Ep. 331 Hunger Habit: Impact of Lifestyle, Self-Talk and Trauma with Dr. Jud Brewer

Today, I have the pleasure of reconnecting with the incredible Dr. Jud Brewer, who was previously on the podcast in June 2020 in episode 99.

Dr. Brewer is an internationally recognized addiction psychiatrist and neuroscientist. He is also a professor at Brown University and a former TEDx speaker, with his talk in 2016 amassing over 19 million views. 

In our conversation, we discuss his latest book, The Hunger Habit, and explore many subjects, from the differences between homeostatic and hedonistic hunger to detachment from body awareness. We look at self-talk, self-judgment, and dopamine survival mechanisms, addressing issues like stress-eating and comfort-eating within the context of the food and reward system. Dr. Jud also shares his perspective on macro tracking, explaining why he does not endorse it, and he introduces his 21-Day Challenge, emphasizing the need to build awareness around our habits and be present. Lastly, we dive into how trauma impacts binge eating, touching on adverse childhood events and effective ways to reflect on our past experiences and how they affect our current behavior.

Dr. Jud’s wealth of knowledge and insights offer a fresh perspective on the interplay between our habits, mental well-being, and relationship with food. Stay tuned!

“Hedonic hunger means somebody is eating- not when they are hungry, but because of a feeling or an emotion. They could be sad, bored, lonely, angry, or tired- you name the emotion, and it could be associated with food. True hunger is physiologic hunger. It is called homeostatic hunger.”

– Dr. Jud Brewer

IN THIS EPISODE YOU WILL LEARN:

• What is the difference between hedonic hunger and homeostatic hunger?
• The evolutionary survival mechanisms that drive human eating behaviors
• How our self-talk impacts our eating habits and body image 
• Why we cannot depend on willpower to change our behavior  
• Dr. Jud shares his concerns about macronutrient tracking 
• Dr. Jud discusses the simple three-step process to healthier weight loss he outlined in The Hunger Habit
• How the brain learns and remembers 
• How past traumas and adverse childhood events can lead to binge eating
• How self-awareness allows us to create healthier eating habit

Connect with Cynthia Thurlow

• Follow on Twitter
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• Check out Cynthia’s website
• Submit your questions to support@cynthiathurlow.com

Connect with Dr. Jud Brewer

• Website
• Instagram and Twitter
• TEDx Talk: A Simple Way to Break a Bad Habit

Previous Episode Featuring Dr. Brewer

Episode 99: How To Change Bad Habits – with Dr. Jud Brewer

Transcript

Cynthia Thurlow: [00:00:02] Welcome to Everyday Wellness podcast. I’m your host, Nurse Practitioner, Cynthia Thurlow. This podcast is designed to educate, empower, and inspire you to achieve your health and wellness goals. My goal and intent is to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives.

[00:00:29] Today, I was joined again by the amazing Dr. Jud Brewer. He’s an internationally renowned addiction psychiatrist and neuroscientist. He is also a professor at Brown University and a former TEDx speaker with his talk from 2016 having more than 19 million views. He last joined me on the podcast in June of 2020 with Episode 99. Today, we spoke at great length about his new book, The Hunger Habit, and speaking about the differences between homeostatic versus hedonistic hunger, the role of detachment of our bodies, the language that we use to speak to ourselves as well as judgment, the role of dopamine, survival mechanisms, the impact of hedonic hunger as this food and reward system, stress eating as well as comfort eating, the role of CICO, the impact on macro tracking and why Dr. Jud is not a fan of this, his 21-day challenge building awareness around our habits being present and lastly, the impact of trauma on binge eating and adverse childhood events and ways to look at our past experiences and our impact on today’s behavior. I know you will love this conversation as much as I did recording it. 

[00:01:55] Welcome back, Jud. It’s such a pleasure to reconnect with you.

Jud Brewer: [00:01:58] Well, thanks for having me. 

Cynthia Thurlow: [00:02:00] Yeah. And I really enjoyed reading your book, The Hunger Habit. Let’s talk about this issue surrounding being detached from our bodies. This is something I clearly see with my own patients and clients, and you have a quote in the book that says, “Hopelessly out of touch with their bodies.” So this is clearly an issue that you’re seeing within your own patients and your own research participants. 

Jud Brewer: [00:02:22] Yes. There are lots of places we could start, but there’s one. Let’s just show how important this question is. For example, a couple of years ago, I started working, doing group medical visit with a bunch of women with binge eating disorder. And we were working together for a couple of weeks and I felt like I was missing something, but I couldn’t put my finger on it. And it turned out about three weeks in, I asked some simple question like, “Well, what’s it feel like when you have an urge to eat? And can you tell if you’re hungry?” Or what I thought was an innocuous question. And then suddenly it was like stunned silence in the room. I was like, “Oh, wait a minute.” They can’t tell the difference from physiologic versus hedonic hunger. And so one woman said, “Well, I just have an urge and I eat.” And that’s what kind of broke it open, broke the dam for me to realize, “Oh, this was a miscommunication with the body and a total distancing from their bodies so much.

[00:03:22] That was the Rosetta Stone for me [laughs] being able to see, oh, it’s funny, in research that term hedonic hunger had to be developed because it’s not even an accurate phrase, hedonic hunger. What it means is somebody’s eating not when they’re hungry, but because of a feeling or an emotion. They could be sad, bored, lonely, angry, tired. You name it, you name the emotion, and it could be associated with food. But they had to come up with this category so they could measure all the times that people ate outside of hunger, because true hunger is physiologic hunger. It’s called homeostatic hunger. And we have these signals that come in. Our stomach rumbles, we feel irritable, we have trouble concentrating. There are a bunch of things that clue us into the fact that we actually need calories. But the fact that people over the years have been, and this isn’t just the last 10 years, this is for a long time, people have been associating eating food not with actual hunger, but with emotions. They had to come up with a new term to actually study it. 

