When Pleasure Backfires & The Truth About Losing Weight - SYSK Choice

You know getting enough sleep is important. But what if you could make a meaningful difference in your health and well-being by getting just 15 minutes more sleep each night? That doesn't sound like much, but research suggests even a small increase can have some surprising benefits. Listen as I explain why those extra few minutes may be more valuable than you think. https://conservancy.umn.edu/handle/11299/162769 We have more ways to entertain ourselves, indulge our desires, and experience pleasure than any generation in history. Great food, endless entertainment, social media, shopping — whatever feels good is usually just a click away. So why aren't we happier? Could it be that all this pleasure is actually making us miserable? Psychiatrist Anna Lembke says our brains simply weren't designed for a world of nonstop gratification, and the consequences can be profound. Anna is medical director of Stanford Addiction Medicine and author of the bestselling book Dopamine Nation (https://amzn.to/3BahOhY). Listen as she explains the surprising connection between pleasure and pain, why getting more of what we want can leave us feeling worse, and what we can do to restore some balance. If losing weight were simply a matter of eating less and exercising more, wouldn't it be a whole lot easier? Yet millions of people struggle to lose weight and keep it off, despite following all kinds of advice about diets, calories, exercise, and metabolism. The problem is that much of what we've been told about weight loss is misleading, oversimplified, or just plain wrong. So what actually works? Joining me to separate scientific fact from popular fiction is Robert Davis, award-winning health journalist and author of Supersized Lies: How Myths About Weight Loss Are Keeping Us Fat (https://amzn.to/3ptX41Q). Listen as he challenges some widely held beliefs about weight loss and reveals what the science really says about shedding pounds and keeping them off. Your cellphone could be a lifesaver in an emergency — even if you're unconscious or unable to speak. But there's something important you need to do ahead of time to make that possible, and many people haven't done it. It only takes a few minutes, and it could make all the difference when every second counts. Listen as I explain how to set it up and why you'll be glad you did. https://www.huffpost.com/entry/android-iphone-emergency-contact-ice_l_5ce2e6aee4b075a35a2b9250 PLEASE SUPPORT OUR SPONSORS MONARCH: Write your own money story with Monarch! Use promo code SYSK at ⁠⁠⁠⁠⁠⁠⁠https://Monarch.com⁠⁠⁠⁠⁠⁠⁠ to get your 1st year of Monarch Core half off at just $50 AIRDOCTOR: Head to ⁠⁠https://AirDoctorPro.com ⁠⁠and use promo code SYSK to get up to $300 off ANY of their select AirDoctor models, plus you will get a 3-year warranty, absolutely FREE! with a 30-day money back guarantee. TREES. COM: Right now, ⁠⁠⁠⁠⁠⁠⁠https://Trees.com ⁠⁠⁠⁠⁠⁠⁠have great deals on planting essentials, up to half off on select plants. And listeners to our show get 20% OFF their purchase when using the promo code SYSK at checkout. KA'CHAVA: Ka’Chava’s new Salted Caramel is the perfect balance of mouthwatering flavor and benefits. Embrace your salty side. Go to ⁠⁠⁠⁠⁠https://kachava.com⁠⁠⁠⁠⁠ and use promo code SYSK to get 15% off your first order! VINTED: Ready to clean out your closet and make some extra money? Download the Vinted app for free and start listing! With no seller fees, you keep every dollar you earn and for a limited time, enjoy free shipping in the US on Vinted. QUINCE: Find your next Fall favorites at Quince! Go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://Quince.com/sysk⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for free shipping on your order and 365-day returns. Now available in Canada, too! PLANET VISIONARIES: In partnership with The Rolex Perpetual Planet Initiative, this is Planet Visionaries. Listen or watch wherever you get your podcasts! Learn more about your ad choices. Visit megaphone.fm/adchoices

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Speaker 00

  Do you want to hear about visionaries creating a better world? People working in conservation, exploration, science and tech alongside storytellers imagining and creating a better future? I'm Alex Honnold, professional rock climber and founder of the Honnold Foundation, bringing you season six of Planet Visionaries. This season, I speak to guests like National Geographic photographer Tom Pechek and Anna Rattman, Executive Director of the Jane Goodall Institute, USA, in partnership with the Rolex Perpetual Planet Initiative. Watch Planet Visionaries on YouTube or wherever you get your podcasts.

• 0:32Mike Carruthers?

  Today on Something You Should Know, how could 15 more minutes of sleep make a huge difference in your life? Then, we live in a world of abundance and pleasure, which should make us happy.

• 0:43Speaker 02

  You would think so, except that our brains are not adapted to a world of infinite pleasures. And the result is that we're actually more unhappy, more anxious, more depressed.

• 0:58Mike Carruthers?

  Also, what you need to do to your cellphone right now in case of an emergency later. And how can people realistically lose weight? Because being overweight is a problem for so many people.

• 1:11Speaker 03

  Certainly, one factor is there's more food at more places. Also, portions are larger, so we dine out more and we get larger portions at restaurants. And studies show that we tend to eat what's in front of us. So if we're served a giant portion, we're more likely to eat it.

• 1:26Mike Carruthers?

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• 2:11Mike Carruthers?

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• 2:54Mike Carruthers?

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• 3:14Speaker 04

  Something You Should Know, fascinating intel, the world's top experts, and practical advice you can use in your life. Today, Something You Should Know with Mike Carruthers.

• 3:27Mike Carruthers?

  Hello, welcome to Something You Should Know. I know you've heard this all your life, that you need to get a good night's sleep, that sleep is very important. And we've talked about it, we've had guests on this podcast talking about how important your sleep is. Well, here's some interesting evidence that backs up what everybody's been saying. A study of over 7,000 high school students showed that A students averaged 15 more minutes of sleep per night than B students. B students averaged 15 more minutes of sleep per night than C students. C students averaged 15 more minutes a night than D students. Amazingly, just 15 minutes more sleep a night can really make a difference.

