Earlier this week, The Atlantic asked Are You Almost Alcoholic? Taking a New Look at an Old Problem. The article explores the usefulness of seeing more of a continuum between being an alcoholic and not being one. The authors write:
Under consideration is a paradigm shift in the way we view mental illness, including substance use. At the core of this new paradigm is the idea that some conditions might be better thought of as existing on a spectrum rather than in terms of discrete categories such as alcohol abuse and dependence. …
We believe that, as opposed to thinking only those men and women whose drinking has progressed to the point where they need help, that many people in the mid-range may also be suffering as a result of drinking. That suffering may take the form of declining job performance and declining health so that the individual does not yet recognize it as being related to drinking.
This makes tons of sense to me and I think it is a useful concept when considering food addiction as well.
But first, a standard caveat. “Food” addiction is a terrible term; people aren’t addicted to most food. For those with issues, it’s probably combinations of fat, sugar and salt in processed foods that are the problem.
Second, I am with Stephan Guyenet that it is unlikely that “obesity is food addiction per se” but that “a subset of obese people can be addicted to food.”
But I think he’s working from an academic’s perspective with this argument:
If I took a person’s cola away, would they get the shakes? Would they break into a convenience store at night to get a cola fix?
He must not know any alcoholics … they don’t all get the shakes when deprived of alcohol. Nor does he probably know too many folks with food issues. They don’t NEED to break into a convenience store to get a fix … there’s one ALWAYS open! Not to mention cheap (hello Taco Bell 4th meal).
Finally, I’m also with Michael Prager who suggests that whether or not you believe food addiction exists, treating it as if it did can be incredibly helpful.
Signs you’re on the wrong end of the continuum
The article in The Atlantic says that these are some of the signs that someone is inching close to the “almost alcoholic” end of the spectrum:
- You drink to relieve stress.
- You often drink alone.
- You look forward to drinking.
- Your drinking may be related to one or more health problems.
- You drink to relieve boredom or loneliness.
- You drink to maintain a “buzz.”
- Your performance at work is not what it used to be.
For me, replacing “drink” or “drinking” with “eat” or “eating” resonates. I think it’s clear that some of us, not all, are behaving in a way that is counter to our health but we seem unable (or unwilling) to change.
Are all overweight or obese folks addicts? No. Is it useful to consider a continuum between so-called “normal” eating and disordered eating that includes addiction? I say yes. And I think it is food reward run amuck.
That said, I do not yet believe that total abstinence from problematic food stuffs is necessary, although for some it is helpful.
Yes, it’s a slippery slope (still need to write the post about my 20 pound swing over the holidays). But more about that in a future post.
Photo credit: Alan Cleaver
Weight Maven is written by Beth Mazur. Beth believes that obesity is more symptom than cause and that the real problem is our Western diet -- especially sugar, refined grains, and industrial oils. Beth writes about nutrition, ancestral health & food policy. And cats! 
I too, and lots of us I suspect, can relate to this continuum idea, Beth. I like your extension of the idea to food. Thanks for picking up on it. Can’t wait to see the post about your holiday ‘swing,’
I believe people can be addicted to food to varying degrees. I experience it myself with certain foods and so I no longer keep them in my pantry. But if everything you eat can trigger you to binge, how do you deal with that? Unlike an alcoholic, who can avoid temptation by not having booze stocked at home and by avoiding places that serve it, we all have to eat. How do you help someone who has a severe food addiction?
I wouldn’t guess that there are many folks whose problems with food include having *everything* they eat trigger them. The comment I linked to at the end suggests there’s a range of reactions to problem foods. Harry can eat chocolate every night no problem. But he has clients that abstain from their problem foods entirely. Me, I found that I can handle a meal once a week or so, more if I’m careful (which I wasn’t at Xmas … hence the major slip).
As far as treatment, there are different options. Michael Prager found help via 12-step and other spiritually based programs. I found help via neurofeedback. For me at least, part of it also involves eating mostly nutrient-dense whole foods and working on keeping stress low so that when I do get emotionally triggered (not food triggered) I have a chance at not responding with food.
It takes the Atlantic to point out that the absolute cutoffs that science requires are not applicable to human reality? Sigh.
Semi-related: have you encountered any more complete commentary or analysis on the mentioned study in this article: http://www.medicalnewstoday.com/articles/242622.php ?
Sigh indeed. Defining addiction for the new DSM is apparently as ornery as defining suitable carb levels for paleo! And no, that study was new to me, but interesting!