Hey there, it's Susan Peirce Thompson, and welcome to the Weekly Vlog. Oh! I have exciting news. A paper is published right now. You can go access it. There's a link below this vlog to go access it. If you're in the podcast listening there, we'll put it in the show notes. It's an article called, The Badly Behaving Brain, how Ultra Processed Food Addiction Thwarts Sustained Weight Loss, and it's published in a book called, “Weight Loss, A Multidisciplinary Perspective,” and it's published online in an open access format, published by me, Susan Peirce Thompson, and Dr. Andrew Kurt Thaw, collaborator on this project. Thank you, Dr. Thaw for pulling me into this project. I'm so excited that we got this done, and a part of me feels like this is the pinnacle of my academic career so far. This article, it's a review article and it covers the science from beginning to end of the relationship between food addiction and weight loss and it's sort of like the more academic and drastically updated version of the science that I presented in the book, “Bright Line Eating®,” but that was published seven or eight years ago now, and the field has matured tremendously. This is of course, a way condensed version and a more hard-hitting academic version. There are over 200 references, citations that we cite in this review article. One of the accomplishments of this article is the incredible collation of the science and the presentation of the sources. If you really want to learn about this subject, it provides you with a comprehensive list of the citations to go check out, and Dr. Thaw was the one really who chased down all of those references and hand formatted them in the format that they require, which was a very strange format, and he did it by hand. So kudos to Dr. T for that incredible effort.
I feel so, so proud of this article. I'm the one who wrote the article from beginning to end, and then Dr. Thaw went in and found all the citations and it was an incredible joint collaboration. Now, if you're not aware of open access publishing, I want to share a little bit with you because this is, it's maybe a double-edged sword and I'll explain that, but I think it's a pretty exciting advance in how academic work is getting out to the world. Now, when you click below, you will be able to access the article directly. You will be able to download it as a PDF and save it to your computer. I think you'll have to create an account, which means you'll have to put in an email address, but you can uncheck the box so that they can't email you, and you'll be able to download the article. You'll be able to read the whole article without providing your email address. This is open access publishing, and when we were doing our research for this article, it was really interesting that the articles we were referencing and sourcing, most of them still were not an open access format, which meant that I was really lucky to have a university affiliation with the University of Rochester to be able to access the science because only still through an academic institution like a medical school or a university and their library, not a public city library, like a university library, can you even access the journal articles that codify the scientific wisdom that we've amassed as a human species, right? Most of it is behind lock and key because that's how the financing of it works, right? The journals, whether it's the New England Journal of Medicine or the Journal of Nature, or the Journal of Science or Endocrinology or whatever, these journals, they need to be able to finance their operations, their editors and their reviewers and their publishing costs and so forth. The way they've typically financed that is by making these university libraries get a subscription to their journal for a huge fee. If you don't belong to a university, if you're not a student or a professor, you can't access those studies. But now there's open access publishing, which means everyone can access the articles, and the person who pays for it is actually the person who's publishing the study. So, like in this case, Dr. Thaw, and I, we paid, this is a British publisher, so it was 1400 pounds. That's about 1,700 US dollars to publish this article in this open publishing format, open-source format. And because we paid that fee, we've now financed your, and everyone on Planet Earth's, ability to access the article. The upside is it's now democratized knowledge. People, any person with an internet account, and I get that that's not everybody on planet Earth, but it's more and more people, anyone with internet access can now access that science. The downside is it's made the playing field even less level for up and coming scientists who want to get their work published. Right now, there's this big publishing fee to get an article published, and if you don't have a grant or a university who can help subsidize some of that, it's going to be even harder. If you live in a country where those kinds of dollars and pounds, like that's a lot of money if you live in Rwanda, if you live in Peru, that's going to sting a lot more than if you have a faculty appointment at the University of Michigan in the United States. It's made the playing field less level in that way, but it's opened the universe in terms of allowing everyone who's a person on planet Earth to be able to access scientific information.
I'm kind of excited about the open access publishing revolution, and I'm excited to have this journal published in open-source format as are other publications in The Journal of Nutrition and Weight Loss. Those also were open source publishing, so you can access the PDFs of those journal articles as well. There were two things I think that most surprised me in writing this journal article. We did a lot of research for this, and one of them was just how much the field of food addiction science has progressed more than I realized. There was a meta-analysis that we accessed that blew my mind. It was on the use of the Yale Food Addiction Scale, and they wanted to do a pooled prevalence across all the studies that have come out using the Yale Food Addiction Scale. What are they all saying on average in terms of what percentage of the population has food addiction? Well, when they went and pulled all the studies that have been published using the Yale Food Addiction Scale as an instrument, they found 6,425 articles. That blows my mind! I would never have guessed that there were 6,425 studies or articles published looking at the Yale Food Addiction Scale and how it assesses food addiction. Wow. Yeah. I would've thought 10 times fewer than that if that is just astronomical. It's incredible. What they found, by the way, is that on average, 20% of the population has food addiction. There's a graph in that review article, that meta-analysis that shows the number of studies on food addiction that have been published year over year from 2010 to 2020, and it shows this incredible increase, this steady annual linear increase from one or 200 studies a year up to almost 400 studies a year, and it's still increasing. Now it's 2024, it's probably 500 studies a year by now. I had no idea that that many studies every year were coming out on the topic of food addiction.
