My doctor’s interesting take on losing weight

I had my physical this week. (Pending anything surprising from the blood work, I seem to be in good health.)

The doctor noted that I’d continued to lose weight, and I observed that he’d lost weight as well.

Over the course of seeing him once or twice a year for several years now, I’d noticed that my doctor struggled just a bit with his own weight. He was a runner, and kept his weight under control when he was able to run. When something (injury, weather, schedule pressures) kept him from running, he tended to gain weight. As this has been my own experience as well, I figured we understood one another a bit better than we otherwise might.

When I mentioned his own weight loss, he said that he’d thought a lot about weight problems, and had decided that the right perspective to address excess weight was that of addiction.

This makes sense to me. At least, I have no doubt that the dopamine pathways involved in other sorts of addictions are involved in people’s poor eating choices.

Continuing, my doctor went on to point out that it’s pretty well accepted that addicts can’t just choose to use whatever substance they’re addicted to moderately. Someone who’s not a smoking addict might be able to choose to smoke tobacco a few times a year, but a smoker cannot. Someone who’s not addicted to alcohol can choose to have a drink or two without going on to drink way too much, but an alcoholic cannot.

I agreed with his analysis, but pointed out that it’s very tough to address overeating with the same strategy. “You can’t go cold turkey on food—you’ll just die.”

“Ah,” my doctor said. “But you can go cold turkey on the foods that you’re addicted to.”

He went on to provide a short list of foods that, if he ate them, he’d overeat—chips, cake, burgers, etc. Instead, he said, you could choose to eat only foods that didn’t trigger those addictive behaviors, and he provided a short list. It started with vegetables and fruits. I forget the next few items—but I immediately recognized the main differentiator. The foods that were safe to eat were foods. The items that were dangerous to eat were industrially manufactured food-like edible substances.

So I told him about Michael Pollan and his book In Defense of Food, and suggested a quick rule of thumb: Things you eat shouldn’t have ingredients; they should be ingredients. Certainly, they shouldn’t have any ingredients that your grandmother wouldn’t recognize.

Without saying that I buy into my doctor’s take completely, I think there’s a lot there that’s of interest. The principles of addiction management had always seemed valid—but not applicable to overeating, because you have to eat. The idea that you’re only addicted to those foods that kick those dopamine reward pathways into overdrive . . . . Maybe that is an insight into how to take the things we’ve learned about managing addiction and apply it to overeating.

(Let me add a disclaimer here, that I’ve grabbed a few sentences that my doctor said and run with them—quite possibly farther and in a different direction than my doctor would have. This post is my response to things he said, not a report of what he said.)

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