Health & science. Feeling good.

Brain Food

Cravings Offer Clues To A Hunger For Comfort

July 11, 1996|By Bob Condor, Tribune Staff Writer.

Her career has made a science out of losing weight, and Judith Wurtman shares (with her physician husband and drug companies) a patent on the first diet pill approved by the U.S. Food and Drug Administration in more than 20 years. Yet Wurtman insists that eating the right foods and keeping physically active still represent the best prescription for weight control.

Apparently, too many cheeseburgers may come with a price that can't be discounted by a "magic pill."

"There's no quick fix," said Wurtman. The Centers for Disease Control now classifies 33 percent of adult Americans as obese (defined as weighing 20 percent more than a healthful body weight). "You especially need to control portion size and maintain muscles by exercising them."

Coming from Wurtman, the recommendation carries unusual impact. She will benefit financially from the sale of Redux, a prescription weight-loss medication approved by the FDA in late April and made available to the public by prescription just a month ago.

Known generically as dexfenfluramine, Redux is a serotonin-based drug. Serotonin is a brain chemical (or neurotransmitter) that signals the body when it's satiated. The neurotransmitter is also associated with such emotions as anger, depression, sadness and anxiety.

Redux is not addictive like amphetamines and promises fewer short-term side effects than a similar serotonin-acting regimen nicknamed "fen-phen" (a combination of fenfluramine and phentermine used for obese patients since FDA approval in 1973 but recently made more popular among physicians when a 1991 study showed that pairing the two led to more effective weight loss). The dexfenfluramine in Redux is a more potent form of fenfluramine designed to make you feel full more rapidly during a meal or snack; you will still get hungry but tend to eat less.

In groundbreaking work at the Massachusetts Institute of Technology--first conducted in the 1970s--Wurtman and her husband, Dr. Richard Wurtman, made the original discoveries that food can play a role in regulating serotonin in the brain (his work) and that overweight people craved serotonin during stressful times, leading them to eat more sweets and other foods high in carbohydrates (her work).

Together, the Wurtmans wondered if a drug could be developed to control serotonin levels in the brain and encourage weight loss. A French drug firm proposed that the MIT researchers investigate dexfenfluramine, which is now available in 65 countries.

Judith Wurtman's specialty as a biochemist has been to explore the link between serotonin and overeating. In several studies funded by the National Institutes of Health, she has found that subjects suffering from stress and mood disturbances ate carbohydrates to relieve their mental state.

"In effect, it's a form of self-medication rather than lack of self-control or bad eating habits from childhood," said Wurtman. "The research shows people were regularly eating carbohydrates when they were not physically hungry but instead at times they were under stress."

This eating pattern responds to what she calls "psychological hunger." Wurtman said people under stress typically eat high-carbohydrate high-fat foods (cookies, chips, candy bars), often as a "reward" or comfort.

"Though you are eating carbohydrates rich in serotonin, the fatty foods seem to interfere with the stress management system in the body," said Wurtman, "you are likely to feel lethargic rather than energized."

One indicator she offers to determine your need for serotonin: If you prefer items like crackers, cookies, tortilla chips, popcorn, bagels, candy and dry cold cereals for your snacks, you are a "serotonin-seeker" during times of stress. Those who choose raw vegetables, fruits, fresh yogurt, cheese, cold chicken or nuts tend to snack more because of habit or boredom than a need for serotonin.

Wurtman, who has co-written a new book, "The Serotonin Solution" (Ballantine), to describe the best food choices for stressed and overweight individuals, has customized diets for serotonin seekers, including ex-smokers, women with significant premenstrual symptoms, shift workers and "stressed-out mommies."

A cornerstone of her recommended diet is high-carbohydrate, low-fat snack (40 to 45 grams of carbohydrates and no more than 210 calories) each day, either in the afternoon before dinner or mid-evening. Even low-fat sweet snacks are OK.

"Don't feel guilty about your choice," writes Wurtman. "You are eating the snack for its effect on your mood and mental energy levels, not its nutritional value."

The nutrition comes with the rest of the day's diet.