My collaborator, Dr. Thaw, he did, I believe, a postdoc at Cornell University in neuroscience back in the day, and it was on something related to appetite and taste preference and things like that. We're talking taste and smell and mouthfeel and eating behavior. A lot of the research was in mice and rats because rodents are a really good animal model for human repetitive behavior. Rodents just have a very similar system to humans, so it's easy to study those systems and rodents quickly and easily and get good data. Anyway, what he said when we did this research together was that there were so many authors of important studies on food addiction that he knew from back in the day who used to study smell in rats or things like that, and now they're studying food addiction. He said that he had no idea how much this field of study has spread. We came to the conclusion that yes, it's true that it's not in the DSM yet, it's not in the ICD yet, food addiction as an official diagnosis, but that from the perspective of the scientific endeavor, it's really matured and become very widespread and very accepted. That was surprising and exciting and relieving.
The other thing that surprised me was just a number in that meta-analysis on the prevalence of food addiction. They looked at it by weight class, and what they said was that for people living with obesity, 28% of them test out as having food addiction, 28%. Now, that's not what I've found with the Food Addiction Susceptibility Scale™, I broke it down by Class 1 obesity, like low level obesity, and then very obese. So, Class 2, 3, 4 obesity. What I found was by my instrument, 33% of people with Class 1 obesity are very high on the food addiction Susceptibility Scale. And 56% of people with higher classes of obesity test out as being very high on the Food Addiction Susceptibility Scale. I thought those numbers were low, to be honest. The idea that just 28% of people living with obesity have food addiction, I don't buy it. That seems off to me. What I learned through doing this review article is that there's this qualifier in the Yale Food Addiction Scale that you can have all kinds of symptoms of food addiction, multiple symptoms, but if you don't answer the right way to the questions testing whether your eating behavior is causing you clinically significant distress or clinically significant impairment, then you won't have food addiction even if you've got all the symptoms of food addiction. My curiosity is where's the role of denial in this, right? If you ask someone, is your eating behavior causing you impairment, right? And they're like, no, my eating isn't impairing me in any way, right? But then you ask them, how's your work life? Well, I've been on disability for a long time, right? Are you exercising? No, I had to stop exercising a long time ago. I can't really move that well. Well, are you in pain? Oh, yeah, pain every day, right? And yet, whatever the umbrella question of, is there a clinically significant impairment going on the way it's phrased or whatever, they think, no, my eating behavior is not causing me any impairment. I am just curious about that. I think there's an opportunity for a study that looks more in depth at the way we're assessing clinically significant impairment or distress, because I think there's a lot of people who do have food addiction that aren't testing as having food addiction. I just don't buy that 28% of people living with obesity have food addiction. That seems low to me.
As this study gets out into the world, first of all, I'm excited to announce it to you. I think that our customer support team is going to be so excited to have this research to pass on to people in just an easy one click format where people say, where's the science? I want to know more about this. Here you go, because it's either in this article or it's cited by this article, and you can then chase down the rabbit trail. There's this DOI, which is a direct access. It's a direct number sequence that you put into your web browser, and it takes you to the article directly. Most of the articles, even if you can't access the full thing, you can access the abstract and read it and get a pretty good sense of what the research was about. The abstract is a pretty good summary usually. I'm super excited just to have it to offer to you as a gift. I called it The Badly Behaving Brain, which is the name of the webinar that I've been giving since 2014. This is the 10-year anniversary of that first Badly Behaving Brain webinar. So it feels like a very full circle moment for that reason as well.
There's a graph at the end of the article that looks at the weight-loss drugs compared to Noom and Weight Watchers and Nutrisystem, and the Zone Diet and Bright Line Eating, and just compares all of the different approaches to losing weight. It's very stunning that Bright Line Eating does as good a job as weight-loss drugs at helping people lose weight, right? Weight-loss drugs and Bright Line Eating among all those I just mentioned, are the only two approaches that factor in addiction. The weight-loss drugs do that by squelching the addiction in the mesolimbic reward pathway in the brain. They literally dampen the dopamine response in the mesolimbic reward pathway. Bright Line Eating does it by healing that part of the brain naturally with the foods that you eat by stopping the relentless flood of dopamine that's causing those receptors to downregulate. It was very gratifying to have that graph. I really encourage you to click on the link and just check out that graph if nothing else. It's so satisfying to have that as part of the scientific record. That was a careful analysis of 12 different published peer reviewed scientific journal articles to put that graph together and really make sure that the numbers were right. I just feel so proud of that, so proud of that. As this is coming out into the world, I just didn't know if anyone would even find it or read it.
Before releasing this vlog here, Dr. Vera Tarman sent me an email saying, congratulations on your article, The Badly Behaving Brain. I have no idea how she heard about it or how she found it. It was such a reassurance that people are going to find this article and read this article. I encourage you to take it to your doctor to take it, to show it to your friends, show it to the skeptics who are sneering about what you do when you don't eat sugar and flour, pass it around. This article can really, really help to advance the field of understanding that there is a significant contribution of food addiction to our obesity pandemic and to the weight-loss issues that people are having in this modern day and age. It has got a whole section on the weight-loss drugs as well. It talks about the science there too. I feel really, really proud of it. Dr. Thaw, it was such a great collaboration. I'm so excited. I think it's going to be Dr. T's last article. He's now a dean, not a professor anymore, and it just has reached the point in his career where this might be it for publishing and such a satisfying thing to put out into the world.
I don't know that this is the accomplishment that's going to have the most impact on the most people, but for me as an academic, this feels like the most significant thing I've done so far. I feel so, so proud of it. If you read it, I hope you enjoy it. The Badly Behaving Brain, how Ultra-Processed Food Addiction Thwarts Sustained Weight Loss, is now published in open access format for you and anyone else to read, enjoy. That's the weekly vlog. I'll see you next week.