Cynthia Thurlow: [00:04:28] Yeah. It’s really interesting because you differentiate– helping people understand differentiate this true intrinsic hunger versus cravings and what physiologically is actually going on in the brain to help explain this. And I think maybe starting there will help people kind of understand that in many ways, whether it’s maladaptive patterns or conditioning that we received while we were children and young adults, but helping them understand what’s going on in the brain physiologically that’s triggering these reactions to whether it’s cues or triggers or other things that are ongoing that stimulate us to eat. 

Jud Brewer: [00:05:05] Yes. Let’s start with the survival mechanisms that are designed to help us really thrive. And those go back, evolutionarily speaking, all the way to the sea slug. So very evolutionarily conserved process where humans before there were refrigerators or food delivery services or all-night diners, we had to remember where food sources were. So imagine our ancient ancestors, whether it’s in the woods or on the savannah, they had to find food and then remember where it was. So, this is a memory device that our brains have evolved to use to help us remember where food is. And you can break it down to three elements, a trigger, a behavior, and a result. So we’re foraging for food, we see the food, there’s the trigger. We eat the food, that’s the behavior. And as a result, our stomach sends this dopamine signal to our brain that says, “Remember what you ate and where you found it?” So it’s there to set up context dependent memory. The same is true for danger. If we’re out foraging, we see danger, there’s the trigger, we run away, there’s the behavior, and then we’re not lunch, we don’t get eaten. There’s the result or the reward from a neuroscience standpoint. We also learn, “Hey, that part of the savannah is kind of dangerous. You should maybe find food elsewhere.”

[00:06:30] And in modern day, we call those positive and negative reinforcement, because that’s how we learn to find food and to avoid danger. That’s healthy, helpful. When our stomach rumbles and it says, “Hey, go get some food because your stomach’s empty.” It’s interesting, the dopamine firing shifts from finding food to anticipating food. So, it’s there as this motivation signal. And I want to highlight that because there’re so many misconceptions of neurotransmitters and particularly dopamine on the Internet, where everybody thinks that dopamine is a pleasure molecule. It’s not supposed to be a pleasure molecule. It is not a pleasure molecule. If you ask my patients, [chuckles] any drug of abuse hijacks the dopamine system. Cocaine, amphetamine, pick any of these that really ramp up dopamine in the synapse one way or the other, blocking dopamine transporter or just increasing release. They talk about paranoia. They talk about restlessness. They talk about these urges that are just so unsatisfactory. I had a patient come into my office once who said, “I feel like my head’s going to explode,” it was someone trying to quit smoking. So, he felt like if he didn’t smoke a cigarette, his head was going to explode. Notice how none of that is related to pleasure, it’s about motivation. Dopamine is a motivation molecule that says, “Get off your couch, get out of the cave, whatever, and go get some food.” So, I just want to highlight that because I think well-intentioned people on the Internet will do research on the Internet, [laughs] and then these things get perpetuated just because they rise to the top, not because they’re true. 

Cynthia Thurlow: [00:08:12] Right. And I think that’s really helpful because I think, in many ways, dopamine is misunderstood or it’s thought of as just this, as you stated, pleasure-seeking molecule. But in fact, it’s far more complicated than that. And so, as we’re navigating these conversations, I think language becomes very important. And that’s certainly something that you discuss in the book, not just the language that we have with ourselves internally, but how we’re actually expressing what we’re experiencing. And so, when you’re working with your patients and trying to determine, unpack, uncover what is the motivation behind their behavior? What are some of the common things that men and women will say to themselves? I think it can be very pejorative sometimes– I will oftentimes say, if someone’s articulating something that’s very pejorative towards themselves externally, I can just imagine the internal dialogue that’s ongoing.

Jud Brewer: [00:09:08] Yes. This is so common that I actually learned this from a western Buddhist monk. [laughs] He described these committee members in our heads, where we have these committee members and the biggest one that I see is the judging committee member, where there’s this voice in our head that says, “You should do this, you shouldn’t do that.” And I’ve heard the joke, “We should [unintelligible 00:09:31] ourselves.” But we think that that is a voice of reason or a voice of, I don’t know, our mother, our aunt, [laughs] or whoever that’s well intentioned. And so, we just assume that’s the way to get things done. And so, if it’s like, “Oh, you should eat healthier, you should not eat that second cookie, or you should exercise more or whatever.” All of these come with not really– I mean, it’s well intentioned. So I could think of it as trying to hold ourselves kindly, but it’s not kindness. It’s kind of, “Oh, judgment, judgment, judgement.” That’s the underlying tone there. So that’s the biggest one that I hear. I’m guessing you’ve seen the same. 

Cynthia Thurlow: [00:10:14] Oh, absolutely. I think especially because I’m known for intermittent fasting, I will hear women that are like, “I’m bad because of X.” It’s either they didn’t fast long enough, they over fasted, they ate too many carbohydrates, and now we’ve vilified carbohydrates. We have vilified so many foods over the past 20 to 25 years that I’ve been in clinical practice. And so, I hear the narrative all the time. What used to work for these women, in particular in their 20s and 30s, stopped working in their 40s and 50s. So they should start coming out. Women are so hard on themselves in particular. And the one thing that I think I have found so fascinating as I’ve started to understand the psychology behind eating and motivational behaviors, so much of it is our interrelationship, whether it’s how we were raised, the relationships we have with our parents, modeling that we saw in our same gender parents, the people we interacted with as a friend or peer group can have such a large impact on how we view ourselves.

