Wednesday, July 14, 2010

are "obese" people "hedonists" when it comes to food?

Yesterday's Wall Street Journal had an interesting article, Eating to Live or Living to Eat?
It talked about the impression that 'obese' people react differently to sweets and forbidden foods than 'normal' weight people. The notion that 'obese' people are hedonists and can't control themselves, that brain chemistry can explain the addiction to food. (See my review of End to Overeating for a brief discussion...)

Lots of the same old same old, 'obese' people are gluttons with a physiological explanation, but a few sentences stood out and gave me hope that we are starting to consider the feeding/eating relationship. They never come right out and say it...

"It's possible that these changes reflect how the brain has adapted to eating patterns in obese people, and that could create a vicious circle, putting them at risk for even more disordered eating," says Dr. Small.

I would have loved to see them talk about those "eating patterns" can we just spit it out? Dieting? Avoidance? Restriction? Years of yo-yo dieting where all of these foods have been forbidden, where maybe the obese subjects have a higher probability of having engaged in dieting? I would like to know. Did they include those factors in the study? (Of note, most obesity studies in children do not take into account at all the feeding relationship...)

There are plenty of other metabolic mysteries, too: Why are some "foodies" who get intense pleasure from eating able to stop when they're full and others aren't? Is the tendency to eat way past fullness genetic or learned behavior, and how much can it be changed?

Did they bother to ask about their eating styles, their dieting histories? Have their brains been wired for years that these foods are for pleasure or are these foods associated with shame, guilt, restriction and intense desire...

On people who have lost significant weight and kept it off through diet and exercise alone:

"They are very controlled individuals, and they are very rare. We had to fly some in from Alaska,"

I think that last part is my favorite sentence. Goes in the face of everything we hear about how simple it is to just eat less and exercise more!

Some of you may remember my favorite quote that these researchers might benefit from:

"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."

What do you think?


  1. I'm always wary of studies which use the words "obesity" and "hedonism" in the same sentence. They tend to equate overeating with pleasure-seeking, which I think is a big mistake: most compulsive eaters will tell you that a binge is not a pleasurable experience. In my own personal experience, binge eating would be closer to self-harm than to hedonism.

  2. I totally agree. This further cements the public perception that people are "obese" (I just got lazy about putting all my quotation marks in...) because they are somehow weaker, more gluttonous, than others. That we might look at an 'obese' person and think, "Wow, they have it good. I'd like to eat whatever I want, but I have self control and they don't." It is so complex. thank you for sharing your experiences. I also think there is a confusion in the lay world around "eating too much" (the old calories in calories out, why don't they just stop...) and with true binge eating experience.

  3. It's very hard to study the effect of dieting in these studies, because it's even harder to find an obese person who has never dieted than to find a "post-obese" person like the one they flew in from Alaska.

  4. Katja, you hit the nail on the head with the "Wow, they have it good. I'd like to eat whatever I want, but I have self control and they don't". I hear stuff like that from my mom all the time, all the time.

    I am a considerably better cook and baker than she is so I'll frequently take food over to share with them and I get the same guilt trip every time. The thing is I've gotten better at cooking and baking a lot of different things, but they never want anything I've done with vegetables or fruit, or for that matter whole grains. So all the get is the macaroni and cheese, ice cream, hot fudge, and breads.

  5. I do wish that these studies would at least consider the fact that there may be a medical reason why people are obese!

    I was a 100 lbs overweight anorexic. Seriously!

    I would eat next to nothing and exercise up to 2 hours every day, but I was still obese and kept gaining weight. I went to so many doctors asking for help because I thought I had a metabolic disorder and was just told over and over again "Eat less. Exercise more." I was eating so little that my hair started falling out, I would fall asleep every time I sat down and I was barely functioning. And I was always hungry. Always. But after every doctor's visit, I would eat even less and exercise even more.

    Then I had to have jaw surgery for something completely unrelated. My jaw was wired shut for nearly 3 months and I was on a liquid only diet. Before the surgery, my doctor cheerfully told me that this could "jump start my weight loss." He estimated I would loss 30-40 lbs. Instead I gained weight and finally a doctor admitted that perhaps I did have a metabolic disorder and tested my metabolism. Sure enough, it was abnormally slow.

    It took 3 more doctors to find one who knew what to do about the metabolic disorder, but once I was on the correct medicine the weight literally melted off and I have kept it off for over 7 years. I am still overweight (about 15-20 lbs), but that is weight that my body won't allow me to lose. So I have accepted it.

    Sorry. This touched a nerve...

  6. I totally agree that we have to consider medical, hormonal causes. At the heart of your story, correct me if I'm wrong, is that no one would believe what you were telling them. This is common, and something readers have commented on before, that is doctors assume 'obese' patients lie if they tell them they are exercising and eating well. (or even not 'well,' but relatively little.) I'm sorry it took so long and involved so much misery. On the other hand, when I saw children for weight concerns, we always ruled out medical causes, which I was unable to find (albeit limited testing) but we also drop the ball by not asking feeding questions. By blithely saying, essentially eat less, exercise more... Not right. I hope my post didn't touch a nerve. If anything I said felt off-base to you, let me know.. There are studies about genetic defects, leptin receptor deficiencies etc, but I believe that our collective relationships with food is a bigger player.

  7. "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."

    People can be addicted to anything in the world, whether it's defined as addictive or not. Food certainly can't be excluded here.

  8. I cannot resist the temptation to note that food is among the most addictive things know, together with water and oxygen. Withdrawal will acutally kill you.

    Other than that -- I feel that the ability to really enjoy food is a blessing, not a weakness. And fat shaming, binge eating, shame of being fat, fear of becoming fat, they destroy the ability to enjoy food, and leave a blank in its place that no matter how much you eat you cannot fill.

  9. I definitely think that food is addicting. While in school, I studied the link between neurotransmitters in our brains, our action and our desires. The mind/body connection is very complicated and the attitude that some people have towards those who are obese ("just eat less and exercise more") is really unfair. As a nutritionist, I have worked with clients who were very overweight or obese, and actually increased their caloric intake (without adjusting exercise), and seen them lose weight. I believe it is about what we eat, not how many calories we eat. Whole foods nutrition can be a very powerful tool for those suffering from obesity, hormonal imbalance, and other major health issues.