0:00

I'm Joe Graydon. And I'm Terry Graydon.

0:03

Welcome to this podcast of The

0:05

People's Pharmacy. You can find

0:07

previous podcasts and more information

0:09

on a range of health

0:11

topics at peoplespharmacy.com. Have

0:15

you ever finished a big bag of chips

0:17

and wondered how that could have happened? Mindless

0:20

eating can become a habit. This

0:23

is The People's Pharmacy with Terry and

0:25

Joe Graydon. Giving

0:35

into cravings often results in feelings

0:37

of shame and blame and guilt.

0:40

Sometimes those feelings make us anxious

0:42

and lead to more cravings, kicking

0:45

a vicious cycle into motion. Our

0:48

guest says willpower is a

0:50

myth and instead

0:52

of practicing self-judgment, we

0:55

should try some self-kindness. How

0:58

can we figure out what really makes us

1:00

feel good? Mindfulness could help

1:02

us find a better reward than M&Ms. Coming

1:05

up on The People's Pharmacy, breaking

1:07

the cycle of food

1:10

cravings. In

1:14

The People's Pharmacy Health Headlines. People

1:18

with sleep apnea usually treat this

1:20

condition with a machine providing continuous

1:23

positive airway pressure. Now

1:25

though, the biggest maker of such CPAP

1:27

machines will not be selling them in

1:29

the U.S. The Dutch

1:32

manufacturer, Philips, has recalled millions

1:34

of breathing devices and now

1:36

will not sell new, resperomics

1:38

devices until it has made

1:41

required changes to its manufacturing

1:44

process. This is likely to take years.

1:47

The problem with the recalled

1:49

machines was sound dampening foam

1:51

that deteriorated and could be

1:53

inhaled, posing a possible cancer

1:55

risk. Although Philips will

1:57

not be selling new CPAP or BIPAP

2:00

machines in the U.S. until it has met

2:02

all requirements in the consent decree

2:04

reached with the FDA. It

2:07

is allowed to provide customer

2:09

support and replacement components for

2:11

machines people already own. Women

2:15

are often warned to avoid medications

2:17

during pregnancy for fear that a

2:20

drug might harm the fetus. Of

2:22

course, there are exceptions when the medicine might

2:25

benefit the mother. One

2:27

such medication is aspirin. Researchers

2:30

often prescribe low-dose aspirin to women

2:32

who are at high risk for

2:35

preeclampsia and preterm birth. Preeclampsia,

2:38

also known as hypertension of pregnancy,

2:40

can put both the mother and

2:42

baby in jeopardy. The

2:44

aspirin study involved almost 12,000

2:46

women in six different countries.

2:49

They were randomized to receive

2:51

either low-dose aspirin or placebo

2:53

starting as early as six

2:55

weeks into their pregnancies. Women

2:58

who took aspirin were less

3:00

likely to deliver preterm or

3:02

experience hypertension, so the drug

3:04

was effective. In a

3:06

follow-up study, researchers

3:08

assessed neurodevelopment in more

3:10

than 603-year-olds. The

3:13

investigators did not discover any evidence

3:15

that aspirin was harmful. The

3:18

lead author stated, "...we

3:20

were able to look at development using

3:22

a number of different instruments and different

3:24

domains and saw no differences in children

3:26

who were exposed to aspirin early in

3:28

pregnancy and those who were not." A

3:32

new study shows that the

3:34

HPV vaccine is extremely effective

3:37

at preventing cervical cancer. Such

3:40

cancers are associated with infection

3:42

with human papillomavirus, also known

3:44

as genital warts. The

3:46

study is from Scotland and utilized

3:48

medical records. Women born between

3:51

1988 and 1996 who were fully vaccinated against HPV when they were

3:57

12 or 13 have not developed

4:00

cervical cancer. That's to say, researchers

4:02

did not find a single case

4:05

in this group in the entire

4:07

country. Approximately 40,000 women

4:10

were vaccinated at that young

4:13

age before becoming sexually active.

4:15

Another 124,000 women got the vaccine when they were 14

4:19

or older. In comparison, 300,000

4:23

women in this same age group

4:26

were not vaccinated. Researchers

4:28

found about 8.4 cases of

4:31

cervical cancer per 100,000 unvaccinated

4:33

women. These results

4:35

confirm earlier findings of HPV

4:38

vaccine effectiveness from Finland. A

4:41

study published in Nature Medicine

4:43

is sending ripples through the

4:45

Alzheimer's research community. The

4:48

researchers reviewed medical records from people

4:50

who had developed Alzheimer's disease before

4:52

they turned 60. Some

4:54

were as young as in their 30s, although

4:57

they did not have known genetic

4:59

mutations that are thought to cause

5:01

early onset dementia. What they

5:03

did have in common, however, was

5:05

a history of childhood injections of

5:07

human growth hormone that had been

5:09

extracted from the pituitary glands of

5:11

cadavers. These cases suggest

5:14

that in rare instances, Alzheimer's

5:16

disease could be transmitted. This

5:19

research raises questions about the role

5:21

of amyloid as the sole cause

5:23

of Alzheimer's disease. A

5:26

new study suggests that music lessons might

5:28

help maintain cognitive function as we grow

5:30

older. The investigators collected

5:32

data online from more than a

5:35

thousand British people over 40.

5:38

Cognitive data from people who sang or played an

5:40

instrument were compared to test results

5:43

from people who don't make music.

5:45

Playing a musical instrument was linked

5:47

to better memory and problem-solving ability.

5:50

And that's the health news from the

5:53

People's Pharmacy this week. Welcome

6:14

to The People's Pharmacy. I'm Joe Graydon.

6:17

And I'm Terry Graydon. Do

6:19

you ever find yourself eating when you're not

6:21

really hungry? Many of

6:23

us snack because we're anxious or

6:25

bored or just have a craving

6:27

for a salty, crunchy snack. Is

6:30

there any way to change habits

6:33

that are not helpful? Our guest

6:35

today is Dr. Judd Brewer. He's

6:38

a neuroscientist who studies addiction.

6:40

He's also a professor in the School of Public

6:43

Health and Medical School at Brown University.

6:45

Dr. Brewer is the author of

6:47

The Craving Mind, From Cigarettes to

6:50

Smartphones to Love, Why We Get

6:52

Hooked and How We Can Break

6:54

Bad Habits. His latest book is

6:56

The Hunger Habit, Why We Eat

6:59

When We're Not Hungry and How

7:01

to Stop. Welcome

7:04

back to The People's Pharmacy, Dr.

7:06

Judd Brewer. Thanks

7:08

for having me back. Dr.

