A really well-researched and well-written book on how the brain controls hunger and eating behavior.
My notes are below. The practical tips for everyday life are in bold.
Introduction
The conscious, rational brain cares about abstract concepts like health, appearance and the future. The non-conscious intuitive brain only cares about concrete, immediate things. The conflict between the two explains why we overeat even when we don't want to.
Overeating and obesity are caused by a mismatch between ancient survival circuits in the brain and an environment that sends the circuits the wrong messages.
The Fattest Man on the Island
A calorie is a calorie, nevertheless some foods are more fattening than others but this is not because of an effect on the metabolic rate but rather because they coax us to eat more calories.
The obesity epidemic is a result of overeating. What’s the most effective way to cause overeating? “Palatable human foods” or the supermarket/cafeteria diet. Making free and tasty foods available leads to substantial overeating.
The Selection Problem
Eating is a complex behavior that requires coordinated decision-making on motivational, cognitive and motor levels. But motivation (which can come from different brain regions in response to different cues) is the fundamental spark that sets the whole behavioral cascade into motion.
The Chemistry of Seduction
Dopamine is the “learning chemical” rather than the “pleasure chemical”. It reinforces sensory cues.
The brain instinctively seeks out calories. Flavors and smells are a quick way for the brain to gather information about a high calorie food before it enters the digestive tract. The human brain is extremely preoccupied with calories. Non-conscious parts of the brain perceive some foods to be so valuable that they drive us to seek and eat them even if we aren’t hungry and even in the face of a sincere desire to eat a healthy diet and stay lean.
Addiction is simply an exaggerated version of the same reinforcement process that happens in all of us.
Eating a bland repetitive diet does indeed reduce spontaneous caloric intake without provoking hunger.
Eating a varied diet is a good maxim for meeting our overall nutritional needs, but it has a dark side: food variety has a powerful influence on our calorie intake. The more variety we encounter at a meal, the more we eat. To beat the “buffet effect”, limit yourself to a few foods when you are in a buffet or party situation. When food reward and variety decrease, so does food intake.
Why do some people develop obesity and others don’t, when we are all surrounded by high-reward foods? One reason is that people differ greatly in the relative reinforcing value of food, that is, how hard a person is willing to work for food, relative to a non-food reward. Another reason is impulsivity. The third factor is the presence of highly rewarding food in your personal environment.
The United States of Food Reward
Diets of non-industrial cultures have three prominent characteristics in common: they include only a limited variety of food, they don’t add heaps of sugar, salt, fat and flavor to their food and they use only a few cooking methods. To our modern palates, they would seem bland and repetitive because modern palates are accustomed to constant entertainment.
Modern foods are very high-reward. In particular, the combination of concentrated fat and sugar (eg, ice cream) is a deadly one for our food reward system. It is also a pairing that is rarely found in nature.
The foods we encounter today are more seductive than what our ancestors would have encountered. Creating an obesity epidemic was not the objective but it is the unfortunate side effect of the food industry’s race to make money.
The Economics of Eating
The brain that drives hunter-gatherers to gorge on calorie-dense foods when they come across them- and because it’s good for them- is the same brain that drives us to overeat in the modern world. In the dangerous environment of our ancestors, it was advantageous to evolve brains that valued present selves over future selves, but in affluent countries today, the future is more certain than it ever was and it makes sense to value our future selves. An exercise to do this is “episodic future thinking”- before making a decision, imagine yourself vividly in the future. This helps the brain to weigh the future more heavily in its decision-making process.
The Satiety Factor
This chapter is an excellent explanation of leptin.
Rodent experiments revealed that the ob gene codes for a small protein hormone secreted by fat tissue and circulated in the blood- this is leptin, the satiety factor. A complete lack of leptin (genetic mutation) can cause obesity in humans. Starvation also lowers leptin levels. Both these responses can be reversed by injected leptin.
But leptin therapy in general is not a miracle cure for obesity- it requires enormous doses and shows an extremely variable response. Leptin is really a mechanism for detecting deficiency, not excess. While low leptin levels in humans elicit a powerful starvation response that promotes fat gain, high leptin levels don’t engage an equally powerful response to promote fat loss.
