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Archive for the ‘Food addiction’ Category

Summer Tomato blogger and author Darya Rose asks why “virtually all health and diet advice” seems directed at “perfect” eaters who “eat for one reason and one reason alone: optimal health and nutrition.”

Rose describes mythical “Nutricons” who “are completely rational about their food decisions” and also points out the seemingly Emperor’s New Clothes aspect of what/how we eat:

Nutrition knowledge is meaningless unless we can actually implement it in our daily lives. … Unless you acknowledge that your actions will never be driven by nutrition knowledge, you’ll continue to spin your wheels and blame yourself––instead of the bad advice––each time nature shows you that you’re a human and not a robot.

To get healthy you need to understand what really drives you to eat, because hoping that you will one day be motivated enough to make salad instead of ordering pizza isn’t very rational.

Per Monday’s QOTD I would add that when trying to understand what really drives “you” to eat, you should also consider how alike “you” are to the millions and millions of other people who are driven to eat pizza instead of salad.

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David Despain has a must-read post on food addiction over at his blog. He’s reporting a session at the recent meeting of the American Society for Nutrition, where the discussion seemed pretty much standard (“yes food addiction exists, look at the lights!” “no, food addiction doesn’t exist … we can’t make cheesecake illegal”).

Too bad researcher and Whole Health Source blogger Stephan Guyenet wasn’t part of the discussion. IMO, his comment on David’s post was spot on (emphasis mine):

At its heart, addiction is an excessive motivation to engage in a reward-seeking behavior, e.g. a drug, gambling, etc. Where do we draw the line between normal reward-motivated behavior and excessive reward-motivated behavior? That’s the tough part. There is no clear line for food, but there is also no clear line for drugs or gambling.

Currently, we say someone is addicted when the pull to engage in the behavior is having a serious negative impact on that person’s life. It’s a very subjective definition but it’s still the best one we have. There will probably never be a useful neurobiological definition of addiction, because fundamentally addiction is defined by behavior. …

In my opinion, arguing about whether or not fMRI data supports addiction is missing the point. If someone is stealing TVs to buy crack, who cares what the fMRI says? If someone is leading a normal constructive life with occasional controlled gambling, but his reward centers light up like a Christmas tree when he sees images of a slot machine, is that person an addict? Of course not. …

Some would say “how can you be addicted to a substance you need to consume, like food?” The key is that we aren’t talking about food in general. We’re talking about specific foods that are highly rewarding, and there is no dietary requirement for those foods just as there is no physical requirement for drugs of abuse. I’ve never heard of an oatmeal or lentil addiction. It’s cake, cookies, chips, candy, and that sort of thing that triggers addiction-like behavior.

In the end, I think food addiction is real, but it doesn’t fully explain obesity.

Yeah, well I hope Mark Hyman gets the memo!

Researcher Carl Hart recently pointed out that “80 to 90 percent of the people who actually use drugs like crack cocaine, heroin, methamphetamine, marijuana—80 to 90 percent of those people were not addicted.”

I suspect that if we’re going to make progress on our understanding of food addiction, we’re going to first have to make progress on our understanding of addiction in general. If discussions on food addiction help in this regard, then to paraphrase Martha, that’s a good thing!

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Behavioral psychology blogger Gregory Ciotti explains the concept of supernormal stimulus … and why it suggests your brain just wasn’t built for junk food, porn, or the Internet. In a nutshell, the idea is that things like junk food or porn provide not-found-in-nature stimuli that our lizard brains find hard to resist.

Ciotti doesn’t say that the solution to this is to go all Luddite (or Grok). Instead, he suggests avoiding habituation:

The real enemy here is complacency—you needn’t feel guilty engaging with supernormal stimuli, but you should feel guilty if you allow yourself to become a victim of your habits, instead of the person in the driver’s seat.

Or as Stuart McMillen’s amazing comic concludes:

Only those who can see the supernormal can learn to silence the reptile.

A bit like “all things in moderation” but with a twist?

HT Julianne Taylor.

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Quote of the day

Neuropsychologist Vaughan Bell suggests that the emotional aspect to addiction is more of a problem than the physical withdrawal:

For many addicts, the physical withdrawal is painful, but it’s the emotional effects of not taking drugs that are worse.

Most smack addicts have a frightening pre-drug history of trauma, anxiety and mood disorders. Drugs can be a way of coping with those emotional problems in the short-term.

Unfortunately, in the longer-term, persistent drug use maintains the conditions that keep the problems going. Even for those few that don’t have a difficult past or unstable emotions, life quickly become difficult after regular heroin use sets in.

If you can stay high, you’ll be less affected by the consequences of both long-standing problems and your chaotic lifestyle. If you stop, you feel the full massive force of that emotional distress.

As I’ve said before, food addiction is not as pervasive as some might imply (paging Dr. Hyman). That said, I think there is a continuum and I don’t think it’s a real stretch to see the parallels between what Dr. Bell describes and what some people may experience with food.

Ice cream isn’t heroin, but it’s legal, far more accessible and potentially just as useful as a coping mechanism.

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I must admit to being disappointed at people who view addiction only through a tolerance and withdrawal lens. The most recent of these is James Fell’s Is sugar addictive … with his people “aren’t knocking over convenience stores or fencing grandma’s jewelry” to get their fix, so therefore it isn’t addictive. As if people need to steal given that crap food is cheap and available 24×7!

