Maggie's Farm

We linked this NYT op-ed this morning: Do You Need That Test?

Of course expensive and extensive testing is ordered, these days, partly because of malpractice. Any doc will say so. It's about CYA.

As a consequence, young docs are being trained to rely more on the tests they can order than on old-fashioned inexpensive clinical, hands-on evaluation and diagnosis. Thus a vicious cycle begins. And it's all free, because "insurance pays for it." So you get the patient's family in on it too: "Doc, we want you to do every possible thing and do every possible test to check out Granny." Is that an argument a physician wants to have?

No doctor enjoys being on the witness stand answering the question "So, Dr., you elected not to order a CAT scan for Mrs. Jones' headache because you trusted your clinical judgement, and felt the expense-benefit ratio was wrong?"

Each single pound you weigh adds 4 lbs. of pressure to your knee joints when walking, and more when running or climbing stairs.

Thus (obviously) if you are 20 lbs. overweight, your knees experience it as equivalent to an 80 lb. backpack - plus the normal effect of the rest of your ideal weight. Knees were not designed for 80-lb. backpacks 24 hrs./day. Over years, the damage increases of course until, one sad day, you finally begin to feel the accumulated damage.

...individuals who lost 10 lbs. would be subject to a total of 48,000 less pounds of pressure for every mile walked.

Walking when overweight is brutal to knees and, from the knee point of view, probably is to be minimized until losing weight. Driving is kinder. Being carried by slaves in a litter is even better because it is kinder to Gaia.

Besides trauma (eg accidents, athletic injuries, athletic overuse and related overuse as in dance), extra weight is the main cause or exacerbation of knee arthritis. It's all about gravity and the pounding your knees take with every step.

Unless the idea of knee replacement appeals to you, the kindest thing you can do for your knees (or your hips, for that matter), is to lose weight - or to be carried around town. Or, like you see in WalMart, maybe Medicare will buy you a $25,000 electric wheelchair.

Americans eat too much, and far too many carbs than is good for them. (Soon, I'll repost the Dr. Bliss diet which I follow diligently to stay under 130 - plus lots of athletics. It is essentially carb-free, except at Birthday Parties and special occasions. Absolutely no fruit allowed - fruit is sugar and a sugary dessert, and there is nothing "healthy" about it.) Here are some links about weight and arthritis.

Happy Knee photo via Theo

Image below is Cleopatra, keeping her knees youthful and healthy.

From a piece by James Silver in The Atlantic, with the above title:

...yes, Wall Street may have a significant percentage of self-serving, ruthless, and manipulative psychopaths and almost psychopaths. And, yes, this fact might be of considerable importance in assessing the "moral fiber" of an investment bank. Whether this is a new phenomenon, though, is a separate question. And, in the current zeal to castigate Wall Street, let us not lose sight of the fact that about one out of every 100 people is a psychopath and 15 out of every 100 people are almost psychopaths. They are husbands, wives, doctors, lawyers, teachers, and store clerks.

And they are a lot closer to you than Wall Street.

Silver views psychopathy (aka Antisocial personality) as a spectrum, from little to lots. That fits my life experience and my professional experience. When I encounter "almost sociopathy", I term it "antisocial traits."  The world of finance, indeed, has no monopoly on sociopathic traits. I suspect the world of politics has far more, proportionately.

An interesting feature of antisocial traits, like narcissistic traits, is that their owners tend not to know they have them. People who worry about having them probably don't have much of it.

Besides "social media," it's interesting to me how others keep in touch with their old friends, how they reach out and make new friends, and, in general, how they keep their interpersonal lives alive, vibrant, and stimulating.

Readers know that I like to host parties at home, both formal and informal. Even if it isn't a time to have deep, intimate conversations as one does in other settings like in restaurants or clubs, it's a way of letting people know that that you view them as a part of your life that matters. That is an important signal to send to people (assuming that they care).

I know the Bird Dogs like to host formal dinners, and especially big semi-formal multi-course game dinners for 25-30, but that sounds like work to me. Sounds like a holiday effort, but they seem to be used to doing it joyfully and without much expense, and take it in stride.

