Dr. Nirmal Nair

How to Train Your Brain to Resist Cravings and Build Healthy Habits

We are addicted to food
Focus on the tip of your nose. Make sure that not a single other thought enters your mind. Maintain this for 24 hours.
Likelihood is that unless you are a Himalayan sage, this is next to impossible. In fact, in many religions, maintaining the mental silence that the above single line task requires, is a sort of Holy Grail.

For many of us for whom weight loss has been a challenge, the task of losing weight can be exactly as above. When inspiration hits, we can maintain the lifestyle that is conducive towards weight loss and lose a few pounds. We are able to avoid the urge to have that one extra helping, stop ourselves mid-way from grabbing a piece of chocolate cake, or maybe even skipping a meal when we are not hungry. Maybe we’ve maintained an exercise regimen for enough time to keep our weight stable.

One of the reasons why food can be so addictive, and ultimately why we end up gaining weight to begin with, is because there’s really no immediate downside to eating. No one has truly gained back the weight they are aiming to keep off by having a slice of chocolate cake. Yet, our younger selves with hummed around with faster metabolisms, owing to greater muscle mass and fewer limitations in mobility – and hence we were able to burn that extra food up more effectively.

The Mind as the Enemy
Our challenge is that at the end of the day, the most powerful enemy is our own minds. In my experience it’s best to see obesity as a challenge of the mind than of the body. This makes it far more difficult to achieve.

There have been studies looking into all this. One such study looked at neural activity in areas related to reward anticipation and impulsivity (anterior cingulate cortex and nucleus accumbens) versus decision making (dorsolateral prefrontal cortex) in patients who went through surgical weight loss. They found that the degree of activity in these regions seem to predict the degree of weight loss.

Put in layman’s terms this kind of makes sense. We all know that we have good days when we are less impulsive, and bad days when we give ourselves exceptions. We all know people who eat a little extra and then obsessively go to the gym to burn off those extra calories. Likewise, we also know people who finish the whole box of chocolates after promising themselves that they would stop at two. (A comparison of
functional brain changes associated with surgical versus behavioral weight loss)

It gets worse if you’re already Overweight or Obese

The difficulty gets worse. The way in which we respond to food, and even how we perceive food when we are hungry can change the heavier, we are. Again, there are subtle neurological changes associated with this. It seems that people who are obese have greater activity in those areas involved in reward processing even after a full meal. What that means, is that even if you are full, the reward centers in your brain still drive you to finish off desert or have an extra helping of something, compared with someone of normal weight. In the fasting state, obese individuals were noted to have increased activation in areas associated with anticipation of reward, while those in the normal weight range have greater activation of those areas involved in cognitive control. This means that when you are hungry, you are likely to eat more of what you sat out to do. The irony of all this is that when we aim to lose weight, or if I tell someone to lose weight, we are expecting to use our willpower to fight deeply ingrained ways of perceiving and interacting with food. Ultimately, we are using the same resource – our
mind- to fight the very thing that is blocking us from achieving our goals – also the mind. This also means, however, of all this is that there are very simple ways to hack this machinery to help us along the way. What you ultimately want to do is re-calibrate your mind to slow down the reward machinery. In other words, as soon as you see lets say that chocolate cake, you want to be able to stop after one or two spoons and set it aside. Over time, this trains your mind to press brakes on our food drive. Here are some
simple things that often help us trick our minds into helping us towards our weight loss than hurt us:

1. Check your weight 1-2 times a week – You want to make this a habit so that you can train yourself to realize when you are going off track. If I check my weight and I realize that I’ve gained 2 lbs, I am ultimately training my subconscious mind to slow down whenever I see something that I crave.
2. Don’t use weight checking to track progress – While its great to see the number on the scale coming down the great downfall of many people is this: The scale is linked to some outcome. We want to see the 1-2 lbs of weight loss. We want to cross the barrier from 200 to 198 lbs. The trick here, is understanding that the scale can help us MOST in those times when we are not following our diet properly. The problem in using the scale purely to track progress is that if we have a day or two when we don’t follow our diet and eat at the buffet for example, we likely will postpone checking our weight until we feel better about ourselves. Doing that means that our reward mechanisms will be left largely unchecked, and we will end up by the end of the week, adding on perhaps 1000 extra calories. DON’T DO THIS.
3. Count Calories – Pick a week where you track the number of calories you burn per meal, per day, per week. Take the average. If your weight remains the same after about two weeks, this tells you roughly how much energy you burn per day. By counting calories, you can put a number on what you need to achieve to sustain your weight loss. It also allows you to succumb to an occasional craving, but compensate for it. If I’ve planned for a nice dinner later in the day, and its likely to cost me 1500 calories, I can plan to skip my breakfast and lunch to make space for it.
4. Nibble – Lets suppose you have again, that big piece of chocolate cake in the fridge. There are those of us, who take that cake and need to have one satisfying slice to be okay. That, I feel is the wrong approach if you’re trying to lose weight. If you finish that cake slice early enough in the day, by evening when you eventually feel hungry, you run the risk of eating additional calories, when you should scale back. The reward mechanisms in a sense, forget the
   cake that you had earlier in the day, and now once again you are your own enemy. By nibbling, you train yourself to stop earlier.
5. Allocate your cravings – One way to regulate your cravings is to allocate your cravings. At the beginning of the day, allocate your junk food calories and put it in a box. Put the cake in a box and tell yourself that you can have this indulgence any way you’d like. If you like having candy or even nuts for that manner – put these in the box too. This will help to train the mind to establish boundaries, and allow for some flexibility in a diet.
6. Exercise regularly – While this goes without saying, I’ve found that for some of my patients, starting an exercise program first helps with healthy eating. It’s almost as though by beginning to exercise, we train our minds to hold a healthy mindset. “I’m putting this much effort into exercise, I should keep it up by eating cleanly”

At the end of the day, our minds can be our worst enemies. We need to maintain a certain change for several weeks or months on end to achieve weight loss. The grand difficulty is getting our minds to work with us rather than against us.

Nirmal Nair, MD