Stanhope explains that all fructose and glucose molecules get delivered directly from the digestive system to the liver. Most of the glucose molecules bypass the liver, because glucose use by the liver is controlled by an enzyme which shuts down when the liver does not need energy. (Glucose, a simple sugar that the body makes when it digests carbohydrates, provides our primary source of fuel.) Therefore, most of the glucose in the drinks sweetened with glucose ended up being used by muscle, brain, and body fat for energy. In contrast, most of the fructose in the drinks sweetened with fructose ended up in the liver. That’s because, says Stanhope, “the enzyme that controls fructose use by the liver never shuts down. It efficiently starts processing all the available fructose molecules, which allows the liver to keep bringing more fructose molecules in. The liver has to do something with all this fructose, so it starts turning some of it into fat for later use. Some of this fat gets sent out in the blood where it increases risk factors for cardiovascular disease.”
Lewis Cantley, a Harvard professor and head of the Cancer Center at Beth Israel Deaconess Medical Center in Boston, is another scientist very worried about sugar, especially its potential link to cancer. His theory is that when we eat or drink sugar, it causes insulin to spike, which may help fuel the growth of certain cancers, including breast and colon cancer. Dr. Cantley is so convinced of the connection that he has practically eliminated sugar from his diet. “I can remember when I was a kid the thought of eating bars and bars of candy was just absolutely fantastic. And now, if somebody offers me something sweet, I might take a bite of it to be polite but I would never finish it.
“I think the problem is a lot of people get addicted to sugar,” he adds. Indeed, he thinks the dependency may be strong enough that people need to move slowly to break the hold. “If you take sugar out of your diet, maybe it has to be done gradually.”
So we’ve got a weight problem in this country, and the same foods that are making us fat are also causing serious diseases. What are the solutions? I think it’s safe to say that some combination of personal responsibility, education, and changing the food environment in this country offers our best hope. “At the end of the day, what each of us does with our feet and our forks is up to us, and so we do have to share in the responsibility for the solution,” said David Katz. “Most of us who manage to be thin are working really hard to make it so, and have a skill set that the rest of the world doesn’t have.”
I totally agree with that. I’ve found an incredible amount of inspiration, smart advice, and new skills from the friends, colleagues, nutritionists, scientists, and other experts dealing with food issues whom Diane and I spoke with as we were writing this book. But making the commitment to get to a healthy thin is a lot harder if we don’t know what’s in our food. So one very important public health step is to require more informative food labels in both supermarket and restaurant foods, including a clear indication of how much sugar is added.
As an illustration, Stanhope points to the label on a yogurt container. “I think the time has come for the companies to have to say ‘added sugar’ versus ‘total sugar’ on the container, so we can differentiate between the sugar that is in the fruit or the milk, and the sugar that is added in the processing,” she says.
That’s just one example of the big-picture solutions Diane and I discuss later in this book. We can’t hope to get on the right track as individuals until we get on the right track as a nation. We need smarter policies and healthier communities if we are going to really solve our problems with food and weight.
CHAPTER FIVE
FIGHTING THE FOOD DEMONS
MY STORY, WITH JOE SCARBOROUGH,
DR. NANCY SNYDERMAN, FRANK BRUNI
With Americans living in a food carnival and eating foods that may have addictive properties, it shouldn’t be a surprise that so many of us have eating disorders. Many of these disorders lead to obesity, while others help us keep our weight down, but not in a healthy way, as I know all too well.
When I set out to write this book, I thought I was writing about problems that were in the past. In recent years, I have managed to maintain my tight grip of control most of the time. But now, at Diane’s insistence, I am trying to release a little bit of that control and settle at a slightly higher weight. My goal is to develop a more relaxed attitude toward food so that I do not have to live at two extremes: feeling hungry most of the time and bingeing occasionally. It’s hard, and the truth is that acknowledging my struggles with food has uncovered some bad influences and feelings that leave me on the edge of reverting to old, unhealthy behaviors.
Joe Scarborough tells another story about me, and it’s one that I hate, because it’s so embarrassing. But I’m in “tell-all mode” here, so I won’t hide it. This one happened when we were traveling. We do that a lot, broadcasting the show from around the country. We tend to have especially long days when we are out of town. Generally it means getting up even earlier than usual, in another time zone, and staying up late to attend events and meet people.
Joe says, “We were at a luncheon for about five hundred people in California, and I took one bite of the meal and thought, that’s not worth the calories. I looked over at Mika, and this skinny woman who I had assumed just didn’t like food, had in thirty seconds devoured the entire plate—the chicken cordon bleu, the sauce, the fries, everything. She probably inhaled about thirty-five hundred to four thousand calories in thirty seconds.”
Joe watched in amazement as I pressed my fingers onto the plate trying to get the last of the crumbs. Moments later, we were onstage in front of five hundred people! Later, he said to me, “I can’t believe you ate that.” I was horrified, too, but it really helped Joe understand why I work so hard to hold myself back. “It hit me that she was struggling every single day of her life to not do what I would do, which is eat when I was hungry. She lived hungry all the time. Every six months or so when she was just exhausted and her defenses were completely knocked down, she would, without thinking, just start eating like the rest of us, except even more ravenously.”
