Wednesday, March 10, 2010

book review: End of Overeating

Bottom line: skip it (the book, not my brilliant review)

David Kessler MD shares his quest to find out why he is a "conditioned hypereater," why certain foods "won't relinquish their hold" on him. The good news- the book has some valuable insights about the American food industry and its calculated, money-making opioid-releasing mixes of fat, sugar and salt, but misses out on major players in why we eat the way we eat- namely restriction and physiology.

There is one paragraph in the book that basically dismisses restriction and dieting as contributing significantly to out of control eating, yet most of his anecdotes pulse with avoidance, restriction and the ghosts of failed diets.

He relates going to NYC and thinking the whole time about a certain ice-cream parlor and how his wife is like an AA sponsor who keeps him from indulging. Maybe dopamine (the "I want it") hormone spikes BECAUSE he thinks he "shouldn't" eat it. There are studies that show that scarcity of food increases dopamine, so why wouldn't self-imposed scarcity (diet and restriction) lead to higher dopamine and obsession with food? He goes on and on about dopamine and the intense wanting of "forbidden foods" but blames fat, salt and sugar alone. Sounds like a fun trip to NYC. (Plus his repeated graphic descriptions of fat on sugar on salt felt like self-indulgent food porn.)

He also barely mentions physiology and blood sugar, hormones or the stress response...
Are these "cravers" providing regular balanced fuel for their bodies or crashing from famished to stuffed with similar spikes and drops in blood sugar and insulin levels? Are they skipping breakfast and lunch to save up calories only to lose control at the office? A person who has fasted all day will be frantic with hunger, and the NORMAL survival instinct is to eat- a lot.

His solution?
Restrict more! Be "flexible," but only eat things that don't trigger you. Have a meal coach berate you for eating too much. Be responsible to your family so that when you "fail" you will feel that you let them down. (Lovely, more guilt and shame, which we know are not positive motivators for change.)
His one size fits all prescription of avoidance, more restraint (though with lots of nice cognitive behavioral language around it) is really more of the same. Want a treat? A single piece of chocolate or a small frozen yogurt should do it- but not yet-maybe after several months of complete abstinence! He implies weight loss will happen if you can just say no-enough.

Dr. Kesslar does not once mention the notion that you CAN learn to eat in a competent, inclusive and joyful way that is grounded in permission, joy and discipline (yes, you have to provide regular meals and enough variety for yourself.)

There is no joy, no balance, no permission.

Consider a competent eater scenario... (see Ellyn Satter's definition of Normal Eating)
Why not look forward to the ice-cream in New York? Plan to enjoy it. Savor it, be in control and then move on and enjoy the other wonderful things in NYC. Eat a good breakfast with some protein, fat and carbs, then plan on a nice meal and ice cream for dessert or skip the meal and enjoy the ice-cream for lunch. Enjoy window shopping and walking through Central Park. (Imagine, actually enjoying NYC, not obsessing about how you can't have ice-cream the whole time!)

Yes, fat and sugar and salt taste good, and they release pleasure hormones, but it doesn't mean these foods can't be enjoyed by competent eaters in a positive way-does it?

The book left me dissapoointed and sad for the many who will read it and think all they have to do is try harder.

"Food might not be addictive on its own, but prohibiting it can set off a cycle of anxiety, craving, and overconsumption that for all purposes looks like addiction."
(can't remember the source, but I love this!)

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