Food on the Brain

This programme contains some strong language and scenes which some viewers may find upsetting.

The human brain is the most powerful organ in the body.

It controls our movement, our senses, our thoughts.

It makes us who we are.

Yet, for some of us, it cannot control what we eat.

-You have the notion that fat is bad.

-Yes, fat is bad.

Your brain is about 65% fat.

In this film, I want to look at how food affects the brain.

If you want your brain to function well,

you've got to be feeding it with the right stuff.

What happens in our brain when we eat certain types of food?

And why can some of us not stop eating?

ALL CHEER

-That's a wake-up call.

-No.

-I don't think so.

-No?

Mm, I don't think 350's too bad.

You've got people walking around here 400, 500 pounds.

Are scientists really planning to use poo to combat obesity?

They even have poo pills now.

-Poo pills?

-Yeah.

-Where you swallow poo?

-You swallow poo - in a capsule...

-I will never be swallowing poo.

Ever!

How does what a pregnant mother ate affect the brain of her unborn child?

We have to remember that the food that we're consuming

during pregnancy is the fuel for the developing baby.

What are the big food giants doing to help?

This is a disaster,

because it's like having free drugs on every corner.

I think they're evil bastards.

If this doesn't change, will everyone be eating in the Heart Attack Grill?

-So, what do you sell?

-I sell death...

and I sell fun, and those two happen to go hand-in-hand.

This is my journey into the inner workings of the brain,

and how it deals with the foods we eat every day.

I've come to America - the world leader in obesity,

but also in cutting-edge scientific research -

to see what's really going on

in the brains of the millions of people like me.

In 2014, according to the World Health Organization,

nearly two billion adults are overweight.

We all know that obesity is a worldwide epidemic,

and that junk foods high in fats and sugars are playing a major role.

Yet we continue to eat them.

I don't need anybody to tell me

that I'm putting the wrong food into my body,

but I'll tell you what is worrying -

when you actually deeply think about the amount of sugar

you're putting into your body,

and what that must be doing to your brain.

One, two, three.

-OK?

-One more, one more!

-One more? One more!

Hoop-la!

The average American consumes 22 teaspoons of added sugar per day.

According to the World Health Organization,

the recommended level is no more than eight teaspoons.

So, added sugar is not the sugar you can see,

it's the sugar that's already in our foods.

Neuroscientist Nicole Avena

has studied the extent to which sugar affects our brains.

So, what type of experiments have you done here?

Most of our experiments have been done on laboratory rats,

and the reason why we do that

is because we're neuroscientists,

so we want to look at the brain

and really understand

on a neurochemical level

what's happening, and so what we've found

is that if we give our rats access to excessive amounts of sugar,

that they come to develop a pattern

that looks very much like an addiction to a drug,

and so they'll show signs of bingeing,

they'll show signs of craving, they'll show withdrawal -

if we take their sugar away, the rats will tremor and shake

-and show changes in blood pressure.

-Will they?!

-Yeah!

Yeah - much like what you'd see during withdrawal from morphine.

So, again, we're seeing lots of parallels in behaviour,

-but also in the brain.

-Hold on a second.

So, a rat that comes off sugar, having binged on sugar for a while...

-Mm-hm.

-So, my equivalent of eating all the chocolate I eat

-and then coming off it - so, a rat tremors?

-Yes.

So, they'll show tremor, they'll show teeth chattering,

which is an indication that they're anxious,

and they'll also show signs of depression

and other indicators of anxiety.

When we go food shopping,

we fill our trolleys with loads of food that have these added sugars.

Just look at the labels of many of the foods in your fridge.

You'll see ingredients like glucose, fructose, sucrose,

maltose, lactose, dextrose -

these are all added sugars,

and Nicole has found that they are highly addictive.

When we overconsume sugar,

it can activate these brain reward systems

that are associated with addiction,

and it can release neurochemicals like dopamine and opioids.

The extent to which they're released in the brain with sugar -

it's not the same as cocaine or heroin

or marijuana or whatever, is it?

Well, it's activating pathways in the brain and areas in the brain

in a similar manner to what we see with drugs of abuse.

So, then we replace the sugars with artificial sweeteners -

-and I still can't win.

-Yeah, it's not a good idea. Studies are showing...

-You depress me, Nicole.

-I'm sorry, I wish I had better news!

Studies are showing that artificial sweeteners, actually,

they can cause you to eat even more

than you would have if you had the real sugar.

-Clear off - even more than if you were...

-Even more.

..drinking the full fat, as I call it - the full sugarload.

-Exactly - and it's actually worse...

-Why? Why more?

Well, we don't really know why,

but we know that this is actually something that's magnified

in people who are overweight or obese.

We know from research that just tasting the artificial sweetener,

just our brain thinking it's sugar,

or thinking it's a real sweetener,

is going to activate these areas of the brain

that are associated with these addiction-like responses.

-It's scary.

-It is.

Many of you watching this are probably saying

that I need my head examined - so that's exactly what I'm going to do.

I've come to Philadelphia to have my brain looked at

by Dr Jennifer Nasser,

one of America's leading nutritional scientists.

So, fNIRS stands for

Functional Near-Infrared Spectroscopy.

Jennifer's experiment will look at two parts

of the prefrontal cortex of my brain -

the sides that control when to stop eating...

..and the front, that makes us want to eat more...

..and more, and more.

What we're going to do is measure the brain activity

and response to you eating, so we can - using this instrument -

we can measure how much activity of oxygen your neurons

in your prefrontal cortex are using as you eat.

