Into this terrain stumbles David A Kessler, a paediatrician and lawyer who was head of the US Food and Drug Administration from 1990 to 1997. In The End of Overeating, Kessler argues that modern food, and the wider food environment, leads to a state of ‘conditioned hypereating’. He believes that by understanding this ‘syndrome’, and changing our eating habits accordingly, we can go a long way towards tackling the problem of obesity. But in making the case for this syndrome, Kessler has to conjure up a near-conspiracy theory about food companies determined to make us eat too much, and at the same time he reduces the psychology of humans to that of lab rats.
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Kessler argues that for thousands of years, ‘human body weight stayed remarkably stable… A perfect biological system seemed to be at work.’ Never mind that there have always been fat people amongst the rich. Poverty and inconsistent food supply may have been significant factors in keeping people skinny in the past. But, Kessler says, ‘in the 1980s, something changed’. Katherine Flegal, a senior researcher at the US Centers for Disease Control (CDC), noticed a sharp rise in the rate of people who were overweight or obese in the late 1980s. For example, in 1960, women aged 20 to 29 years old weighed, on average, 128 pounds (about 58 kilogrammes). By 2000, the average weight of that age group had risen to 157 pounds (just over 71kg). Over the same period, the weight of women in the 40 to 49 age group rose from 142 pounds (65kg) to 169 pounds (77kg). In the UK, one in 10 adults was obese 30 years ago; today the figure is closer to one in four.
What happened? Kessler, drawing on research by Sharon Pearcey and John de Castro, argues that fat people tend to eat more than thinner people. One only has to see the enormous portion sizes in the US to see that this is a plausible explanation for why Americans are fatter than people in other countries. Even Brits, with our impressively large waistlines, find the generosity of American eateries to be somewhat alarming. But, as Kessler rightly asks, ‘having food available doesn’t mean we have to eat it. What’s been driving us to overeat?’
“Despite what Kessler suggests, our psychology is far more complex than that of rodents”
His answer is that our food has been re-engineered to maximise palatability. Almost all the processed and convenience food we eat has been fine-tuned to turn our sensory responses all the way up to ‘11’. We get hooked on our food. At every level, our food is made more pleasurable to eat. Salt, sugar, fat and starch levels are tweaked to achieve the perfect balance; colours, smells and flavours are synthesised to heighten the experience of every mouthful; food is broken down, shredded, moistened and reassembled to ensure that it is as easy as possible to gulp down. The way Kessler describes it, our diets are baby food in Technicolor. That burger, that cookie (Kessler himself is a sucker for cookies, he confesses), those fries and that drink are culinary crack, and we are addicts. The result is that we can’t stop shovelling the stuff down our necks.
As an explanation for obesity, Kessler’s ideas have some substantial problems. For starters, he points out that it is not only the obese who overeat. Lots of people do. What is it that makes some overeaters able to gorge themselves without bursting their belts while others steadily expand? Answering that question would seem to be more interesting than fretting about our excessive enjoyment of certain foods.
Another troubling aspect of Kessler’s thesis is the way he extrapolates from a wide variety of animal studies to make his case. While the effects of foods on animals’ levels of hormones like serotonin and dopamine do have some parallels in humans, our psychology is far more complex than that of rodents.
‘Andrew’ – name changed to protect the innocent – is a case in point. ‘Andrew is about five feet nine inches tall and weighs about 245 pounds’, writes Kessler. (That gives him a body mass index of 36 – definitely ‘obese’ but not so fat as to be ‘morbidly obese’.) Andrew is no wimp, suggest Kessler, having ‘written fearlessly from many of the world’s battlegrounds’: ‘He has spent time with jihadists, suicide bombers, and war-hardened soldiers, and he hasn’t flinched. But when I placed M&Ms on the table before him, Andrew felt barely able to cope.’ Andrew, it seems, is constantly battling against the desire to eat. ‘I wake up in the morning knowing food is my enemy and that I am my own enemy… It’s uncontrollable.’
“The constant struggle between the desire to eat and the pressure to stay thin is leading to a screwed-up attitude to food”
But putting this down to some magic quality about the food seems a little ridiculous. Having elaborated on Andrew’s battle with food, Kessler notes: ‘On a successful day, using maximum restraint, Andrew will consume about 1,500 calories, which is what he wants to eat in order to lose weight. But the next day, he may consume 5,000. He rarely knows when he is full and feels mystified by people who don’t share his single-mindedness.’ Could it be that Andrew has a good ol’ psychological conflict going on between his desire to fit in with society’s norms and be thin – which must be even stronger than normal if you work in the media – and the fact that 1,500 calories per day leaves a big man like him feeling extremely hungry?