At my house, we are partial to hosting semi-stuffy formal dinners for 12 at least monthly from October to March (why else have a formal dining room?), and casual family clambakes, barbecues, pig roasts, or the like in the summertime. Sometimes in the winter it is good to host a decadent after-church brunch with champagne and bloodies, with a guy making omelettes to order, and bacon n' sausage n' pancakes. A big brunch at home is not an expensive party, and people love to come in the winter for good cheer with the fireplaces blazing. People have been known to get good new jobs at our get-togethers.

Every few years, I think it's a good idea to find an excuse to throw a big cocktail party or Christmas party and cast a wide net of hospitality. Inviting people into your home, however humble, means a lot to people. Doing those things right, of course, can be a little bit costly but makes life much more fun.

I enjoy people. If I don't do it, who will?

Friends of ours, recent empty-nesters, have come up with another idea which I like. They term it "Suppertime." Once a week, they just call a couple to join them for an ordinary supper on the kitchen table after work. A cocktail by the fire first, of course. Nothing fancy, no big deal, just a visit for an hour or two at most. Salad and spaghetti, or a grilled ribeye and mashed potatoes, or whatever, and some fruit for dessert.

I think it is a brilliant idea.

What do our readers do?

There are times in life when some relief from mental pain is as much of a blessing as narcotics are for relief from physical pain.

I wrote a post last week titled “No need to worry about that, we have a cure for anxiety today.”

Today, I see that New York Magazine has a lengthy (and, annoyingly not visible on one page) cover story on the same topic: Listening to Xanax - How America learned to stop worrying about worrying and pop its pills instead. Here's a quote from the article:

It turns out that I am afflicted not just with pharmacological Calvinism but with mindfulness skepticism as well. For while I believe, in theory, that learning to coolly regard my anxiety as a purple, hairy monster I could stash in my tote bag, as Mennin suggests, might steady my pulse on sleepless nights, I am suspicious of any cure that requires more effort and expense on my part and more hours away from my work and my family. In this skepticism, I am like my anxious peers. “We go through rough patches, and we do things that make us feel better,” says Lisa Colpe, an epidemiologist at the NIMH, with the vocal equivalent of a shrug. A lot of people with anxiety would simply prefer to live with it; they know that when it becomes unbearable, the drugs will be there.

A cure isn’t what the PR executive with the occasional Klonopin habit wants. “My own personal experience is that there’s a healthy level of anxiety, and I don’t believe ‘healthy’ is the absence of anxiety,” she says. “I live in a world that puts unreasonable demands on me, and sometimes I need help. I wish I could do it without the pills, but I can’t.”

There are more-or-less three sorts of non-major-mental-illness-related anxieties.

One is anxiety about worrisome real situations, one is anxiety related to real guilt, one is neurotic anxiety. Some would place the anxieties of minor emotional problems, eg phobias, OCD, GAD, etc., among the neurotic category, and some would place them in another (non-major) Mental Disorder category.

Thus anxiety (fearfulness) is mainly a symptom of something, and usually not a "disease" in and of itself. Frequently, we find that what people think they are anxious about is not what they think it is.

Regardless of category, we indeed do have pills to put a band-aid on all of these sorts of anxieties.

From a piece about Kierkegaard, The Danish Doctor of Dread:

In his “Works of Love,” Kierkegaard remarks that all talk about the spirit has to be metaphorical. Sometimes anxiety is cast as a teacher, and at others, a form of surgery. The prescription in “The Concept of Anxiety” and other texts is that if we can, as the Buddhists say, “stay with the feeling” of anxiety, it will spirit away our finite concerns and educate us as to who we really are, “Then the assaults of anxiety, even though they be terrifying, will not be such that he flees from them.” According to Kierkegaard’s analysis, anxiety like nothing else brings home the lesson that I cannot look to others, to the crowd, when I want to measure my progress in becoming a full human being.

But this, of course, is not the counsel you are likely to hear these days at the mental health clinic.

