15-14 Story 1: Food Addiction

 

Synopsis: Scientists are learning that some people can be physically addicted to certain kinds of foods, especially highly-processed foods, and suffer withdrawl when they can’t have them. Experts explain the brain chemistry of food addiction, how it is virtually identical to the chemistry of drug addiction and alcoholism, and what it means for the nation’s fight against obesity.

Host: Reed Pence. Guests: Dr. Ashley Gearhardt, Assistant Professor of Psychology, University of Michigan; Dr. Vera Tarman, Medical Director, Renascent Addiction Treatment Center, Toronto, and author, Food Junkies: The Truth About Food Addiction

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Food Addiction

Reed Pence: Most everyone is well aware of the toll exacted by addiction. Drugs and alcohol, and behavior such as gambling are all well documented addictions that can ruin the lives of those afflicted as well as their families. But does addiction go farther than that? Some researchers say it’s played a role in America’s obesity epidemic. They’re finding that it’s possible to be addicted to food.

Ashley Gearhardt: It’s a very controversial line of research, but it’s been a very flourishing area in the last few years where there is a growing body of science that suggest that maybe these really processed foods trigger our brain and our body and our psyche in a way that really resembles drugs and abuse or things like cigarettes or alcohol.

Reed Pence: Dr. Ashley Gearhardt is assistant professor of psychology at the University of Michigan.

Ashley Gearhardt: So I think it’s the idea that how could you be addicted to something that you need to survive. Can you be addicted to air? And that’s why I think our work is really important is that were seeing that it isn’t all foods that people are struggling with there’s more nutritious foods that have been around for generations and centuries like fish, and meat, and nuts, and fruit and vegetables –people just don’t seem to lose control or eat those in an addictive like way. In contrast, in the last few decades we’ve had an explosion of foods that have been engineered and designed to be hyper-rewarding, hyper-palatable. And it seems like it’s these processed foods that people struggle with. What’s important is we don’t need those kind foods to survive. We eat them more for pleasure than we do for sustenance.

Reed Pence: And when we eat those pleasurable foods, the chemicals released in the brain are the same ones released when addicts use drugs.

Vera Tarman: The actual chemicals that were talking about are primarily dopamine. Dopamine is that kind of giddy excited thrilled feeling that you get when you have a bunch of candy for example, or if your using drugs that you get with cocaine.

Reed Pence: Dr. Vera Tarman is medical director of the renascent addiction treatment center in Toronto and author of the book, Food Junkies: The Truth About Food Addiction.

Vera Tarman: We also can get endorphin high which is you know that after you’ve had a big tub of Hagen daaz or some kid of ice cream you get that kind of dulled out, glazed out, numbed out feeling that’s the endorphin bit that you getting. And that’s the same thing that you get when do too many vicodin, so basically the opiates. And then you also get indirectly serotonin, which is that kind of that sleepy feeling after pasta or turkey or something like that.

Reed Pence: There’s a very good evolutionary reason that occurs. If eating weren’t pleasurable, we wouldn’t eat. But Tarman says now there’s a major difference–food isn’t the same as it used to be.

Vera Tarman: With the food that were eating today, the engineered food from the food industry, we’re looking at foods that are more potent then just apples and vegetables, and you know, basically real food that we were eating a hundred years ago. Were looking at foods have been engineered to kind of hijack this normal pleasure that we have been eating, so that it becomes a more euphoric experience, a more comforting experience, and this is why people use food for comfort or for self medication. Were looking at an industry, a food industry that has been deliberately engineering foods to become drugs. I mean they don’t call them drugs, they call them hyper-palatable foods, but for some people who are vulnerable, they act like drugs.

Reed Pence: Tarman says human evolution has set up the brain to prefer foods that served us well in our caveman past–foods that are energy dense: sugars and fats to store up for the inevitable famine. However, she says today’s engineered, processed foods are simply too enjoyable. In some people, they can overrun the brain’s signals that say, “I’m full.”

