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Health Information Under the Microscope: Focusing on the Brain to Shrink Waistlines

Weight management can be a constant struggle for people dealing with obesity, and the challenge isn't likely to get any easier with the holidays and their lavish meals fast approaching. Often, people who overindulge feel guilty about not having enough willpower to avoid excessive portions or second servings.

But research conducted by behavioral experts at Rush University Medical Center finds that weight management goes beyond simply fighting the urge to eat. The research, led by Brad Appelhans, PhD, clinical psychologist and obesity researcher at the Rush University Prevention Center, supports a new counseling approach that views obesity and eating behavior as a result of the way our brains respond when faced with pleasures such as food.

"Typically, overweight and obese patients receive education about how their diet contributes to weight gain to weight gain, and they are simply encouraged to fight the powerful urge to eat delicious foods," says Appelhans, whose research is featured in the August issue of the Journal of the American Dietetic Association. "Yet we know this approach rarely works. Even highly motivated and informed patients struggle to stay away from tasty foods that are high in sugar, salt and unhealthy fats."

Food for Thought
Appelhans has found that the following three biobehavioral processes — the interaction between a person's behavior and biological processes — are consistently related to overeating and obesity:
  • Food reward. The dopamine system, a neural pathway in the brain, is involved in the pathway in the brain known as the reward circuit. Food reward includes both the pleasure received from eating and the drive to consume tasty food. People with altered dopamine systems have stronger cravings for sweet and fatty food. That drive, coupled with easy access to high-calorie snacks, makes these people in particular highly vulnerable to overeating and weight gain.
  • Inhibitory control. The ability to suppress or inhibit urges to eat high-calorie foods is largely controlled by the brain’s prefrontal cortex, which is considered critical for self-control, planning and goal-directed behavior.
  • Time discounting. This is the human tendency to devalue delayed rewards. For example, most of us would rather receive $200 today than $300 a year from now. In the case of eating, it leads to the low success rates of usual diets.

Based on those factors, Appelhans offers some strategies that can help:

  • Remove tempting foods from your home. This prevents activation of the brain’s dopamine system and reduces your risk of overeating.
  • Shop with a grocery list or using online grocers to inhibit the urge to buy unhealthy food.
  • Practice stress-management techniques, since stress promotes overeating and obesity by creating the desire to reward yourself and your dopamine system with unhealthy food. Stress also disrupts the your brain's ability to inhibit overeating.
  • As often as possible, avoid situations such as buffets and restaurants that present more opportunities to overeat and eat foods that are high in calories.
  • Focus on achieving short-term goals, such as cooking a healthy dinner three nights a week, rather than focusing on long-term weight loss goals. The immediate satisfaction you get from meeting short-term goals will help you sustain your motivation as you pursue the ultimate long-term goal of weight loss.

"Obesity is heavily influenced by genetics, as well as environmental factors such as what you decide to stock in your kitchen," Appelhans says. "Though we can't change our biology, counselors can help patients control their weight by making environmental changes that help the brain reduce overeating. This is a big shift in thinking from the typical approach of simply encouraging patients to ignore or fight food cravings."


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Please note: All physicians featured in Discover Rush Online are on the medical faculty of Rush University Medical Center. Some of the physicians featured are in private practice and, as independent practitioners, are not agents or employees of Rush University Medical Center.  

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