A fix starts simply enough. You think about doing something that you like to do—drink a mojito or check your iPhone—and that thought lights up an entire dopamine-driven reward pathway in your brain. You try, but you just can’t get that urge out of your head. You give in. And then, as soon as you satisfy the raging hunger, bingo: You feel another rush. Your brain says, “Yeah! This is amazing. I want more.” You need your fix. More from Prevention: How to Prevent A Binge This Is Your Brain On Food Most of the time, this neurological process is a good thing. This same reward system drives us to learn, to create, to innovate, to pursue our goals. But as a medical doctor specializing in metabolism and weight management, I’ve seen firsthand how the rush of dopamine—a brain chemical that makes us feel a brief burst of pleasure and satisfaction—cuts both ways. That healthy high you get from, say, a run in the park occupies the same pathways as, and can easily become confused with, the dopamine hit from a snort of cocaine or a puff of a cigarette. [sidebar] I’m seeing a growing manifestation of this double-edged sword in my own medical practice. More and more men and women are desperate to find an answer to the same questions: “Why can’t I stop thinking about food? How can a cookie or plate of pasta or bag of chocolates have this kind of hold on me? I feel like a junkie!” More from Prevention: 10 Most Addictive Foods As I’ve listened to people’s tortured stories of unbearable cravings, yo-yo dieting, weight obsession, and emotion-driven stress eating, I’ve seen a pattern emerge. The pleas for help are no longer your standard “Gosh, I’d love to drop 10 pounds before the reunion” fare. Instead, these entreaties are eerily similar to the cries for help from my patients with hard-core drug or alcohol addictions: “I need that sugar fix every afternoon, or I’ll go crazy with withdrawal.” “I need a dose of pizza.” “Chips and dip are like crack to me—once I start, I just can’t stop.” These cravings are the result of a reward system gone awry. New science shows that the mere anticipation of a food-related dopamine high will cause the brain’s reward centers to light up like Times Square on New Year’s Eve. It doesn’t take much to trigger this cascade of brain chemicals: A casually mentioned word, a picture in a magazine or on TV, or a smell from a bakery can awaken the desperate cravings. [header = Why You Can’t Eat Just One] Why You Can’t Eat Just One See if this sounds familiar: Stay up too late; get rotten sleep. Feel like hell in the morning. Reach for sugary, caffeinated foods to stay awake. Seek the numbing of just one more candy, chip, or cookie. Have a glass—or three—of wine at dinner. Without fully realizing it, many people create a life of continuous opportunities to “dope up” in front of the computer and fridge and on the couch. They are driven to repeatedly score hits of what I call False Fixes—anything (like food) that leads to short-term reward in association with self-destructive behavior, followed by feelings of guilt, shame, and defeat. In contrast, Healthy Fixes are productive, positive habits associated with feelings of pride, happiness, and achievement: enjoying delicious whole foods; gardening on a sunny day; walking with your best friend. When False Fixes prevail, Healthy Fixes are tossed aside, you set up bingeing rituals—and voila, you’re ensnared in an endless, vicious, False Fix-seeking cycle. The sad irony is, the more you feed the craving with False Fixes, the less satisfaction you feel—because each time you flood the brain with dopamine, the brain attempts to compensate by battening down the hatches, decreasing the total number of dopamine receptors to lessen the amount of dopamine absorbed. In 2008, Nora Volkow, MD, director of the National Institute on Drug Abuse, published a study in which her team found that obese people who have fewer dopamine receptors also have less activity in their prefrontal cortex (PFC)—the grown-up, responsible part of your brain that gets you to work on time and brushes your teeth and pulls your hand back from the dessert tray. The PFC gets cut off from the action in the mesolimbic pathway, which reaches into brain areas associated with reward, pleasure, and addiction, as well as emotions and memory. It’s a double whammy: You have to eat more to experience pleasure, plus you have a tougher time stopping once you do eat. Seeking The Solution Now before you throw your hands up in despair, I’m not saying that we can’t outsmart our False Fixes. I did—I was once 50 pounds overweight—and I know that you can too. The solution relies on exactly the same brain mechanisms that got us into this mess. We will be looking for our fixes for the rest of our lives, but we have the ability to choose which fixes. In my book The Hunger Fix, I offer the details of a three-stage plan, including fitness activities, meal plans, and recipes, for rewiring your brain and overcoming food addiction. But here are a few suggestions to help you replace Food Fixes with healthy rewards—right now. [header = 1. Ask the Big Question]

