A resource for health professionals, parents, teachers, counselors & kids on the childhood obesity epidemic.

Inside the mind is a spatial sketchpad that can form a picture, and very often the image it forms is an item of food or drink that the person craves. Like the old Etch-A-Sketch toy, the mental screen can only hold one picture at a time. If you take the toy in your hands and shake it, the sketch disappears.

Back in the 1990s, J. G. Quinn (University of St. Andrews, Scotland) and Jean McConnell (Staffordshire University, U.K.) discovered that food cravings are intimately connected with the ability to form a mental image (PDF). If the mental picture can be made to dissolve, the craving (PDF) is weakened.

As an article published by the British Psychological Society phrased it:

This method has been shown to produce selective disruption of the storage of visual material in working memory… The visual interference technique devised by Quinn and McConnell is based on a continuous display of dynamic visual noise during the processing of the primary task. The underlying postulate is that dynamic visual noise disrupts visual imagery by gaining obligatory access to the visual cache of working memory (Quinn & McConnell, 1999), or to the process of generating an image from a verbal description.

It’s not an exact analogy, but visual interference or dynamic visual noise accomplishes something very much like shaking the Etch-A-Sketch. It disrupts the picture — but, what is more, it replaces the picture with a better one. A moving display, even “visual white noise,” captivates the attention, but conveys no message. With something to watch but no content to assimilate, the mind can relax.

Relaxation reduces stress, and the diminution of stress, in turn, reduces cravings. The discoveries made in this area are helping patients with all kinds of addictions, and keeping addictions from developing.

There is a branch of psychology called Elaborated Intrusion theory (PDF). A paper called “Conscious and Unconscious Processes in Human Desire,” written by Jackie Andrade, Jon May, and David Kavanagh, gives a very convincing diagram, along with a thorough explanation that can’t be quickly summarized.

Nevertheless, here are some excerpts:

Imagery is closely linked with emotion… We imagine unwrapping a bar of chocolate and feel the anticipated pleasure of eating it. It is the importance given to imagery that particularly distinguishes EI theory… Episodes of desire are triggered by a range of environmental, physiological or cognitive cues… Desire images are an example of ‘hot cognition’; they have affective content.

The bottom line here is that “selectively blocking the cognitive processes needed for imagery leads to reduced desire.” One way of selectively blocking is to ask the experimental subject to conjure up a neutral picture, like a field full of wildflowers. This second visualization counteracts the first image by pushing it aside. Another way of selectively blocking is to present a neutral yet interesting visual stimulus for the brain to latch onto, keeping it too busy to imagine chocolate-covered bacon.

An important concept here is that “unconscious and conscious processes in desire are based in different but interlinked brain systems.” In saying this, the authors are building on the work of J. Blackburn as reported in an unpublished MSc thesis in 2006:

Preliminary support for distinct roles of liking and wanting comes from a qualitative study of people who had recovered from eating disorders. They reported feeling hungry, but not craving food: They ‘wanted’ food, but didn’t ‘like’ it and thus, did not crave it by elaborating thoughts about food. Instead, when physiologically hungry, they consciously thought about the positive aspects of being in control of their food intake, and of not putting on weight. They were ‘wanting’ food but ‘liking’ the self-control associated with not eating.

Then the authors get into brain imaging, and state that further testing is needed to verify “the prediction that brain regions underpinning visuospatial working memory play a key role in desire,” or, as we are accustomed to calling it, craving. They talk about bottom-up processes and top-down processes, both of which can enable conscious desires, or cravings.

They even get into questions of philosophy. But they are sure of one thing:

Not only can competing cognitive demands prevent an episode of desire beginning, they can also weaken or interrupt a desire that is already established, as shown by the effects of competing tasks on craving in the laboratory. This finding is important clinically: Selective cognitive blockade of the controlled processes needed for desire can potentially reduce craving to the point where it is tolerable, helping to sustain quit attempts.

Your responses and feedback are welcome!

Source: “Visuospatial working memory and the processing of spatial descriptions” (PDF), psy.ed.ac.uk
Source: “Conscious and Unconscious Processes in Human Desire” (PDF), theassc.org
Image by star5112, used under its Creative Commons license.

Jeffrey Norris recently reported for the University of California, San Francisco, on work done by researchers at that institution, on the subject of the stress hormone cortisol, and deep belly fat, the kind that surrounds and encases the internal organs, creating favorable conditions for diabetes and heart disease. Naturally, the topic has larger implications for obesity in general, including childhood obesity.

