Being addicted to anything, from crystal meth, heroin, or prescription drugs to tobacco, alcohol, the internet, or exercise, is a lot more common–and a lot more complicated–than you might think. Perhaps the best way to view addiction is as a loss of control, whether it’s something you’re ingesting (called substance dependence) or something you’re doing (behavioral addiction).
Until relatively recently, doctors thought addictions were pretty much limited to certain legal and illegal drugs and their effects on the brain. These psychoactive substances can cross the protective blood-brain barrier and change the way your mind functions. Ultimately, your brain itself changes, starting to need the substance so intensely that you’d become physically or emotionally ill without it. A mild and controllable habit, performed at your discretion (such as wine with dinner), can transform into an addiction that you simply cannot stop without help.
Look at it this way:
•A habit you can always choose to stop.
•An addiction steals your ability to make that choice.
Obviously behavioral addictions (also called psychological dependencies) don’t involve ingesting psychoactive substances. However, a rich trove of research over the past 20 years has shown that when certain behavioral habits start drifting into the realm of addiction, brain chemicals do indeed change. But instead of the physical withdrawal that occurs when you stop a psychoactive substance (like cigarettes, alcohol, or heroin), when you stop a behavioral addiction too quickly you might experience feelings of guilt, shame, hopelessness, despair, failure, rejection, anxiety, and/or humiliation.
To avoid these miseries, you come to believe it’s just emotionally easier to continue the addictive behavior.
You’re complicated, and so is addiction
With any addiction, know that you’re a whole lot more complicated than you imagine. Research in the field of addiction medicine has focused on genetics (addictive behavior runs through families) and also the release of the pleasure neurotransmitter dopamine, the memory neurotransmitter glutamate, and the stress-relieving neurotransmitter serotonin.
Longstanding addictive behavior has been shown to actually damage parts of your brain involving choice and social cues.
When the choice portion of your brain is affected, you choose small and immediate rewards over larger delayed ones. When the social cue area is damaged, you lose your sensitivity to appreciating the consequences of your behavior.
With obesity and its consequences linked to health and longevity, psychologists have done a lot of research on the nature of food addiction. But the question remains: To what extent is an unhealthful BMI related to poor food choices, nutritionally poor food, and large portions vs. an actual addiction to food itself, including all the addictive risks of genetics and neurotransmitters?
The answer is that everything is involved: poor choices, bad food, giant portions, and addictive behavior.
To evaluate the issue of food addiction, a team of psychologists at the University of Luxembourg recruited a large number of women, both normal weight and overweight, to participate in an interesting project. They were to look at a series of photos of either neutral household objects (a mug, a comb) or a very fattening item of food. When the photo appeared on the screen, they were to press a button as quickly as possible to move on to the next photo. There were two test sessions, one during which everyone arrived at the test site hungry, the other after they’d just finished eating. Here are some of the photos the test subjects viewed.
I’ll bet you know where this is heading. Even though they’d been told to click away from the photos as quickly as possible, there was a direct correlation between a woman’s BMI and lingering on the food photos. The overweight women simply could not help but look at the food longer than the healthy-weight participants, whether or not they were hungry.
Based on previous comparable studies in the area of addiction medicine, this had all the hallmarks of confirming addictive behavior as a major component cause of obesity.
The way forward
So how do you personally approach this if you’re overweight, dieting has never really been successful, and when push comes to shove in the quiet of your room you could admit you’re a food addict?
I’d suggest three steps you can take, and please do all three simultaneously:
- Work with a psychologist trained in cognitive behavioral therapy (in our office, Dr. Janet Chandler or Dr. Meghan Roekle).
- Work with a clinical nutritionist (Marla Feingold, Seanna Tully, Marcy Kirshenbaum).
- Work with a practitioner of Chinese medicine (Mari Stecker, Cindy Kudelka, Helen Strietelmeier). Acupuncture is an especially important component of addiction treatment. In conventional medicine, doctors believe treatment benefits your brain’s neurotransmitter balance. In Chinese medicine, addictions occur because of stagnations of qi (chi),the invisible energy coursing through your body.
If you live too far from WholeHealth Chicago, you’ll need to use the trusty internet to put your food addiction recovery team together. I recommend you begin by locating a good psychologist. Then ask your chiropractor or primary care physician for nutritionist and acupuncturist recommendations.
The main reason for doing everything at once is that effective addiction therapy requires a team approach. The good news is that it can be accomplished in a relatively short period of time. People with serious drug addiction issues go into an intensive rehab program and their lives can be changed in eight to 12 weeks. You can make major changes in your food addiction behavior and dramatically reduce your long-term health risks by crafting your own outpatient rehab program.
Wondering if you’re actually addicted to food? Take this quiz.
Be well,
David Edelberg, MD