There may be nothing wrong with devouring a bucket of French fries with a group of friends. There may not even be anything wrong with devouring a bucket of fries alone in your car. But how often do you do it? Do you have to be going through a break-up, have PMS or just be bored?
We all have different triggers, and in spite of the fact that more than 37 percent of Americans are obese (and swear we’re addicted to certain foods), it’s tough to fi nd any doctor who will agree.
“Food Addiction” is not recognized in the most current Diagnostic and Statistical Manual of Mental Disorders (DSM, 4th edition). While there is anecdotal evidence that overweight people crave grease, salt and sugar, scientists have failed to prove that these yummy ingredients are psychoactive substances (that, like drugs or alcohol, alter a person’s mental state by affecting the brain and nervous system).
Forty-seven-year-old professional photographer Tia Wooley says she consistently uses highly caloric food as catharsis — asserting that she has been a food addict since age 14.
“Food makes me feel better immediately. An hour later, not so much, but the immediate gratification is off-the-charts-good.”
That “off-the-charts” feeling is what authors of a recent article in the American Journal of Physiology must have been referring to, albeit far more scientifically:
During eating, immediate, direct pleasure is derived from mainly gustatory and olfactory sensations, driving consumption throughout the meal until satiation signals dominate… The question here is whether repeated exposure to palatable food can lead to similar neuroadaptive changes in the food-reward system and behavioral dependence (craving for palatable foods and withdrawal symptoms).
It takes less time to fi nish a full bag of buttery microwave popcorn than to decipher the rest of the article’s content, but the authors do clearly assert that the most defendable addictive food ingredient is sugar: “As with drug and alcohol addiction,” they write, “abstinence from sucrose can cause craving and withdrawal symptoms, eventually leading to relapse behavior.”
Advocacy groups like the Rudd Center for Food Policy and Obesity are working to legitimize food addiction. They designed the 2009 Yale Food Addiction Scale questionnaire for use by practitioners to pinpoint sources of food dependence.
Spokane registered dietitian and nutritionist Craig T. Hunt says the Yale Food Addiction Scale makes an excellent tool for physicians.
“Most providers don’t have the time to get into a patient’s psychological or emotional ties to food,” he says. “Doctors have maybe two minutes to talk about nutrition.” He says the information gleaned from the questionnaire, even in the absence of a diagnosis, would be a helpful starting point in talking about compulsive eating.
“I had a woman referred to me who is 347 pounds and diabetic… I’m thinking there probably is some food addiction with a psychological component.”
Hunt says food addiction is more often referred to as “compulsive overeating,” but even that isn’t included in the current DSM.
“Anytime there’s a diagnosis, it gives it leverage for referrals to a specialist, and it would make people who struggle with these issues have more strength,” in finding specific help, says Hunt.
Not waiting for validation from the medical community, Food Addicts Anonymous calls food addiction a “biochemical disease,” having adapted the “12 Steps and Traditions” of Alcoholics Anonymous as its format. Instead of focusing on abstinence from alcohol, they advise abstinence from sugar, flour and wheat.
Kacey Hamilton, a mother to four young children, spent her own childhood watching her father struggle with eating and obesity — what she is certain was an “addiction” to fat and sugar.
“[My dad] would consume half a cake after everyone was in bed like it was nothing,” she remembers. “In my opinion, the most difficult part about an addiction to food is that you can’t quit cold turkey like you can with smoking or drinking… you have to eat to live.”
“My body is built just like my dad’s,” Hamilton adds. “I have a very similar personality, and I have some of the unhealthy cravings he does. Watching him all these years is what has helped me to keep my eating and weight somewhat in check.”
Nearly all providers believe there is an emotional trigger for overconsumption, whether it’s cigarettes, martinis or chocolate frosting.
“All addictions have some component of controlling emotions, or coping… a way to self-soothe pain or sadness,” explains family and marriage counselor Melanie Morlan.
“We struggle with our parents as children or our spouses or partners as adults,” says Morlan. “When our sense of attachment is threatened, we feel afraid, stressed, anxious. This leads to looking for something to numb the pain, or fix the way we look, thinking this will help us find more love or prevent loss of it.”
Morlan says that’s why she spends time with many of her clients helping them work through their own dynamics with eating and body image.
“Food obsession, over-consumption or restriction, as with drugs and alcohol, often become problematic when one is coping with stress, anxiety, emotional or physical pain.
”Wooley agrees that her most serious struggles with eating began during the most stressful time of her life.
“I was really fine until my kids graduated from high school and went away to college,” she says. “I had empty nest syndrome. Then my mom was diagnosed with cancer, and I drove five hours one way each week to help care for her.”
An examination of eating patterns takes most people back to their childhoods.
“Growing up, all the adults I knew were heavy, and it never occurred to me that grownups could be thin. I always thought that that’s what happened when you grew up,” says Dr. Angela Lotrario, an oncologist in Spokane.
“I wasn’t concerned about gaining 25 pounds in college and medical school drinking cases of Pepsi, whole Totino’s pizzas, and boxes of mac and cheese,”
Lotrario says she has gone up and down in weight through adulthood, and fi nally struck a winning formula in the past year, using a nutritionist and meticulously keeping her daily intake at 1200 calories.
“I carried measuring spoons, measuring cups and a little scale with me everywhere,” she laughs. “I had many people saying, ‘Great,’ ‘Way to go!’ and then all of a sudden: ‘You’re not anorexic, are you?’ It seems to me that there is a fi ne line between obesity and eating disorder, and that there’s almost no one at a ‘normal’ weight,” Lotrario concludes.
Still, whether “food addiction” is included in the next edition of the DSM, thereby setting clearer guidelines for diagnosis, Hunt says he foresees a more concentrated effort to work with patients toward their respective “normal” weights.
“The new crop of young doctors are much more tuned into how food affects the body,” says Hunt. “If something’s going to change, like identifying food addiction, I think it’s way more likely to happen now than it was fi ve to 10 years ago.”