-So, we have a part on the side that helps us...

-Round here?

-Yes.

..to slow us down and inhibit or control our activity.

I think mine are dead.

And we have a part in the middle called the medial prefrontal cortex.

So, that's what's telling me, "Keep on eating, keep on eating."

Yes, yeah - or, "I like this," or, "I feel attached to it."

-You know, if you have a big meal at a holiday...

-Chicken pie.

..chicken pie,

and then Grandma brings out your favourite dessert -

and even if you're stuffed,

because Grandma has made something for everybody...

-Grandma's dead, but I still eat it.

-OK.

-But - or somebody else that you're close to.

-Yes.

Right - where if it was somebody knocking on the door

selling you cookies and you're not hungry, you might say,

"Oh, thanks, I've got a cupboard full."

-LAUGHS: I've never said that!

-Ah!

Using cutting-edge infrared technology,

Dr Nasser is going to track my brainwaves in real time.

Start on the broccoli, and if you want more, just let us know,

we'll bring it over.

-I quite like broccoli.

-Good!

We've got a whole big serving bowl for ya!

SHE CHUCKLES

'So, I've got to eat broccoli, ice cream and protein

'in three-minute intervals to see how my brain responds.

'Look what happens after I've started eating the broccoli -

'my brainwaves are already telling me to stop eating.'

-Done.

-OK, there you go.

You can have as much as you want for the next three minutes.

'In contrast, when I eat my favourite sugar-filled yogurt,

'I eat for the full three minutes -

'and there's not a stop signal in sight.

'Look - my brain's telling me to eat more.'

And stop.

'Next up, the chicken sandwich.'

OK, go ahead.

We want to give the chicken a chance to signal your brain

that you've had some protein,

and that takes about 15 minutes.

'Now, you might be thinking at home that I've already eaten a lot,

'so, naturally, I couldn't be hungry.

'It's not what this experiment's about - it's not about hunger,

'it's about how quickly the brain sends out those stop signals

'after eating protein.

'Remember, I've just eaten loads of protein,

'and I've waited 15 minutes for it to digest.

'Now, will my brain act differently with more ice cream?'

-This is like heaven!

-..how long you kept going.

Maybe you should just bring the whole bucket in here!

-Oh, you got it?

-I'll grab it.

-All right.

The results are in.

OK, so, you ate about 112g of broccoli.

OK, remember, I said that you could eat - it fills you up a lot.

You ate 94g of yogurt before you had the chicken.

-Frozen yogurt.

-Frozen yogurt.

-Ice cream.

-Right?

And then you had about 5oz of chicken,

and we waited 15 minutes,

and then you came back and ate more yogurt,

and this time you only ate 62g,

so, after the chicken,

you decreased the amount of yogurt that you ate by about 30%.

Jennifer, I'm not going to tie chickens round my waist

and walk around with them!

Seriously, though! So, any time - I'm being serious! Any time, then...

-If I got up in the morning...

-Right.

-..and I took a lunchbox of chicken,

and every time I see chocolate, I see chips, I see...

Have a little protein first.

I have protein, I have protein, I give it...15 minutes...

-15 minutes or so, yes.

-Am I statistically less likely, then?

-Well, statistics needs numbers - you're just one person.

-Yes.

-So, we can't say...

-You scientists are always so careful.

-You can't say "statistically"...

-Right, but am I more than likely?

-Well, we can...

-Spit it out - am I more than likely?

You were here,

so if you are consistent, then you should be eating less

after you eat protein than if you eat it before.

So, therefore, if I'm sitting down to a big, massive plate,

as I sometimes do, of chicken and French fries...

-Eat the chicken first.

-Eat the chicken first, leave 15 minutes...

-Yeah.

-If I want the French fries, eat them, if I don't, don't.

-Right.

You know, even if you're an educated person, you go up through school,

you learn so much about the world, and life, and all of that,

and it's taken me until I'm 41 years of age to come to America

to find out from you that there are triggers in the brain

that could actually help me control my eating.

It's taken me 41 years to understand those go and stop signals.

Well, part of it has to do with technology -

in the past 15 to 20 years, there's been a lot of brain imaging studies

associated with eating behaviour.

Yeah, but a lot of people watching this tonight,

they've no excuse if they want to help themselves.

Right.

Of course, I'm not only addicted to sugar -

I love junk food.

Back in New York, I'm going to meet one of the leading scientists

on how our diets affect mental health.

Felice Jacka is the president

of the International Society for Nutritional Psychiatry.

When I think of junk food and the effect it's having on my body,

-I think of my stomach, and I think of my heart.

-Yeah.

-I've never thought of my brain before.

-Yeah.

When you, for example,

feed rats a junk-food diet,

you get really pronounced changes to the brain,

areas of the brain that are highly relevant to mental disorders.

-Really?

-Yeah.

-This is fascinating. So, what changes in the brain?

-OK...

-With junk food.

-In particular,

there's an area of the brain called the hippocampus -

-now, the hippocampus...

-That's memory, right?

Yeah, it's really critical for learning, for memory,

but also for mental disorders.

Now, the thing that seems to really help the hippocampus to grow

and to function is a protein called BDNF.

When you feed junk foods to animals, it drops the level of BDNF.

BDNF's like manure for the brain -

it grows new nerve cells in the hippocampus.

-Wow.

-Yeah.

So, Felice's studies claim that junk food can shrink the hippocampus -

one of the telltale signs of depression.

So, food, and what we eat, can cause depression.