• 4:12Mike Carruthers?

  Now, Americans average 6.7 hours of sleep per night. Most people need more than that to function at their best. Why are we getting less sleep? Well, it does appear that the answer is pretty obvious. There are just too many things to distract us from sleeping, like television, the internet, cellphones, and a lot of other things that keep us up at night. So we sleep less, but we shouldn't. And that is something you should know.

• 4:42Mike Carruthers?

  How could it be that having lots of good things in your life, lots of pleasure and not a lot of pain, how could that be bad for you? Could it be that we aren't really wired to have so much pleasure and that we need to balance it out? I mean, you sometimes hear people say, for example, that kids today have it too good. Well, can you really have it too good? Could having it too good actually make you miserable? Well, the answer is yes, according to Anna Lembke. Anna is a psychiatrist, she is Medical Director of Stanford Addiction Medicine and Program Director for the Stanford Addiction Medicine Fellowship.

• 5:22Mike Carruthers?

  She is also author of a book called Dopamine Nation: Finding Balance in the Age of Indulgence. Hi, Anna, welcome to Something You Should Know.

• 5:32Speaker 02

  Hi, thanks for having me.

• 5:34Mike Carruthers?

  So, explain why having too much pleasure can be a bad thing. I mean, what is the problem with that?

• 5:41Speaker 02

  Yeah, the problem is that we have created a world of overwhelming abundance, where we have almost infinite access to high-pleasure goods. But our brains were not evolved for this world. Our brains were evolved for a world of scarcity. And the problem is that because of this mismatch between our primitive brains and the world that we live in now, we've all become more unhappy, more anxious, more depressed. Rates of depression and anxiety are going up all over the world, but especially in rich nations, and especially among young people. And I contend that the reason for that is not because necessarily, you know, the prime

• 6:23Speaker 02

  driver being social inequality, or trauma, or social dislocation, but rather that the prime driver is that we're inundated with dopamine.

• 6:32Mike Carruthers?

  Well, you would think, if we were programmed for scarcity, and now we don't have to really worry too much about that, that we have all these wonderful things, you would think that'd be a pretty good thing, that life is easy and so on we go.

• 6:49Speaker 02

  You would think so, except that our brains are not adapted to a world of infinite pleasures. And the result is that we're actually more unhappy. And the reason for that is because as our brains try to compensate for all of this rewarding stuff that we're ingesting and we're doing, it's doing that through something called the opponent process mechanism. It's actually down-regulating our own pleasure neurotransmitters. So we're essentially inducing clinical depression because we're over-ingesting all of these pleasure goods.

• 7:31Mike Carruthers?

  So it's like your body doesn't want too much pleasure, which seems weird to me. You would think it would like lots of pleasure. I like pleasure, but your body is trying to regulate it.

• 7:42Speaker 02

  The way that I explain this to my patients and to my medical students is imagine that in your brain, there's a balance. And when you experience pleasure, the balance tips one way, and when you experience pain, the balance tips in the opposite direction. So what happens when, for example, I eat a piece of chocolate, I get a little tip to the side of pleasure, and I get a release of dopamine, my pleasure neurotransmitter, in my brain's reward pathway? One of the overarching rules governing this balance is that it wants to remain level. It doesn't want to be tipped very long to the side of pleasure or pain. So the brain will kick in with its own re-regulating mechanisms to bring the balance level again.

• 8:26Speaker 02

  And the way that it does that is by tipping it an equal and opposite amount to the side of pain. I imagine that as these little gremlins, let's call them neuro-adaptation gremlins, that hop on the pain side of my balance, that's that moment of wanting a second piece of chocolate. Now, if I wait long enough, the gremlins hop off and a balance is restored, or what neuroscientists call homeostasis. But imagine if I don't wait, imagine if I eat another piece of chocolate, and another, and another, and now I've eaten the whole box. I end up then with a whole bunch of gremlins on the pain side of my balance, and they like it there, and they don't want to get off. So that means that if I do that over many, many days to weeks, I essentially reset my

• 9:11Speaker 02

  brain to the side of pain.

• 9:13Mike Carruthers?

  Well, isn't this like what we hear about addicts? That a drug addict has to take more drugs just to feel the same?

• 9:20Speaker 02

  Exactly. Then, I need to keep eating chocolate, not to feel good, but just to feel normal, right? And I need more and more potent forms of that chocolate, because the chocolate that I was eating, you know, eventually, I can't win with the gremlins, they'll overpower me. So it's a really, it's a really insidious phenomenon, where nothing else is interesting except for my chocolate. And after a while, even the chocolate doesn't work. I just need to keep eating it so that I'm not tilted to the side of pain.

• 9:49Mike Carruthers?

  Okay, but that sounds like addiction to me. And you're a psychiatrist, and you deal in, you specialize in addiction, but a lot of us aren't addicted to chocolate, we're not addicted to anything.

• 10:01Speaker 02

  Of course, that's, that's very true. But you don't need to be addicted in order to suffer the negative consequences of dopamine deficit. And I guess I would challenge you a little bit, and I would say that I think in this day and age, we all, most of us, have some kind of minor addiction. I mean, I could ask you, is there not some behavior in your life that you engage in more than you would like, or in a way that you would prefer not? And I would argue that because addiction is a spectrum disorder, and because it's engaging those same motivational pathways that get hijacked in the disease of addiction, I would argue that, in fact, we are all a little bit addicted today.

• 10:43Mike Carruthers?