Curing the uneasy soul is not so easy. When it's coming from real guilt, it's not even desirable to cure it. The guilty must suffer to learn, just like school. Good shrinks are not about feel-good, we are about dealing with reality. Reality often does not feel good.

Sorry - I put "sexy" in there to grab your attention and to make a point about words. If you studied cognitive psychology or good old-fashioned linguistics in college, you learned this famous theory about how language determines thought. If you didn't, it's your loss. Their theory is partly wrong, because humans can think without using words, but it is also partly right, because words do effect and shape our thoughts.

But Sapir-Whorf went beyond that. They theorized that language shapes and structures our perceptions of the world - both our output and our input.

Indeed, words and their concepts seem to do that. Goethe said "Man sees what he knows." A birder sees a Parula Warbler, a non-birder sees just a "bird," or doesn't even notice it at all. The universal metaphor of blindness for ignorance is no accident.

Sapir-Whorf is almost an "In the beginning was the word" theory. However right or wrong their theory was, it has been a useful and productive and intriguing one, which is the only true measure of a theory in science.

I refer to Sapir-Whorf because we had two posts a while ago which were, ultimately, about words and how they are used. One about "values," one about "progress." In both cases, these words and their connotations slipped into regular usage and began shaping our thoughts, sometimes without our awareness. After all, "thinking" happens somewhere in the shadowy darkness between awareness and un-awareness.

Cognitive Daily reviews the history of the hypothesis, and recent research on this dusty but still fascinating topic.

A young woman recently commented to me that she thought one reason she was in love with a certain man was because he "made her feel safe." "Safe from what?" I asked. She thought for a minute and said "Safe from the world, I guess."

It's not an unusual topic of conversation among some of my more conservative lady pals to speculate about why women have some tendency to vote more Leftist than men do.

We have lots of theories, but more questions than anything else.

For some examples, Women are more caring and nurturing, less aggressive or more needy than men (maybe, possibly, I sort of doubt it but, if so, why would women think of government as a vehicle for those feelings?)

Or, Women are fearful of losing a man, and want government to step in as a husband if needed

Or, many women don't have a man, and would rather lean on government than on charity

Or, Women are more prone to parental transferences to powerful government, while masculine pride resists accepting government "help" because it makes them feel diminished

We have other theories too.

Here's a piece on a related topic at Reason: "Women vs. the State. It’s time to liberate ladies from unequal and unjust government policies."

It's all about "The Dark Triad."  From Yes, Chicks Dig Jerks, and evolutionary science gives us a good idea why:

The Dark Triad is a combination of psychological traits — subclinical psychopathology, subclinical narcissism, and what Professor Jonason calls “Machiavellianism” — that are, he believes, in fact a unitary phenomenon associated with a higher level of sexual success, defined in the literature as a larger number of total lifetime sexual partners. The correlation of the Dark Triad with larger numbers of sexual partners holds true for both men and women, but the effect is much more pronounced in men. This is unsurprising, inasmuch as men’s relative preference for larger numbers of short-term sexual relationships and women’s relative preference for long-term relationships is, as Professor Jonason notes, “one of the most consistent and strongest sex differences in the field.”

So: Machiavellianism, subclinical psychopathology, subclinical narcissism: not exactly the stuff of a Jane Austen romance, but apparently the stuff of sexual success. Professor Jonason concludes: “Together with low amounts of empathy and agreeableness” (I warned you this was depressing stuff) “such traits may facilitate — especially for men — the pursuit of an exploitative short-term mating strategy.”

But you knew that already, if you are a homo even half sapiens and went to high school.

That's all true of my experience with skirt-chasing seducers. They know how to say exactly what you need to hear but, in the end, you will never be enough for them because, Psychiatric as it may sound, they are really manchilds looking for Mommy while having fun with pseudo-adult seduction, romance and sex along the way.

Image is Luigi Bassi in the title role of Don Giovanni in 1787, via Wiki.

This is as fresh as the day he wrote it. The great (young) man himself conducted the premiere of this astonishing (comic?) opera in Prague, in 1787:

I think a connectome could be rephrased as a soul, but I am not sure what difference renaming it makes. At TED via The Age of Connectome at Cocktail Party Physics.

