Gearhardt’s interest in food addiction is rooted in part in her own weakness for some of these foods. She recalls how, during a time crunch, she stopped at a vending machine in the basement of the psychology department and bought an ancient package of Oreos. She said the cookies tasted like cardboard, but that didn’t stop her from eating every one.

  “I ate the whole package because my body’s responding to this jolt of sugar, jolt of fat that I’m getting, even though it really didn’t taste that great,” she recalls. “Most foods have been changed and altered in a way that really resembles how we’ve created drugs of abuse.”

  Gearhardt developed the Yale Food Addiction Scale to identify people who are most likely to show a dependency on high-fat, high-sugar foods. The scale evaluates classic signs of addiction, such as tolerance and consumption, by asking people to indicate how frequently they engage in certain behaviors, such as these:

  •I find that when I start eating certain foods, I end up eating much more than planned.

  •I find myself continuing to consume certain foods even though I am no longer hungry.

  •I eat to the point where I feel physically ill.

  •Over time, I have found that I need to eat more and more to get the feeling I want, such as reduced negative emotions or increased pleasure.

  She offered me a compelling portrait of the food addict. “You need more and more of the substance to get the same effect that you once did. You used to eat a couple of cookies, and that was enough for you. Now you find yourself eating the whole pack and wanting more.”

  Like drug addicts, food addicts also show signs of withdrawal, like anxiety, agitation, headaches, and disrupted sleep, when they try to cut down or stop eating addictive food. Another similarity is that they often know their behavior is causing them physical and emotional problems, and hurting their personal relationships, but they find themselves unable to change it.

  Food addicts also devote considerable time to the pursuit of food. “There’s a lot of time spent purchasing the substance, using the substance, recovering from the effects of the substance,” Gearhardt told me. “So rather than going out and socializing or going on a walk, your life starts to revolve around the substance.”

  It may sound a lot like a cocaine addiction or alcoholism, but we’re talking here about the “ultraprocessed” foods available to us at every turn.

  New York Times reporter Brian Stelter is someone else who relates personally to the concept of food addiction. His cravings lingered long after he lost that hundred pounds. “I increasingly felt it myself when I would pass by McDonald’s or Burger King or Cinnabon, and I never felt that tug walking by the grocery store where there were fresh fruits and vegetables.
”

  It’s a tug he came to resent. “Let’s assume that there’s some element of weakness there. Maybe it’s 25 percent, 50 percent, 75 percent, but I also assume there’s some piece of it that’s addicting. I began to actually resent it. I would still eat at McDonald’s—I love their salads. But I didn’t like the tug I felt toward the other food when I was there. I wish I hadn’t ever tried it.

  “It’s funny to say those words because it sounds like a drug. I felt it even more after I’d lost the weight. I don’t know if that’s because my body became so used to whatever chemicals and additives are in fast food. I guess that my body is missing and craving those substances, whatever they are.

  “That’s what’s so frustrating about this moment in the culture: that there’s so much we don’t know about what this food does to us.”

  Most overweight people are not food addicts, so dealing with food addiction won’t address the entire obesity challenge, but it’s certainly part of it. Researcher Ashley Gearhardt studied a population of people who had been diagnosed with disordered eating and found that about half of disordered eating individuals met the addiction threshold. Around 10 percent of college students met the threshold.6

  But the more we learn about our response to highly processed foods, the more likely it seems that there’s something biochemical going on in our bodies. You don’t have to be an addict to find your determination breaking down in the face of foods rich in sugar, fat, and salt. You just have to be pulled in by their sensory power.

  Lisa Powell calls some of our food “anti-nourishing, if not downright toxic.” We’re being fed, she says, but we’re not being nourished. “And I think that plays a huge role, both physically and psychologically. I think you don’t reach that sense of satiety. It has nothing to do with how many calories are in the foods you ate, it has to do with the experience of eating, with the flavor and the roundedness of the experience that we’ve lost. It’s all this intense flavor that just goes in a hurry and we aren’t mindful.”

  In his book The End of Overeating, former FDA (US Food and Drug Administration) commissioner David A. Kessler, MD, hearkens back to the comparison between a banana and candy. A handful of M&Ms, he says, has what the food industry calls “better mouth feel. You have to chew less, and they do just ‘melt in your mouth.’” That means the sugar and fat hit your system faster and set off a pleasurable reaction. Add to that the constant barrage of advertising and marketing urging you to go out and buy these foods and their ready availability—a combination that Kessler dubs a “food carnival”—and weight gain is the entirely predictable outcome.

  “If I give you a pack of sugar, and I say, ‘Go have a good time,’ you’re going to look at me and say, ‘What are you talking about?’ Now I add to that fat and temperature and texture and mouth feel and color, and I’m going to put it on every corner, and I’m going to say you can do it with your friends, you can do it at the end of the day when you want to relax. Besides making food more irresistible, we made it socially acceptable to eat at any time. What did we expect to happen?”

  David Kirchhoff of Weight Watchers describes the effect in a darker way, not as a carnival but as “the equivalent of water-boarding people with food, where eventually you’ll break down and you’ll start eating.” Like so many other people involved in the struggle to bring America’s weight down, Kirchhoff fought his own battle, taking nine years to lose forty-five pounds and keep them off.