  Yeah, okay.

• 10:46Speaker 02

  I suggest that whatever that thing is for you, you try abstaining from it for a period of time. And see how hard it is and see whether or not you experience the universal symptoms of withdrawal, which are anxiety, irritability, insomnia, depression, and craving, even just a little bit. And also, what that period of abstinence allows is that we can kind of look back and then see the true impact of our use. Because when we're in it, we often don't see it.

• 11:13Mike Carruthers?

  Okay, well, I'll let people who listen to this decide if they feel like they're addicted. But sometimes I just worry that, like, when you talk to someone like you, it's like, you know, the saying, "To a hammer, everything's a nail."

• 11:26Speaker 02

  Right.

• 11:27Mike Carruthers?

  And I worry that sometimes that everybody's addicted. Well, no, I'm not sure I buy that.

• 11:34Speaker 02

  Uh huh, yeah. And I appreciate you, you know, you pushing back on that and challenging that. And I'm not saying that everybody's addicted. But I'm saying if you are unhappy in your life and you are ingesting on a regular basis a highly reinforcing, potentially addictive substance or behavior, you might consider that substance or that behavior as the possible cause of why you're not feeling good. And the reason that that is a radical suggestion is because we generally think that we are engaging in these recreational activities or recreational drug use in order to feel good or to solve a problem.

• 12:18Speaker 02

  And in the short term, it feels like it works. But with repeated use, it can actually turn on us and be the cause of the problem. So yes, I agree with you. Not everybody is addicted. But it's also true that it's really hard to see it as it's happening. In the book, I talk about, for example, my own, you know, minor addiction to romance novels. And it certainly started out as a completely harmless recreation. But it very quickly escalated over time, where I was, you know, losing sleep, staying up late at night, being tired the next day, not able to really engage in my work the way that I want to. We would have family gatherings

• 13:01Speaker 02

  and I would want and go to my room to read novels instead of being present and enjoying being with my family. Over time, I needed more potent forms of those romance novels to get the same effect. You know, found myself reading Fifty Shades of Grey, you know, in the middle of the night.

• 13:19Mike Carruthers?

  Oh, my God. Control yourself.

• 13:23Speaker 02

  So my point is, as it was happening, it was a really slippery slope. I genuinely didn't really think anything of it. I just thought, oh, you know, I work hard. I need a break, no big deal. But, you know, by the time I was bringing these romance novels to work and reading in between patients, I actually really think I had a problem. Now, it's nothing compared to people with severe addictions and severe life-threatening addictions. But it's on the spectrum. It's using those same, you know, brain pathways. And it was impacting my life. And I did want to make a change when I saw it for what it was. But here I am, an addiction specialist, and I didn't see it until I was pretty far along.

• 14:01Mike Carruthers?

  And so what's the solution? If too much pleasure is the problem, then do we need to have more pain?

• 14:12Speaker 02

  Well, yes, that's exactly what I recommend. And that's why it's so counterculture. You know, first of all, if we do engage in some highly rewarding, reinforcing activity on a daily basis, we probably have become, to some degree, physiologically and psychologically dependent on it. So when we stop doing that for a period of time, that alone is painful. Why? Because again, we tip the balance to the side of pain. We're in withdrawal. So the first thing to do is to just, like, tolerate that pain. So when it comes to, for example, putting your smartphone away, you know, withdrawal will be experienced as intrusive thoughts of all of the things I'm missing out on because I'm not checking my phone. And it might not even be good things. It might be all the bad things

• 14:57Speaker 02

  that I'm not keeping track of that I need to for my job or for my kids. When in fact, that's really illusory. We don't need to be that available and that attached. And so we have to tolerate those thoughts, not act on them, but just tolerate them until, you know, the withdrawal subsides, the gremlins hop off, homeostasis is restored, and we're feeling better again. But we can even go further than that by pushing on the pain side, which is why I always prescribe things like exercise. Because exercise helps withdrawal. And ultimately, repeatedly doing things that are hard and challenging, like exercising or other, you know, challenging intellectual or creative activities, because they're effortful,

• 15:42Speaker 02

  ultimately, you know, reset our pleasure-pain pathway to the side of pleasure. Because it's an adaptive source of dopamine. Because it comes not directly from the activity, but from the activity's after-effects.

• 15:55Mike Carruthers?

  So how much is enough? I mean, so your example of, like, your romance novels, like, where's the line? Like, okay, when you're reading romance novels in between patients, okay, maybe that's the line.

• 16:14Mike Carruthers?

  But where is the line? And then when you hit the line, you probably can't even tell you've hit the line. And then how much pain do you put back in your life to balance out that much? Is it equal 50/50?

• 16:28Speaker 02

  Well, I mean, the prescription is pain. I mean, that's why it's a, you know, it's a hard sell. Because essentially, what I ask my patients, my patients come in, they're anxious, they're depressed, they want help with that. And I say, hey, I have a great idea for you. I'm going to do, I'm going to recommend something that's going to make you more anxious and depressed. But the whole idea is that I want to, they have to do something really hard in the short term in order to feel better in the long term. Sometimes I use the metaphor of chemotherapy, like, patients with cancer have to, you know, engage in this really unpainful treatment in order to cure their cancer. This is a similar thing. You have to be willing to tolerate

• 17:09Speaker 02

  some degree of discomfort and outright pain in order to feel better in the long run.

• 17:16Mike Carruthers?

  I'd love to get you to give me an example, maybe from your own work, as to how this very specifically works. But first, I'm speaking with Dr. Anna Lembke, and the name of her book is Dopamine Nation. You know, after the big Eaton fire here in California last year, we were so lucky. We almost lost our home. We didn't, but what we did get was a lot of smoke and soot inside the house. And honestly, that's when I started really thinking seriously about the air we were breathing. That's when I got my first Air Doctor. And wow, you could really tell the difference. The air just felt cleaner, less dust, less lingering smoke smell, and I slept better, too.