Vera Tarman: I’m convinced that we have finely tuned hormonal system that makes us want to eat when we’re hungry and stop when we’re not. And if you are eating foods that make you want the euphoric effect, it’s bigger then the ability for us to say no, something’s wrong then with this sort of checks and balances of our hormonal system. And what ends up happening is that people who are food addicts are still after the punch, the drive or they don’t wanna crash, ‘cause when you go up too high you’re gonna go lower. And they don’t wanna go lower, they don’t wanna stop eating, because what’s gonna happen: I’m gonna feel bad. They’re full. This is the thing that people who aren’t food addicts don’t, can’t get: it’s not like the person is eating bon bons all night and enjoying themselves watching TV. At a certain point they’re full, and they wish they could stop, but they can’t stop . It’s just like the alcoholic or whoever, they don’t wanna stop because of what’s waiting for them which is basically the crash or the come down.

Reed Pence: But can people truly be addicted to food in the same way people are addicted to drugs or alcohol? Gearhardt says yes.

Ashley Gearhardt: We take those same exact diagnostic criteria that we’ve used to diagnose alcohol addiction, or cigarette addiction, and we apply that to eating behavior and specifically consumption of these kind of highly processed foods. And we are finding that somewhere around 7 to 10% of people seem to meet that diagnostic cutoff for what we qualify as an addiction for other substances. What’s really interesting is it does seem to go up. The prevalence rates of this addiction to these certain foods seems to go up in people that are struggling with binge eating or are struggling with obesity, but we also see evidence of addictive like eating even in children and that’s really concerning to us.

Reed Pence: Tarman says people who love food aren’t necessarily addicts, if food isn’t taking a toll on daily life. She says if someone goes on Weight Watchers and it works, they’re not a food addict.

Vera Tarman: It’s almost like there’s a continuum, and the continuum is comfort eating, just eating for pleasure, maybe overeating a little bit on one side all the way to being unable to control and being totally obsessed on the other side. It’s just the same as drinking. You know, what’s the heavy drinker versus the alcoholic — how do we know? We basically measure it by behavior, like we do the DSM5 and if the person fulfills particular criteria then ok ,they’re addicted.

Ashley Gearhardt: Some of the symptoms that we look for are things like some of these core characteristics we see across addictions are that people start to lose control over their consumption. So somebody struggling with alcohol would say “oh I’m just gonna have one glass of wine tonight,” and then they drink the whole bottle. So, something similar to that with eating is perhaps saying “Ok, I’m only gonna have, you know, a little slice of cake.” But then they kind of lose control and eat maybe the whole cake or half the cake. Now we see things like, even though they might be having really significant consequences, maybe health concerns like diabetes or psychological concerns like depression or guilt shame related to their eating, they can’t cut down, even though they really want to and they try a lot to do so.

Reed Pence: Gearhardt says food addicts will also go through actual physical withdrawal if they cut back on processed foods and try to eat healthier.

Ashley Gearhardt: They report feeling agitated, irritated, preoccupied, elevated cravings for the foods, things like headaches or difficulty sleeping. And we also have people reporting things that might resemble tolerance, and so this is where you need more and more of the substance to get the rewarding effects that you want. So, for something like cigarettes, you used to smoke, you know, three cigarettes a day and now you’re up to half a pack, and if we check in with you in a couple years you might be up to a full pack. We see something similar sometimes with food, that the binges that people are consuming get larger and larger and larger over time. And generally we might just see this and in our population as a whole when we look at our portion sizes for these kind of highly processed junk foods they keep getting bigger and bigger and bigger.

Reed Pence: Tarman says the biggest addictive culprit is sugar, and foods that are loaded with sugar. Gearhardt’s team has carried out two studies to find out which foods cause the most trouble for a broad range of people. The results are really no surprise.

Ashley Gearhardt: Chocolate, pizza, french fries all those kind of foods that are processed that we don’t necessarily find in nature, that are foods that we’ve created in our modern society that are sold by the industry and that are designed in a lab to make sure that they are as rewarding as possible.

Reed Pence: Beans, broccoli and cucumbers were least addictive. Gearhardt then narrowed the analysis even more, and included only people who showed a tendency toward being a food addict. Her group found another strong trend.