[00:11:18] Like, as an example, women being put on a pedestal because they’re able to maintain a certain size or someone that seems to have so much constraints around food, but then they go home and they have so much shame about their bodies and their relationship with food that maybe they binge in secrecy or it’s those kinds of complex behaviors that I find really interesting. And so obviously, this is a lot of the work that you do, is finding that motivational behavior and how to help people kind of reroute their lifestyle choices. 

Jud Brewer: [00:11:49] Yeah. So we might even be able to highlight some of that and just build on. We’ve talked about the healthy homeostatic hunger. Let’s talk about how hedonic hunger gets set up. And this could be, it doesn’t have to start in childhood, but it often does for many people, where it could be as simple as associating birthday parties with cake and ice cream and fun. And so, we lay down this reward value of ice cream being this rewarding thing and we’ve got all these great memories. And to me, ice cream tastes pretty good. Don’t know about you. So here our brains have learned that chocolate or ice cream is rewarding. And then when we come across something that’s unpleasant, like we’re sad or we’ve had a tough day at work, or we feel exhausted, or somebody’s just berated us, or we’ve just berated ourselves, [laughs] that judgmental voice in our head. Then our brain says, “Well, doesn’t chocolate taste pretty good? Why don’t you have some chocolate?” And we think– we don’t even think about this. But our body says, “Well, not really hungry.” But our brain is like, “Yeah, yeah. Have that, try that. Chocolate is pretty good.” And so, we eat some chocolate and we learn this is where stress eating habits come in or comfort eating. That’s why comfort food is called comfort food, because it comforts us.

[00:13:11] I had a patient with binge eating disorder. She’d been binging for probably 20 years, and she was at the point when she came to see me, she was binging on entire large pizzas, 20 out of 30 days a month, so pretty severe. And she described it this way. She said, “I binged to numb myself.” Because she had started this, I think she was eight or 10 when her mom was emotionally abusing her. And she said the only mechanism she had at the time was just to eat because that was something she had control over. So she would start eating and she said she would eat to numb herself. And by the time she came to see me, she was binging, pretty out of control. And then on top of this, she was beating herself up for binging. And because the only thing her brain knew to do to help her with something unpleasant when she would binge, sometimes she would binge on top of a binge as a way to numb herself from beating herself up from binging. And so, you can see how this can become a vicious cycle when we just don’t know how our brain works. 

Cynthia Thurlow: [00:14:11] Yeah. And it’s really interesting. I remember reading that in the book, and for me, it got me thinking about the advent of companies like Weight Watchers as an example. And I guess that started in the 1960s, which preceded you and I being born. But still, that prevailing diet dogma, emphasis on calories in, calories out, how does that factor into the work that you’re doing? Because I feel like we, as healthcare providers, are still working really hard to help people understand that it’s more than just the amount of calories we take in and how much we exercise. There’s so much more to it than making it so simplistic and whittling it down to CICO, as we typically call it. 

Jud Brewer: [00:14:56] Yeah. Are you ready for this? So I was actually fed this in medical school, and I check in with medical students to see what their curriculum is, and they still learn this. And the formula is correct. I call it calories in, calories out, CICO, I guess. [laughs] But it’s the same thing. And so, this formula is correct. And the way I learned it in medical school, it was like a Newtonian law. It’s like, “Oh, yeah, just tell them to stop eating cake and to eat salad, and you’re all good to go.” [chuckles] And I ate it right up. Okay. And then I start my actual practice and I’m like, “What am I missing? Because this is not working. This is terrible.” And then my patients are binging on top of– because they’re feeling bad about themselves. And so I had to go back and look and it turned out– this happened to be at the time when I was studying, trying to help people quit smoking. And we’d just done a big randomized controlled trial in my lab. I was at Yale at the time where we got five times the quit rate of gold standard treatment. 

[00:15:51] And somebody in that program said, “We were developing an app called craving to quit.” And somebody in the program that was pilot testing, it said, “Hey, I’m changing my eating habits.” And I assumed that they were just gaining weight because most people eat more to substitute food for cigarettes because the willpower thing doesn’t work so well. And they said, “No, I’m actually cutting down on my eating habits.” And that was a big aha moment for me to go and look at eating. And then it turns out that this mechanism is really based around eating. We didn’t evolve with cigarettes, but we did evolve with food, because we have to eat. And so that’s when I started realizing that this was a common mechanism. And when you look at it from a neuroscience standpoint, willpower is not in the equation at all. Childhood is not even in the equation to a large degree. We set up these reward values for behaviors so we can set them up as a kid, but we can also set them up later in life.

[00:16:47] If a kid’s throwing a tantrum in the grocery store and then the parent gives them a lollipop to soothe them, then suddenly the kid has just trained the parent to feed them lollipops, and it’s not the parent’s fault. And it’s not the kid’s fault either. They just need some soothing. And so if the parent can step back and just ask, like, “What does my kid need as compared to what do I want?” Which is I want them to stop screaming. And probably everybody in the grocery store [laughter] isn’t pleased about this either, but that highlights how we go down these paths of, oh, just use your willpower and then wonder why it doesn’t work when we’ve been feeding these habits, sometimes for a lifetime.

Cynthia Thurlow: [00:17:27] Yeah.

Jud Brewer: [00:17:27] So I got totally fascinated by this, especially as a neuroscientist, talking to my colleagues who are doing this very basic neuroscience and then doing my own clinical work, I’m like, “Wait a minute. This is a true thing. Like, the neuroscientists are right. They haven’t missed something. It’s not about willpower at all.” And that’s where I shifted my whole research focus and then treatment focus around helping people change their relationship to eating in a different way without willpower. 

Cynthia Thurlow: [00:17:53] Yeah. And so, there’s something you refer to a concept called the abstinence violation effect or AKA eff it when you’ve binged or you’ve gone overboard. And I found this particularly fascinating related to willpower because I think inappropriately so. Certainly, when you trained, when I trained, we were kind of taught, “Oh, it’s just a matter of willpower. You just need to condition your patients to understand that if they just want it badly enough that they can do X, Y or Z, and it just doesn’t work that way.”