7:10

Brewer, your book is titled

7:13

The Hunger Habit. But

7:16

the first point you make is that so many of

7:19

us, we're not eating from

7:21

hunger anymore. Maybe a couple

7:24

thousand years ago we were, but we

7:26

may not even know what hunger feels

7:28

like. How did

7:30

we get so separated from our

7:33

bodily needs? Yeah,

7:35

it's such a great question. There's this

7:37

great ... This is not just a

7:39

story of modern times. There was a

7:41

short story by James Joyce from 1914

7:43

where he described, I think the book

7:47

or the short story was a painful case and there

7:49

was a guy named Mr. Duffy. It

7:52

starts, Mr. Duffy lived a short distance

7:54

from his body. I

7:57

think that's even more true in modern day. So

8:00

we have these great survival mechanisms

8:02

that are actually really really tuned

8:05

to set us up for survival which

8:07

is all about you know making sure

8:09

that we're eating when we need to

8:11

and we're not being eaten by

8:14

our predators and that

8:16

mechanism has gotten co-opted in modern

8:18

day or even some would say

8:21

hijacked to the point

8:23

where we get these our wires crossed

8:25

where we're eating in all sorts of

8:27

situations when we're not actually hungry You

8:29

know this actually this blew my mind

8:31

when I was first starting

8:33

my clinical practice I was working

8:35

with a group of women it happened to be

8:38

all women at the time Who

8:40

all had binge eating disorder and

8:42

for about a month? I felt like I

8:44

was missing something in Translation

8:48

where you know, I was like, what am I

8:50

missing? And it took me about a month to

8:52

figure out that they were not they couldn't actually

8:54

tell when they had hunger signals

8:56

Versus when they were just eating out of

8:59

a craving. They said I have an urge and I eat

9:01

I have an urge and I eat and so there's this

9:03

difference between hedonic hunger

9:05

and homeostatic

9:07

hunger homeostatic hunger is the one that

9:09

says hey my stomach's growling eat some

9:12

food the hedonic hunger is I

9:14

would say more is a later and

9:16

I wouldn't call it an evolutionary adaptation

9:20

It's an anti adaptation Because

9:23

we you know, it's not helpful.

9:25

It's not healthy for us to be eating, you

9:27

know when we don't need the calories Well

9:30

every time we go into a gas station

9:35

We are confronted by so many

9:38

snacks so many eat

9:40

me messages It's

9:42

easy to understand how people would

9:44

be just oh, yeah I

9:46

wasn't really hungry but boy the M&Ms

9:49

they were just right there at the

9:51

counter yelling at me eat me now

9:55

It's like life that's

9:58

that's all those commercials until and

10:01

crunchy, salty, yummy,

10:04

eat me. Yes.

10:07

Was it Odysseus who had to be

10:09

lashed to the mast of his ship

10:11

so that Seren Song wouldn't

10:13

call him to crash his boat on

10:16

the rocks if I've got the mythology

10:18

correct? It's

10:20

the M&M Seren Song that

10:22

says, I'm the perfect color, I'm

10:25

the perfect mouth feel, I'm the perfect taste,

10:27

I'm the perfect crunch. I have

10:29

to say, my favorite, pure review journal,

10:31

The Onion, they

10:35

had a headline that says

10:37

Doritos celebrates its one millionth

10:39

ingredient. Because

10:43

these things are designed to be

10:45

addictive. Everything from vanishing,

10:48

caloric density to bliss points, it's

10:50

dialed in to get us addicted.

10:54

How does it happen that we eat

10:58

from habit rather

11:00

than really in order

11:03

to survive? So

11:06

the basic mechanism, and this has

11:08

been known, Eric Kandel actually got

11:10

the Nobel Prize in 2000 showing

11:12

that this is evolutionarily conserved back to the

11:14

sea slug, which only has like 20,000 neurons.

11:18

And the way it works is there are three

11:20

key elements, a trigger or a

11:22

cue, a behavior, and

11:25

a result, where from a neuroscience standpoint, we

11:27

think of it as a reward. And

11:30

the way it works, so think of our ancient

11:32

ancestors, Savannah, the woods, whatever,

11:34

they had to find food, right? They

11:37

didn't have refrigerators. So

11:39

they would go out foraging. And

11:41

when they would find food, that would be the trigger,

11:44

they would eat the food, that was the behavior,

11:46

and then their stomach would send this dopamine signal

11:48

to their brain that's basically said, hey, remember what

11:51

you ate and where you found it. So

11:54

it's there as a memory

11:56

formation process so we can remember

11:59

where food is. is, right, and

12:01

not worry about remembering every little

12:03

rock that is inconsequential. Does that

12:06

make sense? I

12:08

think so. I mean, you want to be able to

12:10

get to the good stuff, and you want to do

12:13

it without necessarily paying attention

12:15

to stuff that isn't going to matter.

12:18

Yeah, absolutely. It's kind of like our brains, you know,

12:20

they're similar to like a digital camera or something where

12:22

it only has a certain amount of memory

12:24

space. And so you don't want

12:26

to be taking pictures, you know, throughout your day. You

12:29

want to actually take pictures of things that matter. And

12:31

our brains do the same thing with memories. They

12:34

form memories based on things that

12:36

are very emotionally provocative. So when we're surprised,

12:38

you know, if we have a surprise party,

12:40

we're going to remember that, because our brain

12:42

just sets off

12:45

this fireworks show of dope, I mean, that says,

12:47

wow, I was not expecting that. And

12:49

on a to a lesser degree every day, when

12:52

something unexpected happens, our

12:55

brain's going to lay down memory. And

12:57

part of that's to say, hey, yeah, that's

12:59

okay. That was surprising, but it's okay, you

13:01

survived. Or that's surprising, and that almost

13:03

kills you. You should probably remember that one too.

13:07

And stay away from that one. Yes, exactly.