Fortunately, after reading Fell’s post, I came across this one on craving from Dirk Hanson. Hanson, unlike Fell, has a far more sophisticated understanding of addiction. He was reviewing Marc Lewis’ (a fave of mine) participation in a recent conference on addiction and craving convened by the Dalai Lama.

Lewis on why withdrawal is not the issue:

[Craving is] the one condition all addicts agree is their worst enemy. … This is one place where science and subjectivity have to come together. Scientists need to focus on this, because addicts are completely unanimous about it. This is the enemy. It’s not physical withdrawal symptoms, it’s not relief. It is craving.

And what is:

Craving is such an unpleasant state, that after a while, you end up doing it, you get the drugs. I did opiates, and I would spend hours and hours trying to sit on my hands, trying to watch something on TV, trying to go for a walk, and finally, there’s this thing that keeps rising in the background, and it doesn’t go away. It was a constantly growing tension, an anxiety and discomfort, that came from very deep down. You spend most of your energy trying to hold this thing at bay, and according to the ego depletion literature, you can’t do that for very long. These cognitive control centers just give up. They are limited resources.

I don’t know what my issues are and I don’t really want to fall on the sword to call it addiction. But there’s an aspect to what Lewis describes that really resonates for me. I’ve spent too many nights in a convenience store or similar not wanting anything there but not being able to leave until I bought something that I could consume. And knowing how insane this was.

Now this said, I am completely with folks concerned about the problem of overswinging the pendulum and extrapolating food or sugar addiction way too far (see here and here).

I think the truth lies in the middle.

BTW, I recommend reading Arya Sharma’s post Food and Eating Addictions May Not Be the Same. I would argue that the process addictions (eating, gambling, sex) are just as harmful as substance addictions. Fixating on whether or not there is serious withdrawal or robbing grandma is (IMO) dated thinking.

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I am grateful to Evelyn Kocur of the Carb-Sane Asylum for sending me a copy of her forthcoming e-book, Restriction Addiction. According to Evelyn, the book is:

about how food addiction is really eating disordered behavior brought on by restricting food, not by foods causing physical dependence like alcohol and some drugs.

I’m pretty excited about this! I think that Evelyn and I have meaningful differences about our understanding of addiction in general and food addiction in particular, but I think the link between diet restriction and disordered eating (and obesity) deserves a lot more attention than it has received. I’ve written before about what I call the dark side of dieting … it’s what led my weight gain to look an awful lot like the graph on the right:

graph

Re our differences, I’ll be sharing more in the future after I finish reading Evelyn’s book, but I believe the following from Marc Lewis is fundamental to the issue. Lewis is a former drug addict and now neuroscientist who blogs at Memoirs of an Addicted Brain. He recently participated in a conference organized by the Dalai Lama on Craving, Desire and Addiction and he writes regularly against the disease model of addiction.

Just before the holidays, Lewis announced that he’s planning to write a book about a new model of addiction. His premise:

This book makes the case that addiction results from accelerated learning — the acquisition of thought patterns that rapidly self-perpetuate because of the brain’s tendency to become sensitized to highly attractive rewards. I see this as a developmental process, accelerated by a neurochemical feedback loop that’s particular to strong attractions. Like other developmental outcomes, addiction isn’t easy to reverse, because it’s based on synaptic restructuring. Like other developmental outcomes, it arises from neural plasticity and uses it up at the same time. Addiction is definitely bad news for the addict and all those within range. But the severe consequences of addiction don’t make it a disease, any more than the consequences of violence make violence a disease, or the consequences of racism make racism a disease, or the folly of loving thy neighbour’s wife make infidelity a disease. What they make it is a very bad habit.

I am completely with Evelyn that the recent tendency to attribute overeating to addiction is very problematic. But unless your definition of addiction requires severe withdrawal to a physical substance (mine doesn’t), then I think there is something meaningful to be teased out. Stay tuned!

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Stanton Peele, the psychotherapist who often writes about the flaws in the “addiction as disease” model, posted an interesting article for Psychology Today titled Unbelievable Things About Quitting Addictions. His chief unbelievable thing? That ‘heavily’ addicted people (e.g., drug addicts) often quit addictions more readily than ‘less’ addicted ones (e.g., alcoholics).

His conclusion (emphasis mine):

Forget everything you have learned about the disease of addiction. Then, and only then, can you begin to understand it. The most important thing Heyman found in remission is values, and being in a place in life where you can express and sustain them … And why do drug addicts quit more readily than smokers and drinkers? Because—as Charles Winick pointed out in “Maturing Out of Narcotic Addiction” in 1962—maintaining a drug addict career is too arduous.

As the quote suggests, Peele bases this in part on Heyman’s analysis earlier this year of “four major national US surveys of psychiatric disorders and problems related to substance use.” Heyman’s main findings:

  • addiction is generally not ‘chronic’
  • probability of remission the same each year of dependence
  • treatment generally not needed
  • dependence on legal drugs lasts longer

I’ll grant this model of addiction is controversial, but I find the concept that dependence on legal drugs (like alcohol and cigarettes) is more difficult very interesting. It reminds me of something I wrote years ago about a potential link between our diet and the endocannabinoid system: that the effect (of anandamide, THC’s natural relative) isn’t as strong (reduced potency) but it lasts and lasts and lasts.

Seems to me that it would be quite easy to maintain a career as someone with a dependence — or addiction — to food. And perhaps that contributes to what may make quitting that much harder.

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