Well, we think so.

This is what all of the evidence that we've generated

over the last five years really suggests.

So, time and time again, across countries, across cultures,

across age groups, we see that people with better-quality diets

are much less likely to have depression -

people with unhealthy diets, lots of processed foods,

they're more likely to have depression.

The other thing to think about

is that this is not just all about weight -

we see that relationship between diet quality and mental health

quite regardless of weight.

I mean, you can be overweight and healthy,

because you're eating healthy foods and you're active.

You can be thin and be really unhealthy.

They've shown that time and time again.

I find, and some of my friends laugh at me for this,

my memory is not great.

Because of my job I need to retain a lot of facts and I do.

But my long-term memory isn't great. It's really, really not.

I forget people's names all the time.

Can I tell you about a really scary study where

they took a group of sedentary but otherwise healthy blokes

and they put them on a junk-food diet for one week

and they found within one week the same sorts of deficits in memory,

cognition that they see in the animal models that seem to be

-linked to the hippocampus.

-After one week?

-After one week.

So if you want your brain to function well,

you've got to be feeding it with the right stuff.

If this research is right these junk foods are seriously

damaging our brains.

But what can we do when the junk is so readily available?

This is a disaster because it's like having free drugs on every corner.

So people everywhere, all over

the States where they've got massive rates of obesity, they're just

committing suicide by junk-food drug, really.

Really, that's what they're doing.

So we know that even people who are highly educated,

who are wealthy all across the globe,

they're consuming these foods.

It's even more common in those who are less wealthy and less educated

because they have fewer resources to be able to withstand the marketing.

The passion that drives me,

the thing that gets me out of bed in the morning is the anger that

I feel towards the large,

multinational food industry, that I think they're evil bastards

and they're allowed to act with impunity.

You're a world-leading authority in what you do.

To call these people evil bastards, that's strong, strong language.

-You sure you mean it?

-I really mean it,

because there is no doubt that

so much of the huge tidal wave of ill health that the globe is

experiencing is a function of unhealthy diets

-and the way our diets have changed.

-That's not the companies' fault.

It's our fault for eating it. All they're doing is offering it.

It's my fault.

If you put a highly addictive product on every single corner

and you market it heavily and you make it really, really cheap,

and that seductive message all the time, eat me, eat me, eat me...

To understand what is going on in my brain I've come to meet

a psychiatrist, Dr Drew Ramsey, and he's taking a revolutionary

approach to treating some of his patients.

Instead of using drugs to change brain behaviour, he prescribes food.

Breakfast, what time do you wake up and what do you eat?

Wake up about 7:00 in the morning.

-I eat absolutely nothing for breakfast, ever.

-Never?

-Never.

-Coffee?

-Never. I don't like coffee.

-Tea?

-Don't like tea.

When's the first time you eat?

Most days about 2:00.

-Couple of packets of crisps, chips in your language.

-OK.

-Bar of chocolate.

What kind of chocolate? This isn't like...

-Dark chocolate, white chocolate...

-Milk chocolate.

-Milk chocolate.

Or sometimes I would have a proper meal so I would have chicken

and chips, steak and chips...

..lasagne and chips, stew.

-OK.

-Usually about 7:00, 8:00 at night, that's

when I will have another big meal.

Three, four nights a week, burger and chips.

-OK.

-And 9:00, 10:00 at night, that's when I start having...

..maybe five or six packets of crisps, chocolate.

You see, every night...

This is madness.

But every night I convince myself I'm starting my diet tomorrow morning.

So therefore this is my last binge.

When you look at this, what do you see?

-What do you think's missing here?

-I see insanity.

When you write it down, it's insane.

Crisps, chocolate, ice cream, fast food.

You said this was insane. I'm just going to say this is your diet.

You're a successful guy, you have some health issues but...

I hate people saying I'm successful, cos you can't be successful

-and have this.

-OK.

-So that's a bit up here.

I don't feel successful, I feel like a failure.

This is the only thing you failed at in your life, is food.

-Yeah, but it permeates everything.

-I would say so.

I'll be meeting Drew throughout this film to get his advice.

We all know that if you eat junk food it makes you fat.

I'll tell you what I've learned in New York though,

I hadn't thought about the association before between that

terrible food and our mental health,

how you feel inside, how your brain chemistry is actually working.

I just found that really fascinating here.

Do you know what this is doing for me?

It's making me realise how screwed up I am even at a basic

level in terms of what I'm eating

every single day of my life, cos I've met expert after expert

and I am so far off.

I couldn't be harming the body more.

I guess we kind of can learn what to eat to dramatically

improve our lives,

dramatically improve our pleasure in life, and yet quite a few of you

and me...

..we're feeding ourselves with poison.

But why?

I wanted to learn more about what was actually

happening inside the pleasure centres of my brain that make me

want to feed myself with this junk.

Professor Emmanuel Pothos has studied the brains of obese people.

His research has discovered the dopamine receptors in obese

people are significantly less responsive.

And they determine reward when it comes to food.

Palatable food or normal food is not having the same

effect in the obese individual as in the normal-weight individual.

The obese individual is compelled to overeat

to actually get the same sensation of reward

and fullness as a normal-weight individual.

What percentage less release of dopamine is there?

The dopamine receptors are reduced, in the range between 20%

and 50%, that's actually what has been published so far.

-That's astonishing to me.

-That's astonishing.

So, if I'm sitting in a restaurant with someone who is normal weight...

-Yeah.

