018 Why Diets Fail: An Interview with Nicole Avena, PhD

by reeger on February 9, 2014

Why Diets Fail: An interview with Nicole M. Avena, PhDNicole-Avena-PhD-2013

Dr Nicole Avena is a world-renowned neuroscientist and expert in diet, nutrition, and addiction. She received her doctorate in neuroscience and psychology from Princeton University and did her postdoctoral fellowship at the Rockefeller University in New York. She is currently a faculty member at the New York Obesity Research Center, Columbia University, St Luke’s-Roosevelt Hospital, New York..

Dr Avena, along with co-author, John R. Talbott, has a newly released book:
Why Diets Fail. The book has two tag lines “Because You’re Addicted to Sugar” and “Science Explains How to End Cravings, Lose Weight, and Get Healthy.”

In this episode Dr Avena briefly explains how the book came to be and then we dive right into the book and the pivotal question, why do diets fail? We go over:

Our Biologic imperative to eat pleasurable foods Modern Food Landscape: The ease with which we can obtain food.
Serving Sizes
Food-Reward overlap
Food Industry
Processing of food
Variety of Choices
Food Addiction which is both Psychological and Physiological.
Sugar, Sugar, and more Sugar is found in both obviously sugary foods and hidden in many foods where you would not expect to find it, standard Ketchup is a classic example of a food that has sugar high up in the ingredients list but is not every considered to be a sugar-flavored food.

When we over eat highly processed foods, especially sugary foods, Dopamine and other neurotransmitters are released (for further detail on the “other neurotransmitters” I refer you to Dr Avena’s book). Why care about Dopamine and similar neurotransmitters? Because they are responsible for giving us feelings of pleasure, reward, and attentiveness in our brains. In others words, we like how we feel when our brain releases Dopamine and the other neurotransmitters.  These neurotransmitters are also released when a person consumes a drug of abuse (nicotine, alcohol, cocaine, etc).

After consumption of the sugary food or the drug of abuse, our body goes to work metabolizing what we have consumed. During this metabolism Dopamine and the other neurotransmitter levels fall. Our brain is not as happy then, our body energy falls, and we can even go through symptoms of withdrawal. The withdrawal is unpleasant to experience. As a consequence of the unpleasant withdrawal symptoms we seek out relief, usually found by consuming whatever it was that caused Dopamine’s relief to begin with. And so, you can see how a vicious cycle repeats itself, year after year.

SYMPTOMS OF ADDICTION: Tolerance > Withdrawal > Using more or using for a longer time than intended> Intention to or failed attempts to limit or quit > Excessive time dedicated to getting, using, or recovering from use > Social or work consequences due to use > Use regardless of consequences > Tolerance

CYCLE OF ADDICTION: Anticipation/Craving > Binge/Tolerance/Intoxication > Withdrawal/Negative Effect > Anticipation/Craving

ADDICTIVE NATURE: Some people are more prone to addictions than others.
TRANSFER ADDICTION: People addicted to one substance may be more prone to become addicted to something else. This issue is very real and warrants attention and awareness by both the person who is addicted to a substance and the people who care for them.
It is very important to note: Not all obesity is caused by addiction, not all people who are addicted to food or sugar are obese, and not all people are addicted to sugar or food in general.

The 5 Phase Plan: 
1) STOP Sugary Beverages: Cold Turkey
2) Eliminate Junk foods
3) Drastically Reduce Carbs
4) Reduce Hidden Sugars
5) Maintain Your New Way of Eating
Sugar Equivalency: Discussed and explained in detail in the book.
Elimination vs Reduction: Know your Kryptonite. People usually know what food item or items result in low self-control (They can’t have only one cookie or one potato chip or one piece of chocolate). In those cases, make that food item or items something you totally eliminate from your food regime.
Calorie Counting is not required 
Exercise is important

Managing Withdrawal: 

  • Symptoms: Fatigue, Irritability, Sadness, Lethargy, Headaches, Strong Cravings, Drowsiness.
  • Keep your eye on the long-term goal/gains, not the temporary pains
  • Ask for Support
  • Hope (and Plan) for the Best, But also plain for the worst.

Managing Cravings: 

  • Understand What You Crave. Page 156 has a suggestions for food alternatives based on Sugary, salty, crunchy, craving model.
  • Understand When and Why you Crave.

Be Aware of Food Cues
Have a Plan
Avoiding a Relapse (and What to Do if One Occurs) 
Dichotomous Thinking Traps: Be aware of “black and white” thinking traps, “I am either a total success or I am complete failure.” “Because I had one cookie, I blew my entire diet, so I might as well have the entire batch of cookies.”
Keep tabs on your emotions and cope accordingly.
Follow a food regime that is tailor-made to you, your lifestyle, and your needs. Make sure your food regime is realistic within your day to day life, not some perfect version of how you would eat if you lived in a bubble.
Remember your goals. Revise them as Needed.

If you relapse: Remember, every day is a Do-Over. Learn from what happened and begin again.
For the Rest of your Life: ADDICTION FREE
1) Apply what you know
2) Take care when dining out 3) Resist Food Pushers
Reduce reward structures around food such as using toys along with purchase of food (Happy Meals)
Reduce using food as a reward system for children (getting food/candy as a prize for behavior or finishing your dinner) 4) Get to the Root of the Problem
5) Eat Because You’re Hungry, Not because you are Happy, or having any other emotions. Physical hunger is the reason to eat, not emotions.
6) Set Short-Term and Long-Term Goals Know yourself Think about the past
Use Positive Phrasing
Make your goals short-term
Look to the Long Term
7) Be Consistent


To PURCHASE Dr Avena’s books follow this link: Why Diets Fail

Nicole Avena, PhD 

The New York Obesity Nutrition Research Center 

Yale Food Addiction Scale 

One more thing: I totally recommend you check out Dr Avena and TEDEd’s Video explaining how sugar affects the brain: 

In Peace and with Connection,

Reeger Cortell, FNP-C

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