Thursday, March 15, 2012

Changing Food Habits - Contemplation and Preparation

Do you have any idea how complex the neuroscience of your food habits are?  Cinnabon, Chili's, General Mills, et al know way more about your brain than you do.  David Kessler, former FDA Commissioner, pediatrician and Dean of Yale and UC San Francisco Medical Schools, tells the story in The End of Overeating: Taking Control of the Insatiable American Appetite.

Neuroscientists know how the salt/sugar/fat triple whammy messes with the brain circuitry, taking offline the I have had enough now sensors and replacing them with More, please.  Reward centers, neurotransmitters, HPA axis, limbic system, operant conditioning -- they are messing with you.  Neither your meds nor an aluminum foil hat will protect you.

As I have contemplated my Food Autobiography and the Stages of Change, it occurs to me this map I gave you is deceptively simple.  A couple readers have teased me about how long I am spending on this change issue.  When am I going to tell you how to do it, how I changed the way I eat?

What I am telling you is that it took decades.  Kessler has revealed to me how all those decades I was, indeed, reprogramming my brain.

The summary so far:

How The Stages of Change Work

My pre-contemplation thoughts about eating habits included:

  • I weigh too much.
  • Diets fail.
  • I will always be chubby.
  • There isn't enough.

Note -- these thoughts are about weight.  They have nothing to do with health.

But the omnipresence of health information drip, drip, dripping into my brain through countless magazine articles, news stories, and now internet worked their way into my consciousness, creating new thoughts:

  • I am eating myself sick.
  •  I know better.
  •  I fail whenever I try to change.

These thoughts mark a transition to the contemplation stage and another set of thoughts:
  • I know my eating habits are not healthy.
  • I don't know if I can change.
  • I haven't made up my mind whether to try.
  • I am willing to learn more.

The magazines and New Year's Day television commercials want you to skip the next steps.  Just do it.

Why Diets Fail

And this is where it falls apart.  People screw up their courage at the edge of the canyon, and leap.

And fall.

Well, duh.

Like I said, Dr. Kessler explains both why will power does not cross this chasm, and how I inadvertently set myself up to succeed.  I took baby steps, looked before I leapt, deconstructed my eating habits and changed them with targeted interventions, one practice at a time.

It's all about the brain.  The body, brain included, is a beautifully tuned instrument, with mechanisms designed to keep it beautifully tuned.  The word of the week is homeostasis, the capacity to maintain relative balance.  We are born wise, designed to pursue food when we are hungry, and cease eating when we are satisfied.  We are designed to feel satisfied when we have enough, not too much, just enough.  We are designed to speed up our activity level when, for some odd reason, we have overeaten, using up those excess calories and maintaining health.

For many of us, our bodies/brains/feedback mechanisms have been perverted.  We have lost our homeostasis.

Sugar, Fat, Salt: The Three Points of the Compass

Processed foods, packaged foods, restaurant and fast foods are manufactured to hit what the food industry calls the Three Points of the Compass.  The sugar/fat/salt combo has a particularly powerful impact on the nucleus accumbens.

The nucleus accumbens is the pleasure center of the brain.  The image here, marking it in red, magnifies it.  Actually the size of the head of a pin, think of the nucleus accumbens as the G-spot of the brain.  This is where endorphins come from, opioids that magnify pleasure, calm, and even relieve pain.

So imagine eating a banana.  Then another banana.  Then another.  Pretty soon you get tired of bananas, and you stop eating bananas.  Maybe you stopped after one banana.  That is called satiety, when the brain says, enough.

But combine sugar, fat and salt.  Stuff the banana with ice cream, dip it in a salty tempura batter, deep fat fry it and drizzle it with chocolate sauce (laced with fat and salt), and you zing the nucleus accumbens.  It releases those endorphins, the brain's equivalent of heroin or morphine.  The satiety mechanism shuts down.  Your brain stops telling you enough.  You have already eaten a full meal, but you will lick that dessert plate clean.

Coca Cola and movie popcorn -- I can eat that combo forever.  I'll even settle for Pepsi.

So your typical restaurant tricks up menu items with sugar, salt and fat where you have no idea that you are are eating them.

