"When in Doubt, Add Bacon and Cheese": How the Food Industry Hijacked Our Brains and Made Us Fat

Personal Health

Anjali Kamat:While the House of Representatives hopes to hold a vote on health care reform this September, the Senate is considering a bill that concentrates on preventing people from getting sick. The draft legislation would provide up to $10 billion a year for a prevention-and-public-health-investment fund that would include a focus on curbing obesity.

Some Senate Republicans have opposed the bill as wasteful spending, but a new report from the Centers for Disease Control and Prevention warns that the direct medical costs of obesity total about $147 billion a year. That amounts to 9 percent of all U.S. medical costs. It's also over $50 billion more than the annual spending on cancer.

CDC Director Thomas Frieden noted that, "Obesity, and with it diabetes, are the only major health problems that are getting worse in this country."

Speaking at the country's first obesity conference last week, Health and Human Services Secretary Kathleen Sebelius said: "If there was an epidemic of little kids getting cancer, it would be a national crisis. But because it's obesity and the damage doesn't come until later in life, we've been slow to act."

Amy Goodman: In the midst of this national focus on obesity, today we'll speak with a man who's spent the last seven years trying to understand how the food industry has changed American eating habits, made certain foods difficult to resist, helped create the country's No. 1 public-health issue.

Dr. David Kessler is former commissioner of the Food and Drug Administration under Presidents George H.W. Bush and Bill Clinton. He is a pediatrician and served as the dean of the medical schools at Yale and the University of California, San Francisco. His latest book is called The End of Overeating: Taking Control of the Insatiable American Appetite. Dr. David Kessler joins us now from the LinkTV studios in San Francisco.

We welcome you to Democracy Now, Dr. Kessler. You say the three major culprits are salt, sugar and fat. And you're saying it's the food industry that's as bad as Big Tobacco in addicting Americans. Explain your argument.

David Kessler:Fat and sugar, fat and salt, fat, sugar, and salt stimulate us to eat more and more. Does the food industry understand the inputs? Absolutely. They understand that fat, sugar and salt stimulate us, and they understand the outputs. They understand we keep on coming back for more and more.

Have they understood the neuroscience? Have they understood how fat and sugar work? I don't think so. But we now have that science. But what's important is the fact that they have figured out -- they've learned it experientially -- what works, and they construct food to stimulate us to eat more.

AK: Can you talk about the neuroscience behind this? What happens when we keep eating fat, sugar and salt over and over again? What happens in our brains?

DK:We just published an article. Not the typical scientific title, it's called "Deconstructing the Vanilla Milkshake." What do you think it is about the vanilla milkshake? Do you think it's the sugar, the fat or the flavor that stimulates you to come back for more? Which one do you think it is -- the sugar, fat or flavor?

Goodman:Which is it?

DK:It's the sugar. The sugar is the main driver. But when you add fat to the sugar, it's synergistic. With my colleague Gaetano Di Chiara -- Gaetano studies the effect of amphetamine and cocaine on brains' dopamine circuits. Dopamine is responsible for focusing your attention on a specific stimulus. And we always knew that amphetamine and cocaine raise the brain's dopamine level.

But what we did is we studied the effects of not just one nutrient, not just sugar, but sugar and fat, and we found, when you put them together, you get elevations of the brain's dopamine circuitry. And not only that, it doesn't habituate. It doesn't go down time after time. So we see that multipotent, multisensory foods can stimulate the brain's neural circuitry.

Goodman:And you're saying that the food industry, like tobacco, is actively manipulating the addiction. Explain exactly what you mean.

DK:The food industry certainly understands what works. Let me explain to you how it works. Based on past learning, past memory, we get cued. What's a cue? It can be the sight. It could be the smell. It could be location. Every time I walk down Powell Street (in San Francisco), I start thinking about chocolate-covered pretzels. Why? Because I had been on that street before, and I had been into a store, but I had forgotten entirely that I had done that. When I'm on that street that -- just the location -- stimulates thoughts of wanting that creates arousal. It focuses my attention. My brain gets activated. I eat for a second. I have that pleasure. It blocks out all other stimuli. And then I get cued again. And every time I do that, I just strengthen the neural circuitries.

What has the food industry done? They've taken fat, sugar and salt, they've put it on every corner. They've made it available 24/7. They've made it socially acceptable to eat at any time. They've added the emotional gloss of advertising. Look at an ad; you'll love it, you'll want it. They've made food into entertainment. We're living, in fact, in a food carnival.