Jud Brewer: [00:18:24] Right. And I just want to highlight something you just said. If they just want it badly enough, which puts it on them. So more shame, more blame, and a great marketing tool for any program that’s based on a specific diet, because they can say, “Oh, the formula is correct, you just need more willpower, you should sign up for another year.” [laughs] And it’s just really sad because I’m sure that’s well intentioned as well, and I’m sure there’s some profit motive behind it. But I don’t know if you noticed Oprah not too long ago, she’s a big stakeholder in Weight Watchers. She went on the record, like this big Wall Street Journal article where she kind of apologized for telling people to use willpower. And it’s not like it’s her fault. Weight Watchers has been doing this from the inception. It’s like those shame-based weigh ins for the weekly meetings and all of this stuff where it’s like, “Oh, you just need to have more willpower and let’s reward all the people that do have willpower with their way in and the smiles and the congratulations.” Well, that’s just setting people up for failure. 

[00:19:29] And on top of that, this abstinence violation effect comes in. So as my patients call it the eff it. It’s like, “Well, I tried this, I lost a little weight, I gained it back, this is hopeless for me. There’s something wrong with me and so eff it, I’m just going to eat.” And so, they go on a binge or go right back to the old habits or even more. And it’s just really sad because they’ve just been miseducated by the public and by a public servant. I wish we could change medical school and nurse practitioner school curricula to reflect this adage, but I think it’s going to be really challenging because a lot of doctors, a lot of psychologists, a lot of medical professionals have a lot of willpower. And so, they’re like, “Well, there must be something wrong with you or it feels like they have a lot of willpower.” Because they’ve succeeded and they’ve made it through all this higher education process. But you know what? It may not be willpower that got them through that. [laughs] Just saying. 

Cynthia Thurlow: [00:20:30] Yeah, no. And it’s interesting because people will say to me when I’m speaking at an event or I’m doing a podcast, and we’re kind of reviewing listeners questions, what are the questions they want to know more about? And I always tell them that I’m not a good example of what necessarily works for everyone. And it’s important for each one of us to do a little bit of work to find out what’s most motivating or what works best. I think that in many ways, that I have successfully found what works for me personally. Like, my one great vice in life is dark chocolate. Listeners know this, but even I have episodes where like over the holidays, probably, like a lot of people listening, you unknowingly start eating more of whatever your trigger food or foods are. And all of a sudden, before you know it, you’re like, “Wait a minute. I am like way beyond where I should normally be. How do I bring myself back?” 

[00:21:23] And I found for myself on January 1st, fully transparently, I’d eaten too much dark chocolate over two-week period of time. And it was really challenging, maybe for the first time in my adult life to kind of realize that, “Okay, let’s think about why we’re eating it. Maybe it’s the stress of being around family members. Maybe it’s trying to adapt to a crazy travel schedule, whatever it is.” But it’s amazing. The more I resisted eating more chocolate, the more I felt like it was becoming increasingly more challenging to avoid it. And I would assume that’s probably pretty common.

Jud Brewer: [00:21:59] Yes. And that’s where the abstinence violation effect comes in. And this saying, “What we resist persists.” And so, I just want to give a quick shout out to the people in my book, because it’s really these voices from my clinic and from our Eat Right Now program that really bring these concepts to life. Because they’re speaking from their own experience. Almost all of them agree to use their real names because they’re like, “Look, I’m not ashamed of this.” Because they’ve learned how their brains work. And so, I’m thinking of several folks with this abstinence violation effect and how they resisted and resisted and resisted. And there’s a woman in the book, her name is Jackie and she described the craving monster, and she said, “The more she fought with it or ran from it, the stronger it got.” And so here we can learn. I love dark chocolate as well. [Cynthia laughs] But we could even use this as an example of how we can actually change our relationship to eating in a different way. 

[00:22:59] And I’ll start by saying this provocative statement, which is “the why” doesn’t even matter. It doesn’t even matter. So you mentioned, why was I eating more dark chocolate during the holidays? To change a habit. Doesn’t matter, doesn’t matter. As much as our brain is like, “If I could just figure out why, then the implication is that we can fix it.” But really, what we need to figure out is how our brains work. And this reward-based learning system, this reinforcement learning, the only part of the equation that “the why” comes in or is the trigger. It just sets the process in motion. So we could try to avoid our triggers, but that ultimately is really hard, especially when it’s food because we all have to eat to survive. You can try avoiding alcohol or cigarettes, because you don’t need those to survive. But good luck avoiding food. And the other part is, why not actually enjoy some chocolate? I don’t know about you. I know about you now, but I love dark chocolate as well. So we can actually find ways to change that relationship so that we can enjoy the chocolate in a guilt free manner and at the same time, learn how to work with our brains. That’s a winning formula. And we’ve actually seen that in our research. In one study, we got a 40% reduction in craving-related eating through a non-willpower-based methodology. 

Cynthia Thurlow: [00:24:21] No, and I love that idea because I think what we’re looking for is sustainability. Something that we can practice, we don’t feel like is making us more uncomfortable or triggering disordered relationships with food. Because, to your point, we need food to survive. We may not need some other accessory things like alcohol or cigarettes. What are your thoughts on tracking macronutrients? So, whether it’s protein, fat, carbohydrates, do you find that that is helpful for individuals that are trying to cut back on specific things or is the awareness is that helpful or harmful? 

