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Home » Transcript: Dr. Robert Lustig on Hostage Brain: Understanding Dopamine, Sugar Addiction, and Control – DOAC Podcast

Transcript: Dr. Robert Lustig on Hostage Brain: Understanding Dopamine, Sugar Addiction, and Control – DOAC Podcast

Read the full transcript of neuroendocrinologist and sugar expert Dr. Robert Lustig’s interview on The Diary Of A CEO with host Steven Bartlett, on “Hostage Brain: Understanding Dopamine, Sugar Addiction, and Control”, October 2, 2025.

Welcome Back, Dr. Robert Lustig

STEVEN BARTLETT: Dr. Robert, good to have you back.

DR. ROBERT LUSTIG: Oh, my pleasure.

STEVEN BARTLETT: I am particularly fascinated by this term, “hostage brain.” I know you’re in the early stages of working on a book about this subject, but for anyone that doesn’t understand, when I look at this word, the hostage brain, I think of all the times that I’ve been out of control. And when I say out of control, I’m going to let you define it. But when I say out of control, I mean there’s so many things I want to do as it relates to my health, my fitness, other aspects of my life, whether it’s avoiding eating the cookie at 2 a.m. in a hotel room somewhere or other areas of my life where I want to have greater elements of control. What do you mean by the hostage brain?

The Illusion of Control

DR. ROBERT LUSTIG: All of us want to be in control, Steven. I mean, it’s the nature of humanity. We want to be in control. We want to be in control of our lives. Unfortunately, many of us want to be in control of everyone else’s lives, as we’ve seen play out on grand stages lately. Everyone wants to be in control.

And the reason we want to be in control is because then we can mitigate threat. When you’re in control, then threat is low because you’re in control. Problem is, we’re not in control. The more in control, the more a specific area of your brain is basically glomming on. And that area of the brain is known as the amygdala.

The amygdala is your fear center. It’s also your 24-hour sentry. But really what the amygdala is, it’s the point guard on your basketball team. So it surveys the entire court, sees the offense and the defense, and has to make split-second decisions who’s going to score.

Now, a lousy point guard takes all the shots. A good point guard passes off to the guy who has the best shot. A great point guard is going to be able to figure out if he’s going to score or if he’s going to pass it off to somebody else.

If you’re in control, your level of threat goes down. But really your control is an illusion. You really don’t have control. And the more you try to exert it, the more you realize you’re not in control. And what that does is that generates an enormous amount of stress and an enormous amount of pain.

Now that pain can turn inward and we call that depression. And right now, 29% of Americans are depressed and 4.4% of the entire world is depressed. These numbers were infinitesimal a generation ago, and they are basically just pushing up further and further. And the reason is because of this inappropriate illusion of control, and it’s causing an enormous amount of pain.

How do you mollify that pain? How do you basically deal with the psychological pain of lack of control that you yourself put upon yourself? Well, we have loads of ways: cocaine, amphetamine, nicotine, alcohol, sugar, gambling, social media, Internet gaming, pornography. Pick your poison. That’s dopamine.

Dopamine basically provides you with a little bit of pleasure on top of a whole lot of pain. The problem is that dopamine is addictive. And so when you apply a set of pleasures to try to deal with your pain of lack of control, that puts you into a never-ending cycle of consumption and misery. That’s the hostage brain.

Understanding Dopamine

STEVEN BARTLETT: What do I need to understand about dopamine in order to, because I think sometimes awareness is step one in being able to do something about a problem that you might have. So what do I need to understand about what dopamine is and what it’s doing in my brain and how it’s sort of associated with addiction to then be able to do something about it, which I consider step two?

DR. ROBERT LUSTIG: So dopamine basically has two functions. The first is learning. There’s no learning without dopamine. Anytime you learn something, whether it’s positive or negative, it’s because there was a dopamine release.

When you put your hand down on a hot stove when you were three years old and went, “Ah, I’m never doing that again,” that was dopamine that did that. And what it did was it went to your amygdala and it rewired it. That was a rewiring of your amygdala due to the excitatory neurostimulus of that dopamine affecting an area of your brain called the basolateral amygdala. And it laid down and it set up a circuit, and that circuit is still working in you right now.

So dopamine is the learning neurotransmitter. It can be for negative learning, it can be for positive learning. Either way, dopamine is also, when it’s going to another area of the brain called the nucleus accumbens, which is the reward center, that is a stimulus for reward. That is the motivation for reward. That is, in one word, foreplay. That is the excitement, the reason for continuing any given behavior.

You get both out of dopamine. And in short, small bursts, in the right venue, that’s how we navigate life. We navigate it through learning, and we navigate it through reward. You can’t do it without dopamine. Dopamine is good unless it’s bad. And as you know, everything in science is both good and bad.

The problem is chronic overstimulation of any neuron leads to neuronal cell death. Dopamine is a chronic stimulator. And so if you have chronic dopamine being released, what’s going to happen is you’re going to kill the next neuron.

Now, that neuron doesn’t want to die, so it down-regulates the receptors for dopamine so that it’s less likely that one dopamine over here is going to find the receptor over here to bind to, because there are fewer of them.