It hit me that she was struggling every single day of her life . . . She lived hungry all the time.
—Joe Scarborough
Another story still shocks both me and my husband. I had taken an Ambien one night to get to sleep. With my crazy schedule, I need to do that sometimes. The drug can increase the likelihood of sleepwalking, and that’s what I did—down two flights of steep stairs from the bedroom and right into the kitchen. Jim told me what happened next. He thought I was coming down to get a snack because I couldn’t sleep. I said hi to him, and then I went into the pantry and opened this big jar of Nutella.
Nutella is made from hazelnuts, skim milk, and cocoa, and it’s meant to be spread on bread. I love, love, love it. Really, it’s my favorite thing in the world. Never mind that a couple of tablespoons have as many calories, fat, and sugar as a Three Musketeers bar. Never mind that consumers have filed a class action suit against the manufacturer, saying they were misled into thinking Nutella was a healthy breakfast for their kids to spread on toast. I wasn’t thinking about any of that when I reached into a drawer and grabbed a spoon. In the next moment, I began devouring it as if I was the hungriest person on earth.
Then I seemed to say “the hell with that,” as I put down the spoon and reached into the jar with my hand, scooping out the Nutella again and again, then licking it off my fingers. Pretty soon, the stuff was all over my face. I dipped in one hand, then both, again and again. As the Nutella spread up my arm, I licked it off there, too. After I finished the entire contents of the jar I calmly went back upstairs to bed.
The next morning I woke up, took a shower, and went to work, with no memory of the Nutella raid. When I got home that evening and saw Jim, he was like “whoa” and I’m like “what?” And he says, “Nutella?” and when I looked totally confused he said, “Oh my, you must have been eating on Ambien.” Then I kind of remembered. I thought I had just been dreaming about eating
Nutella, but I had actually done this in the kitchen in front of Jim!
To me, Ambien is almost like a truth serum. It frees you of inhibitions, allowing you to give in to temptations you are usually able to resist. The Nutella night revealed the intensity of my ongoing eating issues.
That kind of behavior is obviously unhealthy, and I pray that my daughters will not be as consumed by food as I have been. Throughout my school years and the early days of my career, I was aware that other people also had food issues. But frankly, I didn’t talk to them about their issues, or about my own. It took me a long time to see my own eating disorder as part of a larger picture, one experienced by many other successful people. As I became more aware of that, I recognized how important it is for all of us to share stories about our own battles with food demons, so we can help one another replace shame with support.
Maybe because Diane and I decided to go public with our struggles, a lot of well-known people have been willing to talk very candidly to us about theirs. While we were researching this book, we were both amazed to learn how common many of those stories really are. Sometimes, they are linked to coping with a terribly traumatic event. Dr. Nancy Snyderman understands that as well as anyone.
Nancy weighed 135 pounds when she entered college, just as Diane did. It was a reasonable weight for women at their height, which was about five feet eight inches. Not skinny, but healthy. She told us what happened to her near the end of her freshman year at Indiana University. “My roommate was working late on a really hard calculus problem, and she was getting help from the residential advisor. I remember saying, ‘I’m going to bed, but I’ll leave the door unlocked.’
“An itinerant was hanging around the dorm. He slipped in the front door behind a student who wasn’t paying attention when she came in. Then he went down the hall turning doorknobs. And mine was unlocked. He raped me, and the next thing you know, I’m wandering around campus in the wee hours of morning totally disoriented.”
It was 1971, and rape was mostly hidden from view. The campus police took Nancy back to her dorm room, where she took a shower, got dressed, and went to class. “There was no counseling, no talking about it, no nothing, so I turned to food. Food was my savior. I suspect that if you talk to a lot of women who have some kind of traumatic event in their lives, you’ll find they turned to food for comfort. I found great solace in it.”
I suspect that if you talk to a lot of women who have some kind of traumatic event in their lives, you’ll find they turned to food for comfort.
—Dr. Nancy Snyderman
It didn’t take long for Nancy to put on fifty pounds, her way of trying to disappear from view. It took her a lot longer, almost twenty years, to lose the weight. “Learning to like me was the same path as learning to be healthy; it was the same path as rediscovering my self-esteem,” she says. “Going off to fat camp didn’t help; depriving me of food didn’t help. All it did was make me put food under my bed. I would order salad when I was out in public, and I would sneak the potato chips afterwards.
“Every person who has a food issue figures out how to game the system. I don’t care if you’re anorexic, you’re bulimic, you’re a hoarder—it doesn’t matter if that’s what you want to do. But the only person you hurt when it comes to food is you.”
Frank Bruni, now an op-ed columnist for the New York Times, is another person who initially kept his history of eating disorders secret, later making them public in his memoir, Born Round: The Secret History of a Full-Time Eater. Before becoming a columnist, Frank was the newspaper’s chief restaurant critic for five years. Being a “professional eater” was a curious job for a man who acknowledged to Diane and me that he was a “baby bulimic.”
