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WASHINGTON, D.C. -- If you want to understand why Americans are so belt-bustingly overweight -- why obesity statistics continue to rise, why weight-related health care costs spiral ever upward, why diet hawkers are latter-day oil tomcatters, why collectively, as a red, white and blue people, we cannot put down the chalupa -- you can conduct sociological research. Hunt for a "fat gene." Tabulate the caloric intake versus energy expenditure of watching Star Jones discuss fish-gutting gastric bypass surgery on "Oprah."
Alternately, you can go to a baseball game.
|A tiny cup filled with lots of gut-busting calories.|
It's a lovely, temperate mid-September evening. The Washington Nationals are about to play the Los Angeles Dodgers. I've just entered Nationals Park, and I'm already thinking about ... a pulled chicken sandwich, smothered in tangy sauce. Even though I'm technically here for work. Even though I'm not even hungry.
"Well, what's in your head?" asks David Kessler.
The smell. Smoky-sweet, wafting over the concourse. There's a barbecue grill nearby.
"Have you had it before?"
"Thinking about anything else?"
Actually, yes: Past the center-field gate, the impressionistic bronze statues of Walter Johnson and Frank Howard, and the bustling sports bar in left-center hangs a giant sign plastered with arrows and a cartoon Theodore Roosevelt, reading BIG TEDDY'S BBQ. HOME OF THE ROUGHRIDER.
Kessler spins in a slow circle, gesturing all around us.
"All this stimuli -- the field, the music, the starting lineups, the big-screen TV, the bank ads," he says. "And you noticed the barbecue sign. Did you pay attention to those guys?"
He points at a regional cable crew, blow-dried and resplendent, wrapping up a pregame broadcast from a tent overlooking the left-field seats.
Fat, sugar and salt stimulate the brain's pleasure circuitry, causing a release of opioid chemicals. Opioids have rewarding effects similar to heroin, producing pleasure and relieving pain.
"Of course you didn't," Kessler adds. "What captured you is the one sign off to the left. Fact is, when you and I met outside, food wasn't even on your mind. If you understand eating at a ballgame, you understand the neuroscience of what drives us to eat and overeat."
Kessler understands the neuroscience. A Harvard- and University of Chicago-educated doctor, lawyer and former head of the Food and Drug Administration, the 58-year-old is the author of the best-selling "The End of Overeating," in which he argues that processed food loaded with fat, sugar and salt -- essentially, ballpark chow -- literally hijacks our brains, altering our mental circuitry and chemically compelling us to eat ... and eat ... and eat ... and eat some more, until our bulging waistlines match our sagging sense of self-control, all while a manipulative food industry creates ever-more-tantalizing grub that makes us fatter and hungrier still.
Which is just a bit scary. Especially for those of you lucky enough to secure a ticket to the ongoing major league playoffs.
Still, are bite-sized brownies really the boss of us? Are we one nation under chili cheese nachos? Should Glenn Beck stop worrying about President Obama and start worrying about what Kessler calls "conditioned overeating?"
|Nothing like a plate of tacos ... loaded with fat, sugar and salt.|
I wanted answers. So I invited Kessler to a ballgame:
The Nationals Park concourse is akin to any ballpark concourse in the country, a garden of delights that's less pastoral baseball cathedral than kettle corn-strewn county fair. Walking to our seats, Kessler and I pass a gelato stand ... a Dippin' Dots ice cream kiosk ... a neon sign reading Grand Slam Grill. We pass onion rings and burgers, chicken fingers and half smokes. To our right, a man two-fists a half-empty popcorn tub and a cirrus load of pink cotton candy, the latter spiraling up, up and away into his open mouth; to our left, three undersized women scarf oversized hot dogs while hunching over a mustard-splattered condiment stand, oblivious to both the national anthem and the relish on their cheeks.
A girl strolls past, noshing on a veritable Everest of nachos.
"That has to be 3,000 calories," Kessler says. "Probably enough energy to sustain someone for a full day. Which is fine sometimes. The problem is that our behavior becomes automated."
We get in line for some food. There's a menu placard under the heat lamp: Chili Mac, Chili Dog, Chili Frito Pie. Limited spectrum, but philosophically consistent. Kessler asks a cashier: What's your most popular item? Chili Nachos! He orders a basket.