(Unrelated, how TED became brain candy)

Remember how Russell Crowe in Beautiful Mind gradually slid into a paranoid psychosis, letting the audience experience some of the reality-confusion along the way? Ron Howard depicted this process well in that movie; the creepy feeling that things are getting a little strange. 

It may not be a general-interest topic, but it is an issue which Psychiatrists are frequently presented. You consult with a late teen or young adult, usually on the urging of a parent, who has shown some decline in functioning and has some new anxieties and some peculiar symptoms.

A seasoned shrink thinks "Hmmm. This smells sort-of pre-psychotic but of course I might be wrong." (Much of medical care is as much art and experience as it is science. Never, ever go to a young doctor.)

Apparently our instincts in this area are right at least 50% of the time, which isn't very good.

This article at Neuroanthropology is excellent: Slipping into psychosis: living in the prodrome.

What's the difference between wholesome obsessions, distractions, avoidances and diversions - and unhealthy ones? (I am not speaking clinically about obsessions and compulsions here, but just in the layman's sense of the words.)

The difference is in the purpose, not so much in the thing itself. The most common ones we all see in daily life are:

- TV, radio, and listening to music
- Shopping
- Reading
- Surfing the net
- Sports, exercise
- Sleeping and napping
- Socializing
- Hobbies
- Sex and erotic activities
- Computer games
- Drinking and drugs
- Work, chores, and projects of all sorts
- Mental preoccupations of all sorts

That covers most of life, doesn't it? Trust me - I am all in favor of fun and productivity. Not one of these things is necessarily unwholesome - except when they are used as avoidance of something or things. That usually - but not always - means when they are not done in moderation and in proportion.

Why do so many of us have our best thoughts and insights in the shower? Because we aren't doing any of those things in the shower...generally speaking.

Only the mentally strongest people - and I do not include myself in that category - routinely face their anxieties, worries and fears; routinely deal with every responsibility or burden immediately, or routinely face their relationships or the realities of themselves: their weaknesses, their guilts, their unsettling thoughts and feelings, their disappointments and sadnesses, regrets and remorse, boredom, loneliness, or empty feelings - or just "being with oneself."

There is an expression in AA: "Move a muscle, change a thought." It's good advice if one is avoiding a dangerous thought but it's bad life advice if one is avoiding thoughts that need to be considered and faced and maybe even acted upon.

If I decide on a Saturday nap after two hours of tennis in 90 degrees, fine. But if I decide on a nap (maybe without realizing it) because I am worried about paying the bills, not so fine.

Having kids is a great diversion and distraction. For years, it will fill your life with preoccupations and duties which have the advantage of being truly responsible and loving. But when they get older, you face yourself again.

Therefore, whenever I find myself immersing myself in something, I try to remember to ask myself why. That's not obsessive navel-gazing, it's just common sensical self-monitoring. "Metacognitive," as they say.

And when I drive, I try to leave the radio off - so I can listen to the real news about what is going on with me, my soul, and my life.

Otherwise, I'd be out of touch.

 Photo is a 1923 Silvertone radio

We mentioned that theme here yesterday. Compassion without discernment is generally moral vanity or spiritual-ish pride; often foolish, often counterproductive or destructive, and often humiliating to the recipient. It reminded me of this well-known speech by Ivan Illich (not Ivan Ilyich, who died) on the topic of paternalistic "help." The intro:

An address by Monsignor Ivan Illich to the Conference on InterAmerican Student Projects (CIASP) in Cuernavaca, Mexico, on April 20, 1968. In his usual biting and sometimes sarcastic style, Illich goes to the heart of the deep dangers of paternalism inherent in any voluntary service activity, but especially in any international service "mission." Parts of the speech are outdated and must be viewed in the historical context of 1968 when it was delivered, but the entire speech is retained for the full impact of his point and at Ivan Illich's request.

It's a classic, here. He concludes:

I am here to suggest that you voluntarily renounce exercising the power which being an American gives you. I am here to entreat you to freely, consciously and humbly give up the legal right you have to impose your benevolence on Mexico. I am here to challenge you to recognize your inability, your powerlessness and your incapacity to do the "good" which you intended to do.