Jud Brewer: [00:24:58] I would say if I had to pick one or the other in general and it’s really hard to generalize for individuals, but in general, I’ve seen it to be more harmful than helpful. And here’s the reason. One, it’s really hard to accurately track. Two, there are lots of reasons for us to then focus externally rather than listening to our bodies. So it actually divorces us and distances us from our own bodies. And relatedly, number three is that our bodies generally tell us everything that we need to know as long as we can learn to listen to them. So I’ve seen many, many failures where somebody says, “Oh, I can have this number of calories or I can eat this number of carbs.” I remember a guy tracking his calories and he’s like, “I’ve got this number left.” And so, he opens up one of those bowl size dishes or containers of ready-made icing and gets out a spoon. And then just, it’s like, “Okay, this number of calories, boom, boom, boom.” One, it turns my stomach just to think about that. But two, it’s like, “Well, somebody who’s like, I love icing, and I have this number of calories.” It’s probably not the healthiest way to go about living. And if his aim is to, I mean, he was trying to lose some weight I think, let’s listen to our bodies, because our bodies are going to tell us everything that we need to know. Let’s use dark chocolate as an example. Why don’t we use that as a concrete example? What do you say? 

Cynthia Thurlow: [00:26:23] I think that sounds great. 

Jud Brewer: [00:26:25] Okay. And I highlight this process in the hunger habit. But it really is pretty simple where the first thing is three steps. It’s funny how everything ends up being three steps. I didn’t force this function. It was just through our– We did a bunch of research over 10 years in a lot of focus groups with people in my clinic and using our programs, and it turned out that it was about, with our qualitative research, about three steps. So, the first step is just being able to identify the behavior. If you want to fully flush that out, it could be mapping out the habit loop. So, I think of it as “the why, the what, and the how?” So why am I eating? And not as a way to focus on “the why?” to fix it, but just somebody can differentiate hedonic versus homeostatic hunger. So they’re eating because they’re hungry, great, they’re listening to their body. If they’re eating outside of hunger, if they’re overeating, probably not so helpful or healthy. And then “the what?” Are they reaching for comfort food? Are they reaching for the calories that their body is telling them that they need? And the more people can calibrate and listen to their bodies, the more they’re like, “Yeah, I need some protein right now, as compared to, I want some carbohydrates.” The carbs are tricky because they trick us into thinking, it’s like, “Oh, you need me, but it’s really you want me, because I’ve been refined that way so that you will want me.”

[laughter] 

[00:27:45] Somebody said this to me a little while ago. They were talking about, I think, it was Good & Plenty candies. And he said, “It tastes like more.” [laughs] Because you can’t even differentiate what exactly one of these artificial things is like. And for me, it was gummy worms. Gummy worms really taste like more. And when I really pay attention, they taste kind of sickly sweet. They’re not very good. And we can go into that later. But that’s the first step, is like, “What is it that I’m eating?” And then, “How am I eating? Am I paying attention as I eat or am I just scarfing it down?” So for me, gummy worms, I’d eat the whole bag, because I was just so addicted, it was just like, “Okay, at least they’ll be out of the house.” So that’s the first step, is just recognizing– I think of it. You can simplify it to just, what’s the behavior? Am I eating because I’m hungry or because of some emotion, boredom, something else or just habit, often you see the food and you eat it.

[00:28:43] The second step really leverages the brain in a beautiful way. Our brains are so beautiful in how they work. And so, there’s a part of the brain called the orbitofrontal cortex that determines the reward value of something. And often we talked about, we set a reward value when we’re kids, like ice cream, cake, things like that. So we set this composite reward value and then we forget about the details and we go through life. And this is actually helpful so that we don’t have to relearn everything every day. We can make decisions quickly. From a calorie standpoint, our survival brains will look at broccoli versus chocolate and say, “Chocolate’s got more calories. Go for that.” And that’s why often we’re like, “Well, why do I like chocolate more than broccoli?” Well, our brain saying, “Hey, prepare for famine.” Even though for most of us, we don’t need to prepare for famine. But the important thing here is we set these reward values and the only way to change them is through awareness. I want to highlight that. I’m going to say that again. [chuckles] 

[00:29:46] “The only way to change your habit is by paying attention to how rewarding or unrewarding the behavior is.” No willpower, no childhood. The childhood can be where the reward value gets set up, but in present moment, it’s not about our childhood, because that’s over. That’s happened in the past. And so, let’s use a concrete example. Let’s say chocolate cake. Let’s say, there’s a new bakery that opens up in my neighborhood and I go in there. I don’t know how good their chocolate cake is, so I eat their chocolate cake. And if it’s the best chocolate cake I’ve ever had, my brain gives a dopamine signal, that says, remember this. It’s called a positive prediction error because it’s better than expected. It’s an error meaning it’s different from the baseline, okay, not that something went wrong, but something actually went dopaminergically right, as in, I learned something. On the other hand, if it’s the worst cake I’ve ever had, I also learned something, which is these guys need to get their act together if they want to keep their bakery going. I’m not coming back because I’ve gotten a negative prediction error that says, “Hey, not the greatest cake.” 

[00:30:52] And we can leverage that in two ways and we actually did a study and published it now a couple of years ago, where we have people pay attention as they overeat or as they ate junk food, and we could actually measure the change in reward value. Are you ready for this? It only took 10 to 15 times of somebody paying careful attention as they over ate for that reward value to drop below 0. And what that meant was that they were getting consistent negative prediction errors that said, “Hey, you need to update the reward value of this behavior.” Whether they learned it as a clean plate club as a kid, or just didn’t want to waste food, or they’re not paying attention in a social situation, whatever it is, when somebody overeats, they can actually unlearn that pretty quickly, which is great. And that’s really the power of our brain. Our brains are tremendously plastic. They can change very quickly as long as we know how they work and we can leverage those mechanisms. So, I’m going to pause there, I said a lot with these first two steps, but before we go into the third step, does all of that make sense? 

