By MARC SIEGEL

July 20, 2003 -- FAST food is in fast trouble. On this coast, where cheeseburgers are not being replaced as readily by sprouts and tofu salad to-go as on the other coast, there is serious concern about the effects on the brain of a high-fat high-cal, fast food meal. It has already been shown by studies at Rockefeller University that if you eat fats, you crave more fats. And that if you start to showcase tasty french fries, shakes, and burgers to kids at a young age, they are likely to stick to the same choices later on.

Now, along comes a study from the University of Wisconsin, reported on in this week's London Times, The Post and BBC television, that claims that rat brains are affected by fast food in the same way as heroin. Fast food causes a surge of opiates or endorphins, and the body becomes dependent on this cocktail and experiences actual withdrawal symptoms if it is taken away. Hormones are changed so significantly by this high cal bombardment, that even appetite is no longer suppressed at the conclusion of such a gaudy meal, and we crave more, and more.

Of course, submitting a rat to the test tube equivalent of a quarter-pound cheeseburger with fries and a shake is not exactly the same thing as studying a human engorging with fast fat.

When heroin is scarce, the brain is opiate starved, and a sweaty, shivery, heart-racing craving results. True, fats in rats appear to be involved with opiate release in the brain, too. Take the fats away and the brain may cause you to crave, but not with the same degree of body torture.

The point is that fast food advertising, its availability, its tangy taste, and its physiological addiction potential all create more need for a dangerous product. Clogged hearts, cancerous organs, strokes, are all waiting at the end of the road.

Yet none of these scary facts lead to the conclusion that the fast food chains should be sued for putting an unhealthy product out there. The government suggests 1,800- 2,300 calories per day with only 35% from fat as a healthy diet. One fast food meal of a big cheeseburger, fries, and a shake may have the entire daily requirements in one meal, with over 65% of it from fat and most of the rest of it from sugar, but people don't have to choose to eat those meals. Until the FDA makes it illegal to go over the daily requirements in some way, fast food is violating no law with its caloric contents.

We can't expect the fast food industry to auto-regulate.

However, there is already a role for consumer education in sending these restaurants heading in the right direction. Demands for salads have put salads on the menu.

McDonalds in France has taken to nervously issuing warnings to sedentary kids not to eat its meals more than once a week. I'm all for this result, but I'm not sure about the means. Change should come mainly by regulation and education with threat left as a last resort.

One of my patients came in with a rat bite, and other than asking about her rabies shot, I almost asked if she had a craving for french fries .

But I also know that, as human beings, we have more choices than rats; if we are also caught in fast food mazes, they are of our own devising.

Dr. Marc Siegel is associate professor of Medicine at NYU Medical School.

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