Book Review: The End of Overeating by David A. Kessler, MD

kesslerFor his book “The End of Overeating: Taking Control of the Insatiable American Appetite” (Rodale Books), Dr. David A. Kessler talked with David Mela, a Netherlands-based scientist for Unilever, who sees a clear contrast between the Dutch and American cultures of eating. Said Mela:

“We go to a meeting in America and somebody will inevitably bring in a huge plate of bagels and cream cheese and muffins…For Europeans it comes off as bizarre, but it just seems to be expected here.”

Kessler also interviewed France Bellisle, a teaching obesity researcher in Paris, who often says to her students, “What, you have not brought anything to eat into the classroom? If we were in America, you would have brought your coffee, your doughnuts, your chocolate bar with you to eat.” She tells Kessler that in France, “Nobody has given even a fraction of a second to the thought that they could have brought food into the classroom. They’ve never done it before, and they are not tempted to do it. There is nothing in the environment that stimulates such inappropriate eating at an inappropriate time.”

Dietician Meredith Luce told Dr. Kessler that in America in the 1950s, people ate meals, but that “snacks were the sole property of growing children, to provide an extra opportunity to nourish the growing body. Adults didn’t eat snacks.”

Similarly in France, there is a long-standing three-meal structure, with no snacks in between.

“You learn very early on as children that you just don’t (snack between meals),” said Bellisle.

I can remember hearing mothers on old TV series like “Leave it to Beaver” calling after their scrappy spawn such warnings as, “Don’t fill your belly with candy, you’ll spoil your appetite for dinner!” But those were shows that came along before I did, in 1970. By the time I arrived on the American scene, snacks were a part of daily life. And for me, there was never any appetite to “spoil” – I ate so frequently from morning ‘til night, I didn’t recognize the physical sensations of hunger until I went on my first diet as a teenager.

 Ours was a house well-stocked with Hostess and Little Debbie snack cakes, bags of Fritos, Chips Ahoy and Pepperidge Farm cookies. They were there for between-meals eating. And sometimes, just for a change of pace, we piled into the family van and Mom drove to the nearby 24-hour convenience store where we’d all pick out our own snacks. I usually went for those crispy little shoestring potatoes in the can, polished off with a handful of “chocolate footballs”, sold for a penny apiece in a fishbowl next to the cash register.

I can’t imagine a life without junk food available 24/7, or the chain restaurants where we ate many a family dinner, and where I’d be taken on dozens of dates in my late teens and early twenties. I can’t imagine a supermarket devoid of processed foods in colorful boxes, from Pop-Tarts to Hot Pockets. In my adult life as an office worker, I never attended a staff meeting that didn’t include a tray of croissants and bagels, or at least one birthday cake. And what desk jockey doesn’t get the three o’clock munchies, take the elevator to the newsstand in the lobby, and get their daily fix of M&Ms or Combos?

But it’s this availability of food, and processed food in particular, that Dr. Kessler blames for a big part of the country’s obesity problem. We eat food all the time, because it’s there, and it’s irresistible.

And it’s that irresistibility that gets the rest of the blame.

Kessler argues that giant food corporations and restaurant chains (whom he’s collectively dubbed “Big Food”) knowingly design “hyperpalatable” foods that drive us to overeat. They do this by using combinations of salt, fat and sugar that alter our brain chemicals and essentially addict us.

He makes a compelling argument, too. Over the course of seven years, Kessler met with top scientists and food industry insiders who confirmed his suspicions again and again.

A high-level food industry executive admitted that “Higher sugar, fat, and salt make you want to eat more,” and there’s plenty of scientific evidence within the pages of Kessler’s book to back up that claim, along with specific, technical explanations of exactly what these food combinations can do to your brain, and how they can drive us to eat with unnatural abandon.

It’s heartening reading for anyone like me who’s felt completely out-of-control around certain foods, and hopelessly overpowered by their pull. It can be a relief to know that it’s not an inherent personal flaw that makes us devour a plate of nachos or wolf down two or three cinnamon buns in a mindless three minutes. As Kessler points out, “Conditioned hypereating is a biological challenge, not a character flaw.” For some people whom Kessler considers particularly susceptible to “conditioned hypereating”, this kind of consumption is the result of machinations in our brain’s reward system triggered by highly palatable foods – foods too often purposely engineered to turn us into junkfood junkies.

One experiment detailed by Kessler showed that lab rats were willing to work almost as hard to get a snack high in sugar and fat as they were to get cocaine.