Endorphins and a Chef Salad

True story.  Spring, 2005:  I had just gone off the third antidepressant of the season, and was giving myself a medication holiday from antidepressants and the zillion sleeping pills that never managed to overcome the side effects of SSRIs.  So I did a detox diet.  This was before trying to change my eating habits.  It was simply about clearing my system and giving my poor overworked liver a rest.

This particular detox diet has three stages: a starter week of not eating things that overwork the liver (red meat, animal fat, sugar, wheat, white rice, alcohol...) and substituting foods that are kind to it (spinach, yams, eggs, soy, whole grains, olive oil...); a 3-5 day liquid fast; and a reentry period, adding foods back one at a time, to discover any unrecognized food allergies.

So out at lunch with a good friend, I went for the healthiest item on the menu, chef salad, Italian dressing on the side; hold the croutons, please; I'm not eating wheat.  The salad arrived, dressing indeed on the side, but topped with croutons.  No problem -- six weeks had passed since my last SSRI and my irritability levels had dropped back to my normally placid self.  I could pick them off.

But there they sat, staring at me from the edge of the plate.  Near the end of the meal, I thought, The diet says reduce wheat consumption, not eliminate it.  What could one crouton hurt?

So after four days without any sugar, flour or animal fat, I popped that little thing in my mouth.

The rush rivaled that hit of nitrous oxide in that dorm room thirty years before.

I popped a second one in my mouth.

I had not felt so calm in months.

Sugar/fat/salt -- it's an unregulated drug.

Detox

Betcha can't eat just one.  The trick is to get it out of your system.

But I discovered it is possible to get it out of your system.  All those baby steps, all those years.  First milk, from 4% to 2% to 1% and after a number of years, skim.  I did it, because less fat is good for me.  But taste changes.  Now, when I don't have a choice, when I have to drink 2%, I don't think, This isn't good for me.  I think, this doesn't taste good.  It really doesn't anymore.

Ditto sugared cereal.  I weaned myself from adding sugar, then from added sugar.  When Multi-Grained Cheerios upped their sweeteners, I found I was disappointed.  I no longer liked them.

Ditto salt.  Stay away from Chili's and Red Lobster long enough -- when I went back, I no longer liked the food -- too salty!

Turn down the sugar/fat/salt stimulation, and you turn down the brain activity that compels you to pursue more.  You recover a healthier sense of satiety.

From Contemplation to Preparation

These baby steps were preparation for the changes to come.  They were experiments that changed my thinking.

  • I know more and more about how food affects my body.
  • My habits are getting healthier.
  • I am enjoying these habits.
  • Maybe I really can change.

I didn't have a plan, and I hadn't reached the tipping point.

Coming up -- more on The End of Overeating, dopamine, will power, operant conditioning, reprogramming...


No New Year's Resolutions - Change Your Life December 29, 2011 -- Overweight is a major health issue, the largest contributing factor to early death for people who have mental illness.
The Stages of Change and Weight Loss January 3, 2012 -- How do you change a habit?
My Food Autobiography and the Stages of Change March 8, 2012 -- Pre-contemplation and contemplation.
Dopamine -- Can't Live Without It March 23, 2012 -- The brain science behind habit formation and an experiment to try.
Relapse/Maintenance -- Stages of Change May 24, 2012 -- Review and finishing up the series.



book jacket from Amazon.com
Stages of Change graphic was created by Todd Atkins, who placed it in the public domain
photo of dandelion by 4028mdk09used under the Creative Commons Attribution-Share Alike 3.0 Unported license
photo of Glen Canyon by Sascha BrückJeff Kubina and used under the Creative Commons Attribution-Share Alike 3.0 Unported license
image of nucleus accumens by The Brain.mcgill.ca and used under the Creative Commons Attribution-Share Alike 3.0 Unported license
flair from Facebook.com

3 comments:

  1. Thank you so much for this piece. It is great!

    ReplyDelete
  2. Awaiting the next installment...Will she be able to do action and maintenance in one piece? Or two? Or three? Blessings!

    ReplyDelete
  3. Seeing what I'm eating any type of change in my food habbit would simply be called "health diet"

    ReplyDelete