Five years ago, UCSF pediatric endocrinologist Dr. Robert H. Lustig came out swinging with Fat Chance, a well-argued if polemical exposé of how the processed sugar industry has come to dominate food production (and consumption) with disastrous effects—not simply obesity, but metabolic syndrome, which affects circulatory health, mental health, sleep patterns, anxiety levels, overall longevity, various risk levels for cancer, and much more. (I only recently learned that while preparing the book, this career physician in his 60s obtained a law degree in order to better understand both the regulatory framework around the food industry and the kinds of fights he’d be up against by publishing such a muckraking book.)

Now he’s back with the even more compelling The Hacking of the American Mind. Like Fat Chance, his fundamental arguments are embedded in endocrinology—the study of developmental and behavioral activities of metabolism and growth as reflected by the endocrine/hormone system. Endocrinology impinges on sleep habits, eating habits, physical and psychological health, reproduction, movement, digestion, sensory perception, and mental acuity—it is by its nature broad-ranging, as is this book.

Lustig’s thesis is that not one but several industries consciously develop products designed to foment addictive behavior, showing convincingly (from an endocrinological basis) that the brain signaling pathways implicated in substance addictions (drugs, alcohol) are the same as those implicated in behavioral addictions (addiction to social media, for example). He lays out in plain language how the dopamine stimulus mechanism works, how it can be abused to the point of permanent damage (i.e. an addiction that is essentially unrecoverable, from which you can never return to steady state), how the serotonin production system mediates these reactions, and how some of the very same addictive behaviors actually thwart the behaviors that would promote serotonin production and a healthy balance between the two.

His wide-ranging assault affects processed food, substance abuse, and most significantly for modern audiences who “aren’t addicted to anything,” the profound new role of “attention addiction”—being unable to tear your attention away from social media, craving ever-more-frequent little hits of dopamine when someone “Likes” your post or retweets your tweet, and digging yourself into a cycle whose chemical effects on your body, and short- and long-term effects on your mood, mental health, and physical well-being, are no different from those resulting from substance addictions.

As in Fat Chance, Lustig writes in an informal, direct, highly-readable, no-BS voice that makes it sound like he is in your classroom addressing a small group of students. At the same time, the evidence he musters—and his ability to bring such a diverse array of topics within a clearly-laid-out organizing framework—is worthy of a MacArthur for the same kinds of reasons that Jared Diamond deserved one for the work leading up to Guns, Germs & Steel. 

I know far too many people—of all ages—about whom it’s not too much of a stretch to say that if this book isn’t behavior-changing for them, it will be all downhill from here. If you don’t want to be one of them, it behooves you to read this book.