The blog Science of Eating Disorders recently had an interesting guest post on Binge Eating: When Should We Call It An “Addiction”?
I think they make a really great point re the difference between overeating and food addiction/binge eating. Unlike the former, where people may eat mindlessly or feel that they can’t turn down the cookies at the office or the dessert after dinner, with the latter (emphasis mine):
individuals often obsessively restrict their food intake and then later binge on high-calorie foods. Like drug addicts, these individuals spend an inordinate amount of time obsessing over food intake and hiding their behaviors from others. They skip out on social interactions to engage in their behaviors.
Furthermore, the way these individuals over-consume food is not reflective of “mindless overeating,” just because tasty food is available at their fingertips; it is ravenous, compulsory, and abnormal. Sometimes food is even tossed away as an attempt to avoid further binge intake, and then subsequently consumed straight out of the trashcan when the individual “gives in” to the behavior.
It seem very likely that the behavior between so-called “normal” eating and addiction is a continuum and it’s not necessarily as simple as whether one “eats out of the trash” or not. But I don’t really understand people scoffing at the idea that people can be addicted to food because their experience is only with theirs or others in the “mindless overeating” group.
What’s more interesting to me in this post, though, is the discussion of deprivation’s potential role in the development of this type of disordered eating. The author of the post suggests that it is the:
intermittent exposure to highly palatable, often sugary foods, often coupled with some compensatory food restriction and significant distress that results in food intake that can in any way be called “addictive”—not simple overconsumption of high-calorie foods. Both caloric restriction and intermittent sugar intake alter dopamine transmission in response to rewards, and intermittent—but not continuous—access to high-fat substances induces the typical “sawtooth” pattern of binge-restrict behavior in animals; reflective of human ED behaviors where individuals restrict food intake in between periodic episodes of binge eating.
Thus, perhaps it is the combination of these two behaviors, bingeing on fatty foods and subsequently attempting to restrict caloric intake, that produces an exaggerated response to food rewards and encourage compulsory food intake akin to compulsory drug intake.
I mentioned a while back that Emily Deans has also written about the link between dieting and “food addiction type behaviors.”
It boggles the mind to contemplate the idea that this theory may have merit. Our war on obesity coupled with the 24/7 availability of hyperpalatable, highly processed food may well be a perfect breeding ground for overeating and potentially food addictions. Anecdotes aren’t “real” [TM] science, but as the poster child for BED *and* someone who started dieting at age 9, it rings scarily true for me.
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! 
Some of this behavior sounds like what one sometimes encounters in internationally adopted children. The advice in that case (today) is to provide a food box to which the child has access at all times. We also know that a mismatch in nutritional status in utero vs early childhood predisposes to metabolic imbalances. It crossed my mind that these various arms of inquiry might learn a little from one another.
Thanks for this, Beth. This is a subject I’ve been looking at for quite a while, and it was quite the controversy at several professional eating disorder meetings I’ve recently attended. I talk about that here: http://www.fitwoman.com/2013/03/25/exploring-food-addiction/.
I guess bottom line is that I wonder at calling this behavior an addiction when, in our experience, a person CAN recover to eat in reasonable amounts the foods they previously felt overly attracted to. Calling it an addiction, to me, sort of takes it out of the realm of possible recovery. What do you think?
I don’t find this at odds actually. I’m with Gabor Mate who talks about the fact that it isn’t the substance per se that is addicting … it’s the behavior around the substance that is problematic. Given that, I personally think that there is a path to recovery that doesn’t include abstinence of problematic food or foods. But I don’t discount the experience of others who feel strongly the other way (e.g., Michael Prager).
I think we need to learn a lot more about this before we can say for sure. But that said, I think that considering a more functional definition of “addiction” is useful. In one of his Recovery 2.0 talks, Tommy Rosen has such a definition: a behavior you continue despite significant negative consequences over the longer term. Clinical folks may object to the “watering down” of addiction in this way (clearly there are differences with withdrawal etc), but I think that the patterns of substituting (e.g. cigarettes for alcohol or sugar for opiates) suggests that it’s not solely the substance at play.
One thing that’s important to recognize too is that there are likely different types of addiction where food is concerned. I talked about this in the past: there can be food/substance addiction (e.g. to sugar) as well as eating/process addiction (e.g., volume). Those of us who are binge eaters may fall more in the latter camp, and we may have an easier time with incorporating “problem” foods compared to the former.
