The Doc comes clean; Pizzeria Aroma

The Doc here.

I don’t mind admitting it: I struggle with the food thing.

Mind you, I’m pretty active. Ridiculously active, actually, compared to many in my peer group. I run a minimum of twenty miles a week, and often up to 25 or 30. On my non-running days, I’m in the gym, without fail, usually working on my cardio, but periodically making sad attempts to develop an effective strength training routine. Literally the only days I’ve missed workouts since January 1, 2006, have been days when I’ve been hospitalized, such as my recent five-day incarceration for the pulmonary embolisms. The day after I was discharged, however? I was back at the gym. Hell, I was back on the elliptical the day after I ran my first marathon. I don’t miss gym days, and every day is a gym day of some sort.

The eating thing, though…woof. That’s a problem that I have yet to definitively solve.

The problem is pretty straightforward, in at least some of its facets. It boils down to, I have a particularly hard time saying “no” to experiences that entail pleasure, especially immediate and emphatic pleasure. I also have a hard time saying “yes” to experiences that aren’t immediately gratifying or interesting, such as meal planning, grocery shopping, and putting foods in my mouth that don’t spike the levels of dopamine and serotonin in my brain in short order.

Mind you, I’m not using my brain chemistry as an excuse. It’s true that my brain pretty transparently is dysregulated in its ability to produce and circulate dopamine, the neurotransmitter (brain chemical) that is responsible for motivation and drive toward gratifying experiences. I have a pretty clear cut diagnosis of Attention Deficit Hyperactivity Disorder, which pretty much boils down to impaired ability to plan, self-discipline, and otherwise put attention where it needs to go, when it needs to go there, and these symptoms are directly traceable to my brain’s chaotic relationship with dopamine. The reason why stimulants are so often prescribed for ADHD, in fact, is because they solve the problem of dopamine dysregulation by, basically, flooding the brain with dopamine.

Which is great, I will attest, for the times when your brain isn’t producing and circulating enough dopamine. Though chronically flooding the brain with dopamine via artificial means also has a tendency to destroy the normal function of dopamine in the brain, i.e., to help us identify and move toward experiences that are pleasurable, gratifying, and otherwise enhance our ability to live and survive. You know, like eating.

More to the point, eating things that are high in sugar and carbohydrate, because the are the foods that our evolutionary ancestors most needed in order to survive. That is, foods that immediately spike our focus and energy levels (because they spike our blood sugar), thus alerting us to predators and other threats in our environment, and also pack on the pounds, thus helping our cave-person ancestors make it through winters in which resources were scarce.


So, I happen to have neurochemistry that works against me in our modern world, where high sugar, high carbohydrate food is readily available, where packing on the pounds is actually a long-term disadvantage to our ability to survive and thrive, and cultivating wildly variable blood sugar levels doesn’t contribute to our ability to focus and thrive. It’s a family trait. My dad struggled with addictive tendencies his entire life. My mom has one of the most profound cases of undiagnosed, untreated ADHD I have literally ever seen in my life. I always kinda chuckle when people go down the “ADHD doesn’t exist” route with me– evidence for the dysregulation of dopamine in peoples’ brains is far more robust and consistent than the evidence for, say, complex trauma disorders that are conceptually removed from Cluster B personality disorders.

Which doesn’t mean I’m doomed to always overeat, or to always choose foods that actively work against my effective functioning in the world. The fact is, no matter how our neurochemistry inclines or affects us, it can’t make decisions for us. Our brain chemicals, much like our past experiences, can whisper in our ears, try to nudge us toward one behavior or away from another, but our behavioral decisions are still our own. We don’t have to do what our feelings are telling, or sometimes begging us, to do. As I recently covered on my personal development blog,, our feelings are only one source of information, for us to use as we see fit.

However…defying what our neurochemistry is inclining us to do is a bitch. It’s a real, real bitch.

