By Lyndsey Layton
Washington Post Staff Writer
Monday, April 27, 2009

If anyone noticed the man foraging through the trash, they would have assumed he was a vagrant. Except he was wearing black dress slacks and padded gardening gloves. “I’m surprised he didn’t wear a tie,” his wife said dryly.

The high-octane career path of David A. Kessler, the Harvard-trained doctor, lawyer, medical school dean and former commissioner of the Food and Drug Administration had come to this: nocturnal dumpster diving. Sometimes, he would just reach in. Other times, he would climb in.

It took many of these forays until Kessler emerged with his prize: ingredient labels affixed to empty cardboard boxes that spelled out the fats, salt and sugar used to make the Southwestern Eggrolls, Boneless Shanghai Wings and other dishes served by the nation’s second-largest restaurant chain.

Kessler was on a mission to understand a problem that has vexed him since childhood: why he can’t resist certain foods.

His resulting theory, described in his new book, “The End of Overeating,” is startling. Foods high in fat, salt and sugar alter the brain’s chemistry in ways that compel people to overeat. “Much of the scientific research around overeating has been physiology — what’s going on in our body,” he said. “The real question is what’s going on in our brain.”

The ingredient labels gave Kessler information the restaurant chain declined to provide when he asked for it. At the FDA, Kessler pushed through nutritional labels on foods sold through retail outlets but stopped short of requiring the same for restaurants. Yet if suppliers ship across state lines, as suppliers for Chili’s do, the ingredients must be printed on the box. That is what led Kessler, one of the nation’s leading public health figures, to hang around dumpsters across California.

The labels showed the foods were bathed in salt, fat and sugars, beyond what a diner might expect by reading the menu, Kessler said. The ingredient list for Southwestern Eggrolls mentioned salt eight different times; sugars showed up five times. The “egg rolls,” which are deep-fried in fat, contain chicken that has been chopped up like meatloaf to give it a “melt in the mouth” quality that also makes it faster to eat. By the time a diner has finished this appetizer, she has consumed 910 calories, 57 grams of fat and 1,960 milligrams of sodium.

Instead of satisfying hunger, the salt-fat-sugar combination will stimulate that diner’s brain to crave more, Kessler said. For many, the come-on offered by Lay’s Potato Chips — “Betcha can’t eat just one” — is scientifically accurate. And the food industry manipulates this neurological response, designing foods to induce people to eat more than they should or even want, Kessler found.

His theory, born out in a growing body of scientific research, has implications not just for the increasing number of Americans struggling with obesity but for health providers and policymakers.

“The challenge is how do we explain to America what’s going on — how do we break through and help people understand how their brains have been captured?” he said.

Kessler is best remembered for his investigation of the tobacco industry and attempts to place it under federal regulation while he was FDA commissioner from 1990 to 1997. Although he was appointed by George H.W. Bush, Kessler became popular among Democrats for his tough regulatory stance. He got the nickname “Eliot Knessler” after he authorized the U.S. attorney’s office in Minnesota to seize a large quantity of Citrus Hill Fresh Choice orange juice in 1991 because it was labeled “fresh” when it was, in fact, partially processed. After he was elected in 1992, President Bill Clinton asked Kessler to continue to run the FDA.

Kessler, 57, sees parallels between the tobacco and food industries. Both are manipulating consumer behavior to sell products that can harm health, he said.

Whether government ought to exercise tougher controls over the food industry is going to be the next great debate, especially since much of the advertising is aimed at children, Kessler said.

“The food the industry is selling is much more powerful than we realized,” he said. “I used to think I ate to feel full. Now I know, we have the science that shows, we’re eating to stimulate ourselves. And so the question is what are we going to do about it?”

The idea for the book came seven years ago as Kessler was channel-surfing and came across an overweight woman named Sarah on “The Oprah Winfrey Show.” While Sarah was successful in nearly every aspect of her life, she tearfully told Winfrey, she could not control her eating.

Kessler was mesmerized by Sarah — she was describing his own private struggle. “I needed to not only figure out Sarah — I needed to figure out myself,” he said. “Little did I know it would lead me into real fundamental issues of what makes us human and how our brains are wired.”

At 5-foot-11, Kessler’s weight has swung from 160 pounds to 230 pounds and back, many times over. He owns pants in sizes ranging from 34 to 42.

“I was a fat kid,” he said. “I grew up in the world of Entenmann’s cakes. I was pretty much of a science nerd. If you looked in my refrigerator in college, it was Entenmann’s.”

Every few years, Kessler would go on a diet and apply the kind of discipline that enabled him to earn a law degree from the University of Chicago while attending Harvard Medical School. “I’d lose weight and over time gain it back,” said Kessler, who also completed a medical residency at Johns Hopkins Hospital in Baltimore at the same time he worked as a staffer to Sen. Orrin Hatch. “I couldn’t control it.”

The man who took on Big Tobacco was helpless when confronted with a plate of chocolate chip cookies. He couldn’t focus on anything else until he had eaten them all.

“My weight was yo-yoing all the time,” said Kessler, who estimates that 70 million Americans struggle with conditioned hyper-eating. “And I never understood why.”

He embarked on a mission to figure it out while serving as dean of the medical school at Yale University and later the University of California at San Francisco. UCSF fired Kessler from his position as dean in December after he alleged financial malfeasance at the institution. The university maintains there were no financial misdeeds; Kessler says he was forced out because he blew the whistle. He remains on the faculty at the medical school and lives in San Francisco with his wife, Paulette, a lawyer. They have two grown children, both of whom live in Washington.

