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    Could You Really Be Addicted to Food?

    About two years ago, I posted a discussion on my Diet Community asking WebMD members if they thought they were addicted to sugar. The board lit up like Times Square, with men and women of every age swearing that cookies, candy, ice cream, buttered bread and chips were more like crack than food products.

    I hear it all of the time. A frequent lament is “If I even see the stuff I’ve got to run the opposite direction or there’s no stopping me.” Others note “After I get a hit of that cake, I go into a La La land of pleasure. That is, until I wake up and realize what I’ve just done to myself.” And then there’s “I just can’t seem to get enough of it. I keep praying that after this binge it’s over,I’ll never do this again. But then I just want more.” Doesn’t this sound a lot like the language of substance abuse? Makes you wonder. Well, you can stop wondering. Now there’s a hot new science study that suggests you may indeed be experiencing an addictive process in your body. Let’s see what all of the fuss is about.

    chocolate milkshake

    Photo: Hemera Technologies

    For some time now, scientists have been chasing down compelling parallels between the brain functioning of drug abuse and that of addictive-like eating behaviors. Just recently researchers have released findings of a study, which will appear in the August issue of the Archives of General Psychiatry, in which addictive eating brains respond to food cues with a similar brain circuitry pattern as substance abusers. When these people saw food they craved, their brain’s reward centers went into hyper-drive, similar to a drug abuser when in the presence of their drug of choice.

    In the study, 48 women spanning the range from lean to obese, were evaluated with a special test, the Yale Food Addiction Scale, to determine their level of perceived addiction. This was then compared with any neural activation noted using a functional magnetic resonance imaging device (FMRI) when these women were subjected to cues about an impending delivery of a delicious chocolate shake versus a tasteless liquid, or the actual consumption of the shake versus the tasteless liquid.

    Lo and behold, the women with the highest addiction scale score also had the most impressive activation in those parts of the brain most associated with reward and the motivation to feed. These brain centers (anterior cingulate cortex, medial orbitofrontal cortex, amygdala) are also the same ones implicated with activation in substance abuse. Wait, there’s more. Once the addictive-eaters were consuming the chocolate milkshake, the parts of the brain that control satiety and thus help us rein in further eating, actually showed decreased activity. They weren’t firing on all cylinders and thus these women didn’t have the same braking system as the non-addictive eaters. They just kept consuming and then wanted more. Sound familiar?

    What can we learn from this study? First, the researchers have made history by showing a correlation between a person’s self-perception of addictive-like feelings toward food (the Yale assessment) and actual measurable brain activation. Second, the study also validated the scale since there was a strong correlation between high scores and neural activation. Third, weight was not correlated with score. That means that a lean looking person may have strong addictive tendencies but has learned how not to succumb to addictive-like eating. Hey, there’s hope!

    So here we sit in a home and work environments chock full of endless cues to overeat. If you’re one of the high scoring food-addictive folks, these are rough waters to navigate. Clearly, it’d be a great idea if the countless commercials and ads pushing the food addict’s “crack” would end, making it easier to stick with a healthier program. Don’t hold your breath.

    So, is this all about personal responsibility? Here’s what the researchers concluded:

    “Further, if certain foods are addictive, this may partially explain the difficulty people experience in achieving sustainable weight loss. If food cues take on enhanced motivational properties in a manner analogous to drug cues, efforts to change the current food environment may be critical to successful weight loss and prevention efforts. Ubiquitous food advertising and the availability of inexpensive palatable foods may make it extremely difficult to adhere to healthier food choices because the omnipresent food cues trigger the reward system. Finally, if palatable food consumption is accompanied by disinhibition [loss of inhibition], the current emphasis on personal responsibility as the anecdote to increasing obesity rates may have minimal effectiveness.”

    As a physician and scientist, I am intrigued by this new research. Look, everyone’s different. There’s no doubt that there are people who have a strong biological drive toward addictive eating behaviors. For that matter, there’s probably an addictive eating spectrum, with plenty of folks under the bell shaped curve as well as outliers. We’ll probably find out that this addictive tendency has both innate genetic as well as environmental mediators. The question right now is what to do?

    While we wait patiently for more great science to help guide us, I suggest that people who feel like food addictions are ruling and ruining their lives, do the following:

    Take the Assessment:
    Here’s the actual Yale Food Addiction Scale Survey. Have a look and see how many questions you’re answering positively. Academicians are using this tool at present, and thus the formal interpretation would require a professional. However, you can get the general gist of it with your own review. For most food addictive people, this validates how they’ve been feeling all along.
    Take Control:
    Just because you have this problem doesn’t mean you have no control. You do and you must take control now.

    1. Clean up your environment: If food cues get you going, eliminate them wherever you possibly can. Get rid of any addictive food substances in your living and working environment. Clearly, you can’t control everything, but you can seriously decrease the tendency toward addictive eating by eliminating as many food cues as possible.
    2. Arm yourself with a refocusing mantra: In those circumstances when you simply cannot control all food cues (e.g. theater, mall, dinner party, grocery shopping), it’s helpful to chant some kind of inner dialogue that helps to coach you through the tough times. For instance, “I may not be able to control everything that happens to me, but I can control my response. And I will.”
    3. Blow off the ads: Try to decrease your exposure to food ads and cues. TV is the worst. It’s just round-the-clock cues to overeat. If you’re a CSI Miami-aholic, then see if you can record the show and then you can quