- So what we think happens is that over time there are a number of cues in your environment. And when
I say cues, it could be anything from a billboard showing you a milkshake, to sitting on the couch
at 10 o'clock every night having a brownie. Me. To your neighbor bringing you dinner because
you're sick. Could be work parties, could be walking past a candy bowl. So cues can be
visual. They can be smell. They can be emotional. They can be time. They could be all those things.
And when you say cue to me that's something that was almost trained. Mm-hmm, so that's exactly what
we think happens, is that these two areas of the brain become hypersensitized in people that are
vulnerable. So not all Americans are vulnerable. But there are people that are vulnerable to this, and
that over time these cues become associated with food so that your brain becomes what we call hyper
sensitized, these dopamine areas and it starts to grab your attention, and makes you want it. I think
all of us in high school may have heard about Pavlov. The bell rings, the dog salivates. Exactly,
that's that's what we're talking about. Yes, associative conditioning, Pavlovian conditioning.
So I think about how when I was a kid growing up, my mother's gonna kill me, but when I was a
kid growing up if I did a good job with dinner, I could have the reward. Which was dessert.
And it was ice cream, or it was chocolate, or was something you know, sugary. And so I started to
think of that as the reward for doing well. And to this day I love having chocolate. You know at
the end of the, and and even at the end of my busy clinic day, I got a piece of chocolate
waiting for me. Because I love having a little bit of chocolate. I mean have I been conditioned? You have.
All of us I think have at least some of that that goes on. Well exactly. But it's where it creates a
physiological difficulty and emotional difficulty that it becomes problematic. So I think almost
everybody, except for a few exceptions, overeats at some level. And so all of us do it and all of us
have had cue induced learning in so many words. And all of our brains have some sensitization, it's
just people that fall in the more extreme areas tend to eat when they're not physically hungry.
And then there's another piece to this. If I can add, that some people say that they feel hungry
all the time, and I often wonder if that's this kind of arousal that occurs when you see the
cues that happens to them all the time. So they feel hungry but they're not physically hungry.
They just want food. Not to throw one company under the bus but it's so ubiquitous. I think, I
drive by the golden arches. Hmm mm. I mean the golden arches themselves eventually become a cue? Yeah
and so you've been trained since you're a little kid. You can you see the arches and you start smelling
hamburgers and french fries. Even talking about this makes me think about their french fries and
their chocolate milkshake which is what I had as a kid. You can still remember that taste. So so so
it's worked. I mean they're if I am working for those companies I am intentionally
trying to create those cues. Mm-hmm. That's how you sell product, and and we understand that as part
of it. So so people get queues and it can be all sorts of different queues from a jingle. It could
be a workplace area. What about the the emotional part of it where where I'm stressed, I'm sad, I eat.
How does that fit into this as a cue? So there's actually a relatively large body of literature of
the relationship with stress, overeating, and obesity. And I know that on other shows they've kind of
discussed some of that, so I won't go too far into it, but essentially the stress system and cortisol
system creates the same kind of arousal. The thing that you're describing, if we were to talk
about cue reactivity, it means that when you feel stressed you eat, and so anytime you feel stressed
you have this urge to eat. Even though you're not physically hungry. And again I can use the couch
example. You know if you sit on the couch every night and eat a brownie at 10 o'clock, and watch
the news. The news becomes a cue. Your couch becomes a cue, and the time ten o'clock becomes a cue. Huh!