yourself. let me give you one other fact. two-year olds. to your notes compensate for their eating. what do i mean by that? if you get a 2-year-old excess calories at launch they're going to eat fewer calories later in the day. bye four quadcore 5:00 after having sugar, fat and salt throughout their toddler lives, four and 5-year-olds, measure the ability to compensate and you can see they've lost the ability. they no longer regulate their intact. you have children that are four and five of never been hungry or have any sense of being hungry any time during the day they eat constantly. it is as if the reward circuits of the brain are being hijacked

and override the ivies homeostatic mechanisms. what is the task? tobacco, great, great leap of 15 years of effort. tobacco is easier? why? because you can live without tobacco. you don't need tobacco. food and we need to live so how are we going to handle it? problem is that all food. we have taken food and process to such an extent, we have processed to such extent it is predigested. we are eating in essence baby food. if you don't believe me, adult beebee phone -- count the number of jews. the average blight 20 years ago was about, you know, about 20 times. today food goes down in a wash, it is so predigested and

processed and what happens when it is predigested it made of fat, sugar, salt it hijacks the brain, and it is in essence self stimulation is what is going on. but is the key? how do we succeed? how did this country succeed over the last 50 years with tobacco? sure, we finally in the next couple of days when is the president going to sign? finally there is going to be legislation. but it wasn't legislation or regulation that started, what has been the success so far, but has been the key ingredient? that has accounted for the success today over the last 50 years? we didn't change the product, the product is the same.

education? well, what was the one thing philip morris and the other companies cared more about the and anything else? mauney? no, image but what about image. what they cared about was the social the acceptability of their product. dak 30, 40 years ago tobacco was a reinforcing substance and it was positively viewed. they need is something you wanted and something that was your friend. that was the key. will was the real change, the real success? what did we collectively do as a country? we changed the reenforcing substance for something that was positively valence to something that was negatively valance. so social acceptability, change the product. social norms have a great deal to do with whether we are going

to approach something. that is my friend i want, or my enemy i'm going to avoid it. where do we have to focus? the problem, i think the problem is very much not only sugar, fat, and salt, but 80 is a big food and i don't just mean the industry. i'm talking literally about big food. the challenge is as hard a public health challenge as we can and ragin. it's not just about office or the woman on oprah. it's about our kids because once you lay down the circuitry, once you fadel the learning the only way to do with this is the downed new learning were circuitry and the fact is we have to be up front all would circuitry never goes away. the greatest gift you can give somebody is to not have the

circuitry that responds constantly to sugar, fat, and salt has been laid down in millions of americans. once you recognize our behavior as a nation is becoming conditioned and driven it's not just of the learning circuits, the motivational habits because of putting sugar fat and salt and that is the result -- that's happening in society. that has profound implications for policy. but as many of you know in this audience, you have not shy away from big tasks before and i will tell you 15 years ago a number of loss when we started had serious doubts whether tobacco was possible and changing and getting a regulation for the fda sometimes, just sometimes things you think are in a possible can

happen. thank you very much. [applause] we have time for some questions? >> first of all, thank you. bravo to everyone in this room that helped block the journey on behalf with recent back to tobacco. a specific question for the future the next steps and kind of time lines concept about when the behavior is in the gereed. now the behavior we know given the diabetes type ii statistics and population contaminated for want of a better word, what about the breaking of the individuation, the demuro network's you mentioned and that if of literature account

relapsed behavior and learning can be taken from some of them related to the addictions being studied now. >> a wonderful question and we could spend an hour, several are worse talking about that question. it's one of two reasons i wrote the book. but the question has a degree of sophistication. you recognize by asking that question that the only way to overcome the past learning that's laying down the circuitry is to lay down new learning on top of that. i joke a little but it's true what's the definition of free have? rehabed is laying down new learning, new circuitry. let's just agree on something, by its are not going to work yes they work in the short term but by its don't work and with great

admiration with carless and barbara in the bookstore, all the books on by yet -- i don't think that there are many and this bookstore but the diets by their very nature can't work. why not? once the near circuitry is laid down can you take 30 days, 60 days, 90 days, and just white knuckle and lose weight? of course. but what's quinn to happen when you finish doing that? and you still have the old nero circuitry. you've laid down new of learning on top of the old learning and go back into your environment and constantly get bombarded with the old queues. it is a fait accompli you're going to get it back. you're only way to deal with this step add new learning, new circuitry. how do you do that? i mean, what is the rehab? what is that process?