AK: You talk about the $330 billion restaurant food industry, and one of the things you say is that food is increasingly being assembled, not cooked, in these kitchens of chain restaurants. Can you give us an example? Talk about going to Chili's, or talk about going to any of the restaurants you talk about. And, you know, take us from the beginning to the end, how a dish is prepared.

DK:So, take an appetizer in a modern American restaurant. Take buffalo wings. What are they? You take the fatty part of the chicken, fried usually in the manufacturing plant first. That loads about 30, 40 percent fat. Fry it again in the kitchen of the restaurant. That loads more fat. That red spicy sauce? What is it? Fat and sugar. That white creamy sauce on the side? Fat and salt. What are we eating? Fat on fat on fat on fat on sugar on fat and salt.

Goodman: Let's get personal -- your own story, your own dealing with what you eat, how you've gained weight, how you've lost weight and the different people that you've spoken to as you've researched this book?

DK:I have suits in every size. What I wanted to understand when I started writing The End of Overeating was why it's so hard for so many of us to resist eating.

You know, one night I was watching Oprah, and there was a woman on the show, very well-educated, very well-spoken, and I remember what she said. And I was trying to listen as a physician, as a clinician. She said, "I eat when my husband goes to work in the morning. I eat before he comes home at night. I eat when I'm happy. I eat when I'm sad. I eat when I'm hungry. I eat when I'm not hungry." And then she said, "I don't like myself." And I could understand, I can relate to that behavior. And I wanted to understand what was going on with that woman.

So what I did with my colleagues at the University of California, San Francisco, with the scientists -- I wanted to know how many people have characteristics, behavioral characteristics, like that woman.

Let me give you three characteristics. Some people, when I raise these, say, you know, they can't relate, they don't understand these. Others say I'm describing them. First, a hard time resisting your favorite foods, a lack of control in the face of highly palatable foods. Two, a lack of satiation, a lack of feeling full when eating. Three, a preoccupation with thinking about foods between meals, or sometimes when you're eating something, you're thinking about what you're going to be eating next; even with that food right in front of you, you're thinking about what you're going to be eating next.

Those three characteristics: loss of control, lack of satiation, a preoccupation with thinking about foods.

What we found is about 50 percent of obese individuals, 30 percent of overweight individuals, about 20 percent of healthy weight individuals -- that may not seem like a lot, but when you extrapolate, that's some -- and there's risks of extrapolation -- that's some 70 million Americans have this evidence of conditioned hypereating. It's behavior that is both conditioned and driven.

And this is the most interesting part. When we studied -- when we scanned the brains of these individuals who have evidence of these three characteristics, this conditioned hypereating, we see activation of the brain's reward circuits, elevation -- activation -- of the brain's amygdala, both during the anticipation of foods -- even without the foods, just them thinking about the foods or smelling the foods, there's greater activation of those rewards circuits.

And those reward circuits, when they start eating the foods, stay activated and don't shut off. So, for the first time, we have an explanation. We can say to that woman -- we can say to millions of Americans who have a hard time resisting their food in front of them, it's not their fault. There's a biological reason for why it's so hard to resist.

AK: I want to turn to the issue of labeling. Can you talk about how you got the labels, the nutrition labels of the food that the restaurant industry uses? How did you come upon these? Did the food industry just give you the labels?

DK:The label that we worked on back in the 1990s is now on all processed foods on the supermarket. No, the food industry didn't give us that label. We had to fight very hard for that label that's labeled the nutrition facts on all processed foods.

The Washington Post, in fact, did a story, because to research the book I had to recently go Dumpster diving. The reason I had to go Dumpster diving is that label is not on all restaurant foods. In fact, very little of restaurant food has the information today. So we have a lot of information about what's in foods in the supermarket, but very little information in the restaurant area.

Goodman:Here in New York, they passed a law that chains have to say how many calories foods have, a certain size store. How is that -- does that happen in other cities in the United States? And it's not in restaurants, but it's in places like Starbucks.

DK:I was in New York City, and I think that disclosure of calories is very, very important, and it's starting to happen in other cities. And there is legislation that is moving through Congress that would have disclosure of calories on restaurants, certainly the chain restaurants.

Greater disclosure, how much added fat, how much added sugar, how much added salt there is to a product, I think, is a very, very important first step in giving Americans information.

Once you understand, once we have the scientific evidence, which we now have, that our behavior is becoming conditioned and driven -- and it's not just our behavior, it's the behavior of our children, that we're, in essence, laying down the neural circuitry, that learning that stays with us for a lifetime -- the fact is, once we understand that and the consequences of that, does the food industry have to change? Absolutely.

Is there a greater role for government in disclosure and education? Absolutely.

But just because our brains are being, in essence, activated, hijacked, manipulated doesn't mean we shouldn't be able to take steps to protect ourselves, to fight back.

AK: And your reaction to the latest report from the Centers for Disease Control and Prevention on how much obesity costs add to the overall medical costs? And also, if you can also talk about when obesity started increasing in this country, when it became an epidemic of sorts?

DK:Very concerning, certainly as a pediatrician. Back 10 years ago, there were 4 cases of Type 2 diabetes per 1,000 individuals. Type 2 diabetes, I could just as well write "obesity" on the medical chart for the vast majority of cases. Today, that number has more than doubled; there are 9 cases per 1,000 individuals.

But my greatest concern is that the incidence of Type 2 diabetes, which used to show itself in individuals in their 50s and 60s, we're now seeing in children. We're seeing as young as 10, 12, 14.

And my concern is that we used to have adults live for two, three decades with Type 2 diabetes, the renal implications, the eye complications, the peripheral-vascular complications. They would live for two, three decades. And those consequences were major. But now you're going to have children who are going to live for five, six, seven decades after the onset of Type 2 diabetes, and the amount of morbidity, as well as mortality, that will result is very, very concerning.

Goodman:What about those who are saying that this whole issue of obesity costing Americans so much, I mean, in terms of chronic diseases, and now as we talk about health insurance and health insurance reform, is simply a way of pushing diet pills? I'm looking at a piece that says this week Health Affairs published a new study showing obesity accounts for an ever-growing share our health care costs. So the author decided to interview Paul Campos, the author of The Obesity Myth, which argues that the health benefits of losing weight are largely imaginary, that we're using health to advance our class bias in favor of thin people, particularly thin women. 

DK:Type 2 diabetes, a very serious illness, it results from the accumulation, we think, of fat and muscle that affects glucose, metabolism in the bloodstream. It has profound consequences.

In fact the reason I started writing the book, I was sitting in my office at Yale Medical School with a group of residents and fellows, and I said, "If you want to stay alive, what are the things you can do?"

I mean, three-quarters of us are going to die from either cancer, heart disease or stroke. And it was very interesting. I started pulling all the literature on the evidence on how you can prevent those three major killers -- cardiovascular disease, cancer and stroke. And it was very interesting, because the librarian who was helping me over a period of months, I noticed, as she was pulling those articles, she lost 30 pounds. We all know that weight is not good for us, but I don't think we understand the extent to which it really contributes to significant morbidity and mortality.

AK: Can you put this in the context of the health care debate? Why haven't the reform advocates in the health care debate taken on the food industry?

DK:Well, I think many people who are working on health care reform -- and we're getting closer and closer -- are very concerned about the cost of health reform.

I think the fact is, obesity, with the increase in obesity -- and you mentioned -- you know, this is a phenomenon really of the last three decades. I asked my colleague Katherine Flegal at the Centers for Disease Control, one of the great epidemiologists, to graph for me how weight has changed over a lifetime.

She went back in the 1960s and 1970s, well, what happened, we would enter our adult years, you know, age 20; we would gain maybe 2, 3 pounds between 20 and 40. We would level off and be plateaued; and then we would lose 2, 3 pounds in our 60s and 70s. But our weight was relatively stable. We now enter our adult years much bigger, much heavier. And, in fact, we continue to gain weight much later, through much later years.

But if you look at where it starts, it starts in childhood and adolescence. That's where the major weight gain is happening. And understand, it's not just the weight; it's laying down that neural circuitry, that old learning, because once you have that old learning and that old neural circuitry laid down, the only way to change that behavior is to lay down new learning and new neural circuitry. So, it's not the stuff of easy solutions. Diets are not going to work.