Cynthia Thurlow: [00:31:57] It does make sense. And I think for people that are listening, helping them understand that this growing awareness piece is so important, because to me, when I hear the word awareness, it’s a pause, it’s a reset. It’s getting familiarized with what is going on around you and within yourself around this particular challenging behavior that you are attempting to shift or change. 

Jud Brewer: [00:32:23] Mm-hmm. Yes, that’s put nicely. And notice how none of that has to do with telling ourselves that we did a bad job, or we did a good job, or we should do better or we shouldn’t do this, or we should do that. All of that’s up in our head. What really drives change is our body. I think of it this way, that our feeling body is much stronger and wiser than our thinking brain. As much as we like to think that we can do anything, well, and for anybody that thinks they can, I say, “Go for it. Just think your way. Tell yourself to stop eating junk food and see how well that works.” Most people have tried that and failed. So that’s really leveraging the strength of our brain. It seems paradoxical at first and I will say it seems extremely scary at first to most people, especially people that have the voice of the food police in their head where they set up all the food rules and then they police themselves and they put themselves in food jail for whenever they break the rules and then they beat themselves up. It’s a terrible cycle to be stuck in. I still [chuckles] remember the look on several people’s faces when I said, “Just go ahead and eat whatever you want.” And they’re looking at me like I’m crazy. And one person said, “I can’t do that.” And I said, “Well, it’s going to be hard to change until you give yourself permission.”

[00:33:47] Jackie actually highlights this beautifully in the book where she talked about giving herself permission. She had just come off of a very unpleasant interaction with her mom, let’s just put it that way, and she used to drive to a grocery store and then go and listen to loud music and get a bunch of food and binge in the car. So she sits in the car– I think she was crying at the time because it was a really tough interaction. And then she gives herself permission to get whatever she wants in the grocery store. This is part of the she joined our Eat Right Now program and was using the tools to do this to give herself permission. And she goes in and she started asking herself each time, “Well, what’s going to happen if I get this and eat this?” Because she’d done it so many times, she could actually feel into the results. And she actually came up with this term and I love it. We call it developing your disenchantment database or data bank. She’s from the UK, so she called it your disenchantment data bank. And the idea is that the more we do a behavior that’s unrewarding, the more that gets laid down in memory. 

[00:34:47] And as long as we can recall what that was like, we can leverage it without having to go and experience it again. If we haven’t paid attention, then we need to collect those data, which is why I give my patients permission or have them give themselves permission to go and eat because they’ve got to develop the information. But most folks already have that stored away somewhere. So Jackie develops this disenchantment data bank. She goes in the store. She’s like, “If I eat this, this will happen. If I eat this, this will happen.” And she walks out of the store, I think it was with avocado and some spinach. And she said she left the car park laughing like a lunatic if I remember correctly. Because she’s like, “Oh, my God, this is tremendously freeing to give myself permission,” because she had developed that disenchantment and she had gone to the bank and taken out the deposit that she’d put in. And she’s like, “Oh, yeah, this is the best thing.” 

[00:35:40] And the best thing actually gets into the third step, which I call the bigger, better offer, which can simply be stepping out of the old habit loop. And the way I think of step three is it’s really finding anything that’s more rewarding, not a substitute, but really finding a behavior that’s sustainable, as you said earlier, that’s more rewarding than the old behavior. And for many people, it’s simply stepping out of the old habit loop. And maybe we could use. I’m sorry to keep talking so much, but I just get excited about this. You talk about dark chocolate and there’s actually my friend Dana Small, who’s a food researcher at Yale, did a study for her PhD thesis with dark chocolate. Actually, it was with any chocolate, she gave people choices to pick their favorite chocolate. And then she started feeding them while she was scanning their brains and also had them rate how much they liked the chocolate. So at first, it’s like their favorite chocolate, and they’re like, “I can’t believe I’m getting paid, somebody’s feeding this to me, [Cynthia laughs] this couldn’t better.” And then she kept feeding. That was the catch. And you can just imagine how this goes. I think the record, the person that ate the most squares of chocolate, I think it was 74 pieces of chocolate. 

Cynthia Thurlow: [00:36:51] Oh, my gosh.

Jud Brewer: [00:36:51] I know, but she would basically feed people until they rated the scale as, this is disgusting. Eating more would make me feel sick. And so, what that highlights is that our bodies have these inborn, very wise mechanisms to tell us when we’ve had too much. And I think of this as the pleasure plateau. So can we use you as an example, if that’s okay. 

Cynthia Thurlow: [00:37:12] Absolutely. 

Jud Brewer: [00:37:13] Okay. So do the thought experiment and think back to a time when you are eating dark chocolate. And so, describe the first square or the first bite. How the taste feel? Just the general experience.

Cynthia Thurlow: [00:37:27] I mean, it’s blissful to me, I’m happy, my tastebuds light up, I’m really enjoying, because I like salted dark chocolate. So I’m really enjoying the marrying of those two flavors. And I’m happy with that one square, I’m really blissful. 

Jud Brewer: [00:37:45] Yeah, yeah. And I found that a little bit of cacao nib as a little crunch is part of it or even a little bit of cayenne. So, yeah, I’m totally with you on the sea salt. And you can see how you can find that bliss point, so to speak. Okay, so now the question is, as you imagine eating the next bite and the next bite, ask yourself, “Is this better than the same as or worse than the last bite?” And you don’t need to go through every single bite. But can you see where that starts to plateau out-

Cynthia Thurlow: [00:38:17] Exactly.

Jud Brewer: [00:38:18] -from your experience?

Cynthia Thurlow: [00:38:19] Yeah. And that’s why, for me, I always try to be cognizant and present. So, I eat it slowly because I’m enjoying it. I’m trying to savor that first bite. But if I have another square or a few more squares, absolutely, that bliss point starts to kind of digress. It’s not nearly as wonderful as the first bite. And so, I think that’s why I’m so conscientious about enjoying and savoring the first square, because I know if I have two more or one more or five more, I know that I’m not going to feel nearly as good as I did with the first. 