-..and we are both having some ice cream,

and they have a small amount and they say, "That feels great,

"that's lovely," and I'm eating more and more and more,

because I'm fat and I'm releasing 50% less dopamine, possibly,

then of course I'm going to eat more, to feel as good as the thin man.

Yes, I would say that is now a reasonable explanation.

It kind of, in a way, kicks into touch this notion that fat

people are just simply greedy, simply lazy, simply wrecking themselves,

that they are set up in life to be more of a failure in terms

of their diet than some other people who are lucky enough not to

have less dopamine release. Correct?

Everybody accepts that there is

a stigma associated with obesity, right?

I mean, you can see that in every society.

So, I don't think we can talk about happy and lazy people, exactly,

we are talking people who are struggling through

a very serious health problem.

Here's a question. Can fat people improve their dopamine receptors?

We don't have any evidence that the dopamine system really

corrects itself, ever.

So, we think this deficit is on very early in life,

in individuals who are predisposed to obesity,

and even if the individual is not predisposed to obesity,

and at some point in their life, they develop bad diet habits,

let's say, you know, I haven't seen yet an experiment that

shows that this deficit can actually be, um, recovered.

That depresses me.

Because I've clearly got that gene,

and probably about ten million of them!

Yeah, if we realise right from the get-go that it's going to be

a lifelong challenge, a lifelong struggle,

then I think we are better prepared for it.

I know all about this lifelong struggle.

Five years ago, I made a film called Dead Fat,

and you should be warned, the next scene is disturbing.

'You are about to see the reality of obesity, close-up.

'I witnessed the autopsy of a 30st woman.'

All the tissue is abnormal fat.

'I visited a funeral home with oversized coffins.'

-It is noticeably wider.

-Yes, it is noticeably wider.

'And I got a glimpse into my future

'and the future of millions of us across the world.'

I don't want my heart to be swollen like that.

Then, change your lifestyle.

'I did change.

'This was me, last year.

'I had lost 7st on an extreme diet. I felt great about myself.'

'And this is me now.

'I'm heavier than I ever was.

'Perhaps psychiatrist Dr Drew can help me understand

'if I'm always doomed to fail.'

I lost 100 pounds on these things, which are essentially energy bars.

Have a look through some of the ingredients.

Yeah, I was looking at this, this is, like,

a rice crispy treat with some fake vitamins stuck on there.

Isolated soy protein. Oh, this is great.

This is, like, the most highly processed protein you can have.

Tapioca starch - that's sugar.

Glucose syrup - that's sugar.

Fructooligosaccharides - that's another way to say sugar.

Toasted oats - that's a real ingredient.

Then there are some nuts.

So far, there is oats and nuts that are good.

Raisins, which they soak in vegetable oil.

Because there wasn't enough in there already(!)

This is basically, so far, sugar, almost entirely sugar,

and then Omega 6 fats -

the vegetable oil for sure is some type of soy bean oil, I would guess.

But that bar is saying that I'm getting all the nutrients,

all the vitamins that I need in a day,

three of those with 600 calories,

and I lost 7st, I lost 100 pounds.

Do you think this is the way to health?

-Honestly?

-But tell me why not.

Well, there are a couple of reasons why not.

First of all, it's not a real food.

This wasn't made for your health, this was made for a shelf life.

You put this down, we come back in five months,

it's going to look the same.

I wonder if also you love this because you know it's going to fail.

-What do you mean?

-Well, you know that you're not going to just eat this

for the rest of your life, you know you are going to start craving

your chicken pie, so you know at some point this is going to fail.

So, you can love it, because it's a little bit of...

You get some momentum, it's great, it's a nice period,

you're losing weight, feeling good about that,

but you know you're not going to live on this.

So, that is the psychiatrist in you now saying...

well, this is a question, are you saying there is a self-destruct

element, as I know it's going to fail? Is that what you mean?

If this is your solution, I don't have a lot of hope,

because I don't think it's sustainable, I don't think

these sorts of gimmicks and plans and highly processed foods

create a sustainable, healthy lifestyle for people.

Remarkably, a new science could provide people like me with hope.

The latest research believes that the gut is the second brain of the body,

and the bacteria, or microbio, that live there

can send signals to the brain, telling us what to eat.

Certain sorts of bugs like certain sorts of foods,

and if one sort of bug is predominating,

-it might be driving you to eat that high-fat food...

-Really?

..rather than that sugary food.

-So, from there up, it's signalling to drive us to eat stuff?

-Yeah, yeah.

But how does what is in your gut drive your weight?

Because it's what you put in your mouth that drives your weight, right?

It's really complicated, we are trying to work that out.

But diet, stress and medication, such as antibiotics,

they are the main thing.

This gut stuff is where we get these horrible faecal transplants?

-Yeah, yeah, that's right!

-It's unbelievably boak!

-They even have poo pills now.

-Poo pills?!

-Yeah.

-Where you swallow poo?

-In a capsule...

-I will never be swallowing poo. Ever!

So, there is a very common and very nasty condition called C diff,

and that's basically when you've been given loads

and loads of antibiotics and you've just ruined your gut microbiota.

Now, first-line treatment for that is a faecal transplant...

-when you take faecal matter from a healthy person...

-Poo?

-Poo.

..you quite literally put it in a

vitamiser, with some saline solution. And you...

-Shove it up there.

-That's exactly right.

And indeed, in Europe, at least one trial at the moment is

under way to look at whether if you take people who are obese,

-and you do a faecal transplant from people who are naturally lean...

-No!

