by guest blogger Pam Peeke, MD, MPH, FACP, best-selling author and expert on health, fitness, and nutrition
It’s an all-too-common scenario: You wake up in the morning swearing today’s the day when you’ll eat clean, nourish yourself with a healthy breakfast at home, and pass up the glistening bakery goodies that tempt you every day. You make it to work without incident and then stress hits–any kind of stress, from a new project deadline to a caustic remark from your boss. A little while later, you find yourself with pastries in hand, wolfing down sugary anesthetics and wanting more. When you finally pop out of your food trance, and the reality of what you’ve done begins to settle in, the ensuing feelings of shame and guilt stoke your stress levels more and you’re already plotting your next food fix. You wonder: Why do I keep caving to these cravings? Where’s my discipline and willpower?
This is your brain addicted to food.
That’s right. Addicted. You might tell yourself, I’m not addicted to food. I just love a good sweet now and then. Well, I’m here to tell you that food addiction is real; it affects more people than you know, and manufacturers actually design food products so that they are as addicting as possible. Yes, that perfect combination of salty, sweet, and savory was created to make sure you keep reaching for more. That’s why I wrote The Hunger Fix, because I want to change the game that is rigged against you.
Here are 6 ways to beat food addiction:
1) Take the test. First, you need to find out if your relationship with food is a healthy one. Take my Food Addiction Quiz. This is a special assessment developed by Yale University researchers to evaluate your relationship with food. Experts believe that the majority of people who are overweight or obese have some level of food addiction. However, anyone of any age and size can have this issue.
2) Know your staples from your treats. Our brains are rigged to seek out the delicious reward of natural carbs like berries from a bush or veggies from the ground. We savor healthy fats from avocados, olive oil, and fish and lean meats. Our brains drive us to forage around to find these foods so that we have quick energy (from carbs) and long-lasting fuel (from fat). These natural whole foods have sustained us since the dawn of time. Our brains were acclimated to the taste of these rewards. Every now and again, we’d savor a treat that contained more natural sugar (grapes) or fat (dairy or meat). This mix of staples and treats became our natural balance of healthy nutrients. Flash-forward, and now we have manufacturers creating “hyperpalatable” foods–full of sugar, fat, and salt. And because they are ubiquitous, cheap, and easily accessible, fewer people cook. Grab and go is now the way to go.
3) Rein in your reward center. When hyperpalatables compete with natural foods, your brain’s reward center, which secretes the pleasure chemical dopamine, gets hijacked. Insulin levels go up and push you to want more and more. Suddenly, that bowl of fresh berries can’t compete with the über rewards of a Pop-Tart or a chocolate-coated breakfast bar. An occasional treat, such as a birthday dessert, also leads to a dopamine rush, but then your brain settles down to more normal levels of dopamine. But when you can get your hands on hyperpalatable foods 24/7 and you start the day with that sugary/fatty/salty pastry and grande sugary coffee drink, you end up with an endless appetite for more.
4) Recognize the “False Fix.” After constant exposure and consumption of these hyperpalatables, which I refer to as “False Fixes” in The Hunger Fix, your brain actually changes. The brain cannot tolerate this level of hyperstimulation. As a result, it decreases the number of dopamine receptors so that you no longer feel it as overstimulation. That’s the good news. The bad news is that by doing this, your typical serving of food is no longer as rewarding. You find yourself not feeling as pleased and satisfied. You know the end result. Not satisfied, you end up with second and third and fourth portions, packing on weight along the way.
But wait, there’s more: At the same time your reward center is being hijacked, the brain’s CEO, the prefrontal cortex (tap your forehead and that’s where the PFC is located), is becoming damaged and impaired. The PFC can no longer help you rein in impulses or stay focused and vigilant. That’s why, when someone is in full-on addictive mode, moderation is a moot point. Revolutionary and groundbreaking new studies funded by the National Institutes of Health funded have shown that the brain scans of food addicts show the same changes and damage as those of a cocaine user. And, for your information, research also shows that table sugar (sucrose) is more addictive than cocaine.
