HJNO May/Jun 2023

HEALTHCARE JOURNAL OF NEW ORLEANS I  MAY / JUN 2023 33 tion of those dollars spent on how to influence children and adolescents, who in turn influence their parents. When you think about it, it is not that vastly different from how the tobacco in- dustry invested extensively in market research on how to influence potential customers to start smoking, especially adolescents. Many smokers, and now vapers, especially when they first start smoking, fool themselves into thinking they can quit at any time. Some can, but many cannot, not unlike the person with obesity who always vows to start exercising and eating healthier … tomorrow. The ciga- rette manufacturers rely on this type of think- ing. They understand all too well the addictive power of cigarettes and/or vaping. Their busi- ness model depends on it. Other than targeted advertising designed to influence consumer purchasing decisions, what both the cigarette and the food industry have in common is an un- derstanding of the power of addiction and how to generate the craving loops in the brain that feed the insatiable demand for their products. The neurobiology of addiction Unfortunately, the healthcare profession has allowed the tobacco, food and beverage, and pharmaceutical industries to understand cer- tain principles of addiction and neurobiology before we could ever mount our own coun- teroffensive. Our understanding of addiction science has advanced, however, and better equips us with the knowledge of how to defend against this current epidemic of obesity. Addic- tion is defined as the “pathological pursuit of rewards.” Release of the neurotransmitter do- pamine, which causes a short-lived sensation of pleasure, is stimulated by addictive substances, including food, drugs, and cigarettes. To fully understand the neurobiology of addiction, we first need to understand the functioning of the mesocorticolimbic system, located in the brain. This system is comprised of the following areas of the brain: the ventral tegmental area, amyg- dala, ventral striatum, prefrontal cortex, and the dorsal striatum. Addictive substances cause both acute and chronic changes to dopaminer- gic circuits in this system, perpetuating repeat- ing cycles of craving and reward . Many of these addictive substances act first on the ventral tegmental area, which in turn connects to the “What the food and beverage industry figured out, long before the healthcare profession in many cases, is that the right concentrations of fat, salt, and sugar can trigger activation of these craving loops in the brain through the release of dopamine within the mesocorticolimbic system, thus mimicking the effects of other addictive substances such as alcohol, tobacco, or even opiates.”