Is Food Addiction a Real Thing?

donut
Are you addicted?

When my partner and I first moved in together, he – a naturally thin person whose eating is highly internally regulated and who has never restricted any food in his life AND even enjoys guilt-free overeating on occasion – suggested cookies as a grocery item list. I had just regained a few pounds after my most restrictive dieting period ever, and I looked at him like he was crazy. “Uh, NO! I can’t have cookies in the house or I’ll just EAT ALL OF THEM! I’m addicted to those foods!” He looked at me calmly and said, “Well, that won’t happen to me and I want cookies.” It would be four more years before I stopped dieting and the cookie tug-of-war would peacefully come to an end and I would once and for all stop feeling like I was addicted to sweets.

I recently had a conversation with a woman who considers herself a food addict and has been a member of Overeaters Anonymous for 16 years. She manages her self-described addiction by eating no refined grains and no sugar at all. She maintains a high-protein, low-carb diet. After talking a while I found out a few other things: 1. She was criticized for her weight at a young age, 2. She started self-restricting cookies when she was 7 or 8 years old, and 3. She was often a much higher weight, tried all the diets, and this total abstinence regimen is the only one that has “worked” for her in terms of keeping her weight down long-term. She also frequently talks longingly about what she can’t have but would love to eat. She sometimes bakes brownies just to enjoy the smell and gives them away to friends without having any. She said she never stops thinking of herself as fat, even though she is now “normal weight.” If ever there was a person my heart went out to, it was this person.

We hear stuff like this all the time. Sugar is addicting. Fat is addicting. Refined carbs are addicting. Salt combined with any of those foods is addicting. I was once accused of being addicted to cheese, which is ridiculous because anyone who knows me knows chocolate is my drug of choice! (If I thought of it that way, which I don’t)

To learn more, I emailed a colleague who specializes in nutrition for recovering addicts and food addiction. He sent me a paper which apparently is the foundation for food addiction treatment right now, “Understanding and Addressing Food Addiction” by The National Center on Addiction and Substance Abuse. The paper admits little is known about food addiction, which is why they have chosen to look at it through the lens of substance addiction. Food addiction was considered for the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) but rejected, so in the absence of any other diagnostic criteria, the Yale Food Addiction Scale (a scale that is primarily based on the diagnostic criteria for substance dependence) is often used to determine food addiction.

The paper talks about possible risk factors for food addiction including “obesity/overweight”, early exposure to “overeating and unhealthy eating” at a young age through family or peer groups, genetics, personality trait and psychological tendencies, and more. They state that the individual characteristics associated with food addiction are being female, over age 35, and overweight or obese (interestingly, the same people that are often on a diet). It discusses the relationship of food addiction to eating disorders (there is a higher correlation than in non-ED populations).  It talks about the similar neurological responses of the brain to highly palatable foods (the aforementioned sugar/fat/salt combo) and addictive substances. And in the end, it concludes:

“The food addiction model, like that of substance addiction, describes the ways in which certain food properties or ingredients can produce addiction in individuals who are susceptible to their effects and who consume them in a manner that induces the addictive process (i.e., eating certain types of highly palatable, calorie dense, and nutrient-poor food on an intermittent but repeated basis).  It allows for an explanation and an intervention strategy for those cases of disordered eating that are not adequately accounted for by existing psychological or medical causes.”

In other words, in the absence of psychological or medical reasons for an “addictive” response to food, it blames the food itself.

I find this paper, while highly referenced, problematic. I don’t think it’s asking the right questions.

One major problem is that nowhere does it mention restrained eating or dieting behaviors and their relationship to food-addicted behavior. This is a huge omission because it’s well-documented that highly restrained eaters often have frequent episodes of disinhibition (aka overeating or binge eating), especially with “forbidden” highly palatable foods (read some of that data here and here). Who on a diet hasn’t felt addicted to the very foods they weren’t supposed to eat? It’s no surprise to me that people with eating disorders have experienced more food addiction symptoms; high degrees of eating restraint are common in eating disorders.

I have qualms about treating food the same way as addictive substances. We don’t need addictive substances to live for the most part, and most of us, in our usual activities of daily living, will never come across those substances unless we search them out. They’re easy to avoid (cigarettes and alcohol being exceptions to some degree). Food, on the other hand, is everywhere, and we need it every few hours to achieve nutritional adequacy. One might encounter “trigger” foods multiple times in a day. This puts the onus on the addicted person to try to avoid contact with trigger foods or those who are eating them, and that could lead to extreme social isolation. I had a friend who, once he joined OA, couldn’t eat with me anymore because of potential exposure to all his trigger foods – which was becoming everything except non-starchy vegetables.