The discoveries of Jennifer Daubenmier, Ph.D., and Elissa Epel, Ph.D., add to the larger fund of knowledge that is being accumulated there, about the links between fat, health, and eating behavior. In this instance, the theory is that if people can more sensitively identify their feelings of hunger, and of taste satisfaction, and of fullness, they are far less likely to reach for the chocolate-covered bacon or grab the nearest bag of chips.

This is a reminder of something a correspondent once mentioned, about how the feeling of satisfaction is different from the grossness of a bursting, overstuffed stomach. There is a more subtle sensation, an organic signal the body sends, that signifies another kind of fullness. Talking about a dish composed of kale, carrots, and some other ingredients, she rhapsodized, “You feel like you’ve been fed.”

Here’s how the study went. First, the fat, cortisol levels, and psychological stress of the participants were measured, then:

24 of the 47 chronically stressed, overweight and obese women were randomly assigned to mindfulness training and practice, and the other 23 served as a control group… The training included nine weekly sessions, each lasting 2 1/2 hours, during which the women learned stress reduction techniques and how to be more aware of their eating by recognizing bodily sensations… At week six they attended an intensive seven-hour, silent meditation retreat. They were asked to set aside 30 minutes daily for meditation exercises and to practice mindful eating during meals.

After four months, everything was measured again. Cortisol starts being produced by the body when we wake up, and stressful events or perceived threats throughout the day can trigger the production of even more cortisol, so the stabilization of it is important. But there’s more to it than that, which is all explained in the article. The bottom line is: stress=bad, mindfulness=good.

Even without dieting or calorie-counting, mindful eating and the techniques of stress reduction were shown to make a measurable difference, and the subjects who were able to reduce their stress the most also showed the biggest loss of deep belly fat.

The whole idea is to cut out the automatic responses that trigger mindless eating, whether they originate in external cues or from internal emotional cues. The most surprising thing is, none of this is new. As the reporter tells us, the researchers used for their study the stress-reduction and mindful-eating techniques developed around 30 years ago by Jon Kabat-Zinn, Ph.D.

On this page, the ideas of Dr. Kabat-Zinn are explained, along with his program which utilizes meditation, yoga, and martial arts. If you want to hear it from the man himself, a 72-minute video presentation is available.

Your responses and feedback are welcome!

Source: “Stress Reduction and Mindful Eating Curb Weight Gain Among Overweight Women,” UCSF.edu, 12/07/11
Image (modified) by jetheriot (J E Theriot), used under its Creative Commons license.

The Wall Street Journal‘s Melinda Beck brings news of another way to help people recover from obesity. For years, deep brain stimulation (DBS) has introduced astonishing change into the lives of patients suffering from Parkinson’s disease. Going by the evidence of early trials, DBS can also help those with Tourette syndrome, Alzheimer’s disease, and even addiction.

If, as Dr. Pretlow and many other health professionals believe, much obesity is caused by food addiction, then this is indeed significant news. Beck quotes Helen Mayberg, the neurologist in charge of Emory University’s study of DBS, who says of the subjects:

… [T]hey are not just getting well, they are getting well without side effects and without relapsing…

The reporter also spoke with mood disorders expert Paul Holtzheimer, who specified that DBS can only be employed when the operating physicians have “a good idea which brain regions aren’t functioning appropriately.”

Back in 1954, researchers James Olds and Peter Milner discovered pleasure centers in the brains of lab rats, and, 40 years later, Michael A Bozarth wrote of a 1965 study:

Laboratory animals will lever press at high rates (> 6,000 times per hour) to obtain brief stimulation pulses to certain brain regions… The potency of this electrical stimulation is most dramatically illustrated in a classic experiment where the subjects suffered self-imposed starvation when forced to make a choice between obtaining food and water or electrical brain stimulation.

In other words, the furry little subjects kept pressing those levers for jolts to their pleasure centers, even if it meant starving to death. No wonder Holtzheimer stresses that correct targeting of the area and precise positioning of the “pacemaker for the brain” are of course essential, and adds:

… [Y]ou need to do the clinical trials and have good evidence of the safety and efficiency to balance the invasiveness of the surgery.

No kidding! A wire in the brain is hardcore. The accouterments also include continuation of the wire beneath the patient’s skin and a battery pack implanted in the chest. Beck says:

It can take months to fine-tune settings on the battery pack and adjust medications to give patients optimal movement control… And as with other surgeries, there is a risk of infection, stroke or other complications. Some patients find their speech slurred after the surgery, and others report falling issues.