13:09

You know, like walking out into the street

13:11

looking at her phone instead of looking both

13:13

ways, you know, the car honks. And

13:16

we remember, oh, yeah, my parents taught me this when

13:18

I was a kid. I should look both ways,

13:20

yeah. So

13:23

that's part of how it gets to

13:26

be a habit. How

13:28

do our habits get enchained

13:31

in things that aren't helpful

13:33

to us? Well, this

13:35

is where it gets really fascinating. So about

13:38

20 years ago, my lab started studying, you

13:40

know, I was really interested in breaking bad

13:44

habits. So as an addiction psychiatrist, I was working

13:46

with a lot of patients who were struggling with

13:48

smoking cessation and things like that. And

13:51

so I started looking into the process, and,

13:53

you know, we had developed some programs for

13:55

smoking cessation that worked pretty well. And

13:58

some of the folks pilot-tested. testing our

14:00

programs were saying, hey, I'm actually changing

14:02

my eating habits. And I

14:05

was thinking, well, you know, most people gain weight

14:07

because they substitute food for cigarettes. But

14:10

they would say, no, no, no, no, we're

14:12

actually losing, you know, we stopped snacking based

14:15

on using these tools. And

14:17

that got me to look at eating, and

14:19

I realized that this is actually the core

14:21

process and the way that it works. So

14:23

as we talked about with this process

14:25

of memory formation, it's called positive

14:28

and negative reinforcement. That

14:30

same process is still at play in modern

14:32

day when we have, you know, refrigerators and

14:34

food delivery and 24 hour diners. And

14:38

our brains start to learn, hey, you know, I

14:41

could use this for other

14:43

times when I'm not actually hungry. So

14:45

when we're stressed, if there's something sweet,

14:48

or some comfort food, that's the name,

14:51

we eat something, and we can get, you know,

14:53

we can numb ourselves, as one of

14:55

my patients put it, we can distract ourselves

14:58

with something that tastes sweet. And

15:00

so we learn, oh, you know, grab some

15:03

M&Ms or grab a chocolate bar or some

15:05

ice cream when you're feeling

15:07

sad, or when you're feeling lonely, or

15:09

when you're angry, or when you're, you

15:12

know, all these all these emotions start to

15:14

become associated with eating, because they trigger us

15:16

to eat as a way to make ourselves

15:19

feel better in the absence

15:21

of hunger. That's where hedonic, the

15:23

term hedonic hunger comes from. It's

15:26

based on, you know, feeling rather

15:28

than needing food. We've

15:31

talked to behavioral

15:34

economists, and they've

15:37

actually done some experiments where the

15:40

person in the office has a

15:42

big bowl of candy sitting on

15:44

the desk. And

15:46

everybody who goes by just reaches down and

15:49

grabs a piece, you know, maybe 10 o'clock

15:51

in the morning or 2 o'clock in the

15:53

afternoon. It's like, there it is.

15:56

Yum, yum. And

15:58

if you take away that. bowl of

16:01

candy. People are less likely to

16:03

snack. You don't even have to move

16:05

it very far. Just make it a little less convenient.

16:07

Oh yeah. This idea of

16:10

convenience and habit.

16:13

It's like, oh yeah, I do

16:15

that every morning about 10 o'clock

16:17

when I walk past George's desk.

16:19

How do we remove

16:22

those cues that have nothing to

16:27

do with hunger? Well,

16:29

I won't go into this type

16:31

of research because it's been really well done. It

16:33

sounds like you've interviewed some good folks on that,

16:35

but you're highlighting something where there's

16:37

several things that we can look at. One

16:39

is the environment. So if you put the

16:41

M&Ms just out of arms reach, you

16:45

know, and somebody has to take that extra

16:47

step, that can be

16:49

very helpful. And there have been tons of

16:51

experiments done in cafeterias, at workplaces, and things

16:53

like this where you put the healthier food

16:55

options at a certain place versus the unhealthy

16:58

food options, etc. You know, there's

17:00

a reason that all of the

17:02

prepackaged, you know, candy and stuff that

17:04

has a shelf life of a thousand

17:06

years is right at the checkout

17:09

counter at the grocery store, right? Because you're

17:11

standing in line and it's easy

17:13

to just reach over and put it in your,

17:15

well, maybe I don't really need some gum, but

17:18

this looks good, or whatever this cookie is, or

17:20

something else. And so those things

17:22

are strategically placed so that we'll buy more,

17:24

right? That's what a consumer economy is all

17:26

about. So that's one way

17:29

that we can affect our environment, but that

17:31

takes everybody working together, you know? And

17:33

let's just say that folks that are

17:36

looking to profit off of us consuming

17:38

food-like objects, you know, they're

17:40

not as excited as we in the

17:42

public health space because we want to

17:44

help, you know, we want to help people's health

17:47

at a population level. So those types of

17:49

things make a lot of sense. The

17:52

other piece that, and this is where

17:54

my research comes in, is

17:57

like how can we affect things on a personal level?

18:00

You're listening to Dr. Judd Brewer, professor

18:03

in the School of Public Health and

18:05

Medical School at Brown University. His

18:08

books include The Craving Mind, Unwinding

18:10

Anxiety, and his most recent, The

18:12

Hunger Habit. After the break,

18:14

we'll talk about things we can do

18:17

as individuals to help ourselves break the

18:19

craving cycle. Why does Dr. Brewer say

18:21

willpower is a myth? We'll

18:23

get Dr. Ruhl's advice on

18:25

breaking our habit loose. You're

18:39

listening to The People's Pharmacy with Joe

18:42

and Terry Graydon. This

18:45

podcast is made possible in part

18:47

by Coco Villa, backed

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19:50

Welcome back to The People's Pharmacy. I'm

19:52

Terry Graydon. And I'm Joe Graydon.

19:54

The People's Pharmacy is made possible

19:56

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information at cocovia.com. When

20:15

we give into cravings, how does that make us

20:17

feel? Often eating or

20:20

drinking too much makes us feel guilty

20:22

as well as uncomfortable. How

20:24

can we break the cycle? We're

20:27

talking with Dr. Judd Brewer,

20:29

director of research and innovation

20:31

at the mindfulness center at

20:33

Brown University. He is

20:35

professor of behavioral and social sciences in

20:37

the School of Public Health and of

20:39

psychiatry in the School of Medicine. His

20:42

expertise is in utilizing mindfulness

20:44

in novel ways to help

20:47

change addictive behaviors. Dr.

20:49

Brewer's books include The Craving Mind,

20:51

Unwinding Anxiety, and His

20:54

Latest, The Hunger Habit,

20:56

Why We Eat When We're Not

20:59

Hungry, and How to Stop. Dr.

21:03

Brewer, just before the break, we

21:05

were talking about how we

21:07

can reduce the convenience, as

21:10

it were, how we can change

21:12

the environment that invites

21:14

us to eat

21:17

when we're not actually hungry. You

21:19

mentioned that there are some things we might

21:21

consider doing on an individual level. What would

21:23

those be? Well, the

21:26

first thing I'm going to suggest

21:28

is something that probably anybody that's

21:30

struggled with eating habits has tried

21:32

and failed at, which is willpower.

21:36

So often we think, oh, well, I

21:38

just need to build more willpower, and how can

21:40

I do that? It turns

21:42

out there's a fair amount of

21:44

research suggesting I'll just sum it up

21:47

as willpower is more myth than muscle.

21:50

Well, hang on a sec, because I

21:53

cannot tell you how many messages

21:55

we get on our website from

21:57

people who are critical

21:59

of the new drug. drugs like

22:01

osempic and weekovie and munchorno and

22:03

zep and

22:16

blaming going on these days. And

22:21

what you're suggesting is that willpower

22:24

doesn't work. Yes. And

22:27

I just want to highlight the

22:29

shame and blame, which actually is

22:31

anti-helpful, because when somebody is out

22:33

there telling themselves or other

22:35

people that they should or shouldn't do

22:38

this, it makes people

22:40

feel guilty. And what does guilt do?