Through interviews with scientists, psychologists and food industry insiders, and his own scientific studies and hours spent surreptitiously watching other diners at food courts and restaurants around the country, Kessler said, he finally began to understand why he couldn’t control his eating.

“Highly palatable” foods — those containing fat, sugar and salt — stimulate the brain to release dopamine, the neurotransmitter associated with the pleasure center, he found. In time, the brain gets wired so that dopamine pathways light up at the mere suggestion of the food, such as driving past a fast-food restaurant, and the urge to eat the food grows insistent. Once the food is eaten, the brain releases opioids, which bring emotional relief. Together, dopamine and opioids create a pathway that can activate every time a person is reminded about the particular food. This happens regardless of whether the person is hungry.

Not everyone is vulnerable to “conditioned overeating” — Kessler estimates that about 15 percent of the population is not affected and says more research is needed to understand what makes them immune.

But for those like Kessler, the key to stopping the cycle is to rewire the brain’s response to food — not easy in a culture where unhealthy food and snacks are cheap and plentiful, portions are huge and consumers are bombarded by advertising that links these foods to fun and good times, he said.

Deprivation only heightens the way the brain values the food, which is why dieting doesn’t work, he said.

What’s needed is a perceptual shift, Kessler said. “We did this with cigarettes,” he said. “It used to be sexy and glamorous but now people look at it and say, ‘That’s not my friend, that’s not something I want.’ We need to make a cognitive shift as a country and change the way we look at food. Instead of viewing that huge plate of nachos and fries as a guilty pleasure, we have to . . . look at it and say, ‘That’s not going to make me feel good. In fact, that’s disgusting.’ “

Kessler said he’s made that shift in his own life, eating small portions of foods that contain fat, salt and sugar, part of a “food rehab” plan he suggests in the book. He has certain rules — no french fries, ever — that help him navigate through vulnerable moments.

He has embraced spinning — the first time he has regularly exercised. “I hated physical activity, all of my life, mostly because I was fat and it was hard to do,” he said. “But I just wanted to do something. I picked spinning because you can’t fall off the bike.” He worked with a private trainer for weeks just to be ready to take a class. “I was embarrassed to go into the class,” he said.

Now Kessler tries to spin every day and belongs to multiple health clubs so that he has more options for class times.

He avoids the cues that focus his brain on “highly palatable” foods, going so far as to chart a different route through San Francisco International Airport so that he doesn’t walk past the fried dumpling stand.

Kessler’s weight is relatively stable at 162 pounds. But there’s something else that’s changed. As he has come to better understand himself, the food cravings and the resulting anguish he felt have subsided.

“So I’m at peace,” he said. “After 30 years, I’m at peace.”

I call them the MindMafia because they are an underground group of “people” or voices sharing an organizational structure and code of conduct within you. There is the ego, the protector, the pusher, the child, the mother and father and a whole host of other subpersonalities that control you. And each is an important part of your make up.

In pyschological circles, these subpersonalities have been known for years and there are various methods to attempt to identify, understand and work with these entities. Inspired by a particular method called Voice Dialogue that has been around for over 40 years, I developed the MindMafia Mapping Method as a system for identifying, understanding the roles each of these subpersonalities play, how much control they exert over you and, more importantly, a method for negotiating with each of these “people” to change their roles, if they are willing.

This is extremely powerful work that can change your life in an instant, much like hypnosis. But unlike most hypnotic methods, you are completely awake and aware during the entire process.

My MindMafia includes my ego, vulnerable child, magical child, baron (pusher), guardian, cynic and critic to just name a few. Who comprises your MindMafia?

Before starting the MindMafia session, we explored why he thought he was procrastinating. At first, he thought it was because his father often procrastinated on big projects or because his uncle had modeled it for him. Then he mentioned that it might be fear of success. I could tell he was concerned and grasping at straws to determine why he was unfocused and not making the progress he thought he should be. When we entered the MindMafia session, I asked which part of Andy’s subconscious or psyche was contributing to the procrastination. Immediately, a subpersonality called “success” identified itself. When asked why it was causing Andy to put off working on his films, it responded with, “It is a pacing mechanism.” Then it continued, “He worked himself out of a job at his last company. I want to make sure that he uses his time wisely and doesn’t get ahead of himself. He only has funding for two films, one is completed and the second is almost complete. He needs to work toward the official release date and wait for funds from the sale of the first film before he starts his next.” Indeed, Andy had been let go of his previous position because he created several films for his bosses – enough for a year’s worth of releases and they had a backlog of work to edit, package and distribute.

After the session, we debriefed by exploring what this information meant for Andy and how he could use it to his advantage. Armed with the knowledge that procrastination was helping him to stay on target with a fixed deadline and that it officially is caused by the part of his subconscious most concerned with his success, he can relax and enjoy the time his psyche urges him to procrastinate.

A few weeks later, I spoke with Andy and he said, “Now I don’t feel so bad for ‘pacing’ myself and can use that wasted energy  from “worrying” all of the time into channeling more creativity when I’m focusing on work and have more worry-free fun when I’m procrastinating!”

I look forward to sharing more about the method and how it can help you!

Under the careful guidance of a trained MindMafia Certified Facilitator, a person spatially projects their psyche into a physical location. The facilitator guides the person through a physical mapping process to identify major subpersonality identities and record their roles. This map is then used to understand how life is working for the person and negotiate with the subpersonalities to make quick, powerful and sustainable changes in their lives.

The MindMafia Mapping Method was developed by Michael O. “Coop” Cooper.