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Saturday, September 29, 2012

What I've Learned About Food Addiction


This post applies to all so read on.
I'm addicted to desserts and I can't keep them in the house. They just call to me. I can't simply eat a piece or a small portion—no, not me.  Once I start I can't stop and I have to eat them until their gone or I need to throw them in the trash—although sometimes, I’m embarrassed to say, I dig them out of the trash because I just can't let them slip away. And I never know when I'll get to eat them again. Avoidance—total avoidance seems like the only way—yet it never seems to work. I just have no willpower.

No, that's not me speaking—although these statements were certainly true for me at some point in my life. Yes, that time in my early twenties when my eating was emotionally driven and I had no idea what hunger and comfortable fullness felt like.  Rather, the comments above were spoken by many patients that walk into my offices—by the overweight who have unsuccessfully struggled to lose some weight with rigid diets and deprivation, and by those of average weight and below who now approach food in a black and white way, seeing food as the enemy. 

And why wouldn’t they, and you, feel that there is no hope, that you must be addicted to food in the way others are addicted to drugs? The debate about food addiction has again emerged, with media distortions and outrageous researcher conclusions on rat studies and MRI findings. And it will leave you feeling hopeless—unless you see how you are being manipulated and left to believe you are powerless.

Yum! Salted caramel.
The Wall Street Journal put out a rather balanced piece on food addiction. Yet the NY Times article on this subject is an embarrassment.  "Can Food Be Addictive?" makes reference to several studies suggesting that overeating is an addiction, perhaps not much different than addictions to drugs and alcohol. The examples cited?

"...Princeton University and University of Florida researchers have found that sugar-binging rats show signs of opiate like withdrawal when their sugar is taken away — including chattering teeth, tremoring forepaws and the shakes. When the rats were allowed to resume eating sugar two weeks later, they pressed the food lever so frantically that they consumed 23 percent more than before", they tell us. 

Well, I’ve never had my paws shake and my canines never chattered, but this sounds like sugar dependency is a serious culprit! That’s what they’re leading us to believe. But a more detailed review of this 2011 study sheds a whole different light on things. We learn that rats were first deprived, going 12 hours without food to eat, prior to being given the sugar solution. And, this binging was dependent upon the timing of the feeding. One blog describes how "... rats who had received only the food chow on this intermittent schedule, or had unrestricted access to food and sucrose, did not show these effects." That's right—not depriving the rats and actually allowing them access to food including sugar prevented binge eating. The blog reporting on this study appropriately summarizes:

I don't wait for special occasions to eat these!
“This means that after being deprived of the food or drug the rat will self-administer extremely large quantities of the substance once it is available again. This behavior tapers off once the animals are sated, but these binges will consistently occur after each period of deprivation.”

Ok, so they binged when given sugar. But more importantly the research actually confirms the very problem with food deprivation and the resulting out of control eating that we see in our clients who feel trapped in this cycle. No, there was no problem when they could freely feed on food and sugar as desired. Rather, the problem with binging resulted from the withholding of food for long periods, which set the rats and sets my rat-like readers up for trouble.

Might I add that we are not rats in our ability to step in and change our situation. We are not limited to our cages—we can choose to step out of our environment and to control our triggers. And we can certainly avoid deprivation—the biggest trigger for binge eating. You didn’t need a rat study to tell you that, though!

Another study referenced by the NY Times article to support the food addiction theory drew equally absurd conclusions. Researchers at Oregon Research Institute surveyed 151 teens who were in a healthy weight range about their eating habits and food cravings. Then they did brain-scan studies on them while the kids looked at pictures of chocolate milkshakes—more activity in the brain was considered to be linked with greater cravings. Next, they gave them a milkshake to drink while they were having an MRI scan. The kids who'd reported eating the most ice cream over the past few weeks prior to the MRI scans registered lower activity in their reward centers from the milkshake—in other words, less craving for the milkshakes. To me that’s a good thing. Those very kids who had access and consumed these items regularly did not have their brains light up as if they were getting some big reward when offered a milkshake—no, it was no big deal to them.

Yet the NY Times states that these findings "suggest that just as drug abusers and alcoholics need increasingly larger doses over time, children who are regular ice-cream eaters may require more and more ice cream for the reward centers of their brains to indicate that they are satisfied."   One study author similarly concludes that not having as great a response to eating the food (based on MRI) is problematic—that “over consumption of these foods down regulates reward processes. That may, in turn, make you eat more." Really? That's quite a strange conclusion to draw, in my opinion, especially as these kids were not overweight. (in spite of their more frequent ice cream consumption.

