By: Judson Brewer
I recently released an app designed to help people quit smoking. While testing it, one woman reported that she’d cut down on her snacking. Cutting down on snacking while quitting smoking…this wasn’t something one usually hears, and it threw me for a loop.
Most of us who overeat from time to time probably don’t think of it as an addictive behavior. I was surprised, too, when I discovered the link in the brain between cigarette smoking (for example) and overeating.
It was like a light bulb came on. Of course, I’m a scientist, researcher and addiction psychiatrist who studies the brain, so I’m always looking for connections to help me understand why we become addicted to certain behaviors. What was the connection?
Our brains are set up to learn. From an evolutionary perspective, when we come upon a good source of food or water, it is helpful to remember where it is. When we discover something dangerous, that memory is helpful too. And this reward-based learning system (and addictive loop) in its most basic form has three elements: trigger, behavior, reward. We see berries, we eat them, and if they taste good, we lay down a memory to come back for more.
Fast forward to the modern day, where food is plentiful, yet our brains still have the same reward-based learning system. Under the names of positive and negative reinforcement, a lot more is known about how this system works. This is the good news. The bad news is that over time, when we learn to pair triggers that aren’t hunger-based with the same dopamine “hit” that we get from eating sugar, we get into a pile of trouble. For example, if we like chocolate, yet are feeling lonely or stressed, our brain might say to us, “hey, why don’t you eat some chocolate, you’ll feel better.” We eat the sweet, and learn that if we’re mad or sad, we just need to eat some chocolate (or whatever our sugar fix is) and we’ll feel better. No wonder obesity is one of the leading causes of morbidity in the US—the food industry has tapped into our addiction circuits with the cry, “comfort food to the rescue!”
Treatments such as cognitive behavioral therapy are thought to act through the part of our brain called the prefrontal cortex—involved in reasoning, planning and “top down” cognitive control in general. When we know we shouldn’t eat that second helping of cake, this is the part of the brain that helps us control that urge. Unfortunately, like the rest of the body, the prefrontal cortex is subject to fatigue. As the HALT acronym predicts, when we are Hungry, Angry, Lonely, or Tired, we are more susceptible to all of our habits, set up courtesy of reward-based learning. This may be because, as the youngest part of the brain from an evolutionary standpoint, the prefrontal cortex is the first brain region to go “offline” when we are stressed or otherwise depleted.
If we can’t rely on our prefrontal cortex, are there other ways to change our behaviors?
Interestingly, mindfulness training seems to be emerging as a possible solution. Mindfulness helps us pay careful attention to our cravings, such that we can see what they are made up of—thoughts and body sensations. Importantly, with this awareness, we can notice cravings as they arise, see how they change from moment to moment (instead of lasting “forever” as some of my patients have described). As a result, we can stay with them and ride them out instead of getting crushed by them.
My lab has developed mindfulness training programs for a number of addictions. For example, we found that our program was five times better than gold standard treatment in helping people quit smoking. And several years ago, when we were developing our app-based version of the smoking program (Craving to Quit), with the strange comment that our pilot tester made about reducing her snacking, I started putting together our stress-eating program. Because the habit loop is the same as with other addictions, we can use the same mindfulness techniques to help people change their relationship to eating.
In fact, we’re now testing an app-based program called Eat Right Now, that gives daily bite-sized mindfulness training that helps us get out of our unhealthy habits of stress and emotional eating. Through videos, animations, and in the moment exercises, people learn the difference between stress and hunger, and also learn how to not feed the habit of stress eating. We pair this with an online community and a weekly live web-based check in. These elements are important because unlike traditional diet programs, we don’t encourage people to force themselves to restrict their food intake. We simply help them see what rewards they’ve learned to associate with emotional eating, and change their relationship to it. So it is helpful for members of the program to be able to ask questions, and get guidance about the seemingly paradoxical nature of how mindfulness can help them step out of their old habit loop of eating. One bite at a time.
For more information of Eat Right Now, please visit goeatrightnow.com