Monday, January 13, 2014

Food Addiction: The Science

This post comes with much hesitation and trepidation, but I am compelled to share the science behind food addiction with you. I hope you find it as amazing as I do. 
The first day of the "Food Addiction Recovery" workshop I attended at Hilton Head Health was dedicated to the research and the truth of food addiction. It was very hard to sit through, but it was enlightening to know the truth. Although I have paraphrased quite a bit, the majority of this post comes from the information I learned at the workshop.

I am a food addict. And it is real. No matter how many times I have written it and said it the past few months, I don't think I REALLY believed it until I saw the scientific evidence. So buckle your seat belts and embrace yourself for a mind-blowing scientific experience.

Yeah, Science!

2013 marked a year of groundbreaking food addiction science and it is now one of the fastest growing research studies in the U.S. Despite all that, you still can't get "officially diagnosed" as a food addict.
Obesity HAS, however, been defined as a brain disorder based on how food affects the brain. And like most diseases- if not managed or treated, it will eventually kill you.

Let's start with just defining addiction in general.

The American Society of Addiction Medicine defines addiction as:

A primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.
Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.

Let's break this definition down a little bit.

Progressive: Addiction does not happen overnight. An alcoholic does not get drunk once and then immediately meets all the aforementioned criteria of an addict. But over time, they slowly but surely live up to the definition. A food addict might start with overeating by one slice of pizza. Then two, then three, then eventually binging on a whole pizza by themselves. The progressiveness of food addiction is the reason why we gain more after dieting.
Reward: What have you lost because of your food addiction? For me, I have cut time with loved ones short so that I could binge. The reward overpowered my ability to just "be present." As long as I am seeking a reward in the form of food, I am not fully present in whatever situation I'm in.
Relapse and Remission: "Coming clean" then going back to addiction. Hello: yo-yo dieting!

Some questions to ask yourself when it comes to accepting a food addiction are: How does your life revolve around food? How much money do you spend on food?

So now that we are pretty sure we have a food addiction based on that definition, how could it possibly be diagnosed?

Yale Food Addiction Scale is one tool.

Read the DSM-IV Substance Dependence Criteria:

Now, read the column on the right- they are observations from self-identified food addicts:

It seems pretty clear to me that uh... hell yeah! Food addiction is an addiction, just like any other.  (remember, I am not certified in medicine, psychology, or anything as related to this subject) Some psychologists argue that certain people are born with an "addictive personality" and that it is only a matter of time before they develop an addiction to a substance. There are many theories as to what actually "causes" a food addiction. Genetics, emotional stress and dysfunction with processing emotions, family history of addiction, neurotransmitter imbalance, nutritional deficiency, toxic food environment, food allergies and intolerance, metabolic disturbances, hormonal imbalance, compromised digestions, etc... If you want to really dig deep and get to the bottom of your addiction, talk to a psychologist or doctor. Personally, I feel that I am pre-disposed to addiction based on my family's history. I also have Obsessive Compulsive Disorder, which goes hand in hand with Addiction.

Alright, so we've defined addiction in general, and we've diagnosed our addiction to food- what's next? Here comes the complicated part.

Take at look at these brain scans from Dr. Peeke's Website and see if you can tell which one's different:

The normal brain has some red stuff in it- what is that?
 THAT, my friends is a glorious neurotransmitter called Dopamine.
Dopamine is produced in the part of the brain that is associated with reward. It drives our behavior and is associated with survival. For addicts, it's the spike of dopamine that interests us, but unfortunately, that spike comes in the anticipation of eating, as opposed to the actual eating itself. We are rewarded before the food even reaches our mouths!! The reward of eating is blunted because our brain has been flooded with dopamine as we think about eating. The same thing happens in a cocaine user and an alcoholic. Non-addicts have the opposite effect. In this picture, the normal brain is having a dopamine spike during eating, whereas there is no red stuff in the obese brain during eating.

Addicts are constantly chasing a high of some sort because the reward is never there during the substance use. The actual consumption does not match the anticipation. Dopamine has to bond with a receptor. The addict's brain is so flooded during the anticipation, it can't attach to the act of eating because it got so overwhelmed beforehand. So this is what people mean when they say they are "numb" during binges. You aren't truly able to eat with your senses fully intact. Your brain is already worn out. In other words, a non-food addict actually enjoys eating more than a food addict. It's not actually the eating that we love so much, it's the thought of eating that keeps us chasing the high. but since our brains are hijacked by dopamine, we never feel satisfied, hence the constantly reaching for more.

