Can a doughnut be a drug?
Whether it’s ice cream, chocolate, pickles, or pizza, most of us know the feeling of a food craving. But some people think it’s more than that – they think we can be addicted … to food.
“Addiction” is a strong word. It implies a certain loss of control, and a change in brain chemistry. That’s why the notion of food addiction is debated among California scientists who study obesity and addiction.
Rebecca Wolfson joined Anders Lammers and Anja Strejcek from the News21 program at the UC Berkeley Journalism School in trying to better understand the inner struggle of self-described food addicts – through their stories and through science.
(Note: The subjects in this story have altered names to protect their identities)
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REBECCA WOLFSON: This summer, Jill started an audio diary of the moments she comes face to face with what she calls her food addiction.
JILL: It’s about midnight. I ate ice cream, am watching TV, zoning out... I really just wanted to keep eating – I wanted to go back in the kitchen and eat all the yogurt I bought. I had this really crazy moment of just wishing I could go back to the store and get the cake, and just eat the whole cake…
Jill is 47 years old. She lives in Oakland, and rides her bike everywhere. She’s average-sized, moderately overweight. She describes herself as a compulsive overeater, and a sugar addict.
JILL: It’s June 23rd, about 11:15 a.m. I got the idea in my head last night that I wanted to have sugar, and bought some really gross sugar that I would normally never eat, and I bought like twice as much...
I just made myself sick, and I wonder if it is ever going to end. I feel really hopeless right now about it, and I’m scared, actually.
Addiction runs in Jill’s family. Her father and her grandmother were both alcoholics. Her mother is obese.
JILL: It’s early afternoon, and I went to a 12-step meeting, and I cried and cried. I want to go get some sugar, but I’m going to eat dinner first, and then maybe I won’t go and get some sugar.
So, is Jill really addicted to sugar? There’s no scientific consensus on how the term “food addiction” should be defined, or whether the medical community should consider food an addictive substance at all. Robert Lustig thinks it should be.
ROBERT LUSTIG: You’re all familiar with the basic concept of the first law of thermodynamics...
Lustig is a Professor of Clinical Pediatrics at UCSF. He researches the causes of obesity, and thinks that sugar is one of the biggest culprits.
LUSTIG: In human terms, the standard interpretation of this law is the following: If you eat it, you better burn it, or you’re going to store it. Who believes that? Oh come on, you all do. (laughs) I used to believe that. I don’t anymore. I think that’s a mistake.
While society generally blames rising obesity rates on people’s lifestyle choices, Lustig says these behaviors are secondary to a biochemical process in the brain. Lustig thinks that food – specifically sugar – should be considered an addictive substance. Sugar, especially fructose, the sweet part of it, will cause four phenomena, all of which are necessary for the diagnosis of addiction in animals. According the American Medical Association guidelines, first comes craving; second, binging; third, withdrawal; and fourth, a greater likelihood of becoming addicted to other substances.
LUSTIG: There’s something wrong with our biochemical negative feedback system that normally controls energy balance. And we have to figure out what caused it, and how to reverse it.
ELIZA: I used to have fantasies that the only way I would be able to lose weight, and stop binging, would be to be put in jail. My name is Eliza. I’m 64. And I’m a compulsive overeater. And I have been that way probably all my life.
The white powder that you sniff up your nose or the white powder that you put in your throat – it alters your mood, it makes you a different person. It’s definitely a drug.
Eliza lives in San Francisco, and attends Food Addicts in Recovery Anonymous, or FA, meetings. This support group is a 12-step program, modeled after Alcoholics Anonymous, and it’s one of the stricter food addiction groups.
FA emphasizes abstinence from trigger foods, and requires members to adopt an eating plan with a former food addict sponsor. Like many of the self-described food addicts we talked to, Eliza described her binges as a chance to zone out.
ELIZA: There’s something about the repetitive motion in eating a lot of food that puts you in a place – it’s kinda like you kind of leave your body a little bit. If anyone tries to interrupt me, like on the phone or at the door, I get really angry, because I do not want to be disturbed.
As the medical community debates whether to consider food possibly addictive, studies have surfaced examining brain scans of people who’ve ingested sugar.
One study, published in April by Yale’s Rudd Center for Food Policy and Obesity, found that alleged food addicts exhibited neural activity similar to drug addicts.
Researchers at the University of Bordeaux in France found that cocaine-addicted rats worked harder for sugar than they did for cocaine. Given a choice between sugar and cocaine, rats almost invariably chose the sugar – even when faced with increasing doses of cocaine.
The thing about comparing sugar and cocaine is that, if you’re addicted to drugs, at least you can avoid the corner, or the dealer. When it comes to sugar, it really is everywhere.
WOLFSON: Right now I’m at Safeway in Berkeley. I’m going to start off in the cereal aisle. There are lots and lots of options and possibilities... With lots of colorful boxes. Now I’m going to go look at something that’s supposedly pretty healthy, like Raisin Bran, a generic Raisin Bran, listed under pantry essentials. It’s only a $1.29. And in this box there are four servings. A serving size is one cup. And there’s 18 grams of sugar.
I looked at a diverse sample of cereals that day. I was surprised to see that serving of organic, supposedly heart-healthy cereal has the same amount of sugar as a serving of Oreo cookies. Food companies add sugar to hamburger buns, ketchup, bread – nearly everything.
In his book, The End of Overeating, former FDA Commissioner David Kessler points his finger at food companies, which market and engineer sweet, salty, and fattening foods, in order to hook people, and to keep them coming back for more. Kessler estimates that there are more than 70 million food-addicted adults in the U.S.
Human genetic research, animal studies, brain imaging, and biochemical studies of the digestive processes all indicate that some people could experience addictions to food. But skeptics say that none of these findings are conclusive. The American Psychiatric Association doesn’t currently list food addiction in its manual for mental disorders, even though it’s set to add “binge eating disorder” to its next edition.
RONNA KABATZNICK: Some people can look at a piece of food and think it’s disgusting, but somebody else could think it’s the most desirable and delicious food. So it’s not in the food. It’s really in the behavior, and how we relate to it.
Ronna Kabatznick is a psychiatrist and professor at UCSF who specializes in overeating, and doesn’t believe in food addiction. By calling food addictive, she says it strips people of the power to control their eating. As a psychiatrist, she teaches patients to be mindful eaters.
KABATZNICK: With alcohol or drugs, of course, it’s all or nothing. I mean when you’re addicted, it’s hard to be moderate with alcohol, it’s hard to be moderate with drugs. Those kind of treatments require complete abstinence. With food and eating, you have to eat … I mean, that’s part of how we survive.
For self-described food addicts like Eliza, it doesn’t matter what you call her condition. She loses control, and it interferes with her daily life.
ELIZA: After I binge, it takes about five days to get back to normal. I know that, for five days after I binge, if I feel suddenly uncomfortable, angry or moody, I don’t know if that’s how I really feel, or if it’s because of the food. It plays with my emotions for about five days. That’s a pretty big price to pay for a 20-minute binge.
For those 20 minutes, Eliza says that the sugar takes over. And even though “addiction” is just a word, it raises questions that could help us all better understand our relationship with food.
For Crosscurrents, I’m Rebecca Wolfson.
What are your ideas on obesity and addiction? Can you be hooked on eating? What’s your comfort food? Share your thoughts on Facebook.
And for more multimedia content about food addiction, and to hear the stories of more self-described food addicts visit the Berkeley News21 website. You can also download the Ration's iPhone and iPad app for free.