because it is not something that you do in a day or even a week. and again, people don't want to hear this because what is the magic pill that's going to work? it's not going to work. why not? because you are involving the learning memory and have it circuits to the brain. and if you start mucking around in those circuits with any pharmacological agent you're not going to be selected just to food, you're going to have significant adverse reactions because let me assure you we need the learning memory of the brain to be able to be -- to survive, to function. understand this is not -- this is not about this order or disease. i thought when i started writing this book i would end up and physiology and nutrition. this is what makes us human. because we are wired to focus on the sating stimuli as human

beings. if a bear who walked in you would stop listening to me i promise. [laughter] if your child is sick, if your child is sick and you're thinking about your child for some people the stimuli may be alcohol, others, and nicotine. some gambling, sex and illegal drugs but for some of us one of the most is food and at the core of the food is sugar, fat, and salt so how do you cool down dustin inglis? and the answer is you have to change how you view the stimulus. if you look at the stimulus and say that's my friend, that's going to make me feel better there's nothing i can do. there is a critical shift you have to undergo to the point where you look at that stimulus and say that's not my friend but how do you get there because he is a way that's got to taste good, i want that and it is going to taste good in the short

run but you have to want something more and have to substitute things you want more. please? >> i am a general internist and been waiting to ask this a long time. i face this every day. diet and exercise, and i figured that we are hard wired to white sugar, fat and salt. sugar when we've all there wasn't very much food. we had to live in a situation of starvation. sugar was the fastest form of energy, that was the most efficient and salt was essential to life and that is where it comes from and why it's those things. >> there are receptiveness in the oral sensory in the mouth and they are linked directly to the reword centers of the brain and that is why they are so powerful. drugs, the kind of drugs we are talking about go through the brain -- bloodstream to the

receptors the pathways that we are talking about, the learning memory motivation and had it circuits of the brain, sugar, fat and salt or why you're in. that is why it was from an evolutionary perspective and that's why they are so powerful. >> we are hard wired. >> we are hard wired to focus on the ceiling and stimuli and fat, sugar, and salt because of the receptors and the learning, but understand it's learning and conditioning that occurs. the 2-year-old regulates. you expose them. if you expose them to sugar, fat and salt they lose the ability to compensate because sugar, fat and salt become especially when you put it on every corner. we have barriers in this country four or five decades ago that protected us. we only eight at meals, we eight

real food. my hat goes off to michael and alice waters. real food. now we are eating to stimulate ourselves and those reward circuits. >> but also to do manual labor and women at home to cook food. we didn't need to eat that food. >> i won't get into the last 1i will stay away from. [laughter] tourists no doubt my grandmother -- desert was sugar but i didn't have it for breakfast, lunch and dinner and throughout the day. that is the change but understand making that available and socially acceptable and adding to the emotional loss of advertising, lagat and add to light on tv it's not about the nutritional value of two. yes it may be the economic value but look what the ad does. it's getting very emotional loss you will want, you will love it, it's the social acceptability to

want this and wants to add the social acceptability or only amplifying and reenforcing circuits and amplifying the brain's response. thanks for being here. >> good afternoon, dr. kessler, thank you for coming. i have a follow-up to your answer to the first question. how do you change the things you tell yourself into a rehab like i don't want to eat this because i will feel bad later on or something similar to something down here where that's the first thing you think of, where you are looking at a picture of chili cheese fries on the menu and you were not thinking i should eat something else because the chili cheese fries will make me feel bad leader and something like this which we all know kids say that gross, i