Further, this study attributes possible addictive-like qualities of ice cream shakes, made with Haagen Daz ice cream, to the high fat content.  But if it is about the fat, why don’t we have addictions to such high fat items as prime rib or deep fried chicken? Or whole milk, even? No, this just isn’t seen. 

High fat and satisfying!
So maybe it's not the nutrient, the fat or sugar (as implicated above) content at all but the conditions under which we eat. Is it any surprise that those reward centers of the brain would light up in MRIs, similar to what occurs with other addictions, when these very food items are used in our culture as rewards? You know, you had a hard day, so you indulge yourself with an ice cream, ironically just as the old Haagen Daz ads suggested? Or as a young child, you scrape your knee and your mom gives you some cookies to feel better. If we could only allow ourselves to enjoy such pleasurable foods as ice cream without the value judgment we add to it!

The take home message.


What's not in question is how you feel. Clearly, when you experience out of control eating you feel as if your are addicted to food—that you have no control over certain food items or types and that it therefore must be out of your hands to seize control. And with the recent studies I referenced, you might be convinced this is true. But the only clear link with what feels like food addiction is food deprivation. 

This is not a meal!
Continuing to use food as a reward for a hard day or for eating healthy all week is a huge mistake. 

If you’re feeling like you’re addicted to food, consider changing your relationship with food and move from black and white thinking, giving yourself permission to eat those foods you enjoy but think are forbidden. 

Eat in a balanced way--and I don't mean by following the My Plate way. Rather, make the foods you eat enjoyable. Sure, include satisfying less processed foods, too--but not at the exclusion of other foods. 

And take charge of your environment—focus on mindfully eating and truly enjoying your food so you know when you have eaten just enough.

Read more about this approach in some older posts below: 








9 comments:

  1. Yes, yes, yes!

    I don't jump into the food addiction discussion too often because I know that food addiction (or supposed addiction) is definitely not an issue for me. Yes, I like my sweets, but I can actually have a bite or two and walk away. Would I eat a bit more, given half the chance? Yes, but sweets are still not a big deal for me.

    But I still feel that this whole black/white, good food/bad food, right food/wrong food dichotomy is getting us into a much finer mess than we were ever meant to be in.

    I never cease to be amazed by how fearful people have become of food. And how powerful the nocebo effect is: i.e. "I stopped eating sugar for two weeks and felt WONDERFUL!!!" or "I ate perfectly clean for two weeks and the first week was HELL. I must have been detoxing big time!" And to that I answer that it was probably just going off coffee that made you feel so bad for a few days--my one coffee a day "addiction" plays havoc on me at Yom Kippur!.

    If you can help someone to slowly divest herself of the fear of food and be able to eat yummy stuff without gorging, kola kavod to you. It must be really hard to undo all the crazy messages our food phobic culture drills into people's brains.

    Once again, shana tova. Have a great year.

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    1. I couldn't agree with you more--yes, people of all sizes have become fearful of food and have lost trust in their own wisdom and ability to regulate their intake.

      Thanks for reading!

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  2. EXCELLENT post, Lori! A voice of reason.

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    1. Thanks for your comment and for retweeting!

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  3. Food addict and pj geek here. I started writing a very long comment post, but decided just to sum it up. (still long) I am a classic BED , but I've been burned on intuitive eating., I need to find a new RD (have been without one for over a year), but can't decide how to go forward.

    I remember bingeing since I was a very young age and being overweight all of my life. I've read about obesity in children (mom smoking while pregnant, low birth weight, mom not breast feeding and then tack on screwed up family life /detached parenting). Yea, that fits.

    I consider myself somehwat recovered -the qauntity, quality, frequency of binges are much less. I've worked over the years through an outpt ED program , with group therapy attended OA, worked with a few ED Rds and had a eight loss in the 90's. Rebounded.

    I hit my high of 345lbs at 5'2 and age 44 and started over. No more Weight Watchers or diet books. I went back to therapy and my therapist's info listed Ed work (but not really.) I've come a ong way in the work we've done. I had an ED RD for a few years and learned to love exercise. I slowly lose 100 lbs I counted exhanges (diabetic too) and then calories, then less calories, but I would occasionally lapse . what worked =structure and avoiding trigger food and places. I kept lapsing, we went to a local fresh meal delivery program because it was safe, structured. To maintain still required the same kind of meal planning.

    I wanted to break the 200lb mark and pushed with a 1300-1400 calorie. I finally hit a low of 210 in April 2011. My lowest weight in 30 years, and in that weekend I ran a 3 K -that was Big thing for me. But I think I freaked out after that . I didn't like my hanging skin, and I was still obese. I loved the food I had missed and couldn't exercise with the same intensity. My body hurt and I kept getting injured. I gained 10 lbs.