Why aren't diets going to work? You know, if you have that neural circuitry laid down and you respond to fat, sugar and salt, and your brain is wired to do that, sure, you can deprive yourself for 30 days, 60 days, 90 days, you can lose the weight. But then, if you haven't laid down new learning on top of that old learning, if you haven't laid down new neural circuitry, you go back to your environment, you continue to get cued, you get bombarded with all the food cues in our current environment, what do you think is going to happen? Of course you're going to gain weight.

What have we done in the United States? We've taken fat, sugar and salt; we've put it on every corner. We made it available 24/7. We've made food into entertainment. We advertise it as something you'll want. I mean, walk into a food court and watch people eat. We're living, literally, in a food carnival.

Goodman: The issue of the food industry's power and lobbying? I mean, you were an FDA commissioner, them coming to your agency, the FDA. Their power in Congress right now?

DK:Certainly it's substantial. You know, this is a major part of American corporate business. I think many of them are struggling, because they do not want to be in the crosshairs. I mean, there are similarities and there are differences with tobacco. Fifty years ago, the tobacco industry, faced with evidence that cigarettes cause cancer, what did they do? They deceived the American public. They created doubt.

Leave aside what the food industry has known. I mean, we now have the science to show that the fat, sugar, and salt that's being loaded and layered into our food supply is stimulating and activating the brains of millions of Americans. Now that we have that science, scientific information, the question is, what is the food industry going to do?

AK: And how can we pressure the food industry? Do you support government regulation of fast food, of restaurant foods? One of the people you interviewed, one of the fast-food executives, said that everything that has made us successful seems to be the problem.

DK:You know, the joke in the food industry: when in doubt, add bacon and cheese to it. No doubt, the food industry has to change. Once you recognize, once we as a nation understand the consequences of this ever-increasing weight and the fact that our behavior is becoming conditioned and driven and we're laying down that neural circuitry, I mean, in not only us, but our children, does that have implications for school lunch programs? Absolutely. About what we subsidize with our tax dollars? Absolutely. How we disclose the information in restaurants? Very much so.

So, again, once we have the science, that we understand this isn't just a question of will power, it's not a question of just discipline, it's a question of the brains of millions of Americans being activated, it has very important implications for public policy.

Goodman:Well, what about regulating food like tobacco is regulated?

DK:There are similarities and differences. Let me see if I can explain. Nicotine is a moderately reinforcing chemical. Add to that nicotine the smoke, the throat scratch, the color of the pack, the crinkling of the cellophane wrapper, the images that were created 30 years ago of the cowboy, that it was sexy, cool. It was -- smoking was something people wanted to do 30, 40 years ago.

What did we do? We took a reinforcing chemical, and we made it, by adding these other layers of stimuli, into a significantly addictive and deadly product.

I give you a package of sugar, and I say, "Go have a good time." You'll look at me and say, "What are you talking about?" Now add to that sugar fat, add texture, add temperature, add color, add mouth feel, add the emotional gloss of advertising, say you're going to do it with your friends, make it into entertainment. And what do we end up with?

We end up with one of the most profound public-health epidemics. So there are similarities, but there's also differences.

AK:And what do you think of the proposal to impose a soda tax, to tax junk food. A new report from the Urban Institute suggests taxing junk food to help pay for health care costs.

DK:There are a lot of different tools along the way, but how did we succeed to the extent of the success so far with tobacco? What's the real success? Has it been legislation and regulation? President Obama just recently signed the bill giving FDA the authority to regulate cigarettes. So it's not been a question of legislation and regulation.

What the major change is, you know, was the fact that 30, 40, 50 years ago, we looked at a cigarette and said that was something we wanted, that it was cool to smoke. And what did we do? We changed how we, as a country, perceive the product.

Scientists call it changing the valence of the product. Cigarettes used to be positively valenced. How? What did we do? We changed the cigarette from something we wanted into something we don't want.

Today we see it as a deadly, addictive product. It is negatively valenced. What's the difference? If something is positively valenced, you approach it; if something is negatively valenced, you're going to avoid it.

Tobacco, in some ways, is much harder. Tobacco, you can avoid. You can do without, you should do without. Food, we need. Food needs to be rewarding. It needs to be enjoyable. So how are we going to get this epidemic under control?

One of the big issues is the big food, and I'm not talking -- you know, this is not about corporate big. This is literally about big portions of food, food that is layered and loaded with fat, sugar and salt.