-..that it can help them to lose weight.

-No!

They are now seeing whether they can use it for weight loss.

This is ridiculous.

So you'd be going to your skinny friend and asking him

-or her for some of their poo.

-That's right.

But you'd want to make sure your skinny friend didn't have any

nasty parasites but also, really importantly,

that your skinny friend didn't have any mental disorder, because

you may well be getting their mental disorder along with their poo.

-They've tried these faecal transplants in mice.

-Yes.

-What happened?

So if you give basically fat poo

to a mouse, you can make it get fat.

If you give skinny poo to a fat mouse, you can make it get skinnier.

Never have I talked so much more shit in all of my life.

SHE LAUGHS

So let's find out more about these faecal transplants.

Unbelievably, there is

an actual bank in Boston where you can deposit your own poo.

We collect and process faecal material that we

distribute across the US and internationally for use

in faecal microbiota transplant, or poop transplants.

You should be locked up for that, shouldn't you?

It seems a little weird...

Collecting people's stools and sending them around the country.

This is our hi-tech stool collection kit. This sits on your toilet.

The stool is going to go on here, the lid comes on.

And then our donor is just going to drop this off in our lab.

Each donor, when they're dropping off a sample, is going to fill

out their identification, date and time of passage,

and then a little bit about their health history,

just so we know that they are staying healthy.

We have to have extremely healthy individuals.

Only about 3% of people can become a stool donor at OpenBiome.

Would I be a viable donor?

Unfortunately, you would not be a viable donor.

We are very picky about what type of poo we take.

-And one of our exclusion criteria...

-What's wrong with me, big lad?

HE LAUGHS

Unfortunately, one of our exclusion criteria is body weight,

and particularly BMI, or body mass index.

-What about these poo pills...

-Yeah.

-..that I've been hearing about?

Only in America. HE LAUGHS

Yes, it is something we are very proud of here.

Traditionally, faecal transplants are done through a colonoscopy,

-so from the bottom up.

-Shove it up.

It is a little bit unpleasant for patients,

and so we've spent a lot of work at OpenBiome developing poo pills that

essentially take the stool

and then capsulate it in a capsule that you can swallow,

and actually passes into your digestive tract and releases the bacteria there.

Sounds a little gross,

but patients really prefer that to having a colonoscopy.

So can you see a day that, in the same way we go into shops now

and we buy chocolate or we buy vitamins,

can you see a day that we'll be going into a shop and buying shit?

I don't know if we are going to have it over the counter,

but I can imagine a day when your doctor says, "Hey,

"we might want to think about, you know,

"rearranging your microbiome a little bit to improve your health."

It's only the beginning of this ground-breaking treatment,

but the results are impressive.

In the future, we know the microbiome is linked with the digestive

system, with the metabolic system, with the immune system

and even with your brain and your mood and your brain disorders.

And so we are excited about the possibility we can engineer the microbiome

in the future to improve conditions,

even including obesity, which is strongly linked with the microbiome.

-And you mentioned there that the microbiome can be linked to the brain. How?

-Yes.

So, the "gut-brain access" is the way that connection is referred to.

Your body...

The second largest cluster of neurons in your body is in your gut.

-There's...

-Say that again.

-The second largest cluster of neurons in your body,

after your brain, is in your gut.

Starting to make the link between gut disorders and the brain,

there's been a long sort of thought that things like a gut feeling,

you know, exists and we are starting to learn that

actually that might be a real scientific issue.

I find the most intriguing thing you've said today, that the

second biggest mass of nerve cells are here.

That's right.

Yeah!

People see me as being successful enough in the job I do.

Obviously, the thing I'm not successful at is food,

and in this city, New York, food is absolutely everywhere.

And I do wonder what it is doing to our brain.

# They call me, they call me Big Fat

# Cos I weigh 300 pounds... #

The scientific research suggests that if you're fat

and addicted to junk food, your brain is programmed to eat

and drink everything that is bad for you.

Whatever is going on in my head, it seems I'm compelled,

driven to eat this stuff.

At MIT in Boston, Professor Kay Tye has made a startling new discovery.

Using laboratory mice and rats, she's attached a cable that sends

signals directly into the pleasure centres of their brains.

So, basically, what we found was that

when we recorded from these neurons, they initially thought, "Oh,

"maybe they'll respond to sucrose, maybe they will respond to this and that."

Actually what they responded to, not the sucrose itself,

but they were responding to the learned action of seeking the sucrose.

And so, for me, I guess I think the analogy is, sometimes I get up

and go to the refrigerator without actually eating anything,

but I still do it, and it is this habit and it's a habit associated

with action of reward seeking that I've done many, many times.

It is so interesting for me what you have just said,

because when I was on a diet last year,

I actually thought I was going mad, and I'll tell you why.

Because I would go to the shops

and I would get some type of pleasure out of buying the crisps,

the chocolate, the pies,

all of the foods that I would have eaten

but I knew I wasn't going to eat, and I couldn't understand why

I still was getting pleasure or wanted to do that.

-Now you're explaining.

-That's exactly what I'm talking about.

It is this habit that you've done so many times,

and then habits lead to compulsive behaviour.

This compulsion is so strong that once addicted to food,

some of us are unable to stop ourselves from seeking reward.

The same neural pathway lights up in our brain every time.

If these neurons are encoding these habits of reward seeking,

if we used this tool that we have - called optogenetics - to

activate just these specific neurons, would we be able to make the

animal engage in compulsive reward seeking, compulsive sucrose seeking?