  1. Ask the big question Your PFC is always with you, but that doesn’t mean it’s always paying attention. You can call it to action by asking yourself a simple question: Is this healthy? In a California Institute of Technology study, volunteers were flashed images of different types of food and asked which they’d choose to eat. When told to consider healthfulness before making their choices, they were less likely to choose False Fix foods and more likely to choose Healthy Fix foods. MRI scans also showed that the ventromedial area of the PFC (vmPFC)-the site of risk, fear, and decision making—was more active. In addition, scans showed that raising the issue of healthfulness activated the dorso-lateral PFC (dlPFC), a dopamine-driven site of planning physical action, organization, and self-regulation, which in turn nudged the vmPFC. In previous studies, that particular pattern of PFC activity was found among people who had a high degree of dietary self-control. So merely asking yourself Is it healthy?—even before you make your choice—is a willpower-building push-up for your PFC. More from Prevention: The Truth About 12 Confusing Foods
  2. Set implementation intentions At the heart of addiction is the inability to adapt and adjust without falling back on False Fixes to survive a stress. A better strategy: relying on Healthy Fixes. These include eating nutritious foods, getting enough rest, exercising regularly, chewing gum (the repetitive movement is calming), meditating, and gardening. (For more on gardening’s benefits, see “Dig In And Lose More” on p. 3) However, you’ve got to drill that into your brain with the repeated practice of these habits. So how do you accomplish this? Studies have shown that forming what is referred to as an implementation intention (“If I encounter situation X, then I will perform behavior Y”) increases your probability of carrying out your goals. (See “Your Adjust and Adapt Plan” on p. 4 for suggestions on dealing with five common stress scenarios.) These problem-solving skills require some creativity, and by flexing these cognitive and creative muscles—bonus—you’ll increase the release of dopamine in the anterior cingulate, a brain area involved in emotion, anticipation, and decision making. You will also exercise and thus strengthen your PFC, which will give you a Healthy Fix that will, in turn, make you more creative! And that’s the definition of a virtuous cycle. (Are you a stress eater? See how NOT to overeat.)
  3. Full up on safe highs You can still get a food high—on safe, tasty, rewarding Healthy Fix options that decrease the sense of deprivation. “Safe highs” (see list on p. 4) are characterized by a combination of fiber and protein, which science shows takes longer to break down in the stomach, so you feel fuller longer. Your False Fix foods are poisonous to your mind and body. Break free. You are powerful enough to say no. More from Prevention: 10 Healthy Kids’ Snacks You’ll Love, Too [header = Your Emotional Eating Cheatsheet] Get your fix with safe highs To kick a craving, pick one food from each column.   Dig In and Lose More A Case Western Reserve University study found that overweight apes who were given access to a diet rich in greens could eat twice as many calories yet dropped an average of 65 pounds. Why? One reason may be all the time spent foraging instead of eating a hand-delivered diet. We might derive similar benefits through gardening. Spinach, kale, broccoli, red and green bell peppers, beans—all are easy to plant and tend and much cheaper from your own garden. Plus there are cognitive and emotional benefits: Numerous studies have found that spending time in nature calms the mind, allows us to better focus, and even improves mood and self-esteem. Your Adjust and Adapt Plan

Adapted from  Dr. Peeke is a Pew Foundation Scholar in Nutrition and Metabolism and is one of the few physicians in America formally trained in nutrition. She was also the first senior research fellow in the original NIH Office of Alternative Medicine, where she helped to lay the foundation for evidenced- based scientific studies in the field of cancer and nutrition. Dr. Peeke is a medical and science commentator for CNN Headline News as well as PBS’s Health Week. She is presently a regular expert on NBC’s Today Show and has appeared in numerous national television specials. Dr. Peeke is the author of the bestsellers, Fight Fat After Forty and The Hunger Fix: The Three-Stage Detox and Recovery Plan for Overeating and Food Addiction, (Rodale 2012).