This time, though, the rats were craving not dopamine but serotonin. Serotonin is the feel-good substance that helps us feel calm, at peace, optimistic, and positive about ourselves. People with low serotonin levels feel anxious and pessimistic and suffer from low self-esteem. Low serotonin levels have been implicated in sleep problems and migraines, as well as in depression and mood disorders such as chronic anxiety and obsessive-compulsive disorder. Interestingly, heroin addicts often report powerful sugar cravings as they try to detox from their addictive substance, suggesting a strong connection between sugar and the pleasure centers that heroin stimulates.
Also interesting is the fact that when people diagnosed with depression are given meds to boost their serotonin levels, they not only cheer up but also begin to feel more optimistic about the future and express higher levels of confidence and self-esteem. Just that simple switch in brain chemistry helps them go from “I’ll never find a job; who would want to hire me?” to “You know, there was an ad in the paper that looked interesting—I think I’ll check it out.” Or perhaps “I’m so fat and ugly, no one will want me” turns into “Actually, I’m a terrific person with a lot of great friends, and I feel hopeful that someday I’ll meet a great partner, too.” Serotonin is integrally bound up in our view of the world, our predictions for the future, and our feelings about ourselves.
Of course, as a therapist I know that psychotherapy can also change your serotonin levels. And later in this book, we’ll talk about ways that you can start to change the self-critical, negative thought patterns that might be holding you back into self-loving, positive messages. It’s striking that our brain chemistry has so much to do with whether we are able to generate these messages for ourselves or even hear and believe them from others. If your serotonin stores are low, you can hear all the compliments or good advice in the world, and you may very well feel hopeless or anxious anyway. Boosting your serotonin levels is often crucial to any other kind of psychological progress.
So how do you boost your serotonin levels? Sugar will do it—temporarily. So will starchy “sugar-rush” foods made primarily from white or processed flour, including pasta, crackers, breadsticks, and white bread. Of course, foods made with processed flour
and
sugar, such as cookies, cakes, doughnuts, and other baked goods, offer a kind of double-whammy. And, as with the unhealthy dopamine boosters we just looked at, the sugar high is inevitably followed by a sugar crash. After the sugar wears off, you feel
worse
than you did before. You have to keep eating more and more sugar just to get the same high—and eventually, just to feel normal.
Most of us are aware that sweets and starches feel comforting, but we’ve probably come to believe that’s an emotional reaction. Maybe so, but its roots are definitely physical. In a brain-scan study conducted in 2004, scientists found that just the sight and thought of ice cream stimulated the same brain pleasure centers in healthy people as pictures of crack pipes did for drug addicts. Both eating food and thinking about it are deeply biological experiences as well as profoundly emotional ones. If we
feel
addicted to food, it’s because we
are.
Diets Don’t Work—Tackling Addiction Does
People aren’t stupid. Most of us know that when we feel blue, stressed, or out of control, we eat. That’s why we feel so bad about not sticking to a healthy diet. “I
know
this isn’t good for me,” we tell ourselves. “But I can’t control myself! What’s
wrong
with me? Why am I so weak?”
Well, now you know that you aren’t weak at all—you’re simply responding to your own brain chemistry. Overconsumption of high-fat or sweet and starchy foods has taught your body to stop making enough of its own dopamine or serotonin, while tolerance has caused you to need ever-greater quantities of those tempting foods just to feel normal. Take away the addictive foods too suddenly and, like a cocaine addict, you’ll go into withdrawal. And your symptoms won’t last for just a few days. They’ll go on for
two weeks.
Later in this book, I’ll tell you how you can prevent withdrawal symptoms and maintain your brain chemicals so that you never have to feel deprived or uncomfortable while you are changing your diet. But I hope now you’re beginning to see why all your other diets haven’t worked so well. All those other diets relied on willpower. “If only we can be disciplined,” we tell ourselves. “If only we could stop being so lazy and so greedy!” So we South Beach, Atkins, calorie-count, and Blood Type diet our way to insanity. Do you know anyone who has sustained a no-carb diet for years? I don’t. Restrictive diets are unrealistic in the long term, and they also make us more likely to gain weight when we do eat. Animal studies have shown that if you radically restrict energy intake—as with a very low-calorie diet—the body’s cells go into “starvation mode,” trying to conserve all the energy they can. Then, when you begin eating normally again, your metabolism goes haywire and hangs on to the calories for dear life. Your poor body thinks it’s starving and won’t give up a single ounce of fat.
So many of us have experienced this effect firsthand. Our bodies learn to conserve weight by going into storage mode. Suddenly we’re slipping into a painful downward spiral:
Even after you’re had some success on a particular diet—even if that diet offers you healthy choices and a sustainable number of calories—you probably found yourself slipping after a few months. Why?
Again, it’s not that you lack willpower. It’s that you never focused on feeding your brain. Without the physical and emotional support you need, your brain is starving for the serotonin you got from carbs and sugar and desperate for the dopamine in your fatty snacks.
