Why We Cannot Stop Over Eating

Diabetes does not lack for challenges. However, one of the most pervasive problems of this disease is the way in which it interacts with – is central to – our food habits. For both Type 1 and Type 2 diabetics, the simple choice of what and how much to eat affects everything. Our blood glucose levels, our medication dosages, our exercise regimens. What we eat affects everything.

There’s something mysterious about our relationship with food. You’ve felt it. While we can sit down and manage our blood sugar logbooks and insulin dosages, planning and regulating meals does not work in the same way. It can for a few weeks or a couple of months, but food has a power that goes beyond rational thought.

Truly changing what and how we eat doesn’t just take commitment. It seems to take the kind of religious fervor.

The significant questions

The question we need to answer is why. We’ve all known people who commit to regularly exercising, and that can stick. We’ve all known people who make various changes to their lives – reading one great work of literature each month, for example – and succeeded. Why does diet seem so different?

Why is eating right and keeping weight off always presented in such a simplistic way? Most of the mainstream opinion on the topic says that we gain weight when we eat too many calories. Period. If we eat fewer calories, or burn them off through vigorous exercise, then we’ll lose weight. No muss and no fuss.

We’Ve seen the numbers of obese and overweight people skyrocket across this country. We’ve seen cases of Type 2 diabetes increase. So the figures are inevitably alarming: Obesity rates have tripled since the 1960s. By 2020, treating diabetes will cost a half trillion dollars each year. In six years, for those of you keeping track.

Why is this? If weight and diet can be solved so simply, why aren’t we addressing them? If everyone knows why we get fat, why do so many people continue to get fat?

A path toward answers

Researchers David S. Ludwig and Mark I. Friedman offer some ways to address those questions in a piece published in the Sunday Review of the New York Times last month.

They suggest that these issues confound us because the simple answers we’ve believed for so long are fundamentally incorrect. In other words, a calorie is not just a calorie, and simply reducing the number of them we consume will not necessarily lead to healthy weight loss.

Instead, Ludwig and Friedman write, it is an increase in carbohydrate consumption over the last 40 years or so that is to blame. As more and more simple carbohydrates – sugars, – were added to our diets, insulin production was stimulated, and people gained weight. (For some, this extra production can lead to insulin resistance and Type 2 diabetes.)

As people gain weight, the way in which their bodies handle food changes. Our bodies’ relationship with food is reprogrammed.

The authors put it this way: “By this way of thinking, the increasing amount and processing of carbohydrates in the American diet has increased insulin levels, put fat cells into storage overdrive and elicited obesity-promoting biological responses in a large number of people. “

Calories get trapped in our fat cells, which makes us more likely to eat even more to supply our bodies with energy. More of those calories become trapped in our fat, we want to eat even more, and the cycle continues. We keep gaining weight, and attempts to cut calorie consumption is doomed to fail because we keep using a high carbohydrate eating plan that stimulates insulin production.

Why did we start eating like this? The authors point out that a fat has twice as many calories as carbohydrates, so scientists thought that reducing our fat intake was the simplest way to reduce calorie consumption. In the 1970’s, food companies followed the scientists’ lead and swapped out fat for sugars. Waistlines soon swelled.

Where do we go from here

For years, low- and lower-carbohydrate diet advocates were dismissed by the scientific and media community. Many public health assumptions have been tweaked or fallen by the wayside. Fat is no longer an inevitable villain. Simple carbohydrates are treated much more cautiously. So more attention has been paid to sugar in all its destructive forms.

However, that added nuance has not translated into a clear path forward for the general public and those who give them advice. While we have compelling theories and some highly suggestive science, much experimental work remains to be done on the connection between carbohydrates and obesity.

In the Times, the authors wrote: “Existing research cannot provide a definitive test of our hypothesis. Several prominent clinical trials reported no difference in weight loss when comparing diets were purportedly differing in protein, carbohydrate and fat. However, these trials had significant limitations; in the end, subjects reported that they had not met the targets for complying with the prescribed diets.”

“There are better ways to do this research. Studies should provide participants with at least some of their food, to make it easier for them to stick to the diets. Two studies did this – one by the Direct Group in 2008 and the other by the Diogenes Project in 2010 – reported substantial benefits associated with the reduction of rapidly digestible carbohydrate compared with conventional diets. We need to invest much more in this research.”

They then point out that, given the economic burden of obesity and diabetes treatment, such research would be a wise public health strategy. A simple and clear message is needed. One which has the weight of high-quality science behind it.

Putting it in perspective

No one wants to be fat. There is no media pressure for people to pack on the pounds, and precious few cases where tabloids praise hefty celebrities for their size. Indeed, the public as a whole scores people who have problems with their weight.

In other words, we cannot think about or treat obesity like any other public health issue. It is intrinsically different. Smoking was glamorized through countless films and pictures of celebrities with cigarettes. Alcohol and drug abuse has likewise been winked at – or outright endorsed. People do not say that people would be happier, sexier and better at their jobs if they just weighed 50 pounds more.

Fighting obesity and its complications, then, is not as simple as fighting smoking or drug abuse. Such as telling people a particular behavior can kill them. Eating too much is bad for you, starving is scarcely better. There is no healthy balance to be achieved with cigarettes or highly addictive narcotics, but we have to find such a balance with what we eat.

For diabetics, there is little hope of a natural, easy life with food. We will always be on the alert, even when we are stopping by a fast food restaurant or eating a bag of potato chips. We cannot trust how our bodies and blood sugars will react.

Perhaps, though, we can hope to respect what we eat and respect ourselves in the process. If we understand how food affects us, how carbohydrates and fats and proteins act on our bodies, then we can make the right choices for the long term.