  He writes about brain research in his book Weight Loss Boss, and when we interviewed him, he described what happens to many of us at the sight of one of our favorite foods. “A functional MRI can show your brain lighting up like a Christmas tree.” The higher functions of the brain may stay in control initially, “telling you not to eat whatever the trigger food is—ice cream, chocolate, whatever might be the case. You can avoid that food for a period of time, but then something called decision fatigue sets in, and eventually you break down and you’ll start to eat it.”

  When we put this biochemical response together with the food industry’s drive to sell its products, the real problems set in. If eating high-fat, high-sugar food prompts people to eat more and more of it, that’s what the industry is going to manufacture.

  “If you bathe taste buds all the time in excesses of sugar and salt, which is what the typical American diet does, people tend to like products with lots of sugar and lots of salt, and the wrong kinds of fat, and artificial flavorings,” explains Yale’s David Katz. “Then, if you ask food companies to make products that are much lower in sugar and salt, those products do very badly. Nobody buys them. And then the food companies say, ‘Hey, we tried, but we’re not going to go out of business to make the public health types happy, so forget about it.’ And we get stuck there.”

  I asked Zeke Emanuel whether he thought food companies were manipulating consumers by creating foods we can’t resist. He answered me cautiously. “As an ethicist I’m very careful about the words I use and try to be careful about manipulation; it tends to be one of the squishier words. But I would say they adjust, modify, test, and reformulate the products to increase their palatability,” he said. “After all, they want to increase sales. That’s how they make their money. They’re trying to make us happy with what they’re giving us.”

  Sugar is a particularly significant culprit in the obesity epidemic, and it is everywhere in the food supply. Some experts say that recommendations to eat a low-fat diet fostered the problem. In the late 1970s, the US Department of Agriculture, the American Medical Association, and the American Heart Association began urging people to reduce their fat intake. Countless Americans heard that message and in many cases began replacing fats with carbs; but instead of getting those carbs primarily from whole grains, fruits, and vegetables, they upped their consumption of bread, pasta, and potatoes.

  At the same time, food companies began tinkering with their recipes, according to Robert Lustig, MD, a pediatric endocrinologist at the University of California, San Francisco Benioff Children’s Hospital “The food industry was remanded to change its processes. It was basically told ‘we have to go low fat,’” says Lustig, who also directs the university’s Weight Assessment for Teen and Child Health program. “The problem is that low-fat food tasted like cardboard and the food industry knew that.”

  To compensate for the loss of flavor, the industry began replacing fat with carbohydrate, especially sugar. And the cheapest sugar available was high-fructose corn syrup, which it now uses in vast amounts. Not only is high-fructose corn syrup cheap, it helps foods last longer on supermarket shelves. “What happened was the ‘Great Substitution,’” says Lustig.

  “Which is worse for you, the fat or the carbohydrate?” he asks. “When you compare, on balance, the answer is that carbohydrate is worse, because the carbohydrate drives insulin, and insulin drives metabolic disease.” Not only do sugars contribute to the obesity epidemic because of their calories, but Lustig is even more concerned about their direct health impact. “Sugar is the factor that takes you from obesity to metabolic syndrome.” Metabolic syndrome, which is strongly connected with obesity, is a risk factor for type 2 diabetes, high blood pressure, cholesterol problems, heart disease, and fatty liver disease. And Lustig cautions, “There are implications for cancer and dementia, as well.”

  Sugar is the factor that takes you from obesity to metabolic syndrome.—Robert Lustig

  No wonder he has labeled sugar “toxic” and is heading a movement against it.

  Some people seem to be listening. Lustig’s ninety-minute lecture “Sugar: The Bitter Truth” has been viewed more than 3 million times on You Tube since it was posted in July 2009. Listening, perhaps, but not yet acting on the information. It is shocking to me that Americans now consume an average of twenty-two teaspoons of sugar a day. That’s 450 calories right there. Compare that to American Heart Association recommendations that men consume no more than nine teaspoons a day and women no more than six teaspoons, amounts that Dr. Lustig says a
re reasonable, and probably safe.

  Why is sugar so bad for us?

  In limited quantities, our bodies can handle it, explains Dr. Lustig. Take fructose. Traditionally, it was found mostly in fruit and honey. We can metabolize a certain amount of it, especially if it contains fiber, which delays its absorption in the intestine, and gives the liver a chance to spread out the time it takes to metabolize the food. Exercise also helps, because it speeds up energy metabolism within the liver, allowing the fructose to be turned into energy rather than liver fat. But the much wider use of high-fructose corn syrup puts our health at risk.

  “If you overwhelm your liver’s capacity to metabolize fructose, then it’s a poison,” Lustig warns. “A calorie is a calorie in terms of the number of pounds of weight you put on. But that doesn’t mean that a calorie is a calorie in terms of the metabolic consequences. If you put those calories in your subcutaneous fat, you just get fat. If you put those calories in your visceral fat or in your muscle or in your liver, then not only are you going to get fat, but you’re going to get sick, too.”

  Studies of how sugary drinks affect the body, conducted by Kimber Stanhope, a nutritional biologist at the University of California–Davis, suggest that Lustig’s fears are justified. Her subjects were young, healthy people in a hospital setting where it was possible to measure every calorie they consumed. Within two weeks, those who consumed drinks sweetened with high-fructose corn syrup had higher levels of LDL cholesterol in their blood and other risk factors for heart disease, while the subjects who consumed drinks sweetened with glucose did not. LDL cholesterol, also known as the “bad” cholesterol, collects in the walls of blood vessels, causing blockages and increasing the risk for a heart attack from a sudden blood clot in a compromised artery.