TERRY GROSS, host:

Once you've had a bite of salty french fries, or a cheeseburger with all the extras, or a cinnamon bun, you want more and more. It can be hard to stop eating even when you're full. It's not just you. Years of research has taught former FDA commissioner David Kessler that sugar, fat and salt change the brain. Those ingredients are the stars of Kessler's new book, "The End of Overeating." It's about why there's so much sugar, fat, and salt in fast food and processed food, and how that's affecting our brains as well as our waistlines.

Kessler was the FDA commissioner under Presidents George H.W. Bush and Bill Clinton. He's the former dean of the medical schools at Yale and the University of California, San Francisco.

David Kessler, welcome to FRESH AIR. In your book, you blame overeating not only on a lack of willpower, but you say we're eating foods basically that are designed, perhaps intentionally designed, to get us to just keep eating, and that things like sugar, fat, and salt increase your craving. Why do they do that? Why do we keep wanting more sugar when we're eating sweet or more salt when we're eating popcorn, or pretzels, or potato chips?

Dr. DAVID KESSLER (Author, "The End of Overeating"): We used to think of - food was something we ate to fill us up, to satiate us. But in fact, much of the food that we're eating, this trifecta of sugar, fat and salt, stimulate us. And what we now see is the science that shows that much of the food that we're eating, this very highly palatable food, is excessively activating the neurocircuitry of many of our brains. We used to just think that, you know, food tasted good, but we now know what's behind that, and for many of us the reason we keep on eating is because of this sustained stimulation.

GROSS: Now you describe how foods that sound really healthy like a potato or a chicken breast can really just become vehicles for the trifecta of salt, fat and sugar. Give us an example of a food that it kind of sounds healthy, but when you're done with it...

(Soundbite of laughter)

GROSS: ... when the industry is done with it, it isn't.

Dr. KESSLER: Take the spinach dip. You see the word spinach on the menu, you think boy, that's good for me. What is it? You know it's fat and salt with some green things in them. Even our basic chicken breast increasingly has food that's injected or marinated or mixed in a huge cement mixer and it has sugar and fat and salt injected into it. You know, and it's very stimulating. It's very highly affective in getting us to eat more and more.

GROSS: But, you know, as you point out in your book, restaurants aren't shy about advertising all the stuff, not ingredient per ingredient, but how rich these foods are. And you give an example from the T.G.I. Friday menu. And you describe T.G.I. Friday's as the chain restaurant designed to be the ultimate food carnival. So this is one appetizer, the parmesan-crested Sicilian quesadilla. And it says, packed with sauteed chicken, sausage, bruschetta marinara, and bacon, and oozing with Monterey Jack cheese. We coat it with parmesan and pan fry it to a crispy golden brown, then drizzle it with Balsamic glaze. So what's going on in that parmesan-crusted Sicilian quesadilla?

Dr. KESSLER: If you translate what it says on the menu, what is it? It's fat on fat, on fat, on salt, on fat. That's what it is.

GROSS: Let me read another menu item. This is how the menu describes it, or at least how it described it when you were writing the book. And this is from Chilis, which is another chain restaurant, and this is the Margarita grilled chicken. That sounds pretty healthy. Okay. So here's a...

Dr. KESSLER: Absolutely.

GROSS: ... here's a description. We start with tender, juicy chicken breast, marinade it with our classic Margarita flavoring and grill it to perfection. And then the dish is served with rice, beans, strips of fried tortilla, and salsa. And that, I mean that sounds pretty good. So what are your objections to the Margarita grilled chicken?

Dr. KESSLER: Well, if you go look what's actually in the chicken - let me read you what's in there. It contains a 15 percent solution of a marinade, which now - marinade has orange juice, sweet and sour mix, which is sugar, citric acid, soy bean oil, artificial colorings, has triple sec, canola oil, tequila, salt - and that's all added inside the chicken.

GROSS: This is for the marinade?

Dr. KESSLER: The marinade, it's mixed in this huge mixer, sometimes it looks like a cement mixer. And so you have these sugary, fat, syrups added inside the chicken. You think you're eating good grilled chicken. You think it's healthy. Only then do you understand that you have this solution of this sugar, fat and salt added to something that we think is healthy.

GROSS: And it's not like you can say hold the sauce because it's already embedded in the chicken.

Dr. KESSLER: It's - unfortunately it's hold the chicken.

GROSS: Well you actually have a theory about conditioned hyper-eating. That's what you call it. What do you mean by conditioned hyper-eating?

Dr. KESSLER: What the science seems to be showing, and it's still evolving, is that for many of us, many people who are susceptible, highly palatable foods, the foods that we're eating every day now are excessively activating the neurocircuitry of our brain. And for many of us, once we get stimulated, our brains, this neurocirtcuitry doesn't shut off. And the behavior becomes, and this is important, it becomes not only conditioned, but it becomes driven. When it comes, you know, to certain stimuli and certain neurocircuits, not only does it form habits, not only do I learn it, but I become motivated to seek it out. So the behavior becomes conditioned and driven.