I am here to entreat you to use your money, your status and your education to travel in Latin America. Come to look, come to climb our mountains, to enjoy our flowers. Come to study. But do not come to help.

How do you carve nature at its joints, when there are no joints? This is good, from Sailer: If race doesn't exist ...  He quotes:

...as any psychiatrist involved in the making of the D.S.M. will freely tell you, the disorders listed in the book are not “real diseases,” at least not like measles or hepatitis. Instead, they are useful constructs that capture the ways that people commonly suffer. The manual, they go on, was primarily written to give physicians, schooled in the language of disease, a way to recognize similarities and differences among their patients and to talk to one another about them. And it has been fairly successful at that.

and

“The D.S.M. has been taken too seriously,” another expert told me. “It’s the victim of its success.”

When people think of Maslow, they tend to remember two things: the notion of "self-actualization," and his hierarchy of motives.

Maslow made several mistakes (one being the assumption that everybody is just like him, and another being his relative discounting of unconscious motive), but what is most interesting is how some of his ideas became absorbed into the culture in distorted ways.

To what extent Maslow studied Nietzche I do not know, but his post-modern glorification of "self" owes plenty to Nietszche. In the brave new world, Self replaced God, and the value of "self-actualization" replaced - for some - sturdier old values such as duty, honor, perseverence, integrity, decency, and - yes - selflessness.

To what extent Maslow played a role in todays pop-culture "It's all about me" theme I can not say, but what I can say, from speaking with a great many people over the years, that the idea that the person must strive to become a heroic manifestation of his Self has led far more people onto the rocks of life than I can count. One reason is, of course, that nobody's "Self," however talented or untalented, is really all that great, and is packed with the flaws with which each of us stuggles daily.

Furthermore, the culture's version of Maslowism leads to much feeling of failure. After all, if I have not fulfilled my potential" or "become who my inner self really is" or "fully actualized my precious self," a person can feel like a failure in life, a certain narcissistic defeat. We all use our gifts as best we can, given our ambition, inspiration, and industriousness, but I view "sef-actualization" as a false idol.

This post is prompted by a good essay on Maslow and the culture: Abraham Maslow and the All-American Self

The Knishman nails the zeitgeist here: Food Fights and Class Warfare.

He is right that weight is a class and/or cultural thing to some degree. There is a sort of logic to it in an era of plentiful or unlimited cheap carbohydrates in the Western world. Being heavy no longer displays prosperity, while being trim and fit shows that you have the ability to delay gratification for more important goals, such as being more vigorous and sexy, and less of a couch potato.

However, unlike Lefties, I don't care what other people chose to be or what they eat. From Knish,

Social medicine politicizes food consumption and a globalized economy politicizes food production. And the politicized American plate has less on it and at a higher price. While the left obsessively pursues its mission of destroying fast food in the name of lowering social medicine costs and being fairer to farmers, what they are truly accomplishing is to take affordable and filling food off the shelves, as they have done with countless other products that they have targeted.

As lefty pols go, in the last photo I saw, Al Gore looked like a fattie, living off the fat of the land. Last photo I saw, Obama looked semi-anorectic for a middle-aged man-boy. Clinton got fat, had a heart attack, and then got scrawny and ill-looking living on arugula salad.

Here is a brief history: The Real Skinny: Expert Traces America's Thin Obsession. What that brief post misses is that, today, in our culture, trim and fit is sexy and appealing to both men and women. In a way, it seems to say that you have not given up on life, or at least that you have not given up on caring about your body. In fact, "studies show" that being trim and fit helps you get a job, or keep one.

I love a Big Mac once in a while. Who doesn't? A Big Mac and Fries is around 1000 calories. To walk that off takes 4-5 hours of vigorous walking, at least. About 3 hours on the elliptical.

It's been repeated so often that it's become a mantra. Google search. If you walk or run or elliptical or stairmaster or hoeing the fields or whatever over 10,000 steps daily, you have an "active life;"  if under, you fall into the "sedentary life" category.

