Are you addicted to food?
You’d be surprised to hear that Food addiction is a hotly debated topic amongst Weight Management Physicians. It isn’t formally a diagnosis due to lack of human based research, but when most of my encounters with patients entails reports of “I’m addicted to sugar!”, it’s tough to ignore!
Do you experience sweating, agitation, tremors when you’re without refined, processed sugars? OR could it be that you’re addicted to the action of retrieving such foods?
You can’t deny that there are addictive components to manufactured foods. There are great books like Sugar, Salt, Fat by Michael Moss and The End of Overeating by Dr. David Kessler who provide excellent evidence for the science that goes behind manufacturing food that is hyperpalatable, aiming for consumers to reach a “bliss point”. Research has shown that these very foods hijack the brain’s reward system that mirror the neurological pathways of substances such as cocaine, heroine etc. Without boring you with details, repetitive insults to this neurological pathway can result in learned behaviors that result in higher motivation to seek these foods.
It has been tough to delineate whether this “addiction” that people describe is related to a behavioral addiction or a substance (in this case, sugar) addiction. Some clinicians use the Yale Food Addiction questionnaire as a screener, but this also has significant overlap with Binge Eating Disorder.
The importance of this distinction is that management approaches differ. In the event of a behavioral addiction (ie. Binge Eating Disorder), one should dissect the very routine and environment at which food seeking occurs. Behavioural issues tend to very responsive to regular counselling on behavioural change using a technique called cognitive behavioural therapy (CBT). This is my area of interest in tackling weight management.
The very rough plan of action is as follows:
Paying attention to the scenario and external cues that might provoke wanting (ie. couch, tv, evening = CHIPS!),
Listening to the internal dialogue (ie. “I worked out today, I deserve a bowl of chips”)
Reflecting on your feelings after the behaviour (ie. “I feel kind of sick, bloated”)
Using these reflections as facts in the face of future impulses (ie. “I remember last night when I ate that bowl of chips before bed, I felt really sick. I think I’ll hold off tonight”)
Food Addiction on the other hand, often relies on a 12-step plan abstinence model which entails complete elimination of sugar (or in some cases, the triggering foods). This is an issue because it contradicts the plan of established conditions that have overlapping diagnostic criteria like Binge Eating Disorder. Many primary care physicians aren’t comfortable advising a patient to eliminate a whole food group from their diet which can be unsustainable and/or put one at risk of nutritional deficiency. If you’re interested in learning more about Food Addiction, Dr. Vera Tarman is a Toronto-based addictions specialist who has authored a book that chronicles her very own experience with Food Addiction and the clinical anecdotes of those she has diagnosed and helped.
It was my intention that this article clear up any confusion between behavioural addiction versus food addiction. The fact of the matter is, the jury’s still out. Until then, I don’t think we can really discount the journey that people are experiencing with their weight struggle, and that any treatment offered should really be centred on what that person thinks is reasonable and sustainable. Herein lies true patient-centred care.
In good health,
Dr. Sandy