    At the same time my RD left private practice and I went with a rplacement who was younger and worked on the Ie concept. I wasn't sure-no bad foods, no avoiding trigger place, and she even recommended I not journal my food. ?? I kept gaining. I doubted the plan and I doubted her. She didn't know what OA was? In reality , I'd been a food addict longer than she had been alive. The field trip we did to Trader Joes ( my inner foodie loved it but it had been a trigger place). That was our last appointment, because I realized she really didn't get me and (she started talking to me about a line of products she was going to sell).

    I went straight to Nutrisystem and then lapsed on that and had a few binges and then did the fresh meal program again and then NS and in between eating whatever and occasional actual binge type behavior. Here I am-From 210 to almost 270 in 15 months. I couldn't exercise as much or as hard because of injuries and then pain or depression.

    I think what you post about makes sense, sounds great. But am I too hardcore? And I realize my therapist who admits to her own food issues and loves paleo to whole food diets can help a lot of my issues but not really all of my food / Ed issues. I've asked her not to suggest diet recommendations to me and she doesn't.

    I turn 50 on Monday and I will eat cake. I won't binge on it, I know that. On Tuesday, I have a medical check up and also start working with a physical trainer again. I've been very clear on my goals --no injuries, increase confidence, increase health and metabolism and fitness. Ans sure , burning some fat would be the hope.

    I know I want to have a new RD but where do I go? I'm afraid of gaining more weight which I know will happen continuing on my current path. I've seriously thought of contacting you . My work and location in the suburbs of Atlanta make the idea of a long distance RD more of an ideal for me than going with another local. And then concern over the end results. I've been through a lot extremes.

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    1. Glad this was the abridged version! ; )

      First, you are not hopeless, nor unique--please read about "Erin" and "Maggie", two real patients of mine with lifelong binge eating who have each lost and kept off between 100 and 150 pounds and to date, after many years, continue to be able to enjoy eating without "dieting".
      http://dropitandeat.blogspot.com/2010/09/meg-hit-300-pounds-wednesday-and-was.html
      http://dropitandeat.blogspot.com/2011/02/maggies-152-lbs-weight-lossthis-time.html
      http://dropitandeat.blogspot.com/2012/04/winning-jackpot-or-changing-your.html

      I agree that structure is essential--but that structure should not be in the form of a rigid diet plan. As a CDE I'd agree that distribution of carbohydrate is also essential for diabetes management--but that does not preclude eating enjoyable foods and desserts. Really.

      Strategies for managing triggers are an integral part of success with this approach. But if your therapist believes that a "diet" approach to changing your relationship with food is the answer you might want to weight the pros and cons of the therapy.

      Realistic goal setting is also key. It just might be that your 145 pound loss, albeit less wt loss than what you hoped for to bring you under 200 lbs, was as low as your body wanted to be, and pushing past that place because of BMI chart goals or for other reasons is a set up for troubles.

      If you are seriously considering Skype counseling, do email me at eatwrite(at)comcast.net.
      Thanks for your coment.

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  4. Thank you for the reply, and so sorry for the length. As I was writing I realized I really needed to reach out. Turning 50 is a big thing, and I just did (it's after midnight now). You very well may be hearing from me. ..Thanks again , Pj geek-Diana

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  5. Hi – It’s good to read such interesting stuff on the Internet as I have been able to discover here. I agree with much of what is written here and I’ll be coming back to this website again. Thanks again for posting such great reading material!!

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  6. This is a wonderful article that clarifies just how misled the public is when they are "fed media bites" . It seems like the media has an agenda, that fits in perfectly with the Diet Industry - that makes over $60 billion a year on blaming people for being overweight, and offering false promises of fast weight loss. It is a SHAM!
    Another fault of the media is the focus on anorexic appearing movie stars and models; influencing young and even women of all ages to feel inadequate if they aren't size 0. "You can never be too thin or too rich" - look what it did for Whitney Houston!
    When I think of addiction I remember this very insightful line from a song from Credence Clearwater Revivial: "Give me a drink of water, make it against the law; see how good the water tastes because you can't have it anymore".
    THAT is the problem- when we believe we CAN'T ever have a food, it becomes our focus, and the thing we binge on. It's better to eat a case of Haagen Daz, or whatever food is your "forbidden fruit" until it no longer has power over you. And forgive yourself; because it's not your fault.
    Keep writing Lori!

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