If you look at that plate of fries and say, "That's my friend. I want that. That's going to make me feel better," there's little I can do to stand between you and that plate of fries. What we need to do is, we need to change how America perceives food. A lot of people want to be thin. They look at, you know, how much they weigh. So they don't want to be fat.

But on the other hand, they want the food, and there's a disconnect. What you have to do -- this is about how we look at food. And we're going to have to, as a country, change how we look at food and our eating habits. Eating 24/7, eating all day long, that has to change.

Goodman:We're joined here in our firehouse studio by Arun Gupta, journalist, editor of The Indypendent newspaper in New York. He's writing a book on the decline of American empire for Haymarket Books. His latest article is published at Alternet.org and The Indypendent, and it's called "Gonzo Gastronomy: How the Food Industry Has Made Bacon a Weapon of Mass Destruction," looking at how industrial farming is central to the processed-food industry. Arun also happens to be a chef, a graduate of the French Culinary Institute.

I've been trying to keep this away from Anjali right now, which is the bacon, egg McGriddles -- oh, and cheese. As Dr. Kessler said, "When in doubt, add bacon and cheese.”

Arun, can you describe what we're looking at right now?

Arun Gupta:Sure. What this is, is -- I became fascinated by this, because this is essentially the childhood product of bacon soaked in maple syrup. And a few years ago, McDonald's turned this into an actual product, the McGriddle. These are pancakelike biscuits that take the filling for an Egg McMuffin, which is an egg, a pork product, in this case bacon, and cheese. And it's exactly what Dr. David Kessler talks about, where it's just layers of fat, salt and sugar.

You know, for instance, the muffin itself is white flour, refined flour, which is essentially sugar, and it's injected with three types of fat. There's salt. The egg is fat and salt. The bacon is fat, salt and flavorings. The cheese is fat and salt. And then it's topped by another biscuit, which, again, is fat, salt and sugar. So, this fits in with exactly what Dr. Kessler is talking about, how we're being fed these infinite variations of fat, salt and sugar that are highly addictive.

Another aspect that's interesting about it is the bacon has, actually, 18 ingredients. You wouldn't think that bacon would have 18 ingredients. Six of these are apparently types of umami. Now, umami is Japanese for -- it's the fifth flavor, after sweet, salty, sour and bitter. And it's loosely translated as "deliciousness." It's meaty, savory flavor. And it's highly addictive, and it has a response on our neurochemicals also.

And so, McDonald's pumps this with all sorts of umami. This is something I've been looking at. A lot of our foods are pumped with all sorts of umami, everything from savory foods to ice cream, because it elicits an actual neurochemical, physiological response. This thing has something like 80 percent of your daily intake of cholesterol. It's absolutely deadly, even though it's relatively tiny.

Goodman:How many ingredients in the scrambled egg?

Gupta:Well, there are a lot of ingredients because of the margarine that's used. It's something like a dozen ingredients in the scrambled egg alone, most of them coming from the margarine.

Goodman: And this issue of flavoring that you talk overall about?

Gupta:This is another way to get us hooked on foods. The fat, sugar and salt are very important, but also there are certain flavors, like with bacon. Bacon plays a very key role because of the smoked flavor.

In fact, there's a lot of writing being done about this now, that there's kind of a link to our evolutionary past. It evokes these sensations to cooked foods that humans evolved -- cooking predates humanity, actually, by up to a million years. And so, we evolved in conjunction with cooked foods.

And bacon is loaded with all sorts of smoke flavorings, artificial. It's rare that you get natural smoked bacon these days. And then the umami, of course. What is bacon? It's pretty much just salt and fat. And then, in a case like this, it's loaded with the sugar. So, you just get all these various addictive qualities that really try and key in on particular senses.

AK:And, Arun, why bacon as a weapon of mass destruction? And take us back a little bit to how this links to industrial farming and hog farming.

Gupta: Well, I was trying to understand it, because, as someone who cooks a lot and goes to a lot of parties, I've just been noticing a tremendous proliferation of bacon in all sorts of various ways.

I went to a brunch a few months ago, where someone had actually made bacon vodka and bacon ice cream. And I also noticed in popular culture that it was becoming very common, like there's this Wendy's Baconator sandwich, which has six strips of bacon, and it was wildly successful when it was introduced in 2007. It sold 25 million units just in the first eight weeks.

Now, bacon is the end of this food chain, and it is, you know, that joke about "when in doubt, throw cheese and bacon on it." In the high end, in the gourmet-cooking industry, chefs always joke about "bacon makes everything taste better." It does play this key role.