"How much you think this weighs?" Kessler asks.
Uh, too much?
"Ever had those? Eat them fast," says the guy in front of us. "They get soggy after five minutes. And take a fork."
Kessler stands by a garbage can, holding the nachos aloft, their cardboard vessel sagging like a listing supertanker. He runs down the ingredients: fried tortilla chip, cheese, sour cream, chili, some green stuff on top to make it look healthy (pepper, it turns out).
"Take a bite," he says.
I do. Tastes like ... nachos with chili. Mmmm ...
"When you eat this," Kessler says, "it's a roller coaster in your brain."
He drops the nachos into the trash. They land with an audible thud.
|Today's new ballparks are loaded with bright signs that activate your craving for food.|
"It's all fat, sugar and salt."
Loaded and layered together, fat, sugar and salt are Kessler's Axis of Food Evil, the culinary equivalent of the mind-controlling ear worms in "Wrath of Khan." How so? The answer lies in your brain:
• Fat, sugar and salt stimulate the brain's pleasure circuitry, causing a release of opioid chemicals. Opioids have rewarding effects similar to -- egads -- heroin, producing pleasure and relieving pain (for example, infants cry less when given sugar water);
• Fat, sugar and salt also trigger the production of dopamine, a brain chemical that stokes and regulates desire by increasing the attention we direct toward a particular pleasure and the gusto with which we chase it.
As such, Kessler argues, fat, sugar and salt hijack our brains by making food "hyperpalatable." A hyperpalatable food doesn't just taste good; it produces strong motivation to pursue that taste. In study after study, animals given hyperpalatable foods gorge themselves and become fat; in one experiment, animals whose neural reward centers had been stimulated were willing to cross an electrified floor for food, getting shocked in the process, even if they had just eaten.
This, Kessler continues, is why human diets fail: fueled by hyperpalatable goodies like chicken fingers and chocolate chip cookies, the chemical drive for reward overpowers rational thought.
Ever eaten a frosty, creamy, calorie-packed ballpark ice cream cone despite your best and healthiest intentions? Now you know why.
"Most of us like food the same," Kessler says. "But overweight, obese people have a hard time controlling themselves because they want food more."
Kessler and I settle into our seats, about a dozen rows above third base. A beer vendor ambles down the aisle, lugging a cooler of long necks, his canary-colored T-shirt as eye-catching as a school bus.
We've taken the ballpark, the carnival, and now transported that into the way we eat in this country. Everything is the constant bombardment with food cues. It's 24-7. It's on every corner. It's no accident when you think about eating.” -- Dr. David Kessler
"Ice cold beer!" he cries.
Kessler ignores him. Nationals center fielder Willie Harris approaches home plate, bat in hand, digging in to Michael Jackson's "Don't Stop 'Til You Get Enough." Kessler ignores him, too. A pudgy, 20-something man below us is eating nachos, devouring his meal, not stopping until he gets enough ... which apparently will occur when the last remaining strands of shredded queso have slipped the surly bonds of their tissue-paper packaging to touch his waiting tongue.
Kessler stares, transfixed.
"Watch this guy eat," he says, detached as the narrator of a National Geographic documentary. "It's very interesting. He's focused on that food. Most of the time at a ballpark, you're eating on autopilot. It starts with what captures you."
Conditioned overeating isn't a one-time binge. It's a habit. A cycle of sensation and behavior, stimulus and response. And it begins long before the first chili-cheese-laden tortilla chip tastes so good hitting your lips.
Remember dopamine, the chemical that regulates desire? Over time, hyperpalatable foods rewire our mental circuitry so that the brain's dopamine pathways -- the same pathways that light up in response to alcohol, drugs and Olivia Wilde -- activate at the mere suggestion of food.
|The latest trend at some ballparks? All-you-can-eat sections.|
For instance, the smell of grilled chicken.
Or a sign reading BBQ.
Or the cries of a beer vendor.
"Hawkers learned about this long before scientists did," Kessler says. "They understood. If it's out of sight, it's out of mind."
