Are cookies and fries the new cigarettes? And soda, breakfast cereals and ice cream new opioids?
In his new book, “Diet, Drugs, and Dopamine: The New Science of Adat A Healthing Working” (Books of Flatiron), the former FDA commissioner, David A. Kessler, argues that ultra -intensive foods – meaning “irresistible, highly transformed, very pleasant, dense food and high blood sugar”, as he describes them – were deliberately designed by Big Food to be dependent. He calls them “ultra-formulated” instead of “ultra-proro-residents” in order to highlight the deliberate intention on the part of food manufacturers. As a result, 41.9% of adults in the United States are fighting against obesity, he said. And by 2030, it projects about half of us.
It is a “health disaster,” says Kessler, “who has reached its summit at all levels.”
Shelf Help is a chronicle of well -being where we interview researchers, thinkers and writers on their last books – all in order to learn to live a more complete life.
Toxic or visceral fat – which means that fat around our internal organs – has led to an increase in diseases and conditions such as type 2 diabetes, arthritis, blood clots, hypertension, cardiovascular disease, dementia, brain vascular accidents and certain cancers.
GLP-1's weight loss drugs, such as Wegovy and Zepbound, have helped millions of people to lose weight and slow down food desires. But they create additional health problems, says Kessler, and there is not enough scientific data accumulated to speak long -term their effectiveness or safety.
This is a subject that Kessler knows intimately. He has fought against food dependence since childhood, growing up in New York, and his dependence has increased to university and medical school when sub-Sandwichs and Chicken Wings were his awards to study hard. He has since struggled to manage the side effects of GLP-1 drugs. To reverse the obesity crisis, explains Kessler, we must better understand the dependence itself: how ultraprotised foods grasp our rational brain. We must also create a new paradigm for drug addiction, known as Kessler, because the first considers drug addicts through the objective of weakness.
In his book, Kessler invites us to recognize that obesity is a chronic condition which must be treated as such.
Times spoke with Kessler of healthy weight loss strategies for long-term guidelines to use GLP-1 in complete safety, the movement of body positivity and improving lifespan.
This interview was condensed and published for more clarity.
Dr David A. Kessler.
(Joy Asico Smith)
In the book, you speak of “the elephant in the room” with regard to the difficulties around weight loss today. What is this?
We have failed to recognize how difficult it is to escape the attraction of food dependence and to overcome the integrated reward response of our brain to these ultra-formulated foods that flood our food supply. I am not talking about cocaine or amphetamines which excessively divert the circuits of dopamine. But addictive circuits are part of all of us. We are all wired to focus on the most salient stimuli of our environment. And for many of us, these stimuli are these ultra-formulated foods. The food is very, very powerful to change what we feel. It is not a question of will. Our bodies experienced an insidious decline during the last half century. And this was caused by this endless food consumption that can trigger addictive circuits.
How can we “calm the noise”, as you say, around food dependence?
It is the interaction between stimuli in our environment and our brain. Change our environment and we can change remarkably what's going on in our brain. [Environment] Is all outside our body with which we interact, from the moment we wake up until we fall asleep. What you put on your television, which fast food restaurants you spend on the job at work, we are constantly spotted. So you try to eliminate signals. Or change your environment. Many of us do not have the opportunity to leave our environment. And the food industry is not inclined to change its behavior so early. But we now have pharmaceutical aids to help stamp this. The effect of these GLP-1 [weight loss] Drugs on food noise, this is the great discovery.
GLP-1 drugs can lead to serious medical conditions that concern you. What are they,, And that should doctors and pharmaceutical companies do differently?
The fact is that the only way to lose weight – whether medication or diet or surgery – is to have an energy deficit. [GLP-1s] are very effective in making you consume less. But some people eat less than 1,000 calories per day. There are people who eat 600, 800 calories. You should be under medical care or run the risk of malnutrition. Food stays in your intestine longer and this delay in gastric entrance [called gastroparesis] Can cause its own set of symptoms as well as metabolic consequences such as hypoglycemia, low blood sugar and other metabolic states. They all result from malnutrition.
Many doctors who prescribe this is not well trained in obesity or nutrition medicine. And it is very important, if possible, that a team of health professionals, including a dietitian, is available. There is no doubt that [drug companies] Need to do a better job to study real world data. How to use these drugs, how to get rid of these drugs safely, is a key problem. There must be a better labeling surrounding gastropares and the risks associated with these drugs.
(Flatiron Books / Joy Asico Smith)
Most people will not be on GLP-1 for life because they are expensive and have negative effects, you say. However, leaving medication, most people gain weight. So what is the long -term solution?
The question concerns intermittent use – Can I use these drugs to remove my weight? Can I use them, intermittently, during a lifetime? But we have no data yet to know [if] That's sure. But you can use these drugs to condition yourself to learn to eat differently. I eat very differently now – I don't want to put large amounts of food in my stomach. I conditioned myself not to do that. How long it will last, we will see. So you need a range Tools. This can range from nutritional therapy to behavioral therapy through physical activity – and they will vary for the individual. There is no tool that will work for the duration. Pharmacological tools are just one tool, the toolbox should be available. But the most important thing is to recognize that this is a chronic condition that needs continuous care, even after losing weight.
Reaching a healthy body weight begins by understanding dependence, tell yourself, not necessarily the old advice has “Eat less and move more.” Why is it so important?
The ultimate answer East “Eat less and move more.” But we cannot do this because of the physiological and addictive circuits – they stand on the way. We must understand that dependence does not only concern weak and oppressed. This is part of all of us, these circuits. We cannot overestimate the quantity of stigma, shame and distress that many feel because they could not control their weight. They think it is their fault, they do not love each other for that and society has created all these biases attached to it. Simple gratitude [that] Our brains are not entirely under our control regarding these dense energy foods is a very important step.
There is a delicate balance between the body's positivity movement, which encourages people to accept their bodies as it is, and the health crisis which is obesity, which, in your opinion, is a deep cause of many diseases. How do you suggest that we sail this?
This movement did a lot of good – it was ashamed of it, it removed the stigma. But it was at a time when we had no effective tools to reduce visceral fats. You can love your body, but also do things for your health. These things are not diametrically opposed. And I am not comfortable with the quantity of morbidity and mortality associated with visceral fat and saying that we should not do something about it.
(Maggie Chiang / For Times)
As a former FDA commissioner, what is up to you at night these days?
Recognition that visceral fat is causal in a range of cardiometabolic diseases that increase the real handicap during its senior years. I think we are not ready to manage this. We only woken up to the toxic of this visceral fat.
Take -out
“Diet, drugs and dopamine”
To end on a positive note: how much weight loss decrease Future risk of illness?
What is remarkable is that relatively low quantities can have significant effects. If you want to reverse certain conditions, this would require more weight loss. But almost any weight loss will add clinical advantages and be useful to reduce the risk of cardiometabolic.