don't want that, you know, that's more down here and it's fast. saying this which is good, the rehab is good up here but if you want something fast and not just okay i don't want the chili cheese fries because it will make me feel bad but i would rather eat a baked potato because i want that, i want that better here, not just more up here. >> so, the goal scientifically and i know this is not intellectual, it is to avoid that circuitry from being activated. that's the only way you're going to stop eating excessive eating is not to have your brain constantly activated. so there are a lot of his -- sight, smell, location, time of day that will set off the queue

but what is the key for the brain to be activated is the fact past experience, the past wanting, the thoughts of wanting. we did with tobacco by making it a deadly addictive product people didn't want, it cools down the stimulus. now, what's so hard and stimulates the pathways if you have any inner dialogue and ambivalence it's not good for me, that only increases that activation. why -- if you look at alcohol, why has it been so successful? because i am not going to get into the religious aspects, but the fact is it has absolute rules and sometimes that sounds antiintellectual but rules work. i know if you put a huge plate

of royce in front of me i'm going to eat the whole thing. so it is easier for me to have a role that i am not going to be able to do and have it black-and-white. if you know something is impossible and there is no ambivalence your brain isn't going to get activated. if you look at smokers and say it is impossible for you to smoke the next four hours and the brain doesn't it get activated because they know that it's impossible watch a smoker. five never seen a smoker open the emergency exit on a plane and jump out. [laughter] because they know it's impossible and the period of time but watch them toward the end of the flight. that's when the brain becomes activated so if you can develop rules for yourself one of the reasons why plant eating or structure as we talk about helps, if you know you were going to be eating and you are ongoing to allow yourself to eat

all the time them over time all of the queues are going to extinguish and you will never get rid of them entirely. if you were stressed, fatigued, deprived, it will show its head. but to quote on the stimulus you have to not want but it can't be you know, it can't be an ambivalent i don't want it. it has to be i really don't want that and the only when you're going to say i don't want it is to want something more. >> thank you. just a general note and then a question about your time at the fda if you wouldn't mind. i think a lot -- i appreciate you talking abut the symptoms and not just the problems but if i could add a caveat i think a lot of this is about loneliness and foreigners have come and written books about america, [inaudible] robert frank referenced the loneliness and america and i'm

wondering what this is rhetorical, not free to necessarily answer, but in society no other society in history has been founded just on the individual and i think it's the pressure the average american has put on to solve regulate is unheard of in human history including comparing modern day other societies. and having lived outside this country allot over and over again you hear as other societies pick up the fourth and fifth gear lifestyle the fast food -- the value of efficiency versus nurturing human relationships which is usually food brought us together but in this land efficiency value in other words it is a basic biological thing called food as opposed to nurturing part minds, convert mess and a lot of this as pointed out in lectures is the loneliness of society because the individual just

copps all others but i throw that out for something for folks to think about, but you can't underestimate the indoctrination going on as far as the industry and they started this with advertising, promoting smoking, the was calculated but i want to ask on your tenure at the food and drug administration, because in to this issue of obesity, etc., etc., surprised you never mentioned the other profiteers in the drug and is a drug pushing industry, let's call it what it is, is the other drugs as much as you seafood advertise on television is a big forma product and i am thinking specifically about the one that killed tens of thousands primarily women in the country. no one went to jail but if it was an inner city or some person

hillbilly shooting thousands of people as this american home product did no one was held accountable and people are still dying as a consequence primarily due to pulmonary hypertension. you were at the fda at the time of this fall out and i would like to hear what you have to say. >> very eloquently said. a lot of different points. on the first point, on the loneliness, and why -- one of the things that triggers, understand with food food is a very powerful stimulant. it is a reward and how we use the word reward, the great telemental psychologist defines

reword as something that will change how you feel. so because food is why your into the real board pathways, the learning and motivational circuits it can change how we feel such a powerful stimulus and there is no doubt that million sophos, i think the vast majority are using food to self medicaid because when you are in this cycle what happens it to a? of the thoughts of wanting and this will taste good captures your attention and occupies working memory and when that happens in essence to regulate emotional level. and when you use it like that that is part -- that's because

