Cravings: the mysteries of hunger

Of the thousands of books I’ve read, there are a handful that are truly life changing. ‘Craving: Why We Can’t Seem to Get Enough’ by Omar Manejwala M.D. is one. This book tackles cravings head on, and provides powerful science-backed ways to finally break free from our addictions – our shameful little secret like drink, drugs, smokes, shopping, sex or even the newcomers, computer games and social media, and for me, food. It turns out cravings, whatever the source, have a lot in common.
For non-geeks who just want the answers, I read the early chapters so you don’t have to. You can skip the bits on brain functions, chemicals and reward pathways, how patterns get reinforced, or how genetic variations make people more likely to crave different things. It turns out you don’t need to know why you have cravings to start freeing yourself. In the later chapters, Dr Manejwala (let’s call him Dr M) shares what works, based on his years of experience with real people battling all sorts of addictions. And yes, food can be an addiction.
The first key insight is that we can’t do it alone. We are hard-wired to believe what our own brain tells us, even when it is crazy. The good doc describes how powerful are the defence mechanisms that protect our sense of sanity: “A sense of helplessness and loss of control is extraordinarily unacceptable to your brain.“ We can’t recognise that even a small part of us is crazy, even in the face of evidence to the contrary – we’re outraged at the mildest advice, or feel guilt and shame at our “lack of willpower”. Our friends roll their eyes at our transparently flimsy reasons for continuing a patently self-destructive path that can damage our health, pocketbook or relationships.
Under the influence of our cravings, our normally trustworthy brain lies to us, straight to our faces. Because these lies come from our own brain, which we absolutely trust, they are very difficult to detect. And our amazing human brains are creative and subtle in the way they can lie. They can twist like a contortionist snake…is this the original tempter in the Garden of Eden? But it explains why so many who try to go it alone eventually fall down.
One particular anecdote blew away my world view: “An alcoholic told me, “Doctor Manejwala, every drink I ever took made perfect sense to me while I was taking it”. My own dieting had the same tricksy reasonableness – it seemed so logical and compelling at the time. My very own brain lies to me? Wow.
Dr M gives examples like: “It will be different this time.” “I deserve this.” “Look, other people are doing this without difficulty; I must be able to as well.” Sound like that little red devil on Coyote’s shoulder saying “go on, get that Roadrunner”? In my case, I used my formidable research capacity to come up with all sorts of wild theories about how to carry on with my cravings without the bad effects. Things like: “It’s OK, it’s healthy food”. “If I don’t eat when I am hungry, I’ll have a blowout later.” “Frequent small meals stabilise the blood sugar”. How could I not trust my own judgement? Like that worked.
Cravings are ‘sticky’ – in the middle of an attack, it feels like the hunger will last forever unless the urge is satisfied, or that something bad will happen. This was another aha! moment for me: nothing bad will happen if I just sit through the hunger. In the middle of craving, impending doom feels like the truth, but the lie is even worse. Because not only will nothing bad happen if I don’t give in to the craving, all the usual bad will happen if I do give in. Nobody ever died of starvation between lunch and dinner, but they have died from heart disease and diabetes.
Another key insight was ‘salience’ – what your mind pays attention to. Imagine you are sitting around a table with a bunch of people, and your weakness (free chocolate cake, wine, ciggies) is sitting in the middle of the table. Does it distract you from the conversation? You know when someone hits the jackpot on the pinball game, all the lights light up and flash and all the bells ring? My brain was like that when chocolate mint thins were free on a place. You all could just be saying ‘blah, blah, blah’ for all I heard. That’s salience, and when your brain gets all lit up about something, that right there is a trigger for you. It’s not a trigger for other people, but it is something you have to avoid.
So what to do? Dr M takes the controversial position that the current poster child for psychology, Cognitive Behavioural Therapy (which retrains people to observe and correct biased thinking), while great for other things, is not useful for addictions. He says “the brain cannot ultimately outthink itself”. If a person gets one successful “insight”, it can fuel years of attempts to duplicate that success. But your brain can provide your addiction with endlessly varied creativity. “The addict has no effective mental defence.“ ‘Insights’ lead to a false sense of security; then the addict does things that anyone else could see are a bad idea – going to the buffet (or pub, or casino), thinking that the ‘insight’ will protect you (cues such as sights, smells, and sounds are triggers for addictive behaviour).