If your life is stressful or if you feel chronically anxious and unsafe, your serotonin levels probably have been low for a while, making you all the more vulnerable to the power of sugar and carbs. Likewise, if your life feels boring and restricted, if you chronically feel blue and lethargic, your dopamine levels have likely dropped even before you started worrying about your weight.
So what’s the solution? It’s actually simple. You need healthy, feel-good foods and satisfying life activities to balance your brain chemistry. Once your brain is fed, you won’t
need
sweet, starchy, high-fat foods to feel good, because you’ll be getting all the “boost” you need from other sources. Your cravings will be satisfied and your addictions will vanish. You’ll naturally be drawn to healthy foods, and your weight will automatically readjust.
How Diet Rehab Will Help
As part of your Diet Rehab treatment I’m going to do something that might seem a little strange at first: I’m going to start by having you eat
more
food. My approach to addiction is based on “gradual detox,” in which you begin by adding foods that will boost your serotonin and dopamine levels before you ever cut back on
anything.
It’s vital that we come from a psychological place of plenty
.
We need to start out knowing that there is nothing we cannot have if we really want it.
Here’s how forcing ourselves to diet cold turkey creates a weight-
gain
cycle:
If I’m treating patients who want to quit smoking, I tell them they should continue to smoke for a month after making the decision to quit. I realize that might sound odd, but I’ll explain. A habit is fully formed in twenty-eight days. So we spend twenty-eight days
adding
to their life before we take the smoking away. We add activities such as running, yoga, and improving relationships. We start to explore the replacement options we’ll have on hand once the smoking stops, such as the medication Zyban, which is yet another way to increase dopamine levels to counteract the effects of nicotine withdrawal. We’ll also consider nicotine replacement in the form of gums or patches.
Can you see what we’ve used that month to do? Nicotine addicts have now formed new habits that boost the same neurochemicals they have gotten from smoking. After raising these levels, then—and only then—should we remove the nicotine from their system. At that point, the smokers will hardly notice the loss, because they’ll be getting so much dopamine from so many other sources.
The same principle applies to food. Even when you perform weight loss surgery, if you don’t address patients’ brain chemistry, they’ll continue to feel miserable and deprived. They’ll still crave the foods that made them feel good—that did, actually, generate the brain chemicals that we all need to feel good—and then, as happens to most people who have weight loss surgery, they aren’t able to stick to the recommended behavioral changes just one year after the procedure. We all have to feed our brains with the right foods and activities or we’ll never be able to be free from the addiction.
Diet Rehab
will
address your brain chemistry. You’ll learn how to naturally boost your serotonin and dopamine levels, creating the feelings of peace, calm, excitement, and pleasure that you used to get mainly from food. When your brain chemistry is balanced, you’ll be interested in food for pleasure, yes, but you won’t be dependent on it. It will finally return to its rightful place in your life—and your new weight will show it.
Don’t
Call Domino’s!
The frustrating thing about the food culture we live in is that it’s so easy to overexpose ourselves to high-fat or high-sugar/carb foods without even realizing it. For example, in 2010, Domino’s made a change that resulted in a huge spike in sales: They changed the recipe of their pizzas to include 40 percent more cheese. Just one slice of the new version contains as much as two-thirds of a day’s maximum recommended amount of saturated fat—and how many people stop with just one slice?
Not only does saturated fat put us at risk for heart disease, but, as we just saw, it ramps up our dopamine levels and can trigger an addiction. Might that explain, at least in part, why Domino’s sales have risen sharply since the new fattier version hit the menu? Or that pizza is the world’s most popular food?
Finding Freedom from Food
I remember the first time I helped free someone from a food addiction. My patient Michelle—a longtime sugar addict—and I had been working for weeks on creating new, healthy habits to drive out the old, addictive behaviors. For a while, as in any process of recovery, it was tough going. Michelle was a fighter—no question about that—but although she was not yet thirty, she had been through a lot: an intense battle with stomach cancer, a subtly abusive boyfriend, and a long string of dead-end jobs.
Now she was finally working in an office where her boss and colleagues appreciated her, and she was looking at programs for going back to school. For the first time in years she wasn’t dating, which she viewed as her chance to come into her own and discover who she was. She had recently joined a softball team, started cooking more often, and had just about reached her ideal weight.
One day she burst into my office, grinning from ear to ear. “You’ll never guess what happened,” she began, before I even had a chance to ask her how she was. “I was walking by my favorite bakery—and I was thinking so hard about this new project at work, and this idea I had for what they could do, and the way I was going to convince them to put me in charge, that I walked right past it! I’ve never done that before! I didn’t even notice. I even told myself that I could go back, if I wanted to, and get myself a doughnut—I’ve been pretty on target lately, and it was time for a treat—but you know what? I just didn’t feel like it. Dr. Mike, I can’t believe it! I never thought I just wouldn’t feel like eating sugar!” Michelle was describing freedom from addiction, and for her it was a beautiful feeling.