Nobody wants to think of themselves as leading a "sedentary" life because it sounds slothful and decadent, not luxurious. There are roughly 2000 steps per mile, but it's about the steps, not the distance. It is probably not a bad rule of thumb to do it, just to stay fit, energetic, and vigorous.

Urbanites walk far more, in the course of a day, than suburban or rural folks. My theory is that that is why city folk are trim, and country folk tend towards the bulky, but I am sure that fashion plays a role in it too. City people need to look like they have their act together or they won't get any respect.

"What a coinkydinky. I was just about to call you."

Synchronicity, Serendipity, Seriality, and Simulpathity. It's a fun topic, but I can't tell for sure whether Dr. Beitman is writing tongue-in-cheek or in all seriousness. Or perhaps he's a Jungian, in which case all bets are off.

I know people who say "There are no coincidences." Count me an agnostic on the topic.

One interesting aspect of modern life in the Western World is the pathologizing, or "diseaseifying," of moral and character failures. Putting such failures into the disease category is a popular conceit for a number of reasons, not the least of which is the way it seems to let people off the hook. The victim thing.

But while even AA may make use of the disease metaphor, if you go to a meeting you will hear far more about character flaws than about disease. They are not into disease excuses for problem behavior.

I have been posting recently about satiable and insatiable appetites for pleasures - food and for other things, here: For the New Year: Satiety, the Animal Pleasures, the Cardinal Sins, and "Addiction," Part 2  and here The bad news: Eating less keeps your brain younger and more vigorous (with comments on satiety)

Despite the addiction meme, ordinary people still term those who eat more than they need "pigs," people who buy too much stuff "self-indulgent," people who habitually drink too much "drunks," and people with uncontained sexual efforts as "lechers" or as "nymphomaniacs" or "hos". Ordinary language reflects the common sense moral disapprobation of ungoverned behavior.

To say that they "lack a self-governing function" is the disease model, a defect model, but to use it requires turning a verb idea into a noun idea, by reification. The better form is "They do not govern themselves," or, better yet, "They do not exert themselves to govern themselves."  The disease/defect model does not do justice to all of the people who must struggle mightily to resist all of the temptations that life offers.

Pajamas has a piece up about sex "addiction," Sex Addiction 101 - PJM's advice columnist on the Chinese food syndrome of loveless sex: no sooner satisfied, than feeling empty again.

While the article makes the obvious point that people seek pleasure and often seek to replace distress with simple pleasures, it entirely overlooks the moral, spiritual, and character dimensions of lechery as if it were a "chemical imbalance" instead of plain old-fashioned rotten, socially-inappropriate behavior. Sinful too, if anybody believes in sin anymore.

While it seems true that habitual pleasures change the brain a little, so does habitual self-control. Self-control offers many rewards, but few rewards of the instant, animal sort. There are good habits and bad habits. I don't know whether it is a sociological fact, but it seems as if the debauchery and bad habits, once the domains of the very rich and powerful and of the poor, have become democratized and, in the process, excused to some extent (eg the Oval Office BJs).

People I talk to with bad or unrestrained behaviors of all sorts tend to despise themselves for it, and view putting their behavior into a disease category as a condescension. Unless they are guilt-free sociopaths, they know that their behavior is self-indulgent and immoral. People can quit these things, with help and sometimes without help, if they want to or need to, but it means giving up a lot of instant gratification in exchange for, one hopes, better life results and less self-contempt.

Teaching honesty is no longer a priority in our schools:

...there may be a perception in many key areas of contemporary life—law, business, politics, among others—that expecting honesty on a regular basis is a naïve and foolish attitude, a “loser’s” way of operating. Such a perception is practically a mandate for personal dishonesty and a concession to interpersonal distrust. When we no longer assume that those who communicate with us are at least trying to tell the truth, we give up on them as trustworthy persons and deal with them only in a strictly instrumental manner. The bounds of mutual moral obligation dissolve, and the laws of the jungle reemerge.