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• 18:45Mike Carruthers?

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• 19:14Speaker 05

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• 20:39Mike Carruthers?

  So Anna, can you give me like a real life example of how this idea of inserting more pain into your life balances out the pleasure so life gets good again?

• 20:51Speaker 02

  A patient of mine, a young man in his early twenties, came to see me for debilitating depression and anxiety, and he was also somewhat suicidal. And 20 years ago, the first thing I would have done for a kid like this would have been to prescribe antidepressant and recommend psychotherapy. Instead, what I said is, don't play any video games for the next month. He was playing video games 24/7 late into every night. And that's completely counterintuitive. But what I had hypothesized, and which turned out to be true, was that the reason that he was anxious and depressed was because his brain was so inundated and overstimulated

• 21:31Speaker 02

  with this highly rewarding behavior of playing video games that his brain had attempted to compensate by down-regulating his own dopamine and his own dopamine receptors, which meant that he constantly needed more video games and more rewarding video games to get the same effect. And when he wasn't playing video games, he was in a dopamine deficit state, which is essentially the same as clinical depression. So he abstained for a month from video games, which was really a leap of faith for him, and I applaud him for doing that. And what happened was initially, he felt more anxious and more depressed, which I warned him that he would. Why? Because he was in a dopamine deficit state.

• 22:13Speaker 02

  His own brain had down-regulated production of his own dopamine because he was getting all this dopamine from playing video games. So he stopped it, and that gave enough time for his brain to start to generate its own dopamine and generate its own norepinephrine and his own serotonin and all those feel-good chemicals that the brain can make, as long as you're not taking too much of that from the outside. And he came back four weeks later, and he felt better than he had in many years, less depressed, less anxious. I mean, I've seen this so many times, and it's so counterintuitive. When you're in it, you don't see it.

• 22:52Speaker 02

  But once you take a break from ingesting all these high rewards, the brain recalibrates, and people essentially feel better because they're not constantly fighting the gremlins of homeostasis.

• 23:06Mike Carruthers?

  It is interesting that with technology in particular, but with everything, I guess, when you suggest to people that they're doing it too much, there's always a reason why. There's always a yes, but.

• 23:22Speaker 02

  That's exactly what people who try to quit cigarettes, who try to quit alcohol, any drug, you name it, the brain will produce all kinds of rationalizations for why you must do that drug right now. That's exactly what it is. So I think first, conceptually, understanding that you've got a pleasure/pain balance tip to the side of pain, that you're in withdrawal, that that's craving. And if you just wait, if you just wait, those thoughts will begin to subside. That's what's so kind of incredible about it and how we think we're freely choosing to engage on our smartphones, but we're really the slaves of our smartphones. But if with a period of absence, if you can put it away, even just for one single day,

• 24:04Speaker 02

  as you get to the end of that day, you will probably experience like a sense of opening up and a sense of freedom, and that not every thought is preoccupied. I just heard from a patient of mine today, a longstanding patient with a terrible sex addiction, who said, you know, three years ago, 95% of his waking hours, he was preoccupied with using pornography. Now he hardly thinks about it. He has changed his brain, and he's effectively done that by abstaining. Now, the problem with smartphones is, in this day and age, you really just can't not use them because everybody's using them, and most professionals need to use them. But if you abstain for long enough to reset your reward pathways, and you really see

• 24:49Speaker 02

  how you've been using it and how crazy it is in a way, then you can go back to using it with self-binding strategies or barriers that help moderate use.

• 24:58Mike Carruthers?

  It's interesting that you say this, just because I have found that like if I take the weekend off and turn my phone off, you know, the first day, it's a little, geez, I really should check. But by the second day, man, I'm loving it. I am loving the fact that I'm not checking it. And also, that's like, sometimes after a meal, you know, where you kind of crave that dessert, you see other people, oh, God, that cake looks good. But it's a strong craving, but if you abstain...

• 25:34Speaker 02

  Yes.

• 25:35Mike Carruthers?

  In a half an hour...

• 25:37Speaker 02

  It's gone.

• 25:39Mike Carruthers?

  It's gone, and you didn't have the cake, and you don't feel any better or worse. I mean, the net result is the same. You're fine.

• 25:48Speaker 02

  Yes, that's exactly right. You know, I'm really glad you've had that experience because that's exactly what I'm talking about. And that's what I mean by like minor compulsions or minor addictions. You're obviously not addicted to your phone in any kind of serious way, because if you were, you know, two days of abstaining on the weekend would not be sufficient. But it gives you a tiny little window into what it might be like to be severely addicted to something, because it's a very similar type of trajectory. It's just much more severe, and it lasts much longer for people who are severely addicted.

• 26:21Mike Carruthers?

  You know what I wonder is, because every generation, you hear that, you know, kids today, they're doomed, they're, you know, they've... If we were to go back in a DeLorean, back to 1940, would we see the same problem with just different pleasures? Or is there something fundamentally different about today?

• 26:47Speaker 02

  Fundamentally different, and it is technology, which has made all of these pleasurable substances more ubiquitous, more accessible, more potent, and constantly novel. So if we're going to do, you know, the time travel experiment here, what I would suggest is that 50 years from now, we will look back at the way we use these devices today and the way that we let our kids use these devices, the same way that we look back at the way that doctors smoked cigarettes in the 1930s, 40s, and 50s. We will be horrified. We will say, I cannot believe we did that.

• 27:25Mike Carruthers?