Rigged up like this, a person cannot be subjected to an MRI diagnostic test, or go through a security scanner. But if this $60,000 procedure can put a stop to the uncontrollable urges and cravings that characterize an addiction, for instance, to food, all the expense and inconvenience could be worthwhile. Beck quotes a patient suffering from major depressive disorder who said, post-wire:

I was sleeping better. I wasn’t binge eating. I didn’t have any suicidal thoughts.

This particular woman had already tried transcranial magnetic stimulation, as well as more than a hundred old-fashioned shock treatments, without relief, so such an endorsement is very encouraging. Trials aside, approval for widespread use of this therapy will be needed by the Food and Drug Administration, which is kind of odd, since the wire is neither a food nor a drug.

When a case is so extreme as to require surgery, the brain wire seems to hold more promise than bariatric surgery, which entails unpleasant side effects and has an unsatisfactory success rate. Of course, the best way is always, if possible, to get in there with some kind of intervention before true addiction sets in, and avoid any surgery.

Your responses and feedback are welcome!

Source: “Wiring the Brain, Literally, to Treat Stubborn Disorders,” WSJ.com, 01/17/12
Source: “Pleasure Systems in the Brain,” AddictionScience.net
Image by joestump (Joe Stump), used under its Creative Commons license.

It appears that the origins of cravings are both physical and psychological. Laboratory research strongly indicates a chemical basis for at least some food cravings. Additional conclusions have been drawn by scientists in other fields, who observe human behavior through their own lenses. The subjects who are studied often have their own points of view, too, like people involved with the Size Acceptance movement, which seems to present a conflict between fat acceptance and the will to fight childhood obesity.

The bad news about a chemical basis for cravings is that a vicious cycle can be created. Eating sugar, for instance, makes a person desire more sugar, so they eat more sugar, and that sets up a longing for even more… But the good news is, at least some of these self-imposed vicious cycles can be interrupted. The craving will soon go away — if you just stop eating sugar…

But how, when that is the very thing a person craves? Now, the mental and emotional areas become important. Dr. Pretlow has found that young people who are determined to reach a healthy weight are successful when they acknowledge that cutting down on the foods they are hooked on will include a period of withdrawal. There will probably, temporarily, be “intense cravings, feeling antsy, feeling stressed, even depressed.” He says:

Plain willpower is rarely enough to get them through withdrawal. Kids need lots and lots of support and distracting fun activities to get through it.

Adults have control over the home food environment and need to be conscious of such things, especially if a child is asking for cooperation and a change in shopping habits. It really helps a lot if people in the environment take care to not provide the triggers that will set off addictive behavior. Still, the world will not always be so considerate, and kids who succeed come to accept this.

In Chapter 15 of Overweight: What Kids Say, Dr. Pretlow writes of successful kids:

They realize that the urges for great tasting foods are like a bad back. Similar to chronic back pain, the urges will always be there, even though they will get better. The kids learn to go about their lives ignoring the urges, even though they will never totally go away. The more they can ignore the urges, the less the urges grate on them. They read a book, work on a hobby, or shoot hoops to distract from the urges. Just relaxing also helps.

Childhood Obesity News has alerted readers to Melinda Beck’s Wall Street Journal article, “Is Your Personality Making You Put on Pounds?,” where the writer says:

People who feel chronically stressed often use food for energy and comfort and rationalize that they’ve earned it… And almost anything that pampers, distracts or relaxes you can serve as a reward…

Distraction works. Entire books have been written about things a person can do to distract from self-destructive impulses. Overweight: What Kids Say quotes a 14-year-old named Carlie who throws a monkey wrench into the craving process by repeating, “Taste is temporary, weight is forever,” kind of like a mantra. It’s a good idea as far as it goes, and if it works for her, that’s great. It might be even more effective to drop the negative, “weight is forever” part, because that isn’t really a useful idea to impress on the mind and keep reinforcing.

Fortunately, counselors have discovered the usefulness of affirmations in creating a helpful distraction and in carving new mental pathways. Here, from Moya Mulray, are a few examples, and the source page includes explanations of why each one has power:

I make healthy eating choices.
I enjoy exercise and appreciate what it does for my body.
I am healthy and full of energy.
Weight loss is easy and effortless for me.
I do not overeat. I leave food on my plate when I am full.
I practice good portion control.
Body fat falls off of me fast.
I maintain a healthy weight.
My body is beautiful, and it is more beautiful each day.

Your responses and feedback are welcome!

Source: “Is Your Personality Making You Put on Pounds?,” The Wall Street Journal, 01/10/12
Source: “9 Inspiring Weight Loss Affirmations,” Inspirational Quotes and Thoughts
Image by thomas pix (Thomas Kriese), used under its Creative Commons license.