“I don’t find this at odds actually. I’m with Gabor Mate who talks about the fact that it isn’t the substance per se that is addicting … it’s the behavior around the substance that is problematic”
I very much agree with this when it comes to eating disordered behaviours. I’m not sure I entirely agree with Liz, who wrote the post. I’m not sure where I stand (and I don’t know as much about addiction and binge eating as she does, clearly) but I also don’t think it matters all that much what we call it: if it is a behaviour that has negative consequences over the long term, we need ways of fixing it. Overeating or binge eating.
That’s how I feel, anyway.
I’m inclined to think it matters at least a little what we call things. Labels matter, and there is *clearly* an objection to labeling “overeating” as binge eating (recognized now in the DSM 5) or addiction.
And I think that’s right. It may well be that overeating (on one end of the continuum) can lead to binge eating or addictive eating (on the other end), but there are differences in the two, and the ways to fix them are likely different as well.
I found the “your brain on porn” series compelling in this regard. Overeating is something that we may well be evolutionarily wired to do. When faced with surplus food, our lizard brains are like “hey, feast in case of famine” … except the famine never comes.
But there’s a mechanism by which this can go awry. Steven Hayes’ idea of “experiential avoidance” resonates with me as a way to explain this, although I’m sure others have different ideas (Mate’s link re early childhood development being just one).
But you’re certainly right that we need ways of fixing this! And I’m thrilled I found your blog … I can’t wait to read more.
I think there are two main ways we can decide to label or categorize behaviours. Based on etiology or based on the phenotype. Right now, our understanding of etiology is pretty crap. So, the DSM relies on arbitrary behaviours (phenotypes). I think the DSM is crap, frankly, but I think it is important in discourse, online or elsewhere, to take care not to alienate or invalidate others who suffer from similar problems but feel there are some differences in causes or in behaviours. I’m not always good at that, but I’ve come to think that’s an important thing.
Categorizing and labeling can be useful and even important, but I think it depends what the goal is. Like you said, I don’t think focusing too much on it is a good thing.
I don’t actually know a whole lot on binge eating per se (it is just not something I found particularly interesting to understand from a neurobiological basis.) But with regard to:
“I found the “your brain on porn” series compelling in this regard. Overeating is something that we may well be evolutionarily wired to do. When faced with surplus food, our lizard brains are like “hey, feast in case of famine” … except the famine never comes.”
Yeaaaaaaah… I think we should be careful also not to rely too much on the somewhat pseudoscientific field of evolutionary psychology (post-hoc rationalizations). (I didn’t watch the videos, though.)
I’m glad you like the blog! I don’t really write a lot on binge eating, though, not because I don’t think it is an eating disorder or anything, but mostly because I don’t read much about that literature and am more interested in the effects of restricting and purging.
What you write is really interesting and I’ll continue to read and educate myself :)
Cheers!
Tetyana
In 2011 I wrote about novel antecedents food behavior that is considered diagnosable (see link below). The body adapts in many ways to distorted and/or unbalanced eating patterns Hormones profoundly impact and regulate metabolic processes and influence hunger and satiety cues. Other factors that influence metabolism and hunger/satiety cues including gut microbes, endocrine disruptors and persistent organic pollutants. The data is so new, I wonder if there is any research in the eating disorder realm beginning to look at these factors.
What looks like addiction or compulsive eating may be a reflection of far more. As one researcher said last spring when the human microbiome data was published, “we don’t know what we don’t know.”
http://webcache.googleusercontent.com/search?q=cache:8urixfCPDt4J:www.muchmorethanfood.com/pdf_articles/13-16.pdf+&cd=1&hl=en&ct=clnk&gl=us&client=firefox-a
I certainly think those things that you mention are likely in play as far as disrupting our hunger/satiety systems. That said, I do think there’s something of a learned response involved as far as addictive-like eating. But your researcher is spot on!
I am both a recovering drug addict and food addict. I can say with 100% certainty, that in my case at least, food addiction is exactly the same as drug addiction.
The thought processes, obsessive-compulsive nature. All of it is identical.
In my opinion, the same solution applies… complete abstinence from the addictive substance (in my case, added sugars and gluten grains). That’s the only thing that reliable works for any type of addiction.
Several of my friends who are recovering alcoholics / addicts also agree that craving ice cream or whatever feels exactly the same as craving an addictive substance.
Junk foods stimulate the same reward centers as drugs like cocaine. People who are susceptible can be come addicted and trying to exert “willpower” or moderation over an addiction is impossible in most cases.