you're stimulating this reward pathway doing it over and over again. the comments i think are especially important. there's a chapter in the book and i put the chapter in the book. it worked directly on the report circuits. fincen is for [inaudible] in this amphetamine like compound that's been around 30 years. it affects the serotonin levels. understand these drugs are affecting the circuits to make us human. i think as we have this evidence that this overheating is the result of excessive stimulation, drugs that mess around in those circuits are going to by their very nature affect important

human circuits and they are going to affect intelligence and memory and psychiatric symptoms and i think we are learning that and i think we are smarter today than we were. i think it is going to be very hard, if not impossible once you understand eating is the result of stimulation and we need the circuits for of the defense to find something selective for just food, and i think that is -- i don't think it's going to work and i think the agency is becoming much smarter and much more skeptical certainly when -- fees' ar circuits that involve what makes us human. we need the circuits and of the circuits are being hijacked by what we are living in society and to think that you can have a job that is going to decrease the stimulation of the circuits and cool it down, we have got to find a better way.

>> both sides this week -- >> just make it short we have time for two or three questions. >> both sides this week on the labelling made concessions that made the regulation might actually pass this time. but what i hear you saying is it could have labeling helpful walls inouye and unless the basic food is not changed its not going to change the problem. >> i am a very big fan of menu labelling. i strongly support congresswoman rosa delauro's bill, senator tom harkin's bill. we need to get that because it will change how we respond to the stimulus. we need a range of tools. i was giving a talk at google and went into the cafeteria and it was striking. there is either a red, yellow or

green sign right in your face and i will tell you it has a real affect. red means eat small amount for taste, yellow, each a moderate amount common dream as much as you want. i was in charge of regulating food and i tell you it had a major affect on me. we have to change how we proceed stimulus and we have to have greater disclosure. we have to change -- we don't stop with just manual labor. what is served in the schools, with the vending machines -- parents, it's so hard you try as hard as you can and the kids are being stimulated with fat, sugar and salt. they have to change how we regulate advertising manual labor is a key step changing how we perceive the product. >> thank you very much. >> thank you.

>> good afternoon. a quick question despite your comments on rules we can't just tell burger king and mcdonald's to stop serving foods, we could try but it's not going to work. what would you suggest since you are no longer an offical and can talk about these things -- [laughter] general practice is the government could take to push us in the right direction short of banning stuff. >> the freedom of being a former official is great. [laughter] there needs to be further work on the label. there needs to be fond of the pack labeling. i think added sugars and fat need greater disclosure and restaurants, certainly the train restaurants, the information, you shouldn't have to go dumpster diving to get the information. what we subsidize with tax dollars needs to change, the school lunch programs need to change and allowing -- this is i think one of the key areas.

allowing the industry to amplify the real world value of reenforcing whether its nicotine or fat, sugar and salt advertising and adding the emotional loss negative we have to rethink how we look at those things that enhance and amplify the stimulus. i think there's a lot of work now that we know millions of americans are being hijacked. thanks for the question. let's take one more, one or two. >> if you flip over the suggestion you spend so much time talking about fat, sugar and salt, is it possible to fly your people to want protein and parcel which is where the bulk of the calories are going to come from common on sugar carbs. >> it's interesting. each of us, this is highly personal, what we view as the most salient stimuli and what we

want. succumb take vegetarians' for example and i am not endorsing any of these, but if you could be a vegetarian and look at animal fat and say i don't want that, this is what i want, then it's much easier to quell the stimulus on everything else and what you want is vegetarian food. they are increasingly people looking at for saying this is on the process by don't see any food here. and i want to eat something that is going to sustain me and giving me sustenance and i don't see food. that helps you look at rest out there and say i don't want that. i finally got to the point i went to a food coach because she didn't understand the lanier of science. [laughter] i want to know give me advice how she spent her life helping people control eating and she said what you have for dinner and i told her. i felt i had eaten the relatively healthy, told her about the appetizer and entree d