I hate when the time I have available to eat is too early to feel hungry but if you wait until you’re available again you’ll get all grumpy and try to eat someone’s arm off. Kind of an eat now or forever hold your peace kind of situation. So I ate now.
At moments like this I turn to the trusted egg white scramble. It’s light enough that the fact that I’m not necessarily hungry is kind of irrelevant but high enough in protein to carry me over to whenever I eat next. I always add some kind of fat to round it out–today avocado, other times cheese or even nuts–and I use frozen vegetables because it’s just… easy.
I’m having one of those days where the stars are simply not aligning. Went to a meeting I didn’t have. Went to an apartment showing for a place that was already rented. Went to work without a charged laptop. Just, you know…
No matter. I have a delightful evening of activity ahead. Class at FlyWheel (never tried it). We’re talking nutrition counseling opportunities. Cool. Then I’m going back to the studio to support a friend of mine who’s teaching her first class. And then I’m teaching one of mine right after that.
Some people have expressed interest in my food addiction research I did for one of my graduate seminars this summer and I’m happy to share some highlights. I think it’s a fascinating and relevant topic of study, but a lot of the research is contradictory (as is the case with, uh, everything nutrition-related). I won’t share my paper because I’d never publish something I wrote in a night (I did get an A, yes), but these are the highlights…
Why is Food Addiction Relevant?
Today approximately 1 in 3 Americans is obese with the Centers for Disease Control predicting rates of 42% by 2030. While many consider this a uniquely American phenomenon, obesity is actually on the rise worldwide. The Organisation for Economic Cooperation and Development has seen two- and three-fold increases in obesity rates in 19 of their 34 affiliated countries since 1980.
Despite advances in treatment and prevention of obesity-related comorbidities–including diabetes, heart disease, hypertension, high blood pressure, etc.–along with improved public health initiatives promoting weight loss, we (as a global population) can’t seem to get a handle on the obesity pandemic.
This raises the question: Is there perhaps an element beyond voluntary control that is contributing to increased, seemingly unstoppable rates of obesity around the world?
The answer, some say, is food addiction. If food addiction is validated by research, it could have major implications for the treatment and prevention of obesity, which is why it is a hot topic today.
What is food addiction?
Currently, food addiction is defined as an eating disorder according to criteria in the DSM-IV. However, many argue that it better fits the criteria associated with general addiction (as related to substance abuse). Addiction is defined in the DSM-IV as meeting 3 of the following 7 criteria:
- Increased intake
- Persistent desire or inability to control use
- Excessive time spent seeking out or recovering from a substance
- Interference with important life activities
- Continued use despite knowledge of adverse effects
Binge-related eating disorders (including BED and bulimia) meet both the physiological and behavioral diagnostic criteria for addiction.
What’s the evidence for food addiction?
Most of the research I looked at involved animal models (usually rats), but some human studies have been done. The process generally involved a period of feeding–either sugar, fat or a sugar-fat combination–followed by forced abstention. Researchers observe physiological and behavioral changes when consuming the food and later during abstention. Evidence for food addiction in rats includes:
- Neurochemical responses during consumption of sugar – Specifically, the brain sees a spike in dopamine release when consuming sugar.
- Opiate-like withdrawal symptoms during forced abstention – These symptoms include physiological responses like teeth chattering, forepaw tremor, head shakes, decreased body temperature, as well as psychological/behavioral responses like aggression, depression and anxiety. These are classic signs of withdrawal in humans, too. (Minus the forepaw tremor.)
- Continued use despite consequences – In one study, rats would endure electrical shock in order to consume sugar.
Is food addiction associated with obesity?
This is where things get tricky. Most studies I looked at did not find correlations between food addiction and increased BMI. In fact, one study found that rats were actually self-regulating their intake of other foods in order to binge on their addictive substance (sugar). Weight gain was noted in studies where sugar was combined with fat. The conclusion here was that sugar is the addictive trigger but fat causes the weight gain.
If we apply this finding to the human population, I would predict that food addiction could be associated with obesity considering the increased availability of highly palatable, sugar-fat combo foods on the market. Still other studies, however, have noted binge/addictive behaviors on fat-free, no-sugar substances that would arguably be considered unpalatable (like rice cakes, pretzels, etc.). So the palatability of the food may not be the cause of the addictive trigger. Instead, some studies have concluded that food itself is not addictive. It is a consummatory pattern of bingeing and restricting that causes addictive behavior.
One really interesting study also found that sweet taste in the absence of calories (think: artificial sweeteners) signals to the brain to seek sustenance and can trigger binge behaviors. This has major implications for the consumption of “diet” products on the market that reduce calories by replacing real sugar with calorie-free sweeteners.
How is food addiction treated?
Treatment of food addiction is delicate. Unlike other substances of abuse, food is required to sustain life. Imagine telling an alcoholic they have to continue drinking every day in order to survive. As such, abstention is clearly not a solution for the treatment of food addiction.
Right now food addiction is defined as an eating disorder and treated as such. Eating disorder treatment is usually multidisciplinary in approach and could include cognitive-behavioral therapy, interpersonal psychotherapy, medications and self-help groups. Some argue, however, that if food is an addictive substance the way drugs and alcohol are, it should be treated accordingly. Food Addicts Anonymous endorses a recovery program similar to Alcoholics Anonymous’ 12-step program.
And that’s that. Pretty interesting, right? I think it’s a very important topic of study right now. Considering New York’s new soda ban, I think it’s not too far-fetched to consider the parallels between Big Food and Big Tobacco in terms of public policy. When the government decided to address the dangers of smoking we saw tobacco taxation, public smoking bans and counter-advertising, all of which are initiatives we’re beginning to see associated with food, as well. Not saying it’s the same thing. Just that we may see some correlation in the next couple years as government leaders and public health officials scramble to get the obesity numbers under control.