  So it almost sounds as if you're saying that really that the problem now is that today, it's all reward that nobody has to work for, and that that's the imbalance, is that there's no pain, it's all gain.

• 27:40Speaker 02

  And I think we're seeing that now, that that's what we're reaping in society now with, you know, young people, depressed, anxious, suicidal. I mean, it's really tragic. And it's not just young people, it's all of us, you know, where we're all sort of, you know, sort of in this like this constant state of unhappiness and restless, and we can't figure out why. So then on top of it, we feel guilty, because it's like, well, you know, I have a house, I have all the food I could eat, you know, I may even have like, you know, everything that on paper you would want to have, you know, wonderful partner, great kids, and yet, you know, I'm not that happy. And I think a big contributor to it is the way that we're inundated with these pleasure goods.

• 28:21Mike Carruthers?

  Well, this is obviously a problem that affects a lot of people and that a lot of people are concerned about, as evidenced by the fact that your book is a huge bestseller. And I think it's really interesting that your prescription to all of this pleasure in our lives is to insert a little pain, but as you point out, it's all about balance. That is Dr. Anna Lembke. She's Medical Director of the Stanford Addiction Medicine Program and Director for the Stanford Addiction Medicine Fellowship, and the name of her book is Dopamine Nation. There's a link to that book in the show notes. Thank you so much, Anna.

• 28:57Speaker 02

  Thank you so much. It's been a pleasure to talk to you today.

• 29:00Speaker 05

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• 30:59Mike Carruthers?

  It seems just about everybody wishes they could lose five pounds, or 10 pounds, or more. Body weight is a preoccupation for a lot of people. I mean, have you ever passed your reflection in a mirror or a window and maybe sucked in your stomach? Wish you wore a size or two smaller? Or maybe you dreamed someday of going back to the weight you were several years ago? And despite all the diets and programs that supposedly make it so simple to lose weight, it is not so simple. It's hard for humans to lose weight, and in fact, it seems quite easy to gain it. A lot of us weigh more than we should,

• 31:41Mike Carruthers?

  and I suspect most of us weigh more than we wish we did. But in order to lose weight, we have to understand what really works and what doesn't. What science has proven will work as opposed to the myths, fad diets, and old wives tales about how to lose weight. And here to bust some myths and explain the science is Robert Davis. He's an award-winning health journalist who's written three books on health and now has a fourth book out called "Supersized Lies: How Myths About Weight Loss Are Keeping Us Fat." Hey, Robert, welcome. Welcome to Something You Should Know.

• 32:17Speaker 03

  Thank you, Mike. Nice to talk to you.

• 32:19Mike Carruthers?

  Supposedly, we know a lot about health and diet and metabolism and calories and exercise. We know all that we know that you would think this problem of weight loss would be better, or would be getting better. But in fact, it's getting worse. People are getting heavier and heavier. So what's going on?

• 32:41Speaker 03

  Weight loss generates a lot of profits for a lot of people. By one estimate, the weight loss industry is worth more than $60 billion annually in the U.S. And there are lots of players in this industry who stand to profit from misleading information. People who push particular diets. People who say, oh, this is the only diet. This is the best diet. People who... Food companies that sell us foods that they're supposedly weight-friendly. Gyms that tell us, "Join and lose 30 pounds in 30 days." So the list goes on of people who are trying to push ideas that are not only misleading us, but in some cases, making the problem worse.

• 33:20Mike Carruthers?

  Well, what do you think is the reason? And there may be several. But 50, 60 years ago, we didn't have the problem we have now with obesity. People can't have just lost their willpower. So what's happened?

• 33:35Speaker 03

  Well, certainly, one factor is the ubiquity of food. I like to say whether we go to Office Depot or Home Depot, there's food there. Whether we go to our offices or whether we go to the airport, there's food. So I think that's certainly something that's changed over the years is there's more food at more places waiting there, beckoning us, tempting us. Also, we all recognize that portions are larger. So we dine out more and we get larger portions at restaurants. And studies show that we tend to eat what's in front of us. So if we're served a giant portion at a restaurant, we're more likely to eat it. And then there's the food industry. The food industry continues to pump out more and more highly-processed foods, foods that are highly palatable.

• 34:18Speaker 03

  And these are foods that research has associated with weight gain. So I think all those things certainly play a role. And as I mentioned earlier, just the proliferation of bad advice. I think these diets and other approaches that we're told to follow that don't work, I think those have made the problem worse as well.

• 34:37Mike Carruthers?

  So let's start with breakfast. Because a lot of people have heard the saying, you know, breakfast is the most important meal of the day. But a lot of people don't eat breakfast. And many people who do eat breakfast eat a very sweet, donut-y, waffly breakfast. So what about breakfast?

• 34:57Speaker 03

  Yeah, well, that's been something that's been debated a long time. And many people do say breakfast is the most important meal of the day, including for weight loss. And there are studies that actually show that people who eat breakfast are less likely to put on weight, less likely to be obese. The problem with those studies is they just show associations, not cause and effect. And if you look at studies that actually can show cause and effect, so-called clinical trials, what they suggest is there is not necessarily a relationship between eating breakfast and weight. So people who eat breakfast are not necessarily more or less likely to gain weight or to be overweight. So the bottom line there is you should do what's right for you. So if you're not hungry in the morning and you don't want breakfast, don't eat. Wait until you're hungry. If, on the other hand, like me,

• 35:42Speaker 03

  I'm a breakfast eater and I have to eat first thing in the morning, eat, but eat something sensible. Eat a breakfast that is going to be not full of donuts and pastries, but that's going to have healthful foods and that are going to fill you up and sustain you.

• 35:56Mike Carruthers?