22:42

It triggers people to eat. I

22:46

have tons of patients who just,

22:48

you know, they feel guilty about

22:50

not being able to develop their willpower,

22:52

which ironically just triggers them to eat

22:55

more. So I just want to... Sounds

22:57

like a vicious cycle. It does. So

22:59

for anybody out there, you know, who

23:01

thinks that they've got the answer and

23:03

wants people to develop more willpower, I

23:06

would just invite them to be

23:09

reflective about that and make sure that it's... I'm

23:12

sure the intention is good, but the outcome

23:14

isn't always. I'm not

23:16

so sure the intention is good.

23:19

Okay. Well, I'll... But

23:21

we'll give you the benefit of the debt. We'll give them credit for

23:23

that. Right, right. But let's

23:25

just say that it

23:27

doesn't work. Blaming

23:29

and shaming. Forget about it. And

23:32

what about practicing

23:35

self-judgment or

23:37

self-kindness? You've suggested

23:39

there's a big difference. There is.

23:42

And so let's talk about that for a minute, and

23:44

then we can talk about other ways to actually leverage

23:46

the strengths of our brain if willpower is more myth

23:48

than muscle. So often... Boy, and

23:50

I can just... I

23:52

have a number of patients that come to mind when I think

23:55

of this, where they've gotten

23:57

in the habit of judging themselves or

23:59

feeling guilty... about their not being able

24:01

to control their eating behaviors and

24:03

then feel ashamed. You know, guilt is about the

24:05

behavior, shame is about the self. And

24:08

so guilt, they feel guilty about not being

24:10

able to control themselves. And

24:12

then they feel ashamed, you know, of

24:14

themselves. So the two can actually

24:17

feed on each other, the guilt.

24:20

You know, oh no, I can't believe I did this. And then

24:22

the shame, oh, I can't, you know, I'm a bad person. And

24:25

then those just make people feel

24:27

bad. Often I think

24:29

those habits get set up because, you

24:32

know, it feels better than doing

24:34

nothing, even though beating

24:36

ourselves up is still, you know,

24:38

an act of not

24:41

an act of self kindness or self compassion.

24:43

But it just, you know, when somebody

24:45

feels like, well, I don't know anything else to do,

24:47

I might, you know, this might help me change in

24:49

the future. The short answer

24:51

is it doesn't. And it actually sets up

24:54

habits of guilt and shame. So I just

24:56

want to highlight that for anybody that's gotten

24:58

stuck in one of those cycles. You know, it's

25:01

not your fault, it's your survival brain that's just

25:03

kind of gotten misquired a little bit. And

25:06

in contrast, we can start exploring what

25:09

it feels like when we're kind

25:11

to ourselves. And for some people, somebody

25:13

just yesterday said to me on a

25:15

group that we were working with some

25:18

folks with addiction. And

25:20

I said, you know, what's that feel like? And he said, foreign.

25:24

Being kind to myself feels very foreign.

25:26

And so often when we're

25:28

in an addiction cycle, or even just a

25:30

habit of beating ourselves up, it just feels

25:32

really strange to be kind to ourselves. So

25:35

I'll even suggest that people start with, well, what's it

25:37

feel like when somebody else is kind to you? And

25:39

they can generally feel into that. What's

25:41

it feel like when you're kind to someone else? They

25:44

can generally feel into that. And then they can sometimes

25:46

remember a time when they've been kind to themselves. And

25:49

the short answer is, well, let me ask you

25:51

all, you know, pop quiz, hotshot, what feels better

25:53

being into yourself or being kind

25:55

to yourself? Feels

25:57

much better to be kind to yourself. Obviously.

26:01

The grind wins every time.

26:03

But you've just used the

26:05

A word, addiction.

26:08

I think a lot of people, when they

26:10

think of addiction, they think of smoking, they

26:12

think of

26:15

opioids or other drugs. Alcohol,

26:17

perhaps. Yeah, alcohol. They don't

26:20

think about food as something

26:22

that could be addictive. And

26:25

yet, I suspect that

26:27

the food industry has figured

26:29

this out, and they make

26:31

their foods addictive. It's like

26:33

you can't just eat one

26:35

chip. And

26:39

help us better understand how

26:41

certain foods hack our brains

26:43

and our reward systems. Sure.

26:46

Well, you all are probably familiar

26:48

with the company R.J. Reynolds. Yeah.

26:52

So what were they famous for making

26:54

and still do? They were

26:56

famous for tobacco. Yeah. So

26:58

back in the 80s, when the industry

27:01

got busted by Congress, cigarettes

27:04

are not addictive. Wait a minute. They

27:07

started looking to diversify. So if

27:09

you look at the ticker, I think the

27:12

ticker tape for R.J. Reynolds is R.J.R. nab

27:15

because they merged with Nabisco.

27:18

Because they said, we've got a bunch of engineers. Let's put them

27:20

to work. If

27:22

we're going to have to diversify our

27:25

portfolio, let's make food addictive. And there

27:27

was a great book. And

27:30

then actually first, I think I was introduced

27:32

to Michael Moss, if I've got

27:34

his name right, who read a wonderful

27:36

New York Times magazine exposé on the food

27:38

industry way back in 2013, which

27:42

actually has a Doritos as the cover

27:44

art for the article, which is perfect.

27:47

But the idea is they've

27:49

got all these engineers that can design

27:52

substances that we ingest to

27:55

make them more addictive. So there

27:58

are all these things from the bliss point. which

28:00

is this perfect magic

28:02

formula of sugar, salt, and

28:04

fat, you know, the perfect

28:06

ratio. They get people addicted

28:09

to vanishing caloric density. So

28:11

things like Cheetos, you know,

28:13

you put it in your mouth and your brain's like, oh yeah.

28:16

And then your mouth's like, did I just eat something? Cause it's

28:18

gone. And I didn't chew. Wait,

28:23

let me try that again. Oh yeah, I ate

28:25

something. No, I didn't. I ate something. No,

28:27

I didn't. And then the bag's gone. Your

28:29

brain is therefore not registering. Oh,

28:32

I have consumed adequate calories. Your

28:37

tongue has registered. This is

28:39

so delicious. It tastes like

28:41

more. That's what Joe's mother used to say

28:44

about Hershey's kisses. Tastes

28:46

like more. I love that. Tastes

28:49

like more. Absolutely,

28:53

that's it. Yeah. And you

28:55

know, on that note, you know, even, jeez,

28:57

when did the low fat craze come about?

28:59

Was that back in the eighties? It was

29:01

in the eighties, yes. Yeah, so here's a

29:04

fun fact about that. This was

29:06

a boon for the food industry because with

29:08

the corn subsidy, you get these, you know,

29:11

high fructose corn syrup that is like dirt

29:13

cheap. They

29:15

figured out that they could spin low

29:17

fat as healthy. And

29:20

when you spin something as low fat and

29:23

you take fat out of food, our body

29:25

says, well, I'm not full, I'm gonna eat

29:27

more. So they found that they could actually

29:29

get people to consume more of low fat

29:31

food. So they'd actually taken

29:34

more calories, which they would ironically

29:36

store as fat when

29:39

they converted that sugar to fat. But

29:42

then they could build this forever as

29:44

this healthy alternative to, you know, to

29:46

eating fat. And we now know that

29:48

that was certainly more of

29:50

a myth and certainly worked extremely well

29:52

for getting people to over-consume

29:55

and take in more calories. And

29:57

it turns out that human biology is a lot.