In a telephone interview (ironically, conducted while his refrigerator was being repaired), Frank talked about his earliest experiences with food. “It was really more about how huge my appetite was. I was about two years old, and my mother wouldn’t give me a third hamburger. I got so upset that I threw up.” Frank told that story for two reasons: to illustrate his belief that some people are hardwired to be big eaters and “because it is a kind of odd, quirky bit of foreshadowing, since when I was in college there was a period when I was an actual bulimic.” Like Diane, Frank tried “pretty much every diet you can imagine, including juice fasts and eating nothing but fruit for days at a time.”
He, too, tried the Atkins Diet time after time, but it rarely helped him lose any weight. “It was a chronic dieter’s behavior, where you ignore evidence and keep engaging in ‘magical thinking.’ It would do nothing for me, because I think for that diet to really work, it’s betting on you becoming so bored with the monochromatic eating regimen that you won’t consume that many calories,” Frank explained. The diet does not require calorie counting, allowing you to eat as much of the acceptable foods as you want. “I love meat and eggs, and ate so much of them that it didn’t work for me.”
Frank turned to bulimia in college in a desperate attempt to be thin without feeling deprived. “One of the things I found so seductive about bulimia was that I didn’t have the same sense of panic or sacrifice at the beginning of every meal,” he recalls. “I thought, if my willpower fails me, I have this safety valve of throwing up what I ate and the calories won’t stick with me.”
Frank’s reliance on bulimia didn’t last long, but his struggle for weight control certainly did. One of his hardest times came when he was covering George W. Bush’s race to the White House. He was surrounded by food on the campaign trail, and very little of it was nutritious. “Every single meal was some sort of buffet or a bunch of stuff being thrown at us on the campaign plane,” he recalls. “Some days it was just a constant level of fairly abundant eating, and then some days it was stress-induced binge eating after a really, really grueling day. I would feel almost like a drug addict’s desire for a blast of pleasure and a release. I would sit down in front of my hotel minibar and eat the peanuts, then the Oreos and then the Pringles. Before you knew it, I’d eaten every stupid snack in that minibar.”
Frank tipped the scales at 275 pounds. In those days, he recalls, he would allow himself to overeat “because I would tell myself the lie that tomorrow I was going to go on a diet, or the next day I was going to fast. I would end up giving myself permission in the moment to overeat.”
I would tell myself the lie that tomorrow I was going to go on a diet, or the next day I was going to fast. I would end up giving myself permission in the moment to overeat.—Frank Bruni
Eventually, Frank learned the secrets to good eating that helped him break the constant cycle of dieting and weight gain. He lost eighty pounds, in part by redefining appropriate portion sizes, and he has kept that weight off. Gaining control over his schedule was key for him, because it gave him time to cook healthier foods and to exercise rigorously.
When the Times offered him the job as restaurant critic, Frank thought long and hard before accepting it, concerned about the potential impact on his weight. Ultimately, he decided he would be able to eat with enough restraint when he was not working that he could stay “on the straight and narrow.” Ironically, he actually gained some weight after his stint as critic ended.
Like me, Frank has not entirely conquered his food demons. “I still have a somewhat compulsive relationship with eating. I mean, the desire to overeat comes along with some frequency. I’m not a slave to it, as I once was, but I still have to struggle with it, and sometimes I lose the struggle.”
The link between eating disorders and obesity is getting more attention from scientists. For a long time they were considered distinct. Conditions like bulimia and anorexia were viewed primarily as psychological issues, while overweight and obesity were viewed as either genetic or metabolic problems, or as failure to take personal responsibility. But now we are starting to understand that there is a lot of overlap, characterized by an all-consuming focus on weight and food.
This is where my story of food obsession and Diane’s tale of fighting fat conv
erge. Both of us spend an incredible amount of time focused on food. In Diane’s case, she has lost weight, gained it back, and started all over again, virtually her entire life. In my case, I have been so terrified of that loss of control that I have resisted even weight gain that would be good for me. I would be healthier and more at peace if I weighed 135 pounds instead of 125, but I’m afraid that I won’t stop there and the weight will keep on climbing. So I sacrifice and I suffer and I’m hungry a lot. What a waste of mental and physical energy for both of us. “At least your obsession with food helps you keep the weight off—mine doesn’t,” Diane told me with frustration. She may be right, but it is still not healthy. One problem is that being so thin really gets rewarded. When I’m at my thinnest, I have everyone in the world telling me how great I look. Companies send me clothes to wear, and I can’t believe how attractive they are. I feel like a model. Women say to me, “You’re amazing, look how good you look!”
That kind of praise drives me to keep my weight way down. It’s hard not to enjoy so much reinforcement from the outside world. Culture is a very powerful force. Ever since I was a kid, I studied the landscape and I saw how things went for women—prettier and thinner equals success. Diane gets really annoyed when I say this. She thinks I am too willing to accept a culture where women are valued most for their looks. I agree with her that it shouldn’t be that way, but it is, and that’s a fact.
But I am finally realizing that trying to be extremely thin is like trying to collect water in a sieve. It just doesn’t work. I have to come to terms with that. And when I hit the scales at 118, or even 125, that is just not healthy for me. I have more work to do if I am going to reach 135 pounds and still feel good about myself.
Obsessed: America's Food Addiction Page 10