Jud Brewer: [00:38:57] Yeah. So, let’s highlight a couple of things there, because you’re highlighting everything that we’ve seen in our research and I’ve seen in my clinic as well. So one, I love the, I don’t know if it’s a bumper sticker or a slogan, but it’s like, “You must be present to win.” And so you’re describing savoring and the only way to savor is to truly be present. So we’re not eating something to numb ourselves, but we’re eating something to truly enjoy it, that’s the first piece. The second is that our body is going to tell us everything that we need to know. I didn’t hear any willpower in what you described. And so, we can naturally hit that pleasure plateau and coast to a stop without having to slam on the brakes before we go off what I call the cliff of overindulgence. [laughs] So we don’t have to say stop because we’ve coasted to a stop because our brain says, “Hey, you’re done.” The bonus, ready for this? The bonus is there’s more chocolate for later.

Cynthia Thurlow: [00:39:52] No, no. And I actually think about that because my whole family knows I have my little chocolate stash in our pantry. And thankfully, even though I have teenage boys, no one touches my stash because they know I’m like, “This is like mom’s one thing,” but I can tell you if I get to a point where there’s no stash of said dark chocolate, it provokes a little bit of anxiety.

Jud Brewer: [00:40:15] Yeah. [laughs]

Cynthia Thurlow: [00:40:16] I mean, it’s interesting. Like I was saying to my husband, “I don’t ever want to be one of those people who feels like they need a fix.” But to me, if there’s plenty there, I’m like, “Oh, good, so tomorrow when I come back, if I want a square of dark chocolate, it’s there.” Versus if I go to my stash and there’s nothing there, I’m like, “Oh, I’m disappointed.” I’m like, “Oh, this is disappointing.” I’m so sad about this.

Jud Brewer: [00:40:38] Well, maybe said good husband will listen to the podcast and make sure your stash is always full. 

[laughter] 

Cynthia Thurlow: [00:40:44] No, he is good about that. He’s definitely good about that for sure. So where is the point to which I’ll use myself as an example? I do fine with dark chocolate. I can limit. I’m aware of when I’ve had enough and I can put it away. But if you give me a gluten-free brownie as an example, something that has flour in it, totally different. What’s going on in my brain that makes me want more and more and more? I almost feel like the cart is going to go off the rails if I’m not being fully present and cognizant of what I’m doing. 

Jud Brewer: [00:41:18] Yes. So brownies, whether they’re gluten free or not, have– And this has actually been engineered, there’s a term called the bliss point. And so, this perfect mix of salt, sugar, and fat, whether it’s ice cream or brownies. But you can see how there are certain foods that hit that pretty well. Ice cream and brownies are great examples because brownies are basically, what, sugar, butter and flour and some salt and some chocolate, if you make chocolate brownies. And so, the idea there is that our bodies are saying, “Hey, this is a great source of calories and I can pack it in,” and so our bodies are saying, “Eat more, eat more, eat more because they’re preparing for famine.” Whereas dark chocolate is saying, “You know this is delicious. It’s not going to be the fastest way to get calories in.” So we have these built in mechanisms that say, “Don’t bother trying to binge on dark chocolate. The brownies are going to be the best way to do that.” And so, it’s really set up for the– and I don’t know, tell me. I’ve noticed this. I love doing experiments on myself, and one of them is to just look at the different levels of chocolate, the cacao percentage in a chocolate bar. 

[00:42:33] And so, milk chocolate has much lower than semi dark or whatever, like 50%, 60%, 70%. And I’ve noticed that the more monster comes out for me below 70% and so I won’t even [unintelligible 00:42:48] below the 70s anymore because it’s just like that urge to eat more overtakes the joy of actually eating it. And if I want calories, I’d rather get them from something that’s not chocolate, [laughs] like protein. For me, if I need calories, I love eating something that’s a good protein source because it keeps me full for a long time. Especially as compared to, like, brownies or something with a lot of refined carbohydrates. 

Cynthia Thurlow: [00:43:17] Yeah, no, same. And for me, I’ve just learned that I can moderate my behavior around dark chocolate. And same with me, 70% or greater. I mean, if it’s 80%, then I’m definitely– It’s very easy to moderate versus the times in my house. And I have teenage boys. And sometimes there’s like, “We’ll make cookies or we’ll make brownies,” and my husband sometimes will watch me just throw things out. And I’m like. because it’s getting to a point where it’s almost like a siren beckoning to me. And I’m like, “I don’t need it.”

Jud Brewer: [00:43:50] Yeah.

Cynthia Thurlow: [00:43:50] I am aware of that. But I also know that my ability to be present and enjoy and savor is mitigated by that bliss point. And listeners are familiar with the bliss point. We know the processed food industry does a really great job of ensuring that we can have an endless bag of Doritos or brownies or whatever it is, because they want to sell more of their products. And ultra-processed foods are, I think they make up 70% of people’s diets right now. So it really is a huge challenge to manage your hedonic impulses under those circumstances. 

Jud Brewer: [00:44:29] Yeah, for sure. My favorite peer-reviewed journal “The Onion.”

[laughter]

[00:44:35] For those of folks that don’t know what The Onion is, it’s a wonderful satirical newspaper. And they had a headline once that said, “Doritos celebrates its 1 millionth ingredient.” 

[laughter]

Cynthia Thurlow: [00:44:50] So, in your experience, what are the foods that people struggle with most? I’m assuming it’s probably the processed carbohydrates. But is it particular foodstuffs in general that seem to give patients the most trouble? 