30:00

more complicated than just the

30:02

very simple concepts that we've

30:04

been taught relative to

30:06

nutrition like calories in, calories out,

30:09

or don't eat fat, it'll

30:11

make you fat. We're far

30:13

more complex creatures than that, but

30:16

I would like to talk about

30:19

your specialty, which is changing

30:21

our habits. So we've talked a

30:23

little bit about how we develop

30:26

these habits. There's a trigger. Joe

30:31

feels stressed in an airport because the plane

30:33

is late, and so he

30:35

goes and he sees that there are good

30:37

and plenty at the kiosk and

30:39

he buys them. The behavior is

30:42

to eat the good and plenty, and

30:44

then there's the reward, which is instantly

30:46

he feels great and then a little

30:48

bit later. Not so much.

30:50

This is your story. I'm hijacking

30:53

Joe. You can chime in. I

30:55

finally learned that that's not good

30:57

behavior because it ultimately results in

30:59

feeling bad, but at the

31:01

moment it always seems like such a good

31:03

idea. So how can we break these habit

31:15

loops that you have described?

31:18

Well, I think of this and what we

31:20

found over the last couple of decades of

31:22

research is that it turns out to be

31:25

a three-step process. Don't ask me why, but

31:27

here's yet another universal

31:30

rule of threes. And the first

31:32

step is really being able to recognize

31:34

what the habit loop is or even

31:36

just starting with what the behavior is.

31:38

So being able to

31:40

identify when we're eating outside of

31:42

hunger. So it could be boredom.

31:44

It could be we're walking by

31:46

the dish of candy

31:49

or M&Ms. It could

31:51

be that we're in the clean plate

31:53

club, so we've learned to overeat, to

31:55

clean our plate as a kid, and

31:58

it seems strange to leave. on our

32:00

plate, there could be a number

32:02

of reasons that we're eating when we're not

32:04

actually hungry. And so that... It would be

32:07

that the plane is delayed and I'm feeling

32:09

stressed. Yes, yes. Great

32:11

example, this stress eating. And that's

32:13

when we reach for the comfort

32:16

food. And so just recognizing what

32:18

the behavior is, why am I eating

32:21

basically? And if it's

32:23

out of hunger, recognizing that as well, because

32:25

that's the actual natural signal trying to get

32:27

through and saying, guys, listen to me, I'm

32:29

the one that's going to help you survive.

32:33

The other guy's not so much. And that's appropriate then. Yeah.

32:35

Yeah. Yeah. So that's the first

32:37

step. And so we could go as far

32:39

as mapping out the entire habit loop, what's

32:41

the trigger, what's the behavior, what's the result?

32:44

Or we could focus in on the behavior

32:46

itself, just saying, oh, here it

32:48

is. Why am I eating? And

32:51

what is it that's driving me

32:53

to eat? Is it

32:55

the homoestatic signal of hunger or is

32:57

it the hedonic signal of

32:59

I'm stressed because my plane's late or

33:02

something like that? Well,

33:05

then what? So after

33:07

that, and honestly, that is extremely helpful

33:09

for people. I can't tell you how

33:11

many times in my clinic my patients,

33:14

when I just map out of habit loop with them,

33:17

it's like a light bulb goes on in their head

33:19

and they hadn't noticed this for their entire life. And

33:21

they're like, oh my God, this is amazing. And

33:24

so I think of that as if we don't

33:26

know how our brains work, we can't possibly work

33:28

with our brains. And so just that first step

33:30

helps us know how our brains work. Oh, this

33:32

is how we form habits. This is

33:35

my survival brain trying to help me out. And

33:38

also that helps us step out of the

33:40

self judgment of like, hey, there's something wrong

33:42

with me. I'm broken. I need to be

33:44

fixed. No, we're wonderful

33:47

as we are, whoever

33:49

we are, wherever we are in

33:51

our journey. And so

33:53

the next step is really

33:56

leveraging the strength of our brain. So

33:58

I mentioned earlier, that willpower is

34:00

more myth than muscle. When

34:03

you look at the mathematical equations

34:05

for farming habits and breaking habits,

34:07

because they're the same equations,

34:11

they don't include the term willpower at

34:13

all. It's not a variable in the

34:15

equation. So the way we

34:17

set up, I think of it as we set

34:19

habits, and most habits are helpful,

34:21

right? You know, having to relearn how to walk

34:24

and talk and eat, you know, would be exhausting

34:26

every day. So we farm

34:28

habits as a way to, I think of it

34:31

as set and forget. You set a habit, you

34:33

forget about the details. And

34:35

the way we set a habit is based

34:37

on something being rewarding. So as

34:41

a kid, if we learn to get our spoon in

34:43

our mouth, right, that gets rewarded

34:45

because we get food in our mouth as compared to

34:47

all that when we were first learning to eat, you

34:49

know, our face was a mess.

34:52

Right, it ends up all

34:54

over the high chair tray

34:57

and everywhere else. Absolutely,

34:59

absolutely. So we might not remember that,

35:01

but our parents certainly do, you know,

35:03

and it was cute at the time,

35:05

probably. And

35:07

even better when we actually could

35:09

deliver the food more efficiently and

35:11

effectively, you know, and

35:14

more regularly. So we learned to set

35:16

these habits based on reward. And

35:18

the reward could be calories, it

35:21

could be, you know, anything that's positively reinforcing.

35:23

That says, oh, that was good, do it

35:25

again. And so we set

35:27

this up, and then we forget

35:29

about the details. And so the, let's

35:32

use a concrete example. So let's say that

35:35

I eat a piece of broccoli, and I

35:37

eat a piece of milk chocolate. Now my

35:40

brain is going to compare those two. And

35:43

it's going to say, hey, from a caloric standpoint,

35:45

this milk chocolate is more calorically dense. And so

35:47

my brain is going to say, hey, I prefer

35:49

that, you know, if I had given a choice,

35:51

I'm going to pick that milk chocolate. So

35:54

it's going to set up what's called a reward

35:56

hierarchy in our brain. And we're going to,

35:58

you know, it's going to say, hey, You

36:00

don't have to, every time, compare

36:03

broccoli to milk chocolate, it's going to

36:05

prefer the milk chocolate. And

36:07

then for me, I don't know, I'd be

36:09

curious for you all, and where the good

36:11

and plenty fall within this reward hierarchy.