Look at what happens to this rat

when Kay switches on the reward centre in its brain.

It seeks out the sugar. Now look at this.

If the mouse reaches out for the sugar,

this time it is given an electric shock.

But because Kay is activating the reward centre

in its brain, it is compelled to seek out the sugar anyway.

Even if it's getting that shock. Amazing.

Now let's look at what happens

when the rat is placed in an area where there is no sugar

and the reward trigger is switched on in its brain again.

Here, when we turn the light on, you can see that right away the

animal starts licking the floor, behaving in this,

you know, frenzied manner.

The animal licks the floor. There's nothing in the chamber for the animal to actually eat.

So it is not actually tasting anything off the floor, it is

-not getting any stimulus, because there is nothing there.

-It is a completely clean floor.

And yet whatever way its brain has been stimulated, it is

-continuing to want to lick the floor, to eat.

-That's right.

-It's in a frenzy.

-And you'll see,

next, the animal actually does something really remarkable.

Even though there is nothing there to pick up,

it will actually go through the motions of picking up

a non-existent object and engaging in this elaborate feeding sequence.

In the same way we see that mouse licking the floor frantically,

if you imagine what goes on inside our imagination.

I sometimes sit at night

and I imagine myself licking chips, licking crisps, licking the salt off.

I know that sounds insane, but I do.

Is there much between me imagining that and creating that fantasy

in my head and a mouse licking

that little box that it is trapped in?

I can definitely imagine that it is similar.

Of course I don't know what the mouse's experience is like, but that mouse's

behaviour definitely reminds me of experiences that I have had.

So, in that way, I agree with you.

It is nearly comical, isn't it, when you see that rat

grasping into thin air for food?

Well, it is funny until I'm thinking, "Is that me?"

Because I dream about food all day long, whether I need it or not.

Everywhere I go, I'm thinking about it.

So maybe not too much difference between those rats

and some of us who are fat. Now, the big question for us, are we...

are we inclined because of our genes,

are we built to be like that,

or are we creating in it ourselves through greed?

MUSIC: Teardrop by Massive Attack

Or is it a bit of both?

Professor Felice Jacka has studied the impact of eating junk foods

when pregnant.

One of the really important understandings is that what

Mum eats during pregnancy has an impact, not just on the mental

health of the offspring, but on their reward pathways.

So if Mum eats lots of junk food during her pregnancy,

what we seem to see is that the children are much more

likely to find those foods really addictive.

-They are already primed for it.

-In later life?

-Yes.

-Wow!

-And this is why we think that you get this intergenerational transmission of obesity.

It is not just what food is at home, it is

-the addiction that goes with it.

-Hold on a second.

So when women are pregnant, they are very hungry,

they get the munchies, they want to eat chocolate,

they maybe want to eat a worse diet than they were eating.

That can affect their child in later life?

Yes, not even in later life, in early life. So we led the first study.

We looked at over 20,000 mothers and their children in Norway.

We looked at Mum's diet, we look at the kid's diet,

and then we looked at the kid's behaviours.

So specifically mums who had more junk

and processed foods during their pregnancy, the kids had higher levels

of these behaviours like tantrums, aggression, kicking and screaming.

The top-line message is, what you eat

when you are pregnant will have an impact on the brain development

and the development of the immune system in your offspring.

But the really key thing is, what you eat will have an

influence on the early gut microbiota of your child.

So if your gut is not healthy, your microbiota are not healthy,

your baby gets an unhealthy gut microbiota profile.

It's an unhealthy start in life.

An unhealthy start in life, that we think

increases their risk for a whole host of disorders, such as autism,

schizophrenia, allergic disease, heart disease, all sorts of things.

If you were to try to stop smoking to help your baby,

you should try to improve your diet when pregnant to help your baby.

Yes, I would say so. Most definitely.

I wish I had known this when I was pregnant.

I'm going to blame my mother for everything now. SHE LAUGHS

Yeah, well, that's always...

It's the Crunchies my mother has been on, and the chocolate and the crisps.

All through history, the poor mothers get the blame.

But now, you know, from the animal work, we can see that

Mum's junk-food diet, it affects the neurotransmitter

systems in the brain, the reward pathways, the immune

system in the offspring, all of these things that we know are related to

the risk for mental health problems as well as physical health problems.

When I think about food, I think about diet,

I think about losing weight, everything that I can't eat.

But during this film, I've met leading scientists who say food is

much more complex than that, that it affects our mood, our memory.

In fact, they have told me

that it affects every cognitive function that we have.

-# You look like an angel

-Look like an angel

-# Walk like an angel

-Walk like an angel

# Talk like an angel

# But I got wise

# You're the devil in disguise

# Oh, yes, you are

# The devil in disguise... #

America is leading the way in an unprecedented

explosion in the rates of obesity across the world.

But Ireland is not far behind.

It's estimated that by 2030 almost half the male

population of Ireland will be morbidly obese.

Well, there is no other place on earth that has the excess of Vegas.

Everywhere you look around here...it's food and vast quantities...

of it.

MUSIC: Billie Jean by Michael Jackson

I keep saying I have to change my life,

but my brain keeps telling me to eat.

And I can't stop.

Those stop signals just are not working.

If I continue to eat the junk food,

I'm literally gambling my life away.

# She told me her name was Billie Jean as she caused a scene

# Then every head turned with eyes that dreamed... #

-Hi, welcome to The Heart Attack Grill!

-Thank you very much.

-Let's get you prepped and ready for surgery.

-Right.

