Why do we see ever-increasing problems with food consumed to excesses, to the point of addiction, and serious health issues? How do the functions of the brain impact these obsessions? Should food addiction be included in the new DSM. Dr Inaba shares his views.
Transcript (edited):
CNS: Recently in the news – Comedian Jeff Garlin was interviewed by Daily Show host Jon Stewart, Garlin has a new book out My Footprint, a memoir of his longtime food addiction, and a related story out of Canada, talking about food addiction in general. Darryl what are your thoughts on the physiology involved in taste and smell?
DARRYL: Well, its surprising that food and specifically food addiction isnt covered as a major addiction in the DSM 4 (Diagnostic and Statistical Manual of Mental Disorders, 4th edition) or in the proposed DSM 5. It is considered an impulse control disorder, but food certainly fits the bill of how drugs interact physiologically with the body to create craving, create an insatiable need to continue using and certainly some people genetically are going to be more sensitive than other people. There are rats that have been genetically bred to carry a gene that makes them obese. Researchers put those rats next to normie rats (rats without that gene) provide them the same food after they have been weaned and the OB/OB rat becomes totally obese very quickly whereas the other rat stays normal.
CNS: In exactly the same environment.
DARRYL: Same environment same exposure to food. So there is a genetic component. There is also a stress component and all the other factors that we know change the brain in an addict, making them compulsive and/or cause them to crave a drug. Every program Ive ever worked with provided clients with an understanding of food addiction and the problems food can cause, especially for those addicts who quit nicotine. You quit smoking, what do we see? People gain weight right away. People quit alcohol tremendous weight gain. People in recovery from heroine crave sugar, Coca-Cola or chocolate first thing in the morning. This occurs because its the same process of the brain interacting through the reward/reinforcement circuit that we see with drug addiction. The moment people put high sugar, high fat, caloric food into their mouth, their brain releases endorphins, giving them that burst of pleasure, that sense of fulfilling a need, that theyre doing something good. This drives the brain to want to repeat that experience. Weve got to remember, food is a basic survival need. If we cant find food, we would just starve to death.
CNS: So eat all the time whenever you come across food.
DARRYL: Its hardwired into our brain as a basic survival need. When we eat, endorphins are released followed quickly by dopamine which creates that sense of reward and that sense of justification, its all directly wired. Scientists believe that the taste buds are wired into directly into.. the reward/reinforcement circuitry which creates the drive to continue using, continue seeking food. Now, the difference, I guess is as we evolved a neocortex, and we evolved the control circuitry of the brain, we gained the ability to measure the consequences, measure satiation and are able to decide whether we need to keep eating. I guess the difference between a compulsive overeater and someone with a hyper eating disorder is the sense of not getting enough food. People who are normies are able to recognize that theyve satisfied their need for survival; they dont want to become obese because they know it is unhealthy so their brain is able to shut off the drive to continue eating. The brains of addicts, on the other hand, dont function as well and they get stuck on a need to continue to access food. The food industry is complicit in this phenomenon.
CNS: They learned how to sell their product well!
DARRYL: Some add high fructose corn syrup into everything they touch in order to get Americans to be a little bit heavier. It is an instant refine carbohydrate that activates that reward/reinforcement, the endorphin and the dopamine circuitries in that brain that drives people to eat this stuff. And as weve seen and just now developing the science of if you get excessive dopamine than usual, you start to destroy the fibers that connect the control center of the thinking brain to the survival centers of the primal brain. I think Type II diabetes is probably the most prevalent condition in America. I dont think it is an accident that its connected to our fast food, high fat, high sugar diet which immediately activates the addictive center of brain. And Madison Avenue has created such strong branding, causing an almost unconscious awareness in the brains of citizens in this country. So even if you didnt want a McDonalds burger even if you didnt like a McDonalds burger, you couldnt help but be aware of them.
CNS: And you took yourself directly there!