  Generally, I think when people decide that they need to lose weight, they start by looking at calories. They count calories. And they look at how many they take in and how many they burn. And maybe they'll walk more after dinner because that'll burn more calories. What about that theory?

• 36:13Speaker 03

  Yeah, that's often the sort of the basis of the advice we get, right? You should eat less and move more. Eat fewer calories and move more. And sometimes that's abbreviated as ELMM. And I like to say for many people, Elm Street is a dead end. They do that and they find it doesn't work. Now, one reason when it comes to calorie counting is that it's very hard to count calories precisely. You know, we see those big, bold numbers on the food packages that the food has 273 calories. The problem is those numbers are not exact. They can be off under law by as much as 20%. And often, what we see is an undercount. So number one, we often don't know how many calories we're eating with any precision. Number two, it's hard to know how many calories you're actually burning. You know, there are apps.

• 36:58Speaker 03

  There are online calculators. But it's very hard to know how many calories you're actually burning because it varies from person to person and it depends on a number of factors. So if you're not sure how many calories with any precision you're taking in, you're not really sure how many you're burning or need to burn to be in calorie deficit, it's a very hard thing to do precisely. And so on top of that, when you look only at calories, which many of us are told to do, you may end up choosing foods that are not necessarily optimal for long-term weight control because you may end up eating candy or fudge bars or other foods that are maybe lower in calories but are not necessarily going to fill you up and curb hunger. So that's something else. So what matters is not only the number of calories, but also the quality of those foods

• 37:42Speaker 03

  and the effect they have on fullness.

• 37:45Mike Carruthers?

  And what you said about, you know, people really are different, that you and I could do the same things all day long and one of us could burn a lot more calories or end up with a calorie deficit or surplus much different than the other?

• 38:03Speaker 03

  Exactly. And we all know those people we don't like who can eat whatever they want and they never gain an ounce. And there are studies, studies of twins, that show that genetics can play a large role in how our bodies respond to the calories we eat. Just as you say, people... Some people can eat a certain number of calories and gain a lot of weight. Other people, the study suggests, won't gain as much weight. And conversely, with weight loss. So that certainly plays a role. Something else that is interesting to me is there's emerging evidence about the microbes in our guts, the so-called microbiome. And this is new research that's just emerging, but it's very interesting. And what this research suggests is that people have different mixes of microbes in their guts.

• 38:47Speaker 03

  And that mix of microbes can help determine how many of the calories that we consume are actually absorbed. And that makes a difference because if you don't absorb as many of the calories that you consume, you're going to gain less weight. And so that's a factor, too, that may help explain why different people gain different amounts of weight or lose different amounts of weight depending on how much they eat.

• 39:11Mike Carruthers?

  Of all the myths about weight loss, what's the one that you find most interesting or you think people don't really understand? What's the one that stands out to you?

• 39:21Speaker 03

  You know, I wouldn't have said this before writing this book. But after writing this book and talking to lots of people who've struggled for decades, maybe their entire lives with their weight, I would say it's that weight is entirely within your control. And if you are unable to lose weight and keep it off, it's your fault that you're not diligent enough, that you're lazy, that there's something wrong with you. And that, to me, is the biggest myth of all because it's so harmful. Not only does it destroy people's self-esteem and result in all kinds of negative emotions and negative, you know, poor mental health. But I think it can also make it harder for people to live a healthy life and to control their weight over time because often, they just give up.

• 40:04Speaker 03

  And so to me, that's perhaps the biggest myth of all.

• 40:08Mike Carruthers?

  Well, that takes us into my next question, which is there is this theory...

• 40:15Mike Carruthers?

  That there is a, you have a set weight. Your weight is your weight and you can, you can try to lower it, but eventually your body will come back to your weight. You're, you have a weight.

• 40:29Speaker 03

  Yes, the so-called set point theory. And that's the idea, as you say, that there's a range perhaps, or a weight or a range within your, where your body wants to be. And certainly, research does show that when people cut calories, for example, or they exercise vigorously and lose weight, the body fights back because we have this built-in mechanism. Evolution has given us this gift to help protect us against starvation. And, and, and, and so when we start losing weight, the body thinks, uh-oh, something's wrong here. We need to start pushing the weight back up. So unfortunately, or fortunately, we don't live in a society, at least in the U.S., where we have to worry about starvation for the most part and scarcity. But this mechanism that evolution has given us,

• 41:13Speaker 03

  we have, it's going to fight our efforts.

• 41:16Mike Carruthers?

  If somebody was, based on what you know about all this research, if somebody was to ask you, okay, so I want to lose weight, but it would be nice to like, kickstart this. Like, what, what, is there one or two things that really help people like, get on track, see some results fairly quickly that, that encourage them to keep going?

• 41:38Speaker 03

  Well, I would say that just about any diet will help you lose weight in the short term. Whether you want to do a keto diet, a low-fat diet, intermittent fasting, I think any of those approaches has been shown to help in the short term. We're talking over several months. So I think to find what you can tolerate for a certain period of time, and that can help kickstart your efforts. The real challenge though, as we all know, is not losing weight in the short term. It's the long term because the, the statistics are very depressing about the amount of weight, the number of people, the percentage of people who regain some or in many cases, all or more of what they lost. So I think what's key here is whatever diet you choose in the short term, whatever works for you, to also have a plan in place that after several months,

• 42:22Speaker 03

  you're going to transition to a long-term eating plan that you can sustain. That's what's key. And I think it's fine if you use a, one of these diets in the short term to get started and to encourage you. But I think it's unrealistic to count on any of these diets, these short-term diets, these fad diets, as a long-term solution to weight control.

• 42:41Mike Carruthers?