Until reading Kessler’s book, I didn’t realize the lengths to which the food industry goes in creating its hyperpalatable foods. Interviewee Gail Vance Civille is a food industry consultant and the founder and president of Sensory Spectrum. She’s an expert in sensory stimulation and food, and her insights led Kessler to reveal that “Fat makes food feel thicker and richer”. “Fat also lingers after we swallow food, leaving flavor behind in the mouth,” resulting in a pleasurable aftertaste. Apparently, fat contributes to a more satisfying experience with the food as it “wads up” in the mouth, and helps it go down easier — two aspects of the eating experience the food industry has examined in great detail in its efforts to hook us to their smack.

Kessler also writes that according to Civille, “…in the past Americans typically chewed a mouthful of food as many as twenty-five times before it was ready to be swallowed; now the average American chews only ten times.” According to another of Kessler’s interviewees, it’s the processing of food that results in a sort of “adult baby food”, stripping away elements of the whole food like fiber and gristle that make it harder to chew and swallow. With the increasing popularity of easy-to-swallow foods, it’s become easier to ingest more calories. And all that chewing serves an important purpose, contributing to signals of satiation. Without having to work so hard, we can over-consume a given food before we even realize it. A food product developer referred to the contemporary consumption of these easy-to-eat foods as a “shoveling process”.

Kessler’s book is loaded with these revelations about how America eats now versus in its past; how its culture of non-stop eating compares to other cultures, and how its methods of food preparation and presentation differ from those of other countries. It’s full of disturbing evidence that Big Food knows exactly what it’s doing when it serves up food that turns us into snackwhores, and plays games to get around food labeling requirements while stoking us with unnecessary quantities of sugar, fat and salt. For anyone who eats, Kessler’s book is a must-read.

In the last sixty-odd pages, Kessler makes some attempt to offer solutions to conditioned hypereating in the way of “Food Rehab”. This is the book’s weakest content. Some of Kessler’s advice seems contradictory. While he does throw in the occasional disclaimer, such as “It takes individual experimentation to determine how you can structure your environment and strengthen your behavior,” he offers such rigid advice as imposing structure from the outside, “with meal plans that tell you what to eat, when and how much…When you first begin to practice this, there’s no room for deviation…Once you’ve established new patterns…you’ll be able to open the door to other foods.”

This is just one small piece of Kessler’s take-it-or-leave-it advice. But as a recovering compulsive overeater (and perhaps “compulsive hypereater” to use Kessler’s term), I know this approach would not have worked for me. Rather, it would have sent me tramping off in the direction of my “forbidden” foods within a week, in a sort of desperate semi-blind rebellion. Sidestepping any sense of deprivation, I was able to incorporate even my most potent trigger foods in my personal food rehab from the very beginning of my efforts, without any extreme reversal of my healthier behaviors. I say this not to naively suggest that everyone’s reaction to food should necessarily mirror mine, but rather to point out that any treatment advice would have been better left out of Kessler’s otherwise stellar book.

Regardless of his statement that “The idea is to mix and match the tools presented here and to find the ones that work best for you,” many compulsive overeaters are confused by their disorder and even more so by the world’s bewildering spectrum of contradictory treatment options. That said, Kessler’s mix-and-match offerings could easily lead to more confusion, frustration, failure, and ultimately, more despair. By even attempting to serve up a solution, he fails to tread carefully around a disorder that causes immense pain for many people. That pain is most acutely felt in the many failed attempts at curing the disorder, which not only makes the sufferers fatter with each bad try, but every new failure chips away even more at their sense of personal power and self-esteem.

Given the abundance of excellent materials in existence authored by experts in the treatment of compulsive overeating (materials whose approaches work beautifully in the face of engineered hyperpalatable foods and which recognize the food/brain phenomena about which Kessler writes, albeit without the scientific context and buzzwords), Kessler’s pages and pages of suggested “tools” for overcoming conditioned hypereating are unnecessary. This is not a book to go to for serious help.

It has, however, worked wonders in reinforcing my recovery behaviors through education. Just knowing how much sophisticated manipulation is aimed at me every day by Big Food has made me much less likely to fall for it. I recognize how much profit-driven thought has gone into the packaging of food, its smell and texture, its ratios of fat-to-sugar-to-salt diabolically designed to keep me coming back for more of what I don’t need (and less often even want).

Kessler’s research and revelations about Big Food and its contributions to widespread obesity are the real value in “The End of Overeating”.

I agree with his zealous championing of countermeasures like comprehensive labeling on packaged food, calorie counts on all restaurant menus, and strict regulating and exposing of crafty food marketing. However, I’m leery of a potential tide of public opinion that, in demonizing Big Food, forgets Kessler’s message that “conditioned hypereating…is not a character flaw” and eagerly takes the opportunity to further demonize overeaters. Fat people perceived as gluttons are already seen as morally bankrupt, and blamed for everything from global warming to “contagious” obesity. It’s my hope that Americans will take up Kessler’s cause and reverse the trend of incessant recreational eating — but not at the expense of the dignity of those who eat.

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