It’s been said the world is divided into two kinds of people: those who live to eat and those who eat to live. Those who are passionate about food and those who like food but who eat primarily for the sustenance that allows them to live their lives. The truth is the world is much more complex than that.

There is a third category: individuals for whom food is something other than enjoyment or sustenance; people for whom food is a cruel taskmaster that dominates their life day-to-day and often minute-to-minute.

This scenario might sound familiar to you. Although you might feel completely isolated and alone, millions of people struggle with a similar unhealthy, unhappy, and unsatisfying relationship with food.

Like all our physiological systems, our appetite is best suited for the world in which our ancestors lived, a world of feast and famine. When food was scarce, our appetite was “on low”, telling our bodies that little food was required. When food was plentiful, our appetites naturally amped up to allow us to take advantage of the relative bounty.

For many people living in this dawn of the twenty-first century, particularly those of us in first-world or westernized countries, food is always plentiful. There are no caloric “lean times.” Our appetite, that trusty guide that served our ancestors so well in times past, is now out of sync with the reality of our modern lives.

Rather than an aide in our survival, it has become a subversive enemy, undermining our good health and well-being. It needn’t be that way.

Getting Off the Roller Coaster

Appetite is what causes you to daydream about warm chocolate chip cookies, ice cream or shrimp scampi. It is desire and passion. It is a psychological, sensory process that triggers a physiological response.

Adopting the latest new diet will not get you off the roller coaster of appetite control. More than twenty-six million diet books are purchased in the U.S. in a given year. Inevitably, more will be rolled out the next year. This is because all the previously published diets ultimately fail to work on a lasting basis.

People remain desperate for a solution to their struggles with food, and they still hold out hope that the next new diet book will offer the answer. But diets do not work over time.  Countless studies show that while many individuals can successfully lose pounds on diets, the pounds return once there is an inevitable lapse.

You cannot be vigilant about every morsel you take at every meal for the rest of your life. Even during the weeks of relative success, life becomes a tortured regimen. Even when people successfully follow a diet, they experience cravings for food at a much higher rate than non-dieters. And the constant calculation required to determine calorie counts and portion sizes takes away energy and concentration from enjoying both food and life itself.

If diets and diet books do not help, the medical culture has not helped either. “Just do it,” counsels many a healthcare provider, echoing the words of the Nike commercial. Unfortunately, this well-intentioned advice will likely make you feel worse, not only about your weight but also about your lack of willpower.

Disordered eating is caused by biology, not by a deficit in will or character. Disordered eating is often caused by addiction to food. Eating foods high in sugar wreaks havoc with the body’s natural systems of craving and reward, skewing the functioning of neurotransmitters, the chemical messengers in the brain. The food acts upon the part of the brain that makes you feel good, the center of pleasure and reward.

Over time, and with the right biochemical vulnerability, the brain adapts to and compensates for the artificial revving up. Reacting to the sugar assault, it works overtime to restore equilibrium by decreasing the release of dopamine – a neurotransmitter heavily involved in reward-motivated behavior – leaving pleasure and reward circuits depleted. Without dopamine, the brain depends increasingly on an artificial stimulus to feel normal.

For many of you struggling with disordered eating, the dopamine cycle goes haywire in the same way it responds to alcohol in alcoholics. Both alcohol and food cues stimulate the reward circuitry in the brain. Because it is a deep, unconscious process, it is beyond the control of willpower alone.

The New Hope Model: Restoring Control

In my book — Integrative Medicine for Binge Eating — I have attempted to combine insights from different fields of medicine and psychiatry as they relate to disordered eating. After more than 30 years in practice, I am convinced of the direct influences of what we eat and how we digest food on our behaviors and our feelings. This book explores the complex landscape of disordered eating and the tools now available to treat and to prevent it.

Disordered eating comes from a complex interplay between our lifestyle choices, our history and, most importantly, our individual biochemistry.

We can change how we eat and better understand emotional issues that may coexist with an eating problem. Most importantly, we can use science to find our way off the roller coaster. As the problem of disordered eating is fundamentally biological, so is the solution.

If your life involves a pattern of bingeing, shame, and restricted eating, this book will foster hope. You will learn the basic biochemistry behind food addiction and how your brain is caught in a cycle of pleasure and need. Then you can unleash the power of science to change your relationship with food.

My approach does not suggest that there is ONE answer to binge eating. Instead, mine is a comprehensive approach that evolves from the field of integrative medicine.

It is dysregulation in the brain that causes the appetite to run wild. Consequently, the New Hope model is designed to restore brain health. A return to brain health invites the realization of mental and emotional freedom as well as physical balance and well-being, ending a frantic and tortured roller-coaster ride.

Recognizing that cravings for food come from deep within our biochemistry and outside our conscious control should lead us to see disordered eating through a different lens. And just as we have misdiagnosed the problem of binge eating and overeating in the past, we have until now missed finding effective, permanent solutions.

But things have changed, and you can change, too. 

We now have a much more accurate understanding of the complicated, neurochemical process of appetite. We now know that food cravings are the manifestations of a genetically-based biochemical disorder that skews the body’s natural signals of hunger and satiety (fullness).

Over many years, I have treated thousands of patients suffering from appetite disturbances. I have developed a science-based approach to binge eating. This is an integrative approach founded on the insights from current medical research combined with natural strategies.

Because appetite disorders are caused by a combination of many factors, an integrative approach provides the best — and most lasting — solution.

The definition of hope is belief in things you cannot yet see, so I am asking you now to take hope based on my experience. As a psychiatrist in practice for more than twenty years, I have witnessed thousands of patients regain a normal relationship with food and appetite. It can happen to you, too. You can and will get off the roller coaster with the right approach.