Whew. That's a lot to take in, isn't it? I don't know about you, but learning that my brain looks the same as a cocaine user is not pleasant. In fact, it's effin' depressing. The good news is that it doesn't always have to be that way. Through mindful eating practices and overcoming addiction, we can learn to appreciate food as we're meant to: nourishment.

The way I look at food addiction now is that I have shifted the way I look at my weight problem, so now the solution has changed. It's not about eating better and exercising more (that's a no-brainer). It's about learning to control the addiction and managing it.

I have spent a lot of time blaming everything under the sun except for myself. There are some scientific findings that confirm food can be addictive i.e. sugar, but addiction cannot be completely blamed on that. BTW, did you know that sugar is addictive at a primitive level? No sweet foods found in nature are dangerous, so our primal minds tell us that sweet foods are safe. I would bet money that candy companies are aware of this :) Studies have shown that sugar stimulates the brain's reward centers through dopamine, just like other addictive drugs.

How do you overcome food addiction? 

First, you have to remove shame.
Shame is an emotion your addiction wants you to feel. Your "dealer" will do everything it can to keep the addiction going.I consider my dealer as that little voice in my head that constantly overpowers my will and leads me to binge. The dealer gives me 1,000 reasons as to why it's ok to overeat and overindulge.

Next you have to find what makes you aware of your addiction. For me, I ordered a pizza after accepting that I was a food addict and I did not enjoy it at all. That awareness helped me say no the next time my dealer started offering me some "drugs."

Say no to the foods that you KNOW are designed to keep you addicted: sugar products and highly palatable foods engineered by the food industry to go down easily (fast food and junk food).

"There's a biological basis for why it's so hard for millions of Americans to resist food. We are all wired to focus on the most salient stimuli in our environment. For some of us, it could be alcohol; it could be illegal drugs; it could be gambling, sex, or tobacco. For many of us, though, one of the most salient stimuli in our environment is food. And how do you make food even more salient? Fat, sugar, and salt." Former FDA Commissioner David Kessler, MD

Join a support group such as Overeaters Anonymous. Seek counseling. Ask a friend to be your confidant.

Come up with "Food Rules" that you just HAVE to stick to forever and ever. Right now I have two rules that I will follow for the rest of my life. I hope to eventually add more, but for now I am struggling enough to stick to just these:

1) I don't eat pizza. (I've been pizza-free for 8 weeks now)
2) I don't eat what I can't eat in front of others. (in other words, I don't binge. I have not stuck to this one quite as strictly)

The obvious one: Just say no.

Withdrawal will happen. 

And it sucks. And it will bring on lots of not-so-fun emotions. But remember that they are just that: emotions. You are not defined by them and it's just your addiction talking anyways. They'll go away eventually. When I decided to give up pizza for good I experienced a large amount of grief. And anxiety and depression, and sadness. As I was writing the words "I don't eat pizza" for the first time, I started crying. I know this may seem silly to some of you, but giving up something that I attached myself to for so many years as a way of coping was unfathomable. It's not just about the pizza itself, it's about the act of binging. Binging has blanketed me. It has held me as I deal with my problems. The intense fear that is brought on by giving this comfort up is hard to handle. But it is do-able. People overcome addictions every day.

Do Your Research.

Completely submerge yourself into the subject of food addiction. The only thing that seems to really be working for me right now is the constant reminder that I am, in fact, addicted to food. Read about it, Google it, write about it.
Some of my recommendations:
"The Hunger Fix" by Dr. Peeke
"Eat to Live" by Dr. Fuhrman
The Food Addiction Institute:
Overeaters Anonymous:

Will it go away?

This is just my opinion here, but I say no. I am on board with the scientists and psychologists who believe that there are two types of people: those born with addictive genes, and those who are not. I say this because I have some friends with addictions and some without. The ones without simply cannot fathom how someone cannot utilize self-control. The addicts get it. I know people with all kinds of addictions: food, drugs, alcohol, exercise, cigarettes, etc... I also know people who have become sober. I know for a fact that they are not "cured" just because they no longer overeat, smoke, or drink. The addiction struggle never goes away. Managing it gets easier, but the urges will always be there. Lisette, the woman who led the Food Addiction Recovery workshop at H3 labels herself as a "recovering food addict." She has kept her weight off for 7 years (and she looks amazing, btw), but she says she still has the same "monkey chatter" in her head whenever a food craving comes on. But because she has given herself tools and resources to manage her addiction, she is able to fight it.

This won't be the last of the food addiction posts. Please share your story with me, as well as any research you find! The more I learn about the subject, the more I'm motivated to "conquer" it!


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