36:13

But for me, if I eat some

36:15

dark chocolate, hands down, I'm taking

36:17

dark chocolate every time. Then you add a little

36:20

sea salt, maybe a

36:22

little cayenne pepper. I'm with

36:24

you. Yeah. So

36:27

I'm never going to slum it

36:29

into the 70s, because my brain's

36:31

like, I'm not going to eat

36:33

chocolate that's less than 70%, cacao

36:35

content or whatever. Because dark chocolate

36:37

just tastes so much better. And

36:40

for me, I don't even notice, I'm

36:42

satisfied with eating a little bit of

36:44

it, whereas milk chocolate just drives

36:46

me to eat more. It's just, you know,

36:48

it's kind of like that. Tastes

36:51

less more. Tastes like more. Yeah.

36:54

And so I never, it actually, it doesn't

36:56

feel that great. It doesn't taste that great.

36:59

And I don't feel good for

37:01

eating an entire bar when I'm

37:03

driven to do it, versus just

37:05

savoring a few really tasty squares

37:07

of some dark chocolate. I don't know. Does

37:10

that square with you all? It

37:12

does. And we're going to stop

37:14

for a break. But when we come

37:16

back, we're going to try to find

37:18

out how we can actually break some

37:21

of those habits. You're

37:23

listening to Dr. Jed Brewer, a

37:25

neuroscientist renowned for his 2016 TED

37:28

Talk, A Simple Way to Break a

37:31

Bad Habit. He's professor in

37:33

behavioral and social sciences at the

37:35

School of Public Health and psychiatry

37:37

at the Medical School at Brown

37:39

University. He's also a research

37:41

affiliate at MIT. His

37:44

books include The Craving Mind

37:46

and Unwinding Anxiety. Today

37:49

we're talking about his brand new book,

37:52

The Hunger Habit, Why We

37:54

Eat When We're Not Hungry and How

37:56

to Stop. After

37:58

the break, we'll learn more about the hunger habits. more

38:00

about what we can do about

38:02

our eating habit problems. How

38:05

can we choose different rewards so

38:07

that we don't eat things that

38:09

make us feel bad? The

38:12

idea is to leverage our

38:14

reward hierarchy. What really makes

38:16

us feel good? Dr.

38:19

Brewer tells us about someone who was

38:21

able to step out of the food

38:23

craving cycle. We'll get

38:25

details on the eat right plan

38:28

and how it works. You're

38:38

listening to The People's Pharmacy with Joe

38:40

and Kerry Graydon. Welcome

38:50

back to The People's Pharmacy. I'm

38:52

Kerry Graydon. And I'm Joe Graydon.

38:54

The People's Pharmacy is made possible

38:56

in part by CocoaVIA dietary supplements.

39:00

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39:08

of Cocoa Flavanols to support heart

39:10

health. More information

39:13

at cocovia.com. Is

39:16

it possible to change long-established

39:18

habits? Sometimes

39:20

we get into a loop and

39:23

just repeat a behavior that's familiar,

39:25

even if it's counterproductive. How

39:28

can we break habit loops and learn

39:31

new ways to manage our cravings? You

39:33

know, Terry, I was able to

39:35

break my cycle of stress-eating good

39:38

and plenty's when I travel by

39:40

paying close attention to how that candy made me feel

39:43

after I was born. How did you feel? Not so

39:45

good. The

39:50

trick is to use mindfulness to pay

39:52

attention to your feelings. That way you

39:54

can figure out which rewards

39:57

really help and which are a loser. Today

40:01

we are talking with Dr. Judd

40:03

Brewer, an addiction psychiatrist and neuroscientist.

40:06

He's a professor in the School

40:08

of Public Health and Medical School

40:10

at Brown University. Dr.

40:13

Brewer is the author of

40:15

The Craving Mind, From Cigarettes

40:17

to Smartphones to Love, Why

40:19

We Get Hooked and How

40:21

We Can Break Bad Habits,

40:23

The New York Times bestseller

40:25

Unwinding Anxiety. New Science shows

40:27

how to break the cycles of worry and

40:30

fear to heal your mind and

40:32

his latest book, The Hunger

40:34

Habit, Why We Eat When We're

40:37

Not Hungry and How to Stop.

40:41

Dr. Brewer, we were just

40:43

talking about rewards and

40:46

we agreed that most

40:50

people, given the choice between

40:52

broccoli and milk

40:54

chocolate, will usually rate the

40:56

milk chocolate as more rewarding.

40:59

I'm assuming that all

41:02

of the people who have come to see you about

41:04

their eating habit

41:07

problems have

41:09

different things

41:11

that are their specific

41:13

rewards. How

41:16

do we deal with this in order to

41:18

change the habits? Well,

41:20

this is where we can leverage the

41:22

strength of our brain. So we were

41:24

talking about setting up these reward hierarchies.

41:26

So milk chocolate, and for me dark

41:28

chocolate is the highest reward value. We

41:32

can leverage that in two ways. Our brains

41:35

are going to, let me

41:38

preface this by saying, there's

41:40

one critical ingredient for changing

41:42

any habit and that

41:44

is paying attention. So

41:46

let's say that somebody introduces a new

41:49

chocolate bar to me and I pay

41:51

attention. If it's like the

41:53

best chocolate that I've ever had,

41:56

I get what's called a positive prediction error, as

41:58

in it's better than expected. better

42:00

than my gold standard for chocolate.

42:02

And so that's going to go high up in

42:04

the reward hierarchy, and I'm going to learn, hey,

42:06

I should eat this one more, or I'd like

42:08

to eat this one. On

42:11

the other hand, if I'm like, meh,

42:13

you know, mouthfeel isn't quite there, I've

42:15

had better, I get what's called a

42:17

negative prediction error, meaning I learn, oh,

42:19

this isn't such a great chocolate. Both

42:22

of those require awareness. So

42:24

we can leverage awareness, and we all

42:26

have awareness, right? We have to pay

42:28

attention, or we're not going to survive.

42:32

So we can leverage something that we all

42:34

have as a natural capacity, and

42:36

we leverage it by paying attention as we eat.

42:39

So for example, my lab did a study that

42:41

we published now a couple of years ago with

42:44

this Eat Right Now app, where we

42:46

actually had people pay attention as they

42:48

eat junk food or whatever their habitual

42:50

eating was, and also

42:52

as they overeat. And

42:55

the hypothesis was that as people

42:57

pay attention as they overeat, they're

42:59

going to actually start to realize that overeating

43:01

doesn't feel very good, and they're going to

43:03

get that negative prediction error, and then it's

43:06

going to be much easier to stop overeating

43:08

just by paying attention. Notice how willpower is

43:10

not part of this equation. Are

43:12

you ready for this? So guess how

43:14

long it took for that reward value

43:16

to drop below zero. I'm

43:20

going to guess that if you're actually paying attention, it

43:22

doesn't take that long. Absolutely,

43:24

absolutely. So within 10 to 15 times

43:27

of somebody paying attention as they overeat,

43:30

that reward value dropped below zero, and

43:32

they were shifting their behavior, which makes

43:35

sense from an evolutionary perspective, because

43:37

we don't have 20 times to learn

43:40

that the tiger or the bus is

43:42

dangerous. We have to

43:44

adapt pretty quickly, or we're not going to survive

43:47

to pass on our genes. So

43:49

how do you do that with food? Well,

43:52

you bring awareness as you eat. So for

43:54

example, can you think back to the last

43:56

time you overeat or had a big box

43:58

of Good and Plenties? Well,

44:01

I've given up the good and plenty's for

44:04

good, I think. But

44:08

I have to admit that there

44:11

are times when chocolate, mint, ice

44:14

cream, you know, oh, that

44:16

was so good, another

44:19

scoop would be even

44:21

better. And

44:23

so that has happened. Great. So

44:26

that's a great example, actually. And

44:28

I talk about this pleasure plateau,

44:30

where if we truly pay attention

44:33

with each bite, our

44:35

very wise body is going to let us know

44:37

when we've had enough. And

44:39

so with each bite, because if you like chocolate,

44:42

mint, ice cream, it'd be

44:44

great if you paid attention as compared to,

44:46

you know, often we're craving that next bite

44:48

while we've got ice cream in our mouth

44:50

and we're not actually enjoying the stuff that

44:52

we're consuming. So

44:55

if we're going to eat it, we might as well enjoy it. So

44:57

if we pay attention as we eat each bite and we

44:59

ask, you know, is this one better

45:01

than the same as or worse

45:04

than the last bite, we can

45:06

see when we start to hit that pleasure

45:08

plateau and our body is telling us, hey,

45:10

that's enough. Now, one caveat here is that

45:13

we can't just be scarfing it down so

45:15

quickly that we're not registering fullness signals. That

45:17

takes 15 to 20 minutes. So

45:20

if we are truly enjoying and savoring that

45:22

ice cream, let's say a scoop or two

45:24

scoops of ice cream and then we're not

45:26

immediately rushing to the freezer for more, we

45:29

can truly see where we've hit that pleasure

45:32

plateau and that awareness helps

45:34

us do two things. It helps us stop

45:36

when we're full, right, before over consuming because

45:38

that doesn't actually feel good and we lose

45:41

the joy of eating it. And

45:43

two, here's the bonus, there's more

45:46

for later. So

45:48

Dr. Brewer, I wonder if you could

45:50

tell us a story about

45:52

one of the people, perhaps

45:55

one of the people in your book, The Hunger

45:57

Habit, who have

45:59

had six... success using this approach? One

46:04

story, I was going to say, because there are so many great

46:06

stories in that book. There are a lot. Yeah. I

46:08

just want to thank all the folks that just put themselves

46:10

out there to help others by telling their stories. I just

46:12

want to thank the folks in our program,

46:15

my patients, for this. So

46:17

let's pick an example. There's

46:20

a woman named Jackie who,

46:23

ironically, I met her.

46:25

So she started using our, was one of the earliest

46:27

uses of our Eat Right Now program. This is the

46:30

program, this app that we developed that we could study

46:32

and look at all these behavior

46:34

changes, like 40% reduction in craving-related

46:36

eating. So she came in early to

46:38

our program. And what I

46:40

learned later was that she's actually a yoga

46:43

and a mindfulness instructor. And so she came

46:45

in really feeling guilty

46:47

because she's like, I teach mindfulness and

46:49

I can't control my eating behaviors because

46:52

she had a long history where she

46:54

would binge eating and she

46:57

would clerically restrict and

47:00

do all these things where she just

47:02

got in these really vicious cycles of

47:04

eating and just felt completely out of

47:07

control. And

47:09

then discovered this

47:11

process, this three-step process that we're talking about. I'm

47:13

just realizing we've only talked about two of the

47:15

three. So we'll talk about the third in a

47:18

minute. But she

47:20

started to realize that she could

47:22

actually learn to be with her

47:24

cravings. And she described this as

47:27

these craving monsters. So the more she fought

47:29

with a craving monster, the more it fought

47:31

back and eventually always won. So

47:34

that was a struggle she'd had for a long time.

47:37

And so we taught her through

47:39

the program to really start

47:41

playing with this paradoxical,

47:44

which can even sound crazy thing to

47:46

where it's just open to your craving.

47:49

Let it come in and even use

47:51

curiosity as a way to,

47:53

it's like kryptonite. You bring

47:55

out this curiosity, kryptonite, and suddenly the

47:57

craving monster isn't so powerful. strength.

48:01

And the way that works is the

48:03

curiosity helps us learn

48:05

to not just run away from our

48:07

cravings because then they'll always run after

48:09

us but turn toward them and

48:12

then explore them. Instead

48:15

of, oh no, here comes this craving, I have to fight it,

48:17

we can go, oh, well,

48:19

what does a craving feel like? And they

48:21

can start to notice that these are physical

48:24

sensations. They're restlessness, it's heat,

48:26

it's tightness, it's tension. And

48:29

the more we can bring that, oh, of

48:31

curiosity in, the more we

48:33

can open to it and see that these are

48:36

just physical sensations that come and go. And the

48:38

irony is, or the paradox, is

48:41

that we don't have to do anything but

48:43

be with them and they'll come and go on their own.

48:46

And when they come and go on their

48:48

own, we've stepped out of the cycle. That's

48:50

the third step, is stepping out. And

48:53

we can step out through

48:55

being with our

48:58

experience, just learning to open to our

49:00

experience. I love this phrase, the only

49:02

way out is through. And it

49:05

is true for

49:07

cravings. Well, I wonder

49:09

if you could give us a little bit

49:11

more detail about how Jackie was able to

49:13

step out of that cycle. I'd

49:16

be happy to. And this is where

49:18

I think of these two superpowers

49:21

of curiosity and kindness working hand

49:23

in hand. And

49:25

the way that that works, so she had

49:27

a lot of self-judgment and a lot of

49:29

shame around her eating, especially, you know, she's

49:31

a yoga instructor, she's training to be a

49:34

mindfulness teacher, you know. And

49:36

so, starting with

49:38

bringing in heaps and heaps of

49:41

kindness and learning that self-kindness is

49:44

much more rewarding than

49:46

self-deprecation or self-judgment or,

49:48

you know, self-hating. And

49:51

so, from this reward-based learning standpoint,

49:53

we have to help our brain

49:55

see what behavior is more rewarding.

49:58

And mental behaviors are just as important. important as

50:00

physical behaviors. So if

50:03

the old habit is beating ourselves

50:05

up, and this is something

50:07

that Jackie worked with, was just recognizing,

50:09

oh, here I am beating myself up

50:11

again. That's the first step.