But it starts from -- the vast majority of it starts in these factory farms. And what happened is -- you have to go back to the Great Depression, where the government policy essentially started to encourage consolidation of farming as part of national food security.

And after World War II, the government had -- the U.S. government -- had all this surplus food, because it was trying to shore up the agricultural sector. So it used this food in a policy that became known as "aid and trade."

We would first give food to countries as aid. Once they'd get hooked on it, we would trade with them. But what this did was it encouraged consolidation of the farming sector, because we would then subsidize those farmers who were most technologically efficient, who were doing monoculture -- in other words, doing one crop -- because it was economy of scale, because you could direct the inputs better.

And so, the farming sector shrank drastically from 1940 to 1970. In 1940, 18 percent of the populace was still farmers; by 1970, it was 4.6 percent. And so, all this subsidies, essentially, what it did is it created the condition for the concentrated animal feeding operations to arise.

People are very familiar with these. Eric Schlosser talks a lot about it in Fast Food Nation. Michael Pollan is another writer who talks about it a lot. But what they often don't talk about is how government policy played this big factor, because there was cheap water, cheap grain, cheap fuel, cheap land, anti-union laws that allowed these factory farms to come into being.

But the thing is, these factory farms couldn't exist if there wasn't a market for these products, hence the rise of the fast-food industry. And you start to see this in the '60s and '70s.

For instance, where in the early '60s McDonald's was using 175 suppliers for potatoes, when it switched to the J.R. Simplot Co., which was able to provide them with this standardized frozen fry, McDonald's exploded over the next decade. Fries are incredibly profitable. Its growth was something like 400 or 500 percent in terms of the number of restaurants opened.

And then, around 1980, Tyson, the poultry king, did the same with chicken. They worked with McDonald's to introduce the Chicken McNugget. The irony of it was chicken, at that time, was seen as a healthy alternative to red meat. But through the industrial manufacturing, what you came out with was this highly addictive product, pumped full of all sorts of flavorings and chemicals that you would then dip in this fat- and sugar-, salt-laden sauce. And on average, a Chicken McNugget has twice as much fat as a McDonald's hamburger.

And so, what the fast-food and the processed-food industries have done is they've taken these very cheap commodities from the factory farming system; it's processed them, added a lot of value to itself in terms of profit; and then, essentially, made many of us addicted to them. And so, this all fits together, and bacon plays this key role.

And so, what I was doing was trying to explain exactly how bacon ultimately becomes this weapon of mass destruction.

Goodman:High-fructose corn syrup, Arun?

Gupta:Well, this is another example of how government policy plays a role in our diet. High-fructose corn syrup is a derivative of corn. There's massive subsidies for the corn industry. On its own, it couldn't compete with sugar. But because of the subsidies, it brings down the cost of corn.

Meanwhile, there's also tariffs against the importation of sugar, allegedly to protect the domestic sugar industry. And so, what you have, on one level, is you're bringing down the price of corn and its derivatives, like high-fructose corn syrup, through these subsidies. Then you're raising the prices of alternatives through the tariffs. And so, you create this huge supply.

And it's the same exact time that we see companies switch to high-fructose corn syrup, particularly in sodas. And you see this explosive growth. And there are a lot of researchers who argue that high-fructose corn syrup and our consumption of soda plays a key role in obesity.

And so, we have to see that the government plays an essential role in terms of the food choices that we make today and the unhealthiness of America in general, and that, you know, if government is doing this, then we can say, well, the government, one, shouldn't be doing this, and it should directing our money toward healthier, more productive and more sustainable systems.

AK:And the "cheeseburger bill," Arun?

Gupta: This was passed, I think, about three or four years ago. The fast-food industry essentially decided they didn't want to become the equivalent of the tobacco sector, because what you were seeing was that a lot of the lawyers who went after big tobacco started to go after the fast-food industry, because they were making the same argument, that they're manipulating these ingredients to make people addicted to them, with the result that people are becoming obese. And we're seeing these epidemic rates of heart disease and diabetes and also these rises in all sorts of cancers related to diet.

And so, the food industry went to Congress and basically said, "We want immunity." And that's what they got. They now have complete immunity.

Goodman: But it only passed in the House, did not pass in the Senate.

Gupta:I think it did pass both houses of Congress.