  Often it seems that discussions around food, particularly around weight loss, is what not to do? What, what foods are bad for you? That what you need to avoid, rather than what's good for you? That, that, what we have to do is cut out the villains in our diet and that will help.

• 43:01Speaker 03

  So we had in the 1970s and 80s and into the 90s, the idea that fat is the enemy, that if you eat less fat, you'll lose weight. And so we saw a flood of low-fat and no-fat products in the market. And what happened? Not only did people not lose weight, they gained weight and there was an epidemic of diabetes, which is in many cases attributed to this low-fat craze. And so after that, we saw low carb. And then since then, we've seen people naming gluten is the enemy or sugar is the enemy or beans is the enemy or other foods, the list goes on. But the point is that weight loss is more, far more complex than a particular food or category of foods.

• 43:46Speaker 03

  And when this approach is taken, what it does is to divert attention away from the larger issue, which is the overall quality of our diets. It's not about one food or one category of foods. It's the overall composition of your diet that matters. And also it can interfere with optimal health. Because if certain diets, for example, a keto diet, if you do it over the long term and don't eat whole grains, for example, there can be nutrient deficiencies. And so that can be an issue. That can be a very serious side effect of some of these approaches. So that's a myth that we need to be aware of. When, when diet pushers tell us it's all about cutting out some category of food.

• 44:26Mike Carruthers?

  Certainly in any discussion about weight loss, you have to talk about exercise. But as we've talked on this podcast before, exercise is not a great way to lose weight. And, and if you think that you can, you know, eat anything you want and just exercise, it won't work if weight loss is your goal.

• 44:48Speaker 03

  Yeah, that's correct. And I say that as somebody who's an avid exerciser. I am a big proponent of exercise. That said, for all the things exercise can do, everything from lowering our risk of cancer and heart disease to improving our mood, even improving our sex lives. The one thing it can't do ironically is the thing that many, many, if not most, people look for it to do, which is to help us lose weight. And that's a shame because what happens is that too often people go into an exercise program mainly because they expect it to help them lose weight. It doesn't help them lose weight and then they stop exercising. And so the reasons are several. First of all, as you say, it doesn't burn a lot of calories. The kind of exercise that most of us do, which is great for our health, going for a brisk walk,

• 45:32Speaker 03

  taking a yoga class, going for a bike ride, that's not going to burn a lot of calories. And so it's not going to make a big, big dent in our weight. And even when we do exercise vigorously, if you're one of those few people who can go to the gym every day, burn five or 600, 700 calories five days a week, which is hard to do, but if you can do that, it will result in some weight loss in the short term. But over time, your body responds. Your metabolism slows down and it becomes harder and harder to lose weight and you have to ratchet up the exercise more and more. So long-term, it's not a great way to lose weight. So there are other benefits to exercise when it comes to weight. So I want to make sure that's clear. While exercise may not help you lose weight, it actually can, is important when it comes to maintaining weight loss

• 46:14Speaker 03

  or preventing weight gain from, from starting at all. So I think that exercise is important with regard to keeping weight off. It's just not a great way to take off weight in the first place.

• 46:27Mike Carruthers?

  One of the concerns I think people have, and I've had it too, is that when you talk to someone like you who, who points out that, you know, this doesn't work, this is a myth, these things have proven not to be true. It doesn't help people to, what to do. It's telling them what not to do, what doesn't work. But, so now what do you do? So, okay, all these things are, are myths. Now what?

• 46:56Speaker 03

  Yeah, that's a great point. And that's, I, I definitely don't want people to be left with that message that it's hopeless and nothing works. Because what we do know, and there's good research showing that the kind of eating pattern that is optimal for good health is also optimal for maintaining a healthy weight. And so what does that mean? It means the things we often hear about. A diet that's high in fruits and vegetables and whole grains and nuts and beans and seeds, fish, lean, poultry, dairy, if you eat dairy. And that is, that you minimize foods that are highly processed. Things like chips, candy, sweets, fries, fried foods, things like that.

• 47:39Speaker 03

  Now notice, I didn't say you never eat those foods. So it's not, these foods are not villains. It's not as, it's not the same as diets that say certain foods are off limits, you should never eat them. But it is to say that you should focus on eating more of the foods that are good for us, that are good for our weight and to try to eat less of the foods that are not good for our weight. And, and it's a process. I think it's important for people to recognize that food, eating habits build up over time. I know when I was growing up, I ate all these processed foods. I drank soda, I ate donuts, I ate Pop-Tarts, I ate candy, a lot, potato chips. And so it was only through, over a period of years that I was able to change my eating habits. So I was able to focus more on a whole foods diet. And I think that's a very important point

• 48:22Speaker 03

  for people to see this as a marathon, not a sprint, to change their diets over time gradually. So that, and they can still enjoy foods, highly processed food, a piece of cake, ice cream, chips, but to make them occasional treats in moderation rather than everyday staples.

• 48:38Mike Carruthers?

  Let's talk about diet soda. Because I think people believe that diet soda is a good choice. It's a better choice than sugared sodas because it doesn't have any calories. And so therefore, it must be helpful in losing weight.

• 48:54Speaker 03

  But what the research tells us is that's not necessarily the case. It's far more complex. There's research suggesting, some research suggests that a diet soda or diet beverages can result in weight loss. But there's plenty of other research that suggests that it has no effect and even some that it contributes to weight gain. There are different theories. One is that diet drinks mess with our brains. So that they cause us to expect when we drink a diet drink, our brains are expecting calories and that we don't get them. We, our brains say, where are the calories? And it, we get hungry and it causes us to seek out calories so that we end up eating more. That's just a theory, but it is one explanation as to why. There are also theories that some of, certain artificial sweeteners

• 49:38Speaker 03

  may affect the balance of microbes in our guts. And so changing that balance again can affect how we absorb calories that we consume. So that may be a factor. And it may also just be what I like to call, I'll have a large fry, a Big Mac and a Diet Coke. The idea that somehow, well, we're, we're being good when it comes to diet drinks so that we can overindulge in other ways. We have license to do so because we're being virtuous. So that may play a role as well. But whatever the reason, what we do know is that diet drinks by and large do not live up to their promise of promoting weight loss. And in some cases, they may even promote weight gain.

