Is sugar toxic? This was the question posed by CBS News program 60 Minutes last Sunday. The answer was a resounding “yes.” And not only is sugar toxic, it is also addictive according to the experts interviewed for the segment. I have been interested in food addiction for some time now and it seems that the popular media is finally taking notice of this concept. The program featured Eric Stice, Ph.D., a neuroscientist at the Oregon Research Institute who has used fMRI scans to conclude that sugar activates the same brain regions that are activated when a person consumes drugs like cocaine. In addition, he found that heavy users of sugar develop tolerance (needing more and more to feel the same effect), which is a symptom of substance dependence. Nora Volkow, M.D., a psychiatrist at the National Institute on Drug Abuse, has done similar research using brain imaging techniques to show similarities between the brains of people who are obese and people who abuse drugs and alcohol. Nicole Avena, Ph.D., a psychologist at Princeton University, was even able to induce sugar dependency in rats. In my opinion, the research is convincing that sugar and other foods have an addictive quality. The Lay’s potato chip advertising execs were really onto something when they developed their “betcha can’t eat just one” slogan in the 1950s. Talk about ahead of their time!
The question that has plagued me more recently is: what do we do with this information? As a clinician, how do I best help patients struggling with overeating? The most commonly used model to treat drug and alcohol addictions is abstinence (complete avoidance of the drug or alcohol). Should we advocate an abstinence model for the treatment of sugar addiction? This would involve recommending that people completely avoid food and beverages with sugar—a daunting task when you consider the breadth of food products containing sugar. To me, this type of recommendation rings too similar to restrictive dieting: a “weight loss” technique that most research has found only leads to binge eating and weight cycling. When food is off-limits, it tends to take on power and value. The things that you cannot have are only that much more enticing. Think about a 10-year-old boy who is not allowed to see an “R” rated movie. His imagination may run wild with thoughts about what intriguing content that movie may contain. He would be disappointed to find out that most “R” rated movies are actually quite boring, especially for a 10-year-old child. The same happens with food; a doughnut becomes alluring, its shining glaze beckoning you from across the room. You imagine how incredible it would taste, find yourself ruminating about the doughnut far after you have left its physical presence. It may become a symbol of rebellion: “I’m going to be a bad girl tonight and eat the doughnut, screw them all!” and then turn into a symbol for self-hatred, disgust, and shame when you succumb to eating the doughnut. In reality, it’s just a doughnut: simply flour, sugar, and yeast fried in oil. Demystified and eaten mindfully, the doughnut loses its power and is often just as disappointing as the “R” rated movie. However, to the person for whom the doughnut is off-limits, it becomes so much more. This is my concern with advocating an abstinence model to treat sugar addiction. I think that caution should be used when restricting foods from your diet (especially foods that you tend to enjoy) and you should be conscious of the effect that this restriction has on your mind and body. Therapy and mindful eating are tools that can help you in this process. The goal is to create a healthy and peaceful relationship with food that will leave you feeling satisfied. Going beyond the physical nature of your relationship with food into the psychological will enhance the relationship and help restore a sense of balance in your eating.