I defied my neurochemistry for a relatively long time, from a period from early 2006 to, eh, call it about 2010 or 2011. During that period of time, I made some hard decisions about my eating and exercise behaviors, and went from a fairly sedentary grad student to an every-day exercising, mindful-eating, processed-sugar-and-carb eschewing health nut. It was a switch that was, in some ways, kind of Draconian, but the bottom line is that in the long run, I dropped over 70 pounds, and kept it off, all the while acquiring the taste for running which has subsequently blossomed into my main hobby and interest outside of psychology, Star Wars, and DC comics.

Then…I got…I don’t know. Lazy? That feels…kind of unfair to say. It wasn’t exactly laziness that led to me slowly starting to make exceptions to my Spartan eating approach sometime in 2010. Did I get, maybe, cocky? Yeah, that sounds a little more accurate. I got it in my head that, hell, so much of my diet was so healthy, and there was the no-exception, no-excuses daily exercise I had going for me, what harm could, like, one cheat meal on a Friday night do? And hell, once you’ve crossed that line, it’s a short little jump to “Well, lots of reasonable diets recommend taking one cheat day a week, so I shall take one cheat day a week.” Which, then, of course, opens you up to, “Okay, what, you’re telling me one piece of cake/pack of Skittles/slice of pizza is going to derail my entire self-care regimen? Don’t be a black and white thinker, Doc!”

And before you know it…your pants are suddenly tight. Which, granted, isn’t the end-all, be-all criteria of physical fitness or self-care; but it’s also not an incidental development, insofar as the thickening of abdominal fat in men approaching middle age has been shown to have fairly strong correlations with things like heart disease, diabetes, and, well, I’m just gonna take a shot in the dark here, because I don’t know for sure, but I’ll betcha…pulmonary embolisms.

It’s not really that I fantasize about being a particular body shape, or having a particular body appearance. I think I’m both about as secure and insecure about my physical appearance as anybody of my age, gender, and background probably is. It’s more about the feeling of fucking uncontrollability that comes along with losing my edge with the eating thing. More to the point, it doesn’t feel like I’ve made a rational, mindful, coherent and consistent choice to loosen the reins with my eating. I feel like the decisions I’ve made that have contributed to the re-thickening of my abdominal “spare tire” have been impulsive, emotionally-driven…a microcosm of the worst way my dopamine-dysregulated brain makes decisions, in other words.

So. There’s all that.

Now. I told you all of that to tell you this:

I ordered a S’mores Pizza from Pizzeria Aroma on Berwyn in Chicago last night, and it was fucking outstanding. If that thing doesn’t INDUCE Type II diabetes, your pancreas is doing it wrong. Dopamine and serotonin FLOODING the old bean in response to the dessert pizza. The only thing, in the realm of dessert pizza, that I’ve had that rivals this is the apple cinnamon pizza that Pizza Hut used to have on its pizza buffet (at least at one location in DC that I used to frequent before the Great Lifestyle Change of 2006).

The BBQ pizza I ordered along with the s’mores pizza arrived in…unfortunate condition. Cheese having slid halfway down the pie, too much BBQ sauce making the thing messy to eat with your hands, the whole thing just too damn hot. Tasty enough, and I realize sometimes these things just happen in the course of pizza delivery, but still.

“Should” I have ordered those pizzas last night? Well, I tell my patients, when they’re beating themselves up with “should” statements (or, in the words of the late, great Albert Ellis, “shoulding all over themselves”), ask yourself the simple rebuttal question, “Why?” Why shouldn’t I have done this thing? That question will clarify whether the “should” statement to which you’re currently genuflecting is something that’s nudging you in the direction of your goals, or just trying to make you feel bad. In this case, when I ask the “why” query of my own “should” statement, I’m forced to concede that, no, ordering those pizzas last night aren’t in line with my goals– either my goals for my physical health, my goals for being a decision maker, my goals for scheduling and managing my pizza intake so that it doesn’t become a habit too problematic to continue at all.

No, I shouldn’t have gotten those pizzas, I suppose.

But the s’mores pizza from Pizzeria Amore is pretty goddamn tasty.


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