In his book Good Calories, Bad Calories, the science journalist Gary Taubes describes how men forced to consume low-calorie diets end up experiencing a kind of neurosis where they spend their entire time thinking about food. Paul Brickhill in his book about the ‘Great Escape’ in the Second World War points out that the Allied prisoners were driven to plot their highly dangerous breakouts by the gnawing in their stomachs as much as by the need to keep the enemy occupied, something overlooked in the movie version of the story. Hunger is a powerful thing, but the possibility that fat people are genuinely hungry rather than addicted to food seems rather overlooked by Kessler.
Later on, Andrew explains how as a boy he was taken to Carvel, an ice cream chain in New York, every time his team won a Little League game. Whenever he’s back in town, Andrew hankers after an ice cream there. It takes his wife – his ‘AA sponsor’ as he calls her – to stop him from doing it. My reaction to reading this anecdote was to want to slap Andrew and tell him to go and eat the ice cream. Avoiding Carvel might ultimately make him a little thinner, but the therapist’s bills must be a bitch – he should enjoy life’s pleasures rather than constantly deny himself. But it is absolutely clear from this story that what we eat is determined by a hell of a lot more than the stimulation of areas of our brains by particular sensory experiences. It’s also clear that the constant struggle between the desire to eat and the pressure to stay thin is leading to an utterly screwed-up attitude to food. We have developed a society-wide eating disorder.
Kessler uses Andrew’s story to explain why we’re not all drawn to the same foods: those neurological pleasures from sugar, fat and salt get mingled with memories of important events to create strong emotional attachments to food. But this point also rather undermines the argument that we are addicted to food because of some quality of the food itself. Kessler claims that people are addicted to food but that these people are in turn addicted to all sorts of different foods. The location, brand and other qualities of food seem to have at least as great a pull on these individuals as the constituent ingredients, which tends to suggest that the parallel with drug addiction does not hold up. In truth, people have the capacity to obsess on all sorts of inanimate objects, substances and practices. The key to understanding this process lies between our ears, not in fetishising things.
As Patrick Basham and John Luik have argued previously on spiked, in an article critical of this ‘food addiction’ thesis, the whole notion of addiction is dubious, granting chemicals far too great a capacity to control us. For example, they note, ‘human beings, unlike rats, are regularly able to escape the so-called addictions to psychoactive substances. The scientific literature is full of studies in which drug users were able, despite their “addiction”, to stop using their drug of choice. For instance, a 1974 study of Vietnam veterans by Leen Robbins found that only 50 per cent of those who used drugs in Vietnam continued using them after returning to the US, and only 12.5 per cent of these became regular users. And in their study on heroin addiction, Gerry Stimson and Edna Oppenheimer found that users of heroin and other substances move through a cycle of addiction and recovery that is inconsistent with the model of pharmacological compulsion and brain circuitry that dictates behaviour.’
“Food should be a pleasure, and the desire to perfect that pleasure is surely a good one”
The claim that food companies are, in effect, drug pushers is equally crass. Essentially, Kessler is arguing that fast food outlets are guilty of making food that we like too much. This is bizarre. Food should be a pleasure and the desire to perfect that pleasure is surely a good one. From Kessler’s standpoint, we should have government-imposed limits on how enjoyable something is allowed to be, just in case we become addicted to it.
This view of the world does rather fit in with Kessler’s personal history, having been a crusading boss of the FDA who believed that cigarettes had been made more addictive by tobacco manufacturers desperate to sell us even more of what we used to call ‘cancer sticks’ back in the playground. By turning consumers into helpless victims, and obesity into a matter of addiction, there is nothing for it but for experts like Kessler to intervene to restrict and regulate these addictive substances. It is hard to imagine a more killjoy prospect.
The End of Overeating will do little to affect waistlines in America or anywhere else. But it is rather revealing of how people are viewed today: as therapy cases so feeble that eating biscuits and ice cream is now seen as the equivalent of ‘mainlining’ heroin.
Rob Lyons is deputy editor of spiked.
The End of Overeating: Taking Control of Our Insatiable Appetite, by David Kessler, is published in the UK by Penguin. (Buy this book from Amazon(UK).)
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The End of Overeating: Taking Control of Our Insatiable Appetite, by David Kessler