-All right!

-Will one of these fit me?

-Yeah, yeah, we got it.

'I doubt there's a food company that would admit

'to their role in this obesity epidemic,

'but here in Las Vegas, at The Heart Attack Grill,

'you can eat for free if you weigh in at more than 25st.'

PEOPLE CHEER

Yeah!

Whoo!

So, Donovan, what did you come in at?

I came in at 362, I believe. 362.

And it's like... Cos I'm a big guy, right?

So we can probably talk to each other candidly.

-You're high-fiving that nurse...

-Right.

..because you're really fat.

-Basically, yeah.

-But what's... It's not funny, is it?

-No, it's not funny.

But, I mean, it's not something that everybody can say they are,

over 350 pounds. That's the average here in America, I guess.

But, hey, I get to eat free. I'm not ashamed, hey, you know, why not?

-What's your advice?

-A lot of fried foods, you know...

-Do you think you'll ever crack it?

-Oh, yeah.

It'll take that one wake-up call from my doctor, but I'll get there.

-That's a wake-up call.

-Yeah...

-Nah.

-No?

-I don't think so.

I don't think 350's too bad.

You've got people walking around here, 400, 500 pounds in a buggy.

I can still walk. I think I'm still all right.

-All right, thank you, mate.

-Thank you.

-Thank you. Bye.

Thank you, guys.

That guy... That guy is in denial.

Like, you know, he's been applauded for being 360 pounds

and he says, "Ach, it's not that bad, I can still walk."

HE SCOFFS

And I'm no better than he is.

This is obesity gone mad.

All right, guys. Enjoy.

I don't find this funny.

I don't find it funny either.

No-one comes here and follows my programme

and doesn't get exactly what I promise. Right on the door...

What's that, a heart attack?

Right on the door, I promise you that this is bad for your health.

So what do you sell?

I sell death...and I sell fun and those two happen to go hand-in-hand.

I'm going to let you have fun, but I'm going to tell you

you're going to shorten your life.

It's like selling a cigarette.

Now, how can I sell you a cigarette and tell you

it's a good thing for you? Of course not. Ah, here we go.

-One Triple Bypass Burger.

-Now, here is a small little appetiser.

-Here, just put your hand right here, sir.

-This is ridiculous.

-It's not ridiculous.

-It is ridiculous!

No, but this is exactly what you wanted.

-Right, so people don't actually eat this.

-Sure they do.

-Sure they do!

-Come on.

-Come on! Do customers actually eat it?

-They actually eat it.

Now, whether or not they finish it is an entirely different story.

So you're a clever marketing guy, clearly, right?

So you've opened up a restaurant and your marketing is mocking fat people.

-No!

-Yeah. Come on, come on.

-On the contrary.

Look at this, it's ridiculous. It actually makes me sick.

I'll tell you what makes me even sicker.

This is the type of crap that I'm putting into my body,

-destroying myself.

-Right.

And you're making money out of marketing to people like this.

I'm making money doing exactly what people want.

Wait, wait, but that's not everything they want.

They also want the hot dog, oh, yes.

-And they want the chilli fries, right there.

-And the best...

And the best of all, the onion rings.

That's where the real calories are. You know, in the Guinness Book...

-I wonder, does your food actually taste nice?

-There you go.

The onions are incredibly porous

and when you cook them in lard, they suck in all those calories.

-They taste very nice.

-Well, thank you.

But the interesting thing is, as you sit here, mocking people like me

because I'm fat, I'm eating it.

How many calories are in this burger?

So there was 9,983 calories. The...

Which is four times what a man should be eating as his daily allowance...

-in that one burger!

-Something like that.

You need to get a conscience.

I have the biggest conscience in the American food industry

and here's why.

There is not another restaurant in Ireland or the United States

that tells you the exact truth of what you're doing to yourself. I am.

Calling yourself a doctor is probably the sickest thing you've done.

Because what do doctors do? They save lives.

What are doctors trying to do?

They're trying to reduce morbid obesity in people

so that they will live longer.

And you put this on as part of your sick marketing.

I'll show you somebody who does think that I'm a physician.

What is this? What is that?

This is a very good friend of mine,

the cremated remains of a gentleman who died here.

Hit the floor, ambulance came in, took him out.

-He had a heart attack in here?!

-Yeah.

Ambulance came, took him out,

there was no family to speak of, so he was cremated and the rest of

his things stayed here with us in the bar.

There are... These men made their choice, though.

The same way as a man goes into battle in deciding

to die for his country.

Yeah, but it's not funny any more when they actually die, is it?

No, it never was funny to begin with.

I am telling people that they can opt to be dead if they refuse

to do what we call the food Nazis dictate to them, that...

They are advising people on how to prolong their life,

how to avoid type II diabetes, how to avoid wrecking their lives.

They are not succeeding.

So are you actually a good guy who's trying to get people to realise

-that they need to lose weight?

-Not at all.

Do you care about fat people?

No, not a good guy in the least, as the front of the menu will say.

Hashtag 'evil doctor'. That is me.

-Forget about the marketing, do you actually care?

-Do I care?

Do you care that people come in here and they're killing themselves?

I can blurt out, "Oh, yes, I care."

I could try to say something that makes me look better.

Primarily, first and foremost,

is don't get in the way of my profit margin.

And now for the ultimate humiliation.

Do I qualify to eat for free along with all the other fat people here?

Close, but not quite.

324 pounds, it's embarrassing, it's humiliating, it's devastating

and I'm dying.