Kessler calls these suggestions "food cues." Everyone learns them through individual life experience. A cue can be a sound (think Pavlov's famous bell, causing dogs to salivate), a sight (a fast food restaurant's conspicuous Golden Arches), a mood (always eating when elated/depressed), even an emotional memory (cookies just like grandma baked). Cues capture your attention, arouse desire and prime you for gustatory action. More importantly, they do all of the preceding whether you want them to or not: In one study, people given a snack high in fat and sugar for five straight mornings reported craving something sweet at the same time for days afterward.
"We like to think of ourselves as rational," Kessler says. "That all our actions and decisions are thinking. But many of our actions have become conditioned. We all learn in high school about Pavlov's dogs. Pavlov didn't get the power of these stimuli."
A food cue triggers a dopamine-fueled urge. Dopamine narrows our focus and leads us to food. Eating stimulates our reward centers, producing opioids, pleasure and relief. The cycle repeats. Over time, it becomes unthinking, almost automatic, a food-centric operating system installed into our mental circuitry.
In short, conditioned overeating.
Before the drug Fen-phen was taken off the market for causing potentially fatal heart problems, it showed great promise in treating obesity. The reason? Fen-phen increases levels of serotonin, a chemical that decreases dopamine and reduces activity in the brain's reward pathways. (Interestingly enough, serotonin also can lessen cocaine's reward value.) Patients on Fen-phen reported being less single-minded about food, a single-mindedness that can start with ... as something as innocuous as a ballpark hot dog advertisement.
Kessler gestures to the electric signs ringing Nationals Park, installed between the upper and lower decks. Cola. Ice Cream. Beer. Pizza. Iced Tea. Each one colorful and aglow.
"We're all wired to focus on the most salient stimuli in our environment," he says. "We want to be captured. And pleasure is important. Reward is important. But we need to keep in the back of our minds that we are more vulnerable to stimuli than we think."
|Dr. David Kessler, former FDA commissioner, is content to eat one hot dog at a game these days.|
The truth lies in the trash. Kessler leads me through the left-field food court, back behind a pretzel vendor and Boardwalk Fries. He notes every food he sees, categorizing each goody in cold, clinical fashion: Fat on salt. Salt on fat. Sugar on fat. Fat on fat on fat.
"If you just read the labels on this stuff," Kessler says as we search for the garbage bins, "you can see how --"
An usher interrupts.
"Can I help you gentlemen?"
Before I can ask where the Dumpsters are, Kessler turns back toward the concourse.
"For the book, I had to do this after hours," he says.
True story. While researching his book, Kessler went Dumpster diving at a national chain restaurant in Northern California. Multiple times. He wasn't looking for food. He was looking for ingredient labels -- the same labels found on supermarket foods such as cereal, containing the sort of nutritional information restaurants seldom provide.
What Kessler found was disquieting. But not surprising. The restaurant's deep-fried egg rolls, for example, had eight different salts, five different sugars, 57 grams of fat and 910 calories. As an appetizer.
"I always knew food was processed highly," Kessler says. "But the amount of salt, sugar and fat is so high. What's food anymore?
"Thirty years ago, there was what? One size hot dog, beer, soda, popcorn, peanuts and Cracker Jack. We used to have fries, fat and salt. Now there's added layers. Look at what people are eating repetitively."
Kessler's right. Looking around, the line for a vendor selling chili dogs, chili burgers and chili cheese fries is a dozen people deep in two directions. Meanwhile, the line for plain ol' boardwalk fries is, well, nonexistent.
"A place that just sells fries," he adds, "cannot compete these days."
We stop at Dippin' Dots. Kessler orders the cookies 'n' cream, a plastic cup filled with white pellets and chocolate cookie crumbs. He has me take a bite. I taste both flavors, mixing and melting.
"In the food industry, this is called inclusions," Kessler says. "Go to any yogurt place, and look at all the stuff you can add. The less homogenous a food is, the more salient and palatable it becomes."
"Amphetamines and cocaine elevate brain dopamine, right? OK, food, the first time you eat it, you get a little dopamine bump. But because most food is homogeneous and repetitive, you habituate. Get used to it. No bump."
"With food like this that's multilayered and multisensory, you don't habituate. You keep having activation."