Our serious problem today is not simply that many people routinely tell lies. As I have noted, people have departed from the truth for one reason or another all throughout human history. The problem now is that we seem to be reaching a dysfunctional tipping point in which an essential commitment to truthfulness no longer seems to be assumed in our society. If this is indeed the case, the danger is that the bonds of trust important in any society, and essential for a free and democratic one, will dissolve so that the kinds of discourse required to self-govern will become impossible.

I have no way of discerning whether there is anything new here. What I do know is that it is generally a good rule of thumb to let people prove their integrity, rather than assuming that they have any. I have been burned by people enough times to cure me of my optimistic naivete.

Dishonesty and concealment, despite whatever mass culture may do, continues to appall me whether in myself or in others.

It's about time, too. Schneiderman: Empty Praise.

I have always asserted here that "feeling good about oneself" can only come from doing right things and from doing hard things. Even so, we all deserve plenty of criticism and nobody deserves to think that they are wonderful. (We are allowed to think that of others, however, or at least to love others despite their flaws.)

We recently linked When eating healthy turns obsessive.

We have periodically posted here about eating obsessions, whether overeating, anorexia, "organic" preoccupations, people whose approach to food verges on the medicinal, vegetarianism, food fads and food quackery, etc. We shrinks call it all "orality."

As we have often said here, anybody in the Western World would need to make a full-time effort to avoid an adequate diet. Furthermore, medical science has yet to come up with a consensus on what a "healthy diet" really is. Eskimos thrive on seal fat and sea gull meat.  Despite what Mrs. Obama or anybody else tells you, it's all Old Wives Tales. We all would enjoy believing that we can control Fate in some way by one sort of magic or another. Eat fruit? Why? It's pure carbs and just makes you fat. Spend good money on vitamins? Why? It's all Magical Thinking.

During most of human history, any food was scarce and costly to obtain. We have tons of good food, cheap. If anything, too much and too tasty, and we don't have to do drudge labor in the fields all day to get some of it.

I have seen plenty of sturdy young athletes grow up on nothing but Cheerios, macaroni and cheese, and peanut butter and jelly sandwiches. Eat what you like, and thank God we have food choices.

Where's my Big Mac? I've been waiting here two minutes already.

When is enough pleasure and instant gratification enough?

Oh, maybe never, I hear my readers thinking. 

I put the word "addiction" in quotes because I am not referring to physiological addictions such as to narcotics or alcohol, but to the pop culture use of the word, as applied to chocolate, food, sex, money, power, buying, etc. The casual use of the term, of course, refers to the difficulty in stopping the behavior when it doesn't make sense.

I opened the topic earlier, in The bad news: Eating less keeps your brain younger and more vigorous (with comments on satiety)

Some people are studying the brain to try to understand satiety. Some, interested in overweight, are studying foods. I think they are barking up the wrong tree (Yankees might not realize that that is a reference to coon hunting with coon hounds).

I believe that most of these "addictions" are more subcultural and psychological than physiological. Returning to the topic of food, the well-respected scientific journal Elle points this out in Satisfaction Guaranteed:

As a child, were you encouraged to clean your plate and then go back for seconds? If so, you probably didn’t grow up in France, where children are taught to savor the feeling of longing, or envie, for their next course (just think of the cheese!). Our differing notions of satisfaction were examined in a 2006 study of 133 Parisians and 145 Chicagoans published in the journal Obesity. While the French paid attention to an internal cue, the feeling of fullness, the Windy City-ers relied on the external: when their plate was empty; when their companion had finished eating; or when—quelle horreur!—the credits started to roll on the TV show they were watching.

Many Americans ignore the body’s subtler signals of hunger and fullness, hearing only the clanging gong at each end of the pendulum—Starving! Stuffed!—and rarely pausing to enjoy the much more pleasant midpoint: Ahhh, satisfied.

Some subcultures believe in big eating, some in savoring, some in minimalist eating, and, for some, food is just not a central part of life at all - Northern Europeans, for example. I was raised, for example, to learn that a lady always eats slowly, and never finishes the food on her plate. Not in public, anyway. It's not considered ladylike.