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Many of us have had the experience of not being able to stop eating potato chips or something else that happens to be just the right combination of salty, sweet, and flavor-carrying fat. If potato chips are our particular poison, we promise ourselves we'll eat only one. Or maybe only one handful. Later when we are crumpling the empty bag, we wonder why we did not stop.
We are such failures when it comes to our nutrition, we think.
The Lays potato chip company knew this back in the 1960s when they created the advertising tagline was, “Bet you can’t just eat one.”
No kidding.
Experts in nutrition and psychology battle over whether food addiction is "real" in the same way as substance addictions involving alcohol, cocaine, or nicotine, or behaviors such as gambling. But the experiences and understanding of many people—including those with other addictions—is that food addiction can be as real as any other.
Food addiction is especially interesting because it involves both substances and behavior. What many would call food addiction is characterized as binge eating disorder in the Diagnostic and Statistical Manual of Mental Disorders-5 of the American Psychiatric Association. Binge eating disorder is characterized by recurrent binging in which a person eats much more than what most people would in the same amount of time. Binge eating often happens when a person is not hungry or even already feels full. Such overeating is often accompanied by guilt, shame, and embarrassment. There must be a pattern of such overeating, with attendant emotional distress, to warrant a diagnosis; a person must do this at least once a week for three months. Binge eating disorder is on a scale from mild to severe.
Clearly, eating is a behavior that can be engaged in disordered ways. It can become both compulsive and impulsive. Plans and promises not to eat a food, or to only have a certain amount, are often broken in ways that make an individual feel out of control. Of course there are important therapeutic concerns about binge eating, but part of my concern about understanding food addiction strictly as binge eating is that it becomes too easy to focus solely on people’s eating behaviors and then pathologize them.
What room is left for investigating the substances that people are consuming?
Shifting the focus from disordered eating to the addictive qualities of the food consumed is important, since not all foods are created equal in this regard. My emphasis on created is crucial here. In general, people are not binging apples, pears, lettuce, or salmon. No, the foods people crave in this way are the highly processed foods manufactured by the food industry.
What’s so appealing about highly processed foods? What makes us crave and consume them, sometimes to the point of being unable to stop? Certain foods are “hyperpalatable"—loaded with the unholy and unhealthy trifecta of fat, sodium, and sugar, with plenty of extra ingredients that function to preserve and improve appearance (Gearhardt et al 2011). These foods are carefully engineered to achieve a perfect balance to produce pleasure so people keep eating them. People who consume these foods to high degrees may begin to experience their eating as out of control.
These hyperpalatable foods produce a far more pleasurable response in people than less processed foods. Humans produce pleasure-providing opioids when digesting certain amounts of fat and sugar. Recent studies have shown that laboratory animals prefer intense sweetness even above cocaine (Lenoir et al). Lab rats addicted to sugar water demonstrated significant withdrawal symptoms, including shakes and anxious behavior, when researchers were able to block their sugar high (Avena et al 2008).
In consuming these hyperpalatable foods—many of which people would describe as both "comfort" and "junk" food—individuals are looking for a certain sensation of pleasure or relief not unlike what people who use and abuse alcohol, nicotine, or cocaine seek.
If people are eating these hyperpalatable foods in ways that are compulsive and involve a high degree of impulsivity, is it appropriate to begin to speak of “using" food rather than eating food? Here the substance and process dimensions of addiction intertwine, revealing the inadequacy of understanding food addiction as a binge eating disorder.
Furthermore, what place is there for making moral assessments about the industry creating and selling foods the consumption of which produces similar addictive effects as alcohol, cocaine, and other drugs? I am stopping short of calling the food industry pushers. But I am not stopping short of saying that it is contributing to and even profiting from the creation of a public health nightmare. It is legitimate to scrutinize the food industry in the same ways we have the tobacco industry.
Is food addiction entirely the fault of food industry? Most certainly not. But we need to broaden the scope of the questions we ask about food addiction.
Sources:
Avena, N.M., Rada, P., Hoebel, B.B. (2008). Evidence for sugar addiction: behavioral and neurochemical effects of intermittent, excessive sugar intake. Neuroscience and Behavioral Reviews, 32, 20-39.
Gearhardt, A., Grilo, C., DiLeone, R., Brownell, K., Potenza, M. (2011). Can food be addictive? Public health and policy implications. Addiction 106 (7), 1208-1212.
Lenoir, M., Serre, F., Cantin, L., Ahmed S.H. (2007) Intense Sweetness Surpasses Cocaine Reward. PLoS ONE 2(8): e698. doi:10.1371/journal.pone.0000698