Dr M carefully unpeels how layers of self-deception mean an addict can appear better on the outside, but be sicker on the inside. At this stage of the addiction the logic goes “I was able to stop easily, so I am not an addict, so I can start again with impunity because I can stop again anytime…” and then they proceed to end up digging themselves even deeper into their addiction.
So what works? This part of the book you will have to read yourself, and well worth it in my humble opinion. Because I’m so excited about it I will share what I learned, but with disclaimers. Unlike Dr Manejwala:
– I’ve never treated any addicts
– I did only Stage 1 psychology 30 years ago
– I don’t really know what I am talking about and just pulled out a handful of things that appealed to me and might be totally up the wrong tree.
So yeah, I really do recommend the horse’s mouth, its less than $10 as an e-book.
The brain’s survival mechanisms drive us to try the same failed solutions over and over (yet another New Year’s resolution, yet a different diet). This is what makes Dr M’s solutions at first appear completely weird. To the insane addicted part of our mind, the actions he proposes seem totally unrelated to the problem, in the old way we have been trying to solve it. But give it a chance. Dr M calls it “Apparently Irrelevant Decisions” – where you change things about your life that appear unrelated to the addiction.
If we can’t stop thinking of elephants, then we must give the brain something else to do that is not elephants. So it’s not about stopping doing something, but starting doing something new. Without doing any of these topics justice, the briefest list of potential directions:
• develop your own sense of spirituality
• create a sense of belonging
• find people with a similar problem
• inventory your behaviours
• be accountable to someone
• meditate
• ask for help/be teachable
• see things differently
• be helpful and
• practise a genuine love for others.
Some of the things he recommends are about humility vs ego, isolation vs connection and shame vs love. We often feel shame about our addictions, and this is very true for overeaters. But shame does not help us move past the addiction. Giving service, volunteering, doing things for others or for a cause we are passionate about brings a sense of self worth and meaning. Ask not what your country can do for you, but what you can do for your country…sort of thing.
Dr M recommends 12-step programmes, because the evidence shows they work. These cover many of the above points for freeing yourself from addiction. Holy jumping jiminy, I did not want to hear that. I thought they also required you to become a certified Bible basher. I pride myself on my rationality, and to me religion was invented to manipulate the gullible. But the good doc said the scientific evidence was in, and 12-step programmes work. So being rational, I tried it.
I’d only heard of Alcoholics Anonymous, but when I googled, it turns out there are 12-step programmes for all kinds of addictions. If there is not a 12 step programme locally, never fear it turns out there are online meetings, and they are all based on AA meetings, which can do in a pinch. The important thing is to look for similarities, not differences. I thought it was hilarious that I showed up to Overeaters Anonymous, took one look at my generous proportions and thought, it’s one addiction that people can see as soon as they look at you. Not particularly anonymous is it. So why did it take me 40 years to work out that I was an overeater? The strange thing is that Alcoholics Anonymous is absolutely top of mind for alcoholics, but famous diet programmes (WeightWatchers, Jenny Craig) are top of mind for overeaters. ‘White knuckling’ through diet programmes has poor record of long term recovery, because they focus more and more on food, and on mechanics, rather than calming the craving and mental obsessions.
The first step of the 12-step programme is to admit your powerlessness over the addiction, in my case that I had a starkly different response to food than thin people. This is what I learned from the ‘Cravings’ book – I can’t even detect my own craziness, so I need someone or something else as my touchstone for normal behaviour around food.
Every which way I tried to do this using my own willpower and resources, I ended up back where I started. Or worse. Beating my head against a brick wall.
I found the 12-step programme transformative. Not incremental, not piecemeal (like advice on “How to handle the holidays” or “Ways to trick yourself”). Not a bunch of research and facts, not deprivation and willpower. It’s socially, emotionally and spiritually expansive, like having new eyes to see the world. And to my relief I didn’t have to invent an old man with a white beard in the sky. In addition to taming my addiction it has changed my life for the better in ways I could not have expected. When life is less about me and more about what I can do for you, it’s a lot more satisfying. I feel like I’m finally really becoming a grown-up. And the weight has started falling off, gradually and without undue attention.
And as they say on Seven Days “…and this is my picture.” Your mileage may vary! My interpretation of the book may be as accurate as those kids’ colourful crayon interpretations of the news. You may get completely different insights and ideas from this book, but for an ‘outside the box’ way to tackle cravings, try “Cravings: Why We Can’t Seem to Get Enough”.


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