All right, what’s the solution? Science-based detox and recovery from the foods and beverages that you know are causing you to lose control and overeat.
5) Know your enemy. Make a list all of your False Fix foods that you know will lead you to feel out of control and overeat. As you prepare to detox, look around you and inventory the persons, places, and things that enable your food addiction. This isn’t just about switching up False Fix foods for Healthy Fixes. It’s also about examining your entire lifestyle so you can make new, healthier choices to support your recovery. You’re not going to change everything overnight, so you’ll start with small but powerful steps to ensure sustainable, long-term success.
6) Remember these words: MIND, MOUTH, MUSCLE. That will help you organize how you’ll detox and recover.
- MIND: Reclaim your brain. A strong PFC is absolutely required to repair and reclaim your reward center. And you can repair your PFC with transcendental meditation and mindfulness. The key is to practice them daily to stimulate new brain cell formation and to repair damage. When you meditate you cause actual brain changes to help repair and strengthen brain cells.
- MOUTH: Get high…naturally. Achieve a natural “high” from whole foods that increase dopamine production naturally. Specific foods–watermelon, spinach, avocados, tofu, and sesame seeds, to name a few–perform magic and reestablish normal reward responses for natural foods. Also, use powerful protein and fiber combinations–carrots and hummus, peanut or almond butter and apple slices, for instance–that satisfy and stop the urge to splurge on sugary/fatty/salty foods.
- MUSCLE: Every step you take during the day stimulates brain growth, including your PFC, which translates to a bigger, stronger, more focused brain. And one of the mottos of The Hunger Fix is BIG BRAIN, SMALL WAIST. You’ll make smarter decisions and shed extra weight if your brain is healthy. Research has also shown that regular physical activity will also keep you calmer and decrease the chance of relapse. All you need is regular moderate exercise to make this work. Walking is the easiest way to go for most people. Doing it outdoors and stepping up the pace when you can enhances the entire experience and results. I’m not talking marathons here, folks. Just getting up and moving.
The bottom line is that food addiction is real–it’s been acknowledged by world-class scientists–and we need to start taking it seriously. And, more important, we have the ability to reverse the damage and reclaim our healthy, natural relationship with food.
For more, check out my book, The Hunger Fix.
Pamela Peeke, MD, MPH, FACP, is a Pew Scholar in nutrition and metabolism, assistant professor of medicine at the University of Maryland, and a fellow of the American College of Physicians. A triathlete and mountaineer, she is known as “the doc who walks the talk,” living what she’s learned as an expert in health, fitness, and nutrition. Her current research at the University of Maryland centers on the connection between meditation and overeating. She is the author of many best-selling books, including Fight Fat after Forty. Her new book is the New York Times best-seller The Hunger Fix.
Our government and food industry both encourage more “personal responsibility” when it comes to battling the obesity epidemic and its associated diseases. They say people should exercise more self-control, make better choices, avoid overeating, and reduce their intake of sugar-sweetened drinks and processed food. We are led to believe that there is no good food or bad food, that it’s all a matter of balance. This sounds good in theory, except for one thing:
New discoveries in science prove that industrially processed, sugar-, fat- and salt-laden food — food that is made in a plant rather than grown on a plant, as Michael Pollan would say — is biologically addictive.
Imagine a foot-high pile of broccoli, or a giant bowl of apple slices. Do you know anyone who would binge broccoli or apples? On other hand, imagine a mountain of potato chips or a whole bag of cookies, or a pint of ice cream. Those are easy to imagining vanishing in an unconscious, reptilian brain eating frenzy. Broccoli is not addictive, but cookies, chips, or soda absolutely can become addictive drugs.
The “just say no” approach to drug addiction hasn’t fared to well, and it won’t work for our industrial food addiction, either. Tell a cocaine or heroin addict or an alcoholic to “just say no” after that first snort, shot, or drink. It’s not that simple. There are specific biological mechanisms that drive addictive behavior. Nobody chooses to be a heroin addict, cokehead, or drunk. Nobody chooses to be fat, either. The behaviors arise out of primitive neurochemical reward centers in the brain that override normal willpower and overwhelm our ordinary biological signals that control hunger. Consider:
- Why do cigarette smokers continue to smoke even though they know smoking will give them cancer and heart disease?