Jud Brewer: [00:45:05] Well, it depends on the person. So often, people have developed whatever their comfort food is and that can happen early in life. It can happen in teenage years. It can happen in adulthood. And so, the category is really more important than the type of food. And it really comes down. The bottom line is and this is, I’m sure everybody already knows this. Anything that’s processed, basically. For me, it’s simple, like whole food and I like plant-based diet. So whole food, plant based for me is really solid. I feel great after I eat that type of food and I feel pretty crappy and emotional. I get these emotional roller coasters when I eat a bunch of processed, especially carbohydrate-rich food. So I think that’s as a category. I’m not saying anything that’s new or different or even controversial at this point. It’s really our bodies are so wise; they tell us everything. Actually, I’ll highlight this with a story of my own. 

[00:46:07] So we were talking about this third step. I call it finding the bigger, better offer. And what that means is that our brains are going to look for something better than our old habits. And if the old habit is overindulging or eating junk food, then we’ve got to give them something better. And it’s not just finding a better junk food. It’s really about finding something that helps us feel healthy and whole and happy. So when I started paying attention, when I ate gummy worms, to me it was like, “Oh, this tastes like petroleum.”

[laughter]

[00:46:36] I still remember it, like, “Oh, this is sickly sweet.” And so, I became disenchanted with eating gummy worms. We actually have some gummy-type things in our cabinet right now because my wife has some, but she doesn’t even ask me anymore because she knows what the answer is. I’m just not interested. But for me also, it opened up the space to start exploring something new. And for me, it was blueberries. It turned out to be blueberries, which have this, for me, perfect mouthfeel pop when you’ve got a really juicy blueberry sweetness. And I just realized this the other day that you actually get some intermittent reinforcement. The thing that we learn, I’m trying to think how to put it in non-scientific terms. Well, I’ll just say it. The learning mechanism that is most reinforcing for any animal is called intermittent reinforcement. So, it’s basically a slot machine. You don’t know when you’re going to win. And with the blueberries, every blueberry is a payout unless it’s rotten obviously. But you never know which one’s going to be slightly sweeter or slightly more tart. And for me, I like them both. And so it’s like, “Mm, I wonder which one this one will be. [Cynthia laughs] Will be a tart one or a sweet one.” So it even gives a little bit of a lottery feel to it because you don’t know what the next one is going to be like. And I love that about blueberries. They taste great. I don’t overindulge. I get fiber. It’s all good. For me, it’s just pure goodness. 

Cynthia Thurlow: [00:47:59] Yeah. It’s all a win-win. Low-glycemic berries are always a winner in my estimation. Now, one last topic to touch on, because I did get a lot of questions about adverse childhood events, histories of trauma, and the association with binge eating. Can we speak to some of the behavioral mechanisms that you’ve been able to either witness as a clinician or the research surrounding this? 

Jud Brewer: [00:48:22] Yes, and I actually dedicated an entire chapter to this in my book because it’s so important. So, one, I would say for all the people who have had some type of trauma in their past, which is a lot of people, whether it’s micro small t trauma or capital T, my heart goes out to you, because whatever it was, it’s not your fault. And often people feel like it’s their fault. They did something to provoke it or whatever. And I’ve seen this so many times, particularly in women who’ve had sexual trauma, where, because they were attractive, somebody became a predator or something like that. And so often I’ve seen women gain a bunch of weight as a protective mechanism and then struggle with that and then struggle with their self-esteem because of the societal standards that tell them that that is not acceptable. Just really unfortunate cycle of really social conditioning. This is based on what has been allowed, unfortunately, is starting to slowly change in society. So there, I would also say, first, it’s not your fault. Two, I think of this as often we’ve developed coping mechanisms. And the analogy that I use is like, we’ve put on some shoes that have helped us carry us somewhere and protected us. But at some point in our lives, those shoes don’t fit anymore. And we have to honor that those shoes helped us or they were the only things that we had in the past, and we have to honor that, but also at the same time have to learn to let it go.

[00:49:54] If we become too identified with that set of shoes, we’re never going to learn that they might actually be hurting us now when they don’t fit. And it can take a lot of courage to take those shoes off and find a new pair because change is scary to anybody. So, I just want to highlight that piece as well. If we’ve been used to protecting ourselves in a certain way for such a long time, it can be extremely scary to even consider change. But here, I would say the best thing we can do to take care of ourselves is ask ourselves, “What do I need right now so that we can really provide that self-care?” And there are lots of people that have do a lot of great work around self-care and around trauma work. And I’ve brought in some tools that people can use for kindness toward themselves in the book. But really, it’s critical that someone see themselves as worthy of self-care and then take that sometimes very scary action to go out and actually make sure that they’re getting the self-care that they need as compared to just putting on another pair of shoes that doesn’t necessarily fit.

Cynthia Thurlow: [00:50:58] No. Beautifully stated. And I feel like trauma is getting greater focus and awareness over the last several years, and to the credit of people like yourself and Gabor Mate, who’s been a guest on the podcast as well as many others, I think for many individuals, they’ve assumed because they have not had big T trauma, that the little t trauma isn’t such a big deal. I think little t trauma can be just as impactful depending on the individual. Well, I’ve loved our conversation. I highly encourage my listeners to go out and check out, The Hunger Habit. Please let listeners know how to connect with you on social media, how to work with you, how to get your book, etc. 

Jud Brewer: [00:51:37] Sure. So I have a website drjud.com and also I’m on Instagram @dr.jud. So @dr.jud and then on formerly known as Twitter- [laughs]-

Cynthia Thurlow: [00:51:51] Good old X.

Jud Brewer: [00:51:52] -yeah, @judbrewer. But Instagram and my website, drjud.com, are the best way to get a hold of me and got all the book links and things like that there. 

Cynthia Thurlow: [00:52:00] Great. And we’ll look up your prolific TED talk and your other books so that everyone one can check those out as well. 

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