DARRYL: Research shows that if you expose a message to a listener or viewer 4 times an hour, like a jingle or a visual or auditory queue of a certain drug, it creates a memory protrusion in your brain. You do it 4 to 6 times an hour incessantly day after day and it becomes a permanent reinforced memory protrusion or memory bump that that connects all your emotional memories to other memory bumps all over your body. All of a sudden you pass a McDonalds, and you drive right in. Youve just eaten. Youre fine. You dont need food, but youre driving in the takeout line and scarfing down a couple of cheeseburgers that you didnt know you really wanted.
CNS: This is more predominant in our country than in Europe or Third World nations.
DARRYL: I dont think theyre far behind though, Howard. I believe America is the pacesetter for the rest of the world in terms of quality of life, so to speak. Or what people view .
CNS: Obesity a positive quality of life?
DARRYL: Well, I think people in Russia people in Mexico people in poor parts of the world, anxious to come to America to shop in a big supermarket a Costco
CNS: And they probably still know about McDonalds over there.
DARRYL: Yes, there is a McDonalds in every country, along with KFC because those places make money. Corporations know theyve got a winner and they know how to market it to get into peoples subconscious so they crave this stuff. Weve created revolutions in our society, a whole sort of revolution in dieting, revolutions in TV shows, revolutions in reality situations where they are directly addressing people with obesity problems and trying to promote different ways to help them maintain a healthier diet and lose weight. The reality though is if you think a cocaine relapse is heavy, or a nicotine relapse is terrible, or relapsing to heroine is horrible, check out the relapse rates on diets weight loss. Approximately 95, 96% of the people who consciously decide to maintain a healthier diet lose weight and reach some their goals and objectives, relapse back into heavy use and gain the weight they lost and then some.
CNS: Well the diet industry, as you point out, has become an industry of its own. In terms of treatment in the context of drug addiction treatment, what can people do? What should they look for in terms of a way to address their problem?
DARRYL: I think the solution is going to be in medication. I really do. I look at the future in terms of developing non-addicting, non-stimulating medications. The problem to date is looking solely at medications that cause anorexia that stimulate the brain so the amphetamines, the Ritalins, the things like that, that also produce their own dependence and their own dopamine problems are offered. And they dont work with weight. People who are put amphetamines, which are not recommended for weight loss anymore, gain tolerance very quickly to the amphetamine and pretty soon
CNS: Then youre addicted and you go back to eating.
DARRYL: Right. And they eat more than they did before, even though theyre on amphetamines so, I dont think those types of medications work. We are learning more about appetite and enzymes and substrates like rimonabant which control appetite. And were looking at ways of effectively interfering with appetite so people can lose weight in a more realistic way rather than being stimulated to diminish hunger to lose weight. I was very hopeful about a marijuana antagonist that was being developed rimonabant. Scientists chemically produced an antagonist or a blocker to marijuana, not because people overdose or experience toxic effects from marijuana, but because one of its biggest side effects is the munchies. People smoke dope and get the munchies, so researchers realized that if they can block the cannabinoids that might be responsible for our own hunger and appetite, they might get the opposite effect and actually decrease appetite. It was looking pretty good, it was on a fast track to be developed as one of the first reliable diet aids, but they found that when they gave rimonabant to a lot of patients we should have known this the patients got extremely depressed because the other thing about food is it is an antidote for depression. Food, you know, comfort food is comfort food. If you eat high calorie, high sugar, and high fat food when youre depressed, you dont feel as depressed. Food helps deal with stress and it gives that instant reward gratification. There are a lot of factors to consider when dealing with the drive to continue eating or hyper-eating and hopefully were going to develop some medical ways to address those things. Diets, self deprivation and starvation and all that other stuff isnt very effective.
CNS: And the balance, of course, is finding drugs, finding medications that dont have overwhelming side effects. Im sure well talk about this more because it is a topic that is critical to life
That wraps our pod for today. Thanks for visiting the CNS Podcast. Please check back soon for the next in the series and visit our website, www.cnsproductions.com .