Recently, the Center on Addiction put forth a report that examines how our knowledge of the causes and mechanisms of substance abuse might increase our understanding of excessive eating, both of which are significant health concerns and challenges many in the U.S. must face.
The burgeoning obesity epidemic across the nation has encouraged scientists and health providers to investigate how individuals’ unique vulnerabilities interact with the contemporary food environment and contribute to unhealthy overeating. For this reason, food addiction has become a new field of study, with experts examining these eating patterns and behaviors within the addiction model.
The report identified several factors, defining symptoms and biological mechanisms of food addiction and how they overlap with eating disorders and substance abuse.
About Food Addiction
Food addiction is defined as a clinically-significant dependence on eating, which can be both psycho-emotional and physical, of sugary, fatty, processed, and highly palatable foods. Although it is not officially recognized as a disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM), it can be measured using the Yale Food Addiction Scale.
This instrument closely resembles the diagnostic criteria in the DSM for substance use disorders. While extensive research into food addiction has begun relatively recently, much has been discovered about unhealthy eating patterns and their relationship to other manifestations of addictive behavior.
However, it’s important to note that not all overweight individuals eat in ways that reflect an addiction or eating disorder. Furthermore, not all people who meet the criteria for food addiction are overweight or obese. Instead, these are complex human conditions with factors that often partially overlap and require highly-tailored interventions.
The knowledge obtained from years of research, treatment, and work in substance abuse may help manage food addiction and the food environment in the U.S., a problem that contributes to unhealthy eating and a myriad of life-threatening and costly health outcomes.
The addiction paradigm also might help address the stigma and challenges that individuals with food addiction have in managing these significant threats to their health and emotional well-being.
Similarities Between Food Addiction and Substance Abuse
An increasing amount of evidence has suggested there are remarkable parallels between food addiction and substance abuse, such as the following:
Effects on the Brain’s Reward System
The American Society of Addiction Medicine (ASAM) has adopted a rather broad definition of addiction. This definition comprises drug, alcohol, and behavioral addictions, including food, sex, porn, shopping, and gambling. Moreover, the effects that addictive substances and behaviors inflict on the brain are quite similar.
Alcohol, drugs, and, to a lesser extent, certain processed foods flood the brain with the feel-good neurotransmitter dopamine, impacting regions responsible for feelings of pleasure, reward, and self-control. Over time, both the brain’s structure and function are altered, and dopamine receptors are decreased. This overall effect leads to drugs, food, and other substances becoming less enjoyable but still ferociously desired.
As a result of the brain changes mentioned above, compulsive overeaters often find themselves craving sweet, salty, processed, or high-calorie foods, not unlike how a person addicted to heroin craves their next fix. In animal research, rats given sugary drinks displayed addictive behaviors such as bingeing when sugar was accessible.
Indeed, in a study by Yale University scientists, the mere sight of a milkshake could activate the brain’s same reward centers as cocaine among those with addictive eating patterns.
According to some experts, food is believed to be more addictive than crack. At the same time, two-thirds of U.S. adults are considered clinically overweight or obese.
Tolerance and Withdrawal
Hallmark symptoms of addiction include tolerance, dependence, and withdrawal. Tolerance occurs when a person needs ever-increasing doses of a substance to experience the sought-after effects.
Dependence is a condition in which the brain and body have become accustomed to a substance’s presence and can no longer function correctly without it. This condition leads to highly unpleasant withdrawal symptoms when a person suddenly stops using the substance “cold turkey.”
In research, rats given sugary and fatty foods exhibited a strong desire for more generous amounts, along with withdrawal symptoms, such as anxiety, depression, and shakiness, when they no longer had access to the food. This result might explain why individuals who eat a lot of sugary or processed foods crave more of those items, even when they are motivated to curb their habits.
Repeated Attempts to Curb Habits Have Failed
For both drug addicts and overeaters, willpower alone often isn’t enough to quit. And many of those who lose weight gain it back, and sometimes more. Without permanent changes in coping mechanisms and lifestyle, both types of addicts are likely to engage in multiple efforts to stop engaging in addictive behaviors, only to encounter relapse.
Stigma and Shame
The excessive use of food or substances can involve feelings of guilt, shame, and secrecy. Drug addicts frequently withdraw from loved ones in order to conceal the extent of their substance abuse. Food addicts may similarly hide evidence of a binge, eat in isolation, and feel ashamed after eating, encouraging more compulsive eating.
Many neglect activities they once enjoyed due to embarrassment about their weight or obsessive eating habits. And while studies have shown that drug abuse carries a severe stigma, weight bias is also common in school, workplace, and healthcare environments.
Continuing the Behavior Despite Adverse Consequences
Drug addicts and alcoholics will often continue using even after losing nearly everything that was once deemed to be important. Although food addiction may not result in terrible costs such as problems with loved ones or legal issues, overeaters often encounter severe health problems related to obesity, heart disease, diabetes, and exhibit an overall lower quality of life.
Pervasiveness of Comorbid Disorders
It is thought that at least half of all substance abusers also suffer from co-occurring mental health issues. According to some studies, it is also common for overeaters to experience other mental health conditions such as depression. They are also more likely than others who are unaffected to meet diagnostic criteria for binge eating.
Knowing all of this makes it easy to precisely see why losing weight is so difficult for many people. The same factors that cause a person to struggle with a lifelong battle with substance abuse are at play when one eats fatty, sugary, high-processed foods. And although there are undoubtedly notable differences between drug and alcohol abuse and excessive eating, the similarities have become increasingly hard to ignore.
Finally, it is worth noting that process addictions, such as obsessive eating and substance abuse, frequently occur together. The same brain changes, biological and genetic propensities, and impulsive behaviors exhibited by those who experience either of these disorders may contribute to the other’s development.
Food Addicts in Recovery and Substance Abuse
Because there are so many factors shared between food addicts and drug and alcohol addicts, those in recovery from food addiction must avoid using substances and get treatment for these habits if they arise.
Moreover, experimenting with or using substances regularly is more likely to lead to a relapse related to food addiction. For this reason, those in recovery should receive comprehensive, long-term treatment for both disorders concurrently.
Treatment for Food Addiction and Substance Abuse
Fortunately, both food addiction and substance abuse can be treated with a combination of behavioral therapy, counseling, and group support. Just Believe Detox and Just Believe offer programs intended to treat both substance abuse and co-occurring mental health conditions such as overeating and other eating disorders.