Weight Maven

I finally got a chance to listen to Sean Croxton’s podcast with Dr. Vera Tarman titled Understanding Food Addiction.

Dr. Tarman has focused her medical practice on addiction treatment and recovery and is the founder of Addictions Unplugged, a website that “serves as a portal and discussion forum for medical professionals, front-line addiction workers and those affected by addiction.”

If you’re interested in the subject, I encourage you to give the podcast a listen. It’s a little long (about 75 minutes), but Dr. Tarman covers the subject fairly well.

Here are a couple of highlights I found particularly interesting.

Defining addiction. Dr. Tarman likes the American Society of Addiction Medicine’s newer definition of addiction, which includes the ABCDEs:

• Inability to consistently Abstain;
• Impairment in Behavioral control;
• Craving; or increased “hunger” for drugs or rewarding experiences;
• Diminished recognition of significant problems with one’s behaviors and interpersonal relationships; and
• A dysfunctional Emotional response.

Dr. Tarman also mentioned Food Addicts in Recovery’s Are you a food addict? quiz. The quiz is a bit of a mixed bag IMO. Some of the questions are overly general: who wouldn’t answer yes to “Do you eat when you’re not hungry?”

On the other hand, other questions get more to the heart of it. Like “Have you ever discarded food, only to retrieve and eat it later?” or “Have you ever hidden food to make sure you have ‘enough?’” [In case you're wondering, I'd have answered yes to both of these in the not-so-distant past.]

Checks and balances. Dr. Tarman spends a lot of the first part of the podcast explaining the various structures of the brain and pointing out that the problem with food addiction is typically not addiction to “food” (as we’ve known it for hundreds or thousands of years) but is more about newer processed “food stuffs” especially those full of sugar. [J Stanton's Why Snack Food Is Addictive is a good read on this subject.]

She points out that our brain normally handles appetite nicely, but that these modern processed food stuffs can disrupt the brain such that the “no’s” to food just aren’t as loud as the “yes’s” and we wind up continuing to eat ice cream for example when we probably wouldn’t continue to eat brussel sprouts.

Magnification of neurochemicals. Addiction is about the addictive substance but also about the amplification of neurochemicals like dopamine, serotonin, and endorphins. I thought Dr. Tarman’s discussion of two ways that this magnification/amplification can occur compelling. First, a concentrated amount of a substance (e.g., cocaine, alcohol or sugar) can affect the brain. And second, the substance can get to the brain really quickly.

Your mileage may vary, but I think it’s fairly clear how industrial food can apply in both of these cases.

Food addiction vs eating addiction.

Another point that Dr. Tarman made that was a bit of an “a ha” was that people can get addicted to eating volumes of food. This relates to an important distinction in addiction study between substance addiction and process addiction. Cocaine, alcohol, or nicotine are clearly substance addictions, while gambling, sex, or shopping would be process addictions.

Food addiction is perhaps unique in that it can can be both. In Food and Eating Addictions May Not Be the Same, Dr. Arya Sharma distinguishes between food addiction (substance) and eating addiction (process). Discussing the latter, Dr. Sharma writes:

“eating addicts” can get “addicted” to the process of fantasizing about, finding, buying, preparing, and eating food - it may not be one food that they are addicted to, because their addiction it to the processes around acquiring food and eating it and not to a particular food or food group.

Withdrawal. Many people think you can’t be addicted to food because there is no withdrawal as there is for other drugs. Earlier this spring, food reward researcher Stephan Guyenet essentially made the point that addiction means the DTs:

The reward system motivates you to seek the soda and cake, and the hedonic (pleasure) system encourages you to keep consuming it once you’ve begun.

But is this the same as addiction? 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? I’m going to say no.

First of all, no one needs to break into a convenience store to get a cola fix … that stuff is available at very low cost 24×7! In fact, I think it’s the easy access and low-cost that makes industrial food so problematic.

Re the shakes, Dr. Tarman says that there actually is a clear withdrawal experienced by food addictsm, it’s just not the kind we associate with hard-care drug use. And curiously, it’s very common for other addicts to substitute sugar when trying to get off their substance of choice.

As an aside, the fact that most people do not become addicted to food does not mean people cannot become addicted to food. Maybe it’s a continuum of behavior or maybe it’s an issue with the susceptible person’s brain chemistry, but it seems clear that a percentage, hoewver small, of the population is at risk just as with other substances.

Abstinence. Dr. Tarman is pretty adamant about needing to abstain from the substance/process of addiction and that what that is is different for different people.

I’m not convinced on this point. I still like the idea of “intelligent control” of hyperpalatable foods, and I suspect that a Stanton Peele-like approach may be more useful especially when it comes to food.

As I reflect on my post-Christmas lapse, it’s occurs to me that eating hyperpalatable foods is like swimming at a beach with posted riptides. You can be safe, you can get caught and if you know what to do you’ll be fine, or you can be in deep doo-doo.

To extend the metaphor, staying on the beach is safe, but if you want to go in the water, there are probably things you can do to better handle the riptide when it occurs. Peele calls this natural remission. Stay tuned for more thoughts on that subject.

Photo credit: Alan Cleaver