Goodman:Well, Dr. Kessler, as you listen to Arun, your thoughts?

DK:Fat and sugar, fat and salt, fat, sugar and salt, they stimulate us to eat more. The fact is, it's not just the medical consequences.

You know, there are millions of Americans that have this, you know, inner -- almost inner -- torment. They don't understand why they're doing things, why they're eating when they don't want to be eating. And the fact is, I used to think that I was eating for nutrition, I was eating to be sustained, to be nourished. I didn't realize that I was eating for stimulation.

Take a 2-year-old. The average 2-year-old compensates for their eating. What do I mean by that? You give that 2-year-old more calories at lunch, they'll eat fewer calories later in the day. By the time that 2-year-old is 4 or 5 years of age, after they've been exposed to the modern American diet of fat, sugar and salt, they no longer are able to compensate. It's as if the brain's reward circuits override the body's ability to self-regulate. We are conditioning the behavior of our children for a lifetime.

Goodman: Just a comment on that bill, I do think that it was introduced repeatedly in the House and got passed, ultimately was not passed by the Senate. In fact, looking at some information, Florida Republican Congress member Ric Keller, actually missed the vote -- who had introduced it -- because he was rushed to the hospital. But this kind of legislation, if you're talking about this, what you're really saying is a serious epidemic, Dr. Kessler.

DK: It's a very serious epidemic. But understand what this is going to take. This is going to take not just pieces of legislation. Legislation is important. But in the end, we're going to have to view food differently. That's the real difference.

Once our behavior becomes conditioned and driven, you know, if I look it that plate of fries, I mean, or that bacon cheeseburger, you know, I say, "That's my friend, right? I want that. That's going to make me feel better," there's nothing I can do to get in between you and that food. We really are going to have to change how we view food in this country.

Food is so highly processed. It's been so layered and loaded with fat, sugar and salt, it's as if it's predigested. You know, most of us are eating, you know, adult baby food most of the time. Twenty, 30 years ago, there were 30 -- about 20, 30 chews per bite. Today, it's half that. Food goes down in a whoof, I mean, just, you know, in a whoosh. We're self-stimulating ourselves constantly. And we've taken fat, sugar and salt, and we've put it on every corner, and we're eating all the time.

AK: And Dr. Kessler, speaking of how we eat and changing our food culture, can you talk about the issue of choice and availability? You have fast-food restaurants and food laden with fat, sugar and salt, like you said, on every corner. But what are your recommendations to make healthy food more easily available, more easily affordable?

DK: Be careful. You know, the fat, sugar and salt is being layered and loaded not just by the fast-food restaurants, but by, you know, many restaurants, you know, across the economic spectrum.

You know, look at the French. They've always had food that's been highly palatable, that's been very good-tasting. What's the difference? You know, what have they done? Because up until recently, they've not seen the kind of obesity that we have seen.

You know, what they have done is they had certain norms where they eat with certain structure. They would never walk down the street eating or drinking. They would not eat in their cars. They wouldn't have food 24/7 at business meetings. So, they have certain structure.

We had this problem under control back four or five decades. We used to eat at meals. Today, what have we done in the United States? We've taken down those barriers. We are literally eating fat, sugar and salt all day long. There are children who go throughout the day without any sense at all of any sensation of hunger, because they're eating constantly.

So, what do we need to do? Obviously, get rid of the food cues that are activating our brains. You know, try to avoid those. Eat with certain structure, eat in a planned way, so you're not constantly being bombarded. But in the end, this is about changing your relationship with food.

I went into one of the restaurants here in San Francisco the other night, and I asked the chef, what's the most important thing I can ask when I'm ordering something off the menu?

It was a very interesting answer. He said, "Ask where the food comes from." If the restaurant doesn't know where the food is coming from, think twice before ordering it.

Goodman:Finally, Arun Gupta, children and food, marketing to kids?

Gupta: Well, this is a very important aspect. It's one of the many things government should be doing. It should be completely banning all sorts of fast-food and processed-food marketing to children.

In a given month -- this is from Fast Food Nation -- over 90 percent of American children between the ages of 3 and 8 visit a McDonald's. That's an absolutely stunning figure. And they're constantly bombarded with these messages to eat this type of food.

And so, we can easily have government saying, like, no, we're not going to allow this to be marketed to children so that they don't form these unhealthy food habits from the beginning.

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