You know the way we've all joked about in the past

and we've kind of ho-ho'ed, ha-ha'ed,

"Oh, Stephen's talking about his weight again."

Well, I'm dying. There you go.

That's what that reading up there says. Er...

And it's self-inflicted,

that's the most frustrating part about it for me.

It's self-inflicted, I'm killing myself.

And that place in there is a, you know...

Many people would see it as a disgrace.

Some guys mocking, MOCKING, all of this food that makes you fat

and bringing ashes out of a guy that died.

How long is it going to be until I'm in one of those bags?

Pathetic.

MUSIC: Everybody's Talkin' by Harry Nilsson

# Everybody's talkin' at me

# I don't hear a word they're saying

# Only the echoes of my mind... #

So, is there any hope?

Psychiatrist Dr Drew Ramsey certainly thinks there is.

He's arranged to meet me at his pharmacy,

a farmers' market in the middle of New York City.

I've had 41 years now of sugar gives me a hit,

carbohydrates give me a hit, chocolate, ohhhh, crisps...

You just said three things that are the same between the two of us.

-Right.

-I love carbohydrates, sugar gives me a hit,

I love dark chocolate. So...

And I'm also 41. So I think that...

Hold on a second, we're the same age?

And there's something else I told you earlier. You didn't believe me.

We are the same age!

And I know something that shocked you,

I know that I've even the exact same number of calories that I've

spent over the last 20 years, the exact same number.

But do you drink? Do you eat bad food?

Yeah, yeah, I drink. Pizza, beer, I eat all that stuff...

sometimes.

Dr Drew is going to prescribe a new diet of all the foods

that I've hated my entire life,

foods that he says will nourish my brain.

On ice, totally fresh.

-Don't you have to cook it?

-You don't have to cook it.

It's nice and sweet.

-Oh, mmm.

-I'm afraid to, in case it makes me sick.

You're not going to get sick.

This guy here, this guy here looks as if he'll knock me out

if I don't taste his fish.

You better eat that scallop right now, mister! Right this minute!

Don't make the yuck face.

Don't make the yuck face, make the happy face, happy face!

Chocolate pudding. There it is.

-It's quite creamy, actually.

-Very creamy.

Right, now you're talking about a good brain food meal.

-Seafood, greens...

-That does what for my brain?

So, what you're going to get there again, complete protein,

B12, you're going to get a big, big dose of B vitamins, right?

-So all these minerals...

-So what's that doing for my brain?

-Is it growing it?

-Yeah, well, it's going to get it growing, but it's...

It's all basic ingredients of your brain.

-I'll get some ice cream.

-Ice cream!

STEPHEN'S LAUGH DROWNS SPEECH

Still think he's a bit weird.

Of all the brain foods in this place,

Drew has a strange fascination for kale.

-You see, I don't even know what kale looks like.

-You don't know?

-We've got two great varietals here.

-It looks like cabbage.

Well, it is a cabbage family. They're all related to cabbage.

Give a little smell. Very earthy, sulphurous, very herbaceous.

It smells like stone.

-And you're a kale virgin?

-Yeah, I'm a kale virgin.

-You've never had kale before?

-Never had it, total virgin.

This is going to be your first...

Are you ready to, you know, pop your kale cherry right now?

I'm ready to pop my kale cherry.

Let's just try a little...

This is a green curly kale, it's going to taste...

This is going to be a little bitter to you, probably.

But I want you to just try it. We'll both try it here.

Here's a little piece for you. And, cheers.

Now chew it.

Complex flavour, right? Bitter, strong.

Rotten.

So colcannon, traditional Irish dish, mashed potatoes and kale.

-You guys don't eat that?

-No.

-Not as far as I know.

-We all over here think that...

We've been saying that kale is an ancient food in ancient

-cultures like the Irish. That's not true?

-Not in Belfast. I don't know.

-You don't celebrate National Kale Day?

-Definitely, definitely not.

-October 7th?

-There's a National Fish and Chips Day.

-I understand you're the author of 50 Shades Of Kale.

-Yeah, yeah.

Don't get rough, get roughage.

So, in the spirit of trying to change my life, I'm actually going to try

some of these healthy foods that Drew has cooked for my brain.

-Why don't you try a kale chip?

-Try this one.

-Great. What do you think?

Crispy? No, don't do that end, do the other end.

That's to hold, that's the handle. There we go.

LOUD CRUNCH

So, I'm not joking you...

these taste like ready-salted crisps.

I could kiss you!

They actually taste like...

They taste like ready-salted crisps!

That's the lacinato. This is the green curly.

They are BLEEP lovely.

Yeah? Good.

This is just a little kale salad, simple kale salad.

This is a creamy dressing, we put some garlic scapes in there,

a little olive oil and just a little bit of mayonnaise.

And then I think probably for you the most important thing is

there's nothing in there that's bad for your brain.

-Well, there's mayonnaise.

-Yeah, but mayonnaise is eggs and olive...

-It's fat.

-Eggs and olive oil. This is a thing you have to change.

-You have the notion that fat is bad.

-Yes. Fat is bad.

Your brain is about 65% fat.

We all come in all different shapes and sizes, don't we?

And by this stage, most of us know how to look after ourselves,

keeping ourselves safe when we cross the road,

looking for moles on our body in terms of skin cancer.

A lot of us try to keep healthy.

And yet, there's a new way we need to educate ourselves,

because we don't know enough and we're not thinking about it enough,

and that's what we put in our mouths

and how, ultimately, it affects our brain.