Managing our sugar intake, says Dr. Julie Friedman, is like managing an addiction.
“When you have access to that addictive substance all the time, that is where the psychology comes in,” says Friedman, an assistant professor at Northwestern University Medical School and director of weight management programs at Insight Behavioral Health Centers.
In this episode of “The Advice Show,” Friedman talks weight loss strategies, what her own pantry looks like and how a personal medical emergency impacted her to field of expertise.
Below is an excerpt of our talk, but the entire conversation can be downloaded via SoundCloud or streamed via YouTube. “The Advice Show” is part of the Sun-Times Media Local Podcast Network.
Q: I am your perfect patient because I would love nothing more than for obesity to be a disease and – that way – it is not my fault. So convince me, because I am perpetually 20 lbs. overweight.
Friedman: First of all, I do personally believe that obesity is a medical disease. In order to look at why I would believe that, we have to define disease first. Disease is typically something that impairs functioning across a lot of different organ systems or body systems. So from that standpoint, obesity would definitely meet criteria for a disease.
And when you say, “I would love to be told it is not my fault,” I will tell you it is about 60 percent not your fault in the sense that we inherit genes that dictate our weight somewhat.
So if you inherit a certain weight range, it is then your behavior that determines where you are on that range.
But certainly many people eat well and exercise and still struggle with their weight. So some of it is also having to accept what weight range and what genes you have inherited, which is hard to do, especially in this culture where fat is so bad.
Q: Fad diets seem to change every year, but what does the most damage?
Friedman: The single biggest inflammatory food that you can eat is definitely sugar and that that is linked to weight. Now as for the psychology of it, life is too short to go without sugar entirely. And so we have to really teach people. It is really like managing an addiction. When you have access to that addictive substance all the time, that is where the psychology comes in.
I think that is where you find the middle ground, in terms of saying, “How do we get them consuming less sugar?” I have kids, too. They are going to be subjected to sugar everywhere they go. We have to teach them what to do around it. Something as simple as saying, “You can have dessert every night. But you don’t have dessert after breakfast, and you don’t have dessert after lunch.”
Things like that really work because they give people the structure of “moderation.” Because moderation is really a myth. It is very difficult as human beings. We can’t moderate our behavior, especially around sugar.
Q: I need a sugar exorcism.
Friedman: We crave what we eat. If you keep eating sugar, you are going to crave more of it. So then moderation goes out the window, because physiologically, we’re just not able to moderate our food intake.
And we know that. There is really new research that shows that actually the higher consumption we have of refined carbohydrates, the worse our signaling is in our brain to signal our stomach to produce fullness and hunger cues.
Q: This is “The Advice Show,” so give our audience advice about how to moderate weight.
Friedman: First of all I love the idea of a sugar exorcism and I would say go ahead and do that, but do it very temporarily. So the less you are eating it, the less you will crave it. And then we work it into your diet, but we keep it out of your home environment. Have it, plan for it, make it deliberate, but go out and get it, because the minute it is in your home environment, it will haunt you.