You know we used to think it's, you know, it's simply a matter, if you want to control your weight, it's a matter of willpower. No one's given us the tools to be able to deal with it. Diet and exercise, sure it'll work for some period of time. I take you and I put you on a diet. But I don't change your brain circuitry. I get you through the next 30 days, or 60 days, or 90 days, yes you'll lose the weight. But then I put you back in your environment, I can continue to cue you and I've not added any new learning on top of that old learning, and what's going to happen? Of course you're going to gain the weight back.

GROSS: So what are some of your suggestions for effective food rehab?

Dr. KESSLER: There are things I can do just to decrease the amount of stimulation. So don't cue me. You know, take that bread away. I don't want to see that because that's only going to increase the stimulation. Or don't deprive me because if - deprivation's only going to increase the reward value. So taking away the cues, not being primed, decreasing feelings of deprivation, all those can decrease being stimulated. But how realistic is that in our current environment? So, you know, the ultimate goal is to cool down the stimulus. And the way to do that is to want something more. So I can set rules for myself. I can eat in not a chaotic way and say boy, I don't want this now, I'm going to want something better later. So rules work. Structured eating, eating in - in meals. But ultimately is to have what psychologists call a critical perceptual shift. If you look at a huge plate of fries and say wow, that's great. But if you can get to the point of looking at those - that food, that plate of nachos and say boy, what is that? That's just fat on fat on sugar and fat. If you can change what, you know, what scientists call the reward value of the stimulus, then when you are cued by that stimulus, your brain doesn't get stimulated, you don't get activated.

GROSS: What are the ways that you can find out, now, what you are actually putting into your system? If you shop for packaged food in a super market, it's going to say on the label what the ingredients are, how many calories are in it, how many fat calories are in it. And you could actually have a, you know, what you can assume, I think, is an accurate breakdown of what you are going to be eating. You are partly responsible for that, aren't you, those labels, when you are FDA commissioner?

Dr. KESSLER: We are partly responsible for that. In fact one of the people I was interviewing in the book, in the food industry said, you know, Kessler this is all your fault…

(Soundbite of laughter)

Dr. KESSLER: …because you are pretty effective in putting on processed foods, the food label. But where did this go? You know, once you got that under control, where did this go? It went to restaurants and that -there was no food label.

GROSS: Would you like to see food labels in restaurants so that when we ate a cheeseburger or a nacho that we would have the same information we would get if we bought it in a super market?

Dr. KESSLER: I think disclosure is very important. But it's also important to understand that eating has to be pleasurable. It has to be rewarding. But we have to adjust, and I think what's critical, is we need to change how America looks at food. Now - the plain hamburger may be fine. I'm not here to give nutrition advice. And some of my colleagues will disagree with me. But, you know, a hamburger - four or five hundred calories at a meal, you know, I don't have a lot of problems with that. It's when that hamburger has layers upon layers, you know, of bacon and cheese and dressings and you take that four and five hundred calories and you make it eight hundred or 1200 or 1500 calories. That's where I think the damage is being done.

GROSS: What are your concerns about children who grow up with this highly fat, sugar, salt kind of fast food. And that's their normal. That's what - that's the kind of zest-up food that they think is normal food. And that's the way their compass is set when they desire food.

Dr. KESSLER: As a pediatrician that gives me the greatest concern. Because I now understand, that once you lay down that neural circuitry, that gets activated by this highly palatable food - you lay down that learning, that learning stays with you for a life. And we have children now - three, four, five years of age - who are eating constantly all day: fat, sugar and salt. They have never been hungry for a moment in their lives. If you look at the science, what we used to see, was that children at ages two and three and four used to compensate for the eating. Which meant, if I gave them more calories at one meal, they would eat less later on in the day.

Now by giving them this highly palatable rewarding food, they've lost the ability to compensate. The reward circuits of their brain have taken over any of the homeostatic mechanisms that allow them to control their eating in the first place.

GROSS: Well I can hear some people are thinking is now he is going to recommend that the government regulate McDonald's or regulate T.G.I. Friday's. Do we want the government being in the kitchen with the chef?

Dr. KESSLER: If you look at the great public health successes, if you look at tobacco, if you look at seatbelt - how did we win those battles? Sure there's a role for government, I mean, in part. But in the end what do we do? We changed the way we look at tobacco. We changed the way - I get in the car and I don't feel normal unless I put on that seatbelt. So yes, government has a role, the industry has a role, we as consumers have a role. But the first thing is we have to change how we look at food and this is about our relationship with food. It's not simply a matter of government regulation.

GROSS: David Kessler, thank you so much for talking with us.

Dr. KESSLER: Thank you.

GROSS: David Kessler is a former FDA commissioner. His new book is called, "The End of Overeating." Coming up, our critic-at-large John Powers recommends the Starz series "Party Down." It's about to end but there is still ways of watching it. This is FRESH AIR.

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