Ashley Gearhardt: The foods that they found most problematic were foods that had high glycemic load. And what this means is that when they eat this food, they get high blood sugar spikes, so these are often processed high carby, high sugar foods that those foods seem to be particularly problematic for our most addicted eaters. What’s interesting about that is, when we look at drugs and abuse, one of the things that makes them the most addictive is how rapidly they hit your system, how rapidly they’re absorbed. The faster they’re absorbed, the more addictive they are. It’s kind of like cocaine. If you chew a coca leaf people don’t really seem to get addicted to it, but if you refine it into cocaine it hits your system really rapidly. What were seeing is this similar kind of blood sugar spike when it’s elevated. When it’s this rapid absorption of the sugar into the system those are the foods that the addictive like eaters are really struggling with.

Reed Pence: But how does food addiction start? We’re all exposed to food, obviously. We all have to eat. But it could be that a combination of genetic propensity and early, repeated exposure to junk food could add up to trouble later.

Ashley Gearhardt: Kids, especially adolescents, seem to be really vulnerable to addictive substances. Their brains aren’t fully developed. Anyone who has a teenager knows that they’re really focused on reward, and maybe a little bit impulsive from time to time. And what we see is that when they are exposed to things like alcohol or cigarettes at these ages, they’re at greater risk for developing substance abuse problems in the future. So, one thing that really concerns us as this research continues to grow that finds that these processed foods do have an addictive potential, is what does it mean that so many children are so heavily exposed, heavily targeted to these kind of foods? Does that put them at a greater risk for developing lifelong addictive like patterns of eating?

Reed Pence: If all this is true, the outlook for the future isn’t promising. Gearhardt says we know what foods are less addictive and less likely to cause obesity–fruits and vegetables, nuts and lean meats. But it’s economically more difficult to eat those rather than junk foods these days.

Ashley Gearhardt: Right now, the environment is really kind of unbalanced where those foods are more expensive. They’re not as available. There’s a lot of factors that go into that. But when we look at things like cigarettes that have been big public health burdens and continue to be so, we look at what helped us. What helped us get to a point where we’re at the lowest levels of smoking that has ever existed in the United States? And some things to consider possibly are things like restriction of marketing of these potentially addictive foods to children. Right now, teenagers see about 6000 advertisements each year for most of these junk foods that’s not carrots and apples that are being advertised but your Big Macs and your Slurpee’s. So, when it comes to targeting our kids I think it’s really important to consider what we’re okay with.

Reed Pence: Gearhardt says we also might want to consider changes to food economics.

Ashley Gearhardt: The junk foods are pretty heavily subsidized. They’re kind of artificially cheap. So, places like California have been passing taxes on sugar sweetened beverages. It would be really interesting to see what kind of impact that has, or whether that improves public health. We would never advocate, you know, throwing people in jail, you know, for passing out candy on Halloween. But we do want to think about our environment and how lopsided it is right now.

Reed Pence: Gearhardt says the psychological environment is also tough for people who are struggling with their eating behavior. We impose a narrative on them that’s often not true.

Ashley Gearhardt: We say things like people just don’t have personal responsibility, or they’re weak willed, and you know, that’s really a narrative that we’ve had with every addictive substance at some point. Of course, people are responsible for making changes in their life, but when we understand that there is something about that substance, there’s something that cigarette or that drink of alcohol that can hijack their brain in an addictive like way, it isn’t as easy as just telling people to stop. So, what we think about in our lab is what is really gonna help people achieve the healthiest life possible for them. And one thing that we’ve seen with addiction that’s really important is what kind of environment that we all live in. So, right now the environment for food is really set up for all of us to kind of really always struggle with trying to eat healthily. And so one thing we think about is are there ways that we can improve our environment to really help people reach their goals so they’re not starting with the world kind of against them.

Reed Pence: So it may be true that “everything in moderation” isn’t as easy as a lot of us think. You can find out more about all of our guests on our website Radiohealthjournal.net. You can always find our shows on iTunes and Stitcher. I’m Reed Pence.

 

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