Yet another problem is that this paper views highly palatable foods as inherently bad for health; they simply aren’t, and there is no adequate body of evidence to conclusively show this (and we know now that our patterns of eating impact our health much more than individual foods). Many people can incorporate these demonized foods into a balanced diet quite easily without overdoing it or feeling ruled by them (those people all live in France, plus the three I know here. Kidding! I know four here.). In my experience, these are people relaxed eaters who have never dieted and never felt they had to change their body shape or weight.

A lot has been made of the similar ways that highly palatable foods and addictive substances light up certain neural pathways. But guess what – those are pleasure pathways. They also light up when we receive hugs from people we love, hang out with our pets, or have sex. So the lighting up of those pathways alone do not indicate addiction.

There may be truly food-addicted people out there, because anything is possible – but this “addiction” does not happen in a vacuum. If you showed me a food-addicted person who had never dieted, never felt bad about his or her appearance, never been exposed to our pervasive culture of food fear, and never observed or felt weight stigma, I might buy the construct of food addiction in which food is the problem more readily. If that food was broccoli, I’d have no doubt. But it’s never broccoli, and there are few people who meet that criteria.

We’re asking the wrong questions. Based on all I know about dieting, food restriction and disinhibition, food addiction tendencies are more likely driven by high dietary restraint, weight stigma, and a toxic culture of food-fear than a chemical dependency on food. The evidence is the many people who have gotten free of this feeling of food addiction once they healed their relationships to food, eating and their bodies.

So is food addiction a real thing? I think the feeling of addiction to food is a very real thing, yes. But is it the food itself that causes the addiction? In most cases, I don’t believe it is. And I don’t believe more restriction is the answer.

My feelings of addiction to sweet foods went away when I started to feed myself without restraint and abandoned body-shame as a way of life. Once I legalized all foods, the power any one type of food had over me disappeared. I think if we started treating food addiction with liberalization, not more deprivation, we’d quickly see fewer and fewer cases of it.

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17 thoughts on “Is Food Addiction a Real Thing?

  1. Tamara Greenberg October 10, 2016 / 7:41 pm

    THANK YOU!!! This is such an important myth to expose! Great blog! Thank you for all your blogs and please keep writing!!!

    Liked by 1 person

  2. mmapes2 October 11, 2016 / 7:18 am

    This is such a great post. Thank you for sharing! I look forward to each post you make. Thanks for being you & sharing it with the world =)

    Liked by 1 person

  3. Bronwyn October 11, 2016 / 8:45 am

    Great post! You so eloquently said everything I find wrong with the food addiction model. I get so frustrated when people report on how food lights up the same neural pathways as drugs… I’m no, it’s the other way around: drugs light up the neural pathways of food. We needed food to survive so food= pleasure.

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    • GlenysO October 11, 2016 / 9:42 am

      Great way of thinking of it!!

      Like

  4. Andi October 11, 2016 / 9:11 am

    Oh man I needed this post. Thank you.

    Liked by 1 person

  5. Fern Ghauri October 11, 2016 / 1:05 pm

    So, so true! I would bet anything that if “they” started to forbid and/or place a high danger/ pleasure value on brussels sprouts and kale (or ended up placing taboos around them, if not outright forbidding them), and these taboos became part of the punitive underpinning of the anti-food and anti-pleasure culture, we would end up with conversations like this:

    “Oh god, please hide the kale. Just looking at it makes me drool.”

    “No! I am not putting brussels sprouts on the shopping list.”

    “No, doctor, I have not eaten kale for several weeks.”

    “So you think that my potassium/sodium balance/ratio would become better if I cut out brussels sprouts?”

    Liked by 1 person

    • GlenysO October 11, 2016 / 1:58 pm

      LOL – so true!

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  6. Ruth Flett October 13, 2016 / 10:22 am

    You have lots of great ideas. Isn’t food addiction just a way that the body is telling you that you are deficient in a nutrient?

    Liked by 1 person

    • GlenysO October 13, 2016 / 4:18 pm

      Well, we don’t really have any evidence to say that. I would say no. I think if a person feels “addicted” around food, they might want to check their level of physical restriction (actually denying themselves adequate calories, creating excessive hunger, and/or denying themselves certain foods) or their level of emotional restriction (eating the foods but feeling guilty about them, labeling foods good/bad, feeling bad about their bodies and using food as a proxy). But in general, nutrient deficiencies tend to have their own set of distinct symptoms, but food addiction is not one of them.

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  7. Sabrina October 13, 2016 / 5:26 pm

    I’m so glad you brought this up! I have long been skeptical about the validity of the food addiction model for a few reasons: 1) food is necessary for life, and therefore is unlike addictive drugs, which are not; 2) models of food addiction seem to vilify pleasure, which I would argue is actually one of the most important aspects of eating; and 3) because, like you point out, nobody is talking about the underlying restriction that is almost certainly causing the “addiction”-like behavior.