- Why do less than 20 percent of alcoholics successfully quit drinking?
- Why do most addicts continue to use cocaine and heroin despite their lives being destroyed?
- Why does quitting caffeine lead to irritability and headaches?
It is because these substances are all biologically addictive.
Why is it so hard for obese people to lose weight despite the social stigma and health consequences such as high blood pressure, diabetes, heart disease, arthritis, and even cancer, even though they have an intense desire to lose weight? It is not because they want to be fat. It is because certain types of food are addictive.
Food made of sugar, fat, and salt can be addictive. Especially when combined in secret ways that the food industry will not share or make public. We are biologically wired to crave these foods and eat as much of them as possible. We all know about cravings, but what does the science tell us about food and addiction, and what are the legal and policy implications if a certain food is, in fact, addictive?
The Science and Nature of Food Addiction
Let’s examine the research and the similarities between high-sugar, energy-dense, fatty and salty processed and junk food and cocaine, heroin, and nicotine. We’ll start by reviewing the diagnostic criteria for substance dependence or addiction found in the bible of psychiatric diagnosis, the DSM-IV, and look at how that relates to food addiction:
- Substance is taken in larger amount and for longer period than intended (a classic symptom in people who habitually overeat).
- Persistent desire or repeated unsuccessful attempts to quit. (Consider the repeated attempts at diet so many overweight people go through.)
- Much time/activity is spent to obtain, use, or recover. (Those repeated attempts to lose weight take time.)
- Important social, occupational, or recreational activities given up or reduced. (I see this in many patients who are overweight or obese.)
- Use continues despite knowledge of adverse consequences (e.g., failure to fulfill role obligation, use when physically hazardous). (Anyone who is sick and fat wants to lose weight, but without help few are capable of making the dietary changes that would lead to this outcome.)
- Tolerance (marked increase in amount; marked decrease in effect). (In other words you have to keep eating more and more just to feel “normal” or not experience withdrawal.)
- Characteristic withdrawal symptoms; substance taken to relieve withdrawal. (Many people undergo a “healing crisis” that has many of the same symptoms as withdrawal when removing certain foods from their diet.)
Few of us are free from this addictive pattern. If you examine your own behavior and relationship with sugar, in particular, you will likely find that your behavior around sugar and the biological effects of overconsumption of sugar match up perfectly. Many of the criteria above are likely to apply to you.
Researchers from Yale’s Rudd Center for Food Policy and Obesity validated a “food addiction” scale.(i) Here are a few of the points on the scale that are used to determine if you have a food addiction. Does any of this sound familiar? If it does, you may be an “industrial food addict.”
- I find that when I start eating certain foods, I end up eating much more than I had planned.
- Not eating certain types of food or cutting down on certain types of food is something I worry about.
- I spend a lot of time feeling sluggish or lethargic from overeating.
- There have been times when I consumed certain foods so often or in such large quantities that I spent time dealing with negative feelings from overeating instead of working, spending time with my family or friends, or engaging in other important activities or recreational activities that I enjoy.
- I kept consuming the same types of food or the same amount of food even though I was having emotional and/or physical problems.
- Over time, I have found that I need to eat more and more to get the feeling I want, such as reduced negative emotions or increased pleasure.
- I have had withdrawal symptoms when I cut down or stopped eating certain foods, including physical symptoms, agitation, or anxiety. (Please do not include withdrawal symptoms caused by cutting down on caffeinated beverages such as soda pop, coffee, tea, energy drinks, etc.)
- My behavior with respect to food and eating causes significant distress.
- I experience significant problems in my ability to function effectively (daily routine, job/school, social activities, family activities, health difficulties) because of food and eating.
Based on these criteria and others, many of us, including most obese children, are “addicted” to industrial food.
