Weight Maven

Sigh. I’ve been known to dabble in hyperbole now and then, but this August 2nd tweet from Mark Hyman — who is leveraging the concept of “diabesity” to sell books on PBS and elsewhere — pissed me off.

In the article linked in the tweet, Hyman writes:

I’m a food addict. We all are. Our brains are biologically driven to seek and devour high-calorie, fatty foods.

Well, pardon my french, but this is bullshit. Being “biologically driven to seek and devour high-calorie, fatty foods” may be something (I think it’s called evolution), but it is most definitely NOT addiction.

Labels matter

The jury is still out on whether or not food addiction really exists (I say it does), but it’s pretty darn important to not use the term “addict” when it clearly doesn’t apply. And it definitely does NOT apply to ALL of us, in the same way that not all alcohol drinkers become alcoholics nor all drug users become addicts.

So what is addiction really? Here’s the short definition from the American Society of Addiction Medicine (emphasis mine):

Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.

Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.

We can quibble what addiction really is, but I’m putting my stick in the sand that it involves what ASAM describes as the “diminished recognition of significant problems with one’s behaviors and interpersonal relationships.”

Bad science?

So sorry Dr. Hyman … the inability to go through the airport without buying a cinnamon roll (an anecdote he uses in his PBS Blood Sugar Solution special) is NOT addiction. Going for that cinnamon roll could be hunger, or it could be a learned stress response, or it might even be an evolutionary adaptation, but it’s likely not addiction … unless in the process of chowing down you are also blowing off lunch with your travel companion, spending money you can’t afford, or getting home too late to tuck your kid into bed.

If I’m coming off as harsh, I’m sorry. I’ve actually been a fan of Dr. Hyman’s and have seen him speak in person. He’s compelling and attractive … and he has the marketing aspect down pat.

But that doesn’t excuse Hyman from promoting “self-help … disguised as medical science.” Your mileage may vary, but IMO, passing off the desire to eat sugar, fat, and/or salt as food addiction — instead of an evolutionary survival mechanism — is not good science, nor is it good public health. It’s already difficult for some folks to accept the concept of food addiction, and watering it down the way Hyman does will hurt, not help those who are suffering from it.

Epic fail.