    I also know a woman who is a member of OA. She brings her own food with her to social events, so she doesn’t inadvertently eat off her very rigid plan. How can this be recovery? After simply sustaining life, the next most important role of food is to bind us together as social beings. We need it to live, and we need it to thrive. I can’t see how bringing your own salad to a baby shower at which the hosts all cooked from scratch for days ahead of time represents any kind of “recovery.” In all honesty, I think OA is contributing to the problem it purports to solve.

    Just for the record, I have close family with extensive experience in AA. Their involvement in that 12-step program was and still is nothing short of life-saving. So I have nothing but support for 12-step programs for true addictions. But I’m not convinced that food addiction is a true addiction.

    Liked by 1 person

    • GlenysO October 14, 2016 / 11:39 am

      Couldn’t agree more with all your points! Definitely agree the 12 step program is so helpful for many people. You’ve hit it on the head with OA – and the big problem with them is that they also have a focus on weight loss. Like, if you are fat, it’s from some food addiction. That assumption is so flawed.

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      • Sabrina October 15, 2016 / 8:31 am

        I agree! I have read blog posts by a woman who believes she is a food addict. Her “answer” is currently a highly restrictive so-called “whole-foods, plant-based” diet that excludes any flours (even whole grain flours), oils, salt, sugar, and nuts and seeds. Basically all that is allowed are unadorned starchy and nonstarchy vegetables, cooked whole grains (no flours), beans, and fruit. The idea is to eat foods with very low calorie density and to avoid lighting up those pleasure pathways at all, so as not to trigger a binge. She’s answered letters in which people say they are eating pounds and pounds of these foods and still not feeling satisfied. Her answer is that they need to address the emotional reasons for their overeating. So close, but misses the mark. I would argue that 1) the diet is the problem– attempting to remove pleasure from eating actually makes it harder to achieve satiety, and 2) that what these folks really need to examine is the need to be thin at all costs, even to the extent of social isolation (because they can never share a meal with friends and family) and total lack of eating pleasure. Their bodies and their brains are not the problem, and the food isn’t either. It’s the idea that thinner is always better and that being fat is a moral failing that is the problem. It’s so sad to think of these probably otherwise healthy people damaging their emotional and mental health by buying into this food addiction model.

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  8. Grab the Lapels October 16, 2016 / 10:24 am

    I know a woman who keeps candy all over her house because when she wanted it all the time she ate it ask the time. She doesn’t say to herself, ‘No, fatty, you can’t have that’ and she almost never craves candy. It’s interesting. I know her mother constantly and how she can “restrain” herself in such an environment.

    Liked by 1 person

  9. Amy November 16, 2016 / 4:38 pm

    “food addiction tendencies are more likely driven by high dietary restraint, weight stigma, and a toxic culture of food-fear than a chemical dependency on food.” I LOVE THIS LINE! Perfect, perfect explanation to people who insist that they are addicted to sugar/salt/whatever. Thank you Glenys for giving me the perfect line to use with clients and other folks 🙂

    Liked by 1 person

  10. jodietitian December 6, 2016 / 4:44 pm

    Great post! This topic has always fascinated me…. I also am not a fan of the word “addiction” applied to food. Over the close to 4 decades that I have been a dietitian, most of these years working with eating disorders and weight issues, while I do agree that most of these feelings of “addiction” are due to the restriction and crazy culture we live in when it comes to food, I have encountered some people who have not dieted, know nothing about calories or nutrition, yet can’t stop eating certain foods (usually salt and sugar and fat). These people however don’t label it as “addiction” but may say “oh I love that, but I don’t buy it because I just eat the whole thing!”. Some actually enjoy eating the “whole thing” without guilt (rare), but there are those who won’t buy it (for example, ice cream) because they eat it all. Even when they don’t diet. So, I feel while most of this kind of eating is a consequence of dieting/restriction there may be some who also overeat some foods even without a dieting history. I would not call it addiction but clearly something is going on when somewhat “normal eaters” who don’t restrict can’t seem to stop. Maybe they don’t have enough pleasure in their life?! I know it is rare but I still would love to know what that is about….wonder if anyone else has encountered this type of person?

    Liked by 1 person

    • GlenysO December 6, 2016 / 5:06 pm

      That is interesting and I have met a few people like this. I wonder if it’s a consequence of dieting culture being so normalized in our society, so that even people who don’t diet still feel some foods are foods they shouldn’t eat? I’m not really sure. Or like you said, maybe they aren’t getting enough pleasure in their other foods? They probably are pretty exceptional cases, as I don’t feel like I even know any non-dieters (aside from HAES RDs and a few friends) anymore.

      Liked by 1 person

      • jodietitian December 9, 2016 / 3:33 am

        That could be part of it,good food/bad food thinking is definitely normalized! I do know some acquaintances who don’t diet or know much about nutrition yet still think that way….could be a big part of it!!! crazy

        Liked by 1 person

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