Once we gain weight, the lipostat (the brain region that regulates appetite and fatness) regulates adiposity around a higher set point, and becomes one of the primary reasons why we continue to overeat. This doesn’t mean dieting is hopeless but to be successful, it is important to understand, respect and work with what you’re up against.
Diet palatability influences the set point of the lipostat in humans. A weight management secret is to eat simple food, but you have to stick with it long term. Exercise can cause substantial fat loss but it works better for some people than others.
The Hunger Neuron
The brain circuits that control eating and adiposity in rodents are well understood and we’ve cured obesity countless times in rodents. Why can’t we use these techniques in humans? Because of the ethics of manipulating brain circuits. Drugs would be more acceptable but are very blunt tools.
The sating ability of foods is largely explained by a few properties: calorie density up to a certain point (lower the calorie density, the more satiating it is, e. oatmeal), palatability (the more palatable a food, the less filling it is), fat content (the more fat, the less filling per unit calorie), fiber (the more fiber, the more filling) and protein (protein is more filling than carbohydrate or fat).
Rhythms
Sleep restriction increases food intake. When you don’t sleep enough, your lipostat mistakenly thinks you need more energy, which activates your food reward system and causes you to eat more without intending to and often without realizing it. When you don’t sleep enough, you also become a prisoner of your own impulses, more compelled by the immediate reward of eating tempting foods than by long-term costs.
Life in the Fast Lane
Uncontrollable stressors have a stronger effect on the threat response system, and are much more harmful to our health and mental state than stressors we believe we can control. Remarkably, it can make you undereat when only plain, simple food is available but makes us overeat when highly rewarding junk food is available.
The Human Computer This is a summary chapter.
The output of our brain, including appetite and eating behaviors are determined by the input cues it receives. Some cues are processed by conscious circuits and others by non-conscious ones and the latter explain why we overeat despite our best intentions.
(a) The reward system evolved in a world where calories were hard to come by. In the modern world brimming with calorie dense and highly rewarding foods, out hardwired motivation to eat remains strong and drives us to overeat.
(b) The economic choice system weighs costs and benefits of possible actions and selects the best deal. When it comes to food, its primary cues are calories and convenience which is a liability in the modern world.
(c) The lipostat is a system primarily located in the hypothalamus, cued primarily by the hormone leptin, and it non-consciously regulates adiposity by influencing appetite, response to food cues and metabolic rate. It has one job- to keep your adiposity from decreasing (because in the ancient world, more fat= more offspring). This is the system that makes weight loss difficult and often temporary.
(d) The satiety system regulates food intake on a meal by meal basis by making us feel full. It takes cues from the digestive tract and also from the reward system. Calorie dense, low fiber, low protein but highly palatable foods (eg, pizza, ice cream) trip up the satiety system causing us to overeat.
Genetics of these systems could explain why some people develop obesity in the modern world while others stay lean. This is why it does not make sense to judge people for their weight.
The sleep and circadian systems interact with the systems above to influence eating patterns. Stress shifts our eating preferences towards calorie dense and highly palatable comfort food.
Outsmarting the Hungry Brain
We can manage weight by giving our brain the right cues. Things that can be done as a nation: taxes on foods like soda, changing the way government subsidies are allocated, financial incentives for healthy foods, regulating food advertising.
Six steps for a slimming lifestyle
1. Fix your food environment- get rid of tempting, calorie-dense foods around you (home, office), minimize exposure to food ads and visible food, create barriers to easy eating by not keeping ready to eat food around.
2. Manage your appetite- choose foods that are not as calorie dense, and high in fiber and protein for greater satiety. Eat simple foods closer to their natural state. Limit highly rewarding foods.
3. Beware of food reward- Calorie dense combinations of fat, sugar, protein, are highly rewarding and powerfully drive cravings and overeating. Alcohol, caffeine and theobromine in chocolate are habit-forming and may drive consumption of unneeded calories.
4. Make sleep a priority
5. Move your body
6. Manage stress- identify if you are a stress eater, identify the stressor(s), mitigate the stressor(s) by making plans to manage it, practice mindfulness meditation, replace stress eating with more constructive coping methods, and remove comfort foods from your environment.