Gulp. It gets worse. Kessler believes the food industry designs and peddles multisensory, multilayered, brain-hijacking products on purpose -- not because it grasps all the neural chemistry involved, but because it knows what sells. To keep us eating and eating more, the industry keeps upping the stimuli. Portions get super-sized. Fries acquire cheese, then chili. The same pumping-up extends to food cues. Think happy ads and happy meals. Signature slogans and catchy jingles. The notion of food as what one food industry expert calls "eater-tainment," as captivating as a big game or a Hollywood blockbuster.
In Kessler's book, the same expert notes that the food industry's most important goals are to create anticipation and positive psychological associations with food. Meanwhile, a venture capitalist with industry experience lauds Starbucks not for selling worthwhile coffee, but rather for responding to widespread social stress. The ubiquitous latte giant, he says, is all about "warm milk and a bottle." He then cites a colleague's take: If I could put a nipple on it, I'd be a multimillionaire.
|With all the food options, does anybody watch the game anymore?|
In America, we don't just eat to feel full. We eat to medicate and stimulate ourselves.
"We've taken the ballpark, the carnival, and now transported that into the way we eat in this country," Kessler says. "Everything is the constant bombardment with food cues. It's 24-7. It's on every corner. It's no accident when you think about eating."
I'm finally -- mercifully -- eating, munching on a barbecue chicken sandwich. The one I've been craving all night. Kessler's having a hot dog. We're sitting on a metal picnic bench behind center field, watching a big-headed George Washington mascot clown around, discussing American growth.
The bad kind.
The indicators are depressing: In 1960, women ages 20-29 weighed 128 pounds on average; in 2000, they weighed 157 pounds. The average man gains more than 12 pounds from age 20 to 40. Childhood obesity rates are rapidly rising, as are rates for weight and diet-related diseases such as diabetes.
Kessler mentions he recently sat on a panel composed of doctors, experts and epidemiologists. The mood was grim. They took a good, hard look at the country -- crunched the numbers, broke down the charts, reviewed the trend lines. Their prediction? We're fat ... and we're toast. It's too late. Once overeating becomes a conditioned habit, there's no way to reverse it. Enjoy that second jelly doughnut, America, and enjoy your regular insulin shots.
"I'm not that pessimistic," Kessler says. "But if we continue to have this kind of food and environment -- it's hard. To ask people to resist all that and protect themselves is adding an extra burden."
How to break the cycle? Change the food, Kessler says. Smaller portions. Less processing. Reduced amounts of fat, sugar and salt. Better still, change our neural programming. Add new learning atop our old food conditioning.
For much of his life, the 5-foot-11 Kessler has seen his weight fluctuate between 160 pounds and 230 pounds. Cakes. Cookies. Cravings. Disciplined and intelligent enough to complete a medical residency at Johns Hopkins Hospital while working as a Senate staffer, Kessler couldn't control his own urges, didn't understand why he couldn't control those urges. He used to attend Baltimore Orioles games with his future wife, Paulette. She would watch baseball. He would eat.
Today, Kessler weighs a consistent 160-or-so pounds. At the ballpark, he's perfectly happy with a hot dog and a diet soda.
"That's all I want," he says. "I used to be happy going from food to food until my stomach was stretched. No limits. I had to make a cognitive shift. Revalue stimuli into junk.
"By doing Dumpster diving, I understood what went into nacho cheese fries. Internalize that, and you wouldn't want to eat them, either."
At the FDA, Kessler waged war on Big Tobacco, attempting to place the industry under agency regulation. Big Food is different, he says. Society has demonized smoking. It can't demonize eating. What's needed is a less hysterical social shift -- away from food as a source of psychological entertainment and escape, and back toward food as a source of physical nutrition and sustenance.
In other words: stop using food the way we use sports. Stop using our innate mental circuitry against ourselves, just to up-sell a few more jalapeņo poppers.
"Being able to bring this under control is as hard a social challenge as we have," Kessler says. "Because this is also what makes us human. It's what makes us so successful."
He takes a final bite of his hot dog.
"Why do we do the things we don't want to do?"
We shake hands. It's getting late. Kessler departs to catch a cab. I head for the nearest exit, past the food court's glowing signs, the enticements to indulge, the chili-cheese nachos and cinnamon-sprinkled pretzels. I don't feel the least bit hungry.