Take obesity… please. Standup comic Greg Giraldo made fun of the media for hyping the obesity epidemic as if it were as frightening and destructive as the polio epidemic of the early 1950s. (Five-minute video, adult material.) And he had a point. Compared to some of the other things going on in the world, being too fat can look like a pretty ridiculous problem to have.

On the other hand, the serious hand, anybody who looks into the matter will come away feeling apprehensive, and with good reason. Childhood obesity is already a gigantic ticking time bomb, and most of the damage it will do is irreversible. A lot of obese kids have already grown into obese adults with huge obesity-related medical bills, but that’s nothing compared to what we can look forward to 20, 30 years down the line.

The mission of the International Size Acceptance Association is:

… to promote size acceptance and fight size discrimination throughout the world by means of advocacy and visible, lawful actions… to end the most common form of size discrimination and bigotry — that against fat children and adults… to defend the human rights of members affected by other forms of size discrimination as well.

Well, okay, but it can be troubling to see people putting so much energy into this, especially when children and teens are reached by messages that seem to imply that obesity isn’t a problem. For a magazine called BBTeenz (Big Beautiful Teens), young people are encouraged to make recordings and send them in:

Podcasts of encouragement from your personal experiences are highly encouraged. Have some ideas that worked for you to make life easier as a BBTeen? Pass them along!

Many healers realize that until a person loves and accepts herself as she is, she can’t change. Same goes for males, of course. Yes, someone who wants to gain maximum health needs to have a certain amount of self-esteem on board, to even begin such a project. But an excessive amount of acceptance can lead to some strange byways, of which Dr. Pretlow describes one:

Actually, there are a fair number of self-described ‘gainers’ out there, who profess to enjoy being fat and eating whatever they want. Perhaps some kids actually do become obese voluntarily and are content remaining so. Nevertheless, the vast majority of obese kids appear to be addicted to certain foods, typically highly pleasurable foods. They hate being fat and struggle desperately to lose weight or maintain it.

When I have done presentations, obese attendees have protested about my claiming that most obese kids are unhappy being fat. One such protester was the obese president of [a prominent group of childhood obesity professionals], whose attendees the chair said were ‘stunned’ by my presentation. I am outraged when obese physicians profess that kids aren’t unhappy or at health risk being fat.

Attitudes are of course determined by personality, and who would have guessed that, for instance, being a perfectionist can lead to an eating disorder? This and many other topics are discussed in “Is Your Personality Making You Put on Pounds?” by The Wall Street Journal writer Melinda Beck.

One of her sources was Angelina R. Sutin of the National Institute on Aging, who published the results of a 50-year study of nearly 2,000 residents of Baltimore, MD. Beck says:

… [T]hose who scored high on neuroticism — the tendency to easily experience negative emotions — and low on conscientiousness, or being organized and disciplined, were the most likely to be overweight and obese. Impulsivity was strongly linked to BMI, too: The subjects in the top 10% of impulsivity weighed, on average, 24 pounds more than those in the lowest 10%. People who rated themselves low on ‘agreeableness’ were the most likely to gain weight over the years.

Uh-oh, that all sounds a bit controversial! It gets worse. People who are very giving and solicitous of the needs of others often can’t find or accept the same kind of nurturing in return. They tend to suffer from emotional burnout that leads them to seek solace in food instead. People who constantly give, and who don’t get back at least some gratitude or appreciation, can develop unpleasant emotions. Rather than stuffing those emotions down and smothering them with food, experts recommend relieving that stress by journaling or ranting in a mirror.

The personality can affect the BMI in another way: “night owls” set themselves up for obesity in several ways which are explained here, as are the reasons to be concerned about childhood obesity:

Early life experiences also set the stage for overeating years later, researchers have found… The link between emotions, food and weight control starts at a very early age.

As Childhood Obesity News has mentioned many times, the Weigh2Rock kids from whom Dr. Pretlow gathers opinions are fed up with nutrition information. This sentiment is echoed by author and weight-loss coach Renée Stephens who says:

Is there anybody who doesn’t know that broccoli is better for you than a Big Mac? What’s important is identifying what’s going on in our heads and what we’re using the food for.

Your responses and feedback are welcome!

Source: “Lazyboy — Underwear Goes Inside The Pants,” YouTube.com
Source: “ISAA Mission Statement,” Size-Acceptance.org
Source: “Is Your Personality Making You Put on Pounds?,” The Wall Street Journal, 01/10/12
Image by vastateparksstaff, used under its Creative Commons license.