50:13

The second step was asking, what am I

50:15

getting from beating myself up and feeling into

50:17

her direct experience and seeing that beating herself

50:20

up was actually harming her. It felt worse,

50:22

and it would drive that cycle. So

50:24

she would become, she became disenchanted with

50:27

beating herself up because it wasn't helping,

50:29

it was just making things worse. And

50:32

then shifting into this third step,

50:35

she could compare judging

50:37

herself or beating herself up to being kind

50:39

to herself. And the

50:41

self-compassion won every time. And

50:45

because it was more rewarding, it became her

50:47

new habit. So every time she could recognize

50:49

just an old habit of self-judgment, she

50:52

could immediately start to shift and

50:54

bring in the kindness and the

50:56

self-compassion. And that opened the

50:58

door for curiosity. And these were kind of

51:00

hand in hand, it wasn't linear. But

51:03

she could start to get curious about

51:05

the craving monster. I love how she

51:07

describes it, this craving monster. And

51:10

she could turn toward that craving monster.

51:12

And I think the first time she

51:14

did this, so I have this RAIN

51:17

exercise that we use in our

51:19

programs, where it's like you recognize

51:21

that there's a craving, that's the R, you allow

51:23

it to be there, and you even

51:25

open to it. And

51:27

she even commented, I say, smile, it can be

51:29

okay. And she's like, the first time she heard

51:31

that, it blew her mind. She's like, what? This

51:34

could actually be fun. So

51:36

she's like, and she says,

51:38

okay, wow, let's do this. And so

51:40

she just like smiles, and like opens

51:42

to this craving. And then

51:45

the I stands for investigation. So we get

51:47

curious, oh, what does this craving

51:49

feel like instead of, oh, no, you know,

51:51

like bracing ourselves for impact. And

51:54

then the N stands for note, where we

51:56

note our physical sensations from moment to moment.

51:58

So is it tightness? And

52:00

we can ask, oh, what is it? That's where

52:02

the curiosity comes in. And then we can just

52:04

name it. And that naming

52:07

helps, you know, kind of name it to frame

52:09

it. I think Dan Siegel might

52:11

have come up with that. But the

52:13

idea is that if we can

52:16

name something, we can put a frame around it and see that

52:18

it is just a thing. It's not us. So

52:21

a physical sensation is not me. Whereas

52:23

often we think, you know, we're so identified

52:25

with our physical sensations that we feel like, well, this

52:27

is just me. I have no control over this. But

52:31

when we can note it, like, oh, there's

52:33

tightness. Well, is tightness going to make my

52:35

head explode? No. Is tension? No. And

52:38

then we can start to watch these sensations

52:40

come and go on their own and learn

52:42

to ride them out. And that's what Jackie

52:44

learned to do. She learned to ride these

52:46

cravings. And that pushed her

52:48

back in the driver's seat where

52:50

she had control. She realized, oh,

52:53

I can just be with these cravings. They will

52:55

come and go. And that control comes from being

52:58

with them rather than doing something to try to

53:00

fight them or run away from them. Dr.

53:03

Brewer, I wonder if you could break

53:05

down into some detail what

53:08

the Eat Right plan boils

53:11

down to. Yes. So

53:13

we developed the Eat Right Now app. I think

53:15

it was back in 2014 when we first launched

53:17

it. So it's been 10 years. It's

53:20

just pretty crazy because back then, most

53:23

apps on phones were like Angry

53:25

Birds or some video game. So

53:27

we had taken this leap of faith

53:29

of testing out this hypothesis

53:31

that we could actually deliver therapeutic

53:34

treatments through somebody's phone because if they're picking

53:37

up their phone anyway, they might as well

53:39

have their therapist in their pocket instead of

53:42

their billboard that they're paying for.

53:45

So we developed this, you know,

53:47

it's basically 28 sequential

53:51

modules that are about 10 minutes

53:54

a day where it's now fully

53:56

animated, where people learn these concepts

53:58

of how their brain works. and how to work with

54:00

their brain. And then we've got a bunch of theme

54:02

weeks and ways that they can get more

54:05

in depth into it. But it basically teaches

54:07

them this three-step process where they

54:09

learn how their brain works, they learn how to

54:12

really pay attention as they

54:14

consume food, and then how to

54:16

break free from the habit. There's

54:19

a study led by Ashley Mason that was published

54:21

back in, she's five years ago

54:23

now or more, where she got a 40% reduction

54:26

in craving-related eating in people who

54:29

are using the app. So from

54:32

a scientific standpoint, if we go straight

54:34

onto the mechanism and say, okay,

54:36

if it's this reward-based learning mechanism, let's target

54:39

that with awareness, does it work? And the

54:41

short answer is it works pretty well.

54:43

And this is also the same

54:45

program that we were studying to see how quickly

54:47

people's reward value changed. And that's where we got

54:50

a drop below zero within 10

54:52

to 15 times with somebody using what we

54:54

call the craving tool that basically has them

54:56

pay attention as they overeat. Dr.

54:58

Judd Brewer, thank you so much for

55:00

talking with us on the People's Pharmacy

55:03

today. It's my pleasure. You've

55:06

been listening to Dr. Judd Brewer, a

55:09

neuroscientist renowned for his 2016 TED Talk,

55:13

A Simple Way to Break a Bad

55:15

Habit. He's professor in behavioral

55:17

and social sciences at the School of

55:19

Public Health and in psychiatry

55:21

at the Medical School of Brown

55:24

University. He's also a

55:26

research affiliate at MIT. He's

55:28

written several books, including The Craving

55:31

Mind, From Cigarettes to Smartphones to

55:33

Love, Why We Get Hooked and

55:35

How We Can Break Bad Habits,

55:38

Unwinding Anxiety, New Science

55:40

Shows How to Break the Cycles of

55:42

Worry and Fear to Heal Your Mind, and

55:45

his brand new latest book is

55:48

The Hunger Habit, Why

55:50

We Eat When We're Not Hungry and How

55:52

to Stop. Lynn Siegel

55:55

produced today's show, Al Wodarsky

55:57

Engineered, Dave Graden, edits our

55:59

interviews. views. B.J. Lederman

56:01

composed our theme music. This

56:04

show is a co-production of

56:06

North Carolina Public Radio W.U.N.C.

56:08

with The People's Pharmacy.

56:11

The People's Pharmacy is made possible

56:13

in part by Cocoa Via Dietary

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56:35

Today's show is number 1,372. You

56:37

can find it online at peoplespharmacy.com.

56:39

That's where you

56:44

could share your comments about today's

56:46

interview. You can also reach us

56:48

through email radio

56:51

at peoplespharmacy.com. Our

56:54

interviews are available through your

56:56

favorite podcast provider. This

56:58

week's podcast has some additional information

57:00

on how we can use the

57:02

principles we've been discussing to change

57:05

other behaviors besides

57:07

food habits. We'll

57:09

also find out why the

57:12

old mantra, calories in, calories

57:14

out, is not useful.

57:17

Dr. Brewer will also share

57:19

his thoughts on osempic and

57:21

wigovi and all of those

57:23

other drugs that are so

57:25

popular these days. You'll

57:27

find the show on our website on Monday

57:30

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topics we'll be covering. In Durham,

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North Carolina I'm Joe Graydon and

57:52

I'm Terry Graydon. Thank you for

57:54

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57:57

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