• 50:16Mike Carruthers?

  What does the science say about these, supposedly these superfoods? Like avocados and certain other berries that, that supposedly...

• 50:27Mike Carruthers?

  Promote weight loss. What does the science say?

• 50:31Speaker 03

  Yeah, this is a very alluring idea, right? Because the idea is that if we eat some avocado, or chili peppers, or coconut oil, whatever the case may be, it'll help melt away pounds, get rid of fat. That's often what we're promised. And we see news stories trumpeting some study that tell us that some food is going to help us lose weight. The problem with these studies, in many cases, is that they are sponsored by the industry that makes that particular food. And in many cases, they don't even measure weight loss. They measure some marker that's short of that, say, for example, appetite. And yet, we see in these headlines that the food is some kind of miracle food. So, again, this is an example of a misleading idea that's often peddled to us, that it's all about specific foods.

• 51:16Speaker 03

  I think it's the mirror image of the villain myth, that if you cut out certain foods, that'll help you lose weight. The mirror image of that is that if you eat certain magical foods, it'll help you lose weight. And so, again, what's important is not whether you include a particular food, acai berries, or avocado, or whatever. It's the overall composition of your diet. Now that said, these foods can be part of a weight-friendly diet. Grapefruit, which again, is one of these classic superfoods for weight loss. Grapefruit can be part of a weight-friendly diet. So can avocado. So can chili peppers. So there's nothing wrong with eating these foods. It's just that they don't have magical powers to melt away pounds, and we shouldn't expect them to.

• 51:56Mike Carruthers?

  I remember hearing someone say something that I thought was interesting, that as more and more people gain weight, it makes it harder to lose weight, because weight gain is kind of contagious, that people in a house, or people in a community, tend, if they hang out together, will tend to mirror each other's weight.

• 52:17Speaker 03

  Yeah, and there are actually studies that suggest that, in some ways, weight gain can act like a virus, in the sense that it can spread through communities. And that if people have friends, or spouses, or coworkers, or they live in communities where people are gaining weight, they're more likely to gain weight. And that stands to reason, because we tend to mirror the behaviors of those around us. And conversely, if we're surrounded by people who are concerned about their health, concerned about their weight, we're more likely to do that as well. So yes, there's good research showing that this sort of contagion, as it's called, can take hold when it comes to weight.

• 52:54Mike Carruthers?

  It does seem, too, that one really, really powerful technique to losing weight, especially if you're a snacker, is to not bring them in the house. If you don't have them, you can't eat them. But if you have them, you're just creating this temptation that makes it so hard.

• 53:14Speaker 03

  Absolutely. And I think that's a very important point. And I talk about this, what I call strategic planning. And that is things that you can do, like keeping tempting food out of your house, to help, as you anticipate, potential challenges. So for me, and I know for lots of other people, if I have cookies, if I have chips, if I have junk food in my house, I'm going to eat it. I cannot resist it. So what do I do? I don't keep it in the house. So I think it's important, as we think about the various challenges we have, whether it's, you know, I'm in a hurry after work, and I don't have time to cook, and so I end up going through the drive-through. Or I tend to engage in emotional eating. When I'm bored, or lonely, or sad, I eat certain foods. I think being aware of our tendencies,

• 53:57Speaker 03

  and preparing for those, and having plans in place to deal with those things, is very, very important. That's a key factor when it comes to long-term weight management.

• 54:08Mike Carruthers?

  Well, I find it so interesting, that it seems almost universal. You ask anybody, and people say, you know, "I wish I could lose five pounds. Wish I could lose 10 pounds." And it's hard. It's really hard to do that. And it's good to get the truth about what works and what doesn't. What are the myths? And what are the techniques that actually give people a chance to lose that weight? Robert Davis has been my guest. He is a health journalist, who has written several books. And his latest is called "Supersized Lies: How Myths About Weight Loss Are Keeping Us Fat." And you'll find a link to that book at Amazon in the show notes. Thank you, Robert.

• 54:45Speaker 03

  Thank you, Mike, very much.

• 54:51Mike Carruthers?

  Your cellphone is very handy, which is probably why you have it with you all the time. And there's something people should do with their cellphones, that a lot of people don't do with their cellphones, that is very important. And that is to set up an ICE contact. ICE stands for "In Case of Emergency." And rescue and medical workers do look for it. They can open your phone to see your emergency contact information, even if your phone is locked, and you cannot speak. Now iPhone and Android phones have different ways of doing it, but it's really worth the effort to figure it out. You can put in who to call in an emergency. You can put in information about medications you take,

• 55:36Mike Carruthers?

  medicines you're allergic to, and other health conditions you have. If something happens to you, and you can't speak, having emergency information available on your phone for medical workers could save your life. There's an article from the Huffington Post, which explains step-by-step how to do this on iPhones and Android phones. And I'll have a link to that article in the show notes for this episode. And that is something you should know. We rely on you to help us spread the word about this podcast. It's how we grow our audience. It is the best way, word-of-mouth advertising. And so I hope you'll help us out, and tell someone you know, or two people you know, to listen to this podcast.

• 56:20Mike Carruthers?

  I'm Mike Carruthers. Thanks for listening today to Something You Should Know.

• 56:26Speaker 07

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