The wry motto of Eartha’s blog is, “Trying Fitness — because you’ve tried everything else.” She recommends switching grocery stores, cooking at home, choosing snacks wisely, and stocking healthful snacks in a cooler in one’s car. That’s a great idea for parents, especially when the kids are getting chauffeured around a lot. It’s all too easy for a harried mom or dad to succumb to pleas for a junk-food pit stop. Instead, would the kids settle for raisins, sweet apples, frozen grapes, or baby carrots from a mini-cooler? It’s worth a try. Keep some water in there, too.

It’s possible to find many lists of potentially helpful ideas about what to do when the junk-food urge hits. They are offered by health care professionals, and by people who have been through the struggle to beat cravings and either reverse or prevent obesity. It’s useful to remember that not all of the suggestions work for everyone.

For instance, it has often been said that dehydration can be mistaken for hunger. The advice is, if you start to crave a little nosh, drink a few ounces of water instead. It’s one of the most basic, harmless things a person can do, so why not? If it helps one out of 10 people, or if it helps a person one time out of 10, still, that’s progress.

One of Eartha’s commentators recommends pausing to do the research on how many miles of treadmill effort it will take to cancel out the calories in a tempting candy bar. Another recommends eating ¼ or ½ of a pickle to stave off more serious cravings.

If all the sugar disappeared from the face of the Earth, Jill Escher probably would not mind a bit. She says:

Blood sugar imbalances cause powerful cravings and this leads people to spend their days on a roller coaster of blood sugar highs and lows, constantly eating to correct the imbalances. The result? Eating sugar around the clock. Once people understand the biochemical nature of their sugar craving, they realize it’s not about will power. They become empowered to take charge and correct their eating habits to get off of the sugar rollercoaster once and for all.

Sugar avoidance is something that almost everyone agrees on. Dr. Mark Hyman flat-out says:

Eliminate sugar and artificial sweeteners and your cravings will go away.

Dr. Hyman also recommends getting seven or eight hours of sleep, because research indicates that cravings increase with sleep deficit. It could also help to investigate whether the unmanageable cravings might be triggered by hidden food allergies.

Yes, it’s great to correct your habits by quitting sugar, but how do you correct your habits when they are formed by the cravings that you’re trying to get rid of by changing those habits? It’s all very well for people to say “ditch sugar” and it will end the cravings, but how do you stop doing sugar in the first place, when it’s the very thing that you crave most? The first step, that’s what people need.

Maybe the first step is adding some other nutrients to the diet. Dr. Hyman cites a study which showed that the body needs vitamin D, or else the appetite-suppressing hormone doesn’t function right. Vitamin D is in fish and dairy products, and is also obtained from sunlight, another good reason for outdoor exercise. A person could probably benefit from some omega 3 fatty acids also. He adds:

Consider taking natural supplements for cravings control. Glutamine, tyrosine, 5-HTP are amino acids that help reduce cravings. Stress reducing herbs such as Rhodiola can help. Chromium balances blood sugar and can help take the edge off cravings. Glucomannan fiber is very helpful to reduce the spikes in sugar and insulin that drive cravings and hunger.

Dr. Douglas Hunt, one of the pioneers of therapy for food addiction, individually assessed the needs of his patients and treated them with different nutrients, including liver tablets and calcium lactate, depending on what they craved.

Maria Emmerich, a self-described wellness expert in nutrition and exercise physiology, stresses the importance of magnesium, and not just any magnesium supplement, but 600 milligrams of magnesium-glycinate. She says:

Magnesium is also being researched as a natural way to curb food cravings. It is found that as magnesium deficiencies increase so do food cravings. Supplementing with a therapeutic dose of 600 milligrams of a magnesium supplement has been shown to significantly calm food cravings.

These are all clues and cues, and hopefully they will be taken seriously and not ignored. The thing to remember is, when looking for ways to resist cravings, everything hinges on the question of how far a person has wandered down the path toward serious dependency issues. This is why it’s so important to help kids figure it out, before their habits become too ingrained.

Your responses and feedback are welcome!

Source: “Simple Ways to Help Stop Cravings for Junk Food,” TryingFitness.com, 05/05/10
Source: “The Blood Sugar Rollercoaster,”EndSugarAddiction.com
Source: “Stopping Addiction to Sugar: Willpower or Genetics?,” DrHyman.com, 07/25/11
Source: “Miracle Mineral,” MariaHealth, 05/16/10
Image by bradleygee (Bradley Gordon), used under its Creative Commons license.