Here are some of the scientific findings confirming that food can, indeed, be addictive(ii):
- Sugar stimulates the brain’s reward centers through the neurotransmitter dopamine, exactly like other addictive drugs.
- Brain imagining (PET scans) shows that high-sugar and high-fat foods work just like heroin, opium, or morphine in the brain.(iii)
- Brain imaging (PET scans) shows that obese people and drug addicts have lower numbers of dopamine receptors, making them more likely to crave things that boost dopamine.
- Foods high in fat and sweets stimulate the release of the body’s own opioids (chemicals like morphine) in the brain.
- Drugs we use to block the brain’s receptors for heroin and morphine (naltrexone) also reduce the consumption and preference for sweet, high-fat foods in both normal weight and obese binge eaters.
- People (and rats) develop a tolerance to sugar — they need more and more of the substance to satisfy themselves — just like they do for drugs of abuse like alcohol or heroin.
- Obese individuals continue to eat large amounts of unhealthy foods despite severe social and personal negative consequences, just like addicts or alcoholics.
- Animals and humans experience “withdrawal” when suddenly cut off from sugar, just like addicts detoxifying from drugs.
- Just like drugs, after an initial period of “enjoyment” of the food, the user no longer consumes them to get high but to feel normal.
Remember the movie Super Size Me, where Morgan Spurlock ate three super-sized meals from McDonald’s every day? What struck me about that film was not that he gained 30 pounds or that his cholesterol went up, or even that he got a fatty liver. What was surprising was the portrait it painted of the addictive quality of the food he ate. At the beginning of the movie, when he ate his first supersized meal, he threw it up, just like a teenager who drinks too much alcohol at his first party. By the end of the movie, he only felt “well” when he ate that junk food. The rest of the time he felt depressed, exhausted, anxious, and irritable and lost his sex drive, just like an addict or smoker withdrawing from his drug. The food was clearly addictive.
This problems with food addiction are compounded by the fact that food manufacturers refuse to release any internal data on how they put ingredients together to maximize consumption of their food products, despite requests from researchers. In his book The End of Overeating, David Kessler, M.D., the former head of the Food and Drug Administration, describes the science of how food is made into drugs by the creation of hyperpalatable foods that lead to neuro-chemical addiction.
This binging leads to profound physiological consequences that drive up calorie consumption and lead to weight gain. In a Harvard study published in the Journal of the American Medical Association, overweight adolescents consumed an extra 500 calories a day when allowed to eat junk food as compared to days when they weren’t allowed to eat junk food. They ate more because the food triggered cravings and addiction. Like an alcoholic after the first drink, once these kids started eating processed food full of the sugar, fat, and salt that triggered their brain’s reward centers, they couldn’t stop. They were like rats in a cage.(iv)
Stop and think about this for one minute. If you were to eat 500 more calories in a day, that would equal 182,500 calories a year. Let’s see, if you have to eat an extra 3,500 calories to gain one pound, that’s a yearly weight gain of 52 pounds!
If high-sugar, high-fat, calorie-rich, nutrient-poor, processed, fast, junk food is indeed addictive, what does that mean? How should that influence our approach to obesity? What implications does it have for government policies and regulation? Are there legal implications? If we are allowing and even promoting addictive substances in our children’s diets, how should we handle that?
I can assure you, Big Food isn’t going to make any changes voluntarily. They would rather ignore this science. They have three mantras about food.
- It’s all about choice. Choosing what you eat is about personal responsibility. Government regulation controlling how you market food or what foods you can eat leads to a nanny state, food “fascists,” and interference with our civil liberties.
- There are no good foods and bad foods. It’s all about amount. So no specific foods can be blamed for the obesity epidemic.
- Focus on education about exercise not diet. As long as you burn off those calories, it shouldn’t matter what you eat.
Unfortunately, this is little more than propaganda from an industry interested in profit, not in nourishing the nation.
To your good health,
Mark Hyman, M.D.
(i) Gearhardt, A.N., Corbin, W.R., and K.D. 2009. Brownell. Preliminary validation of the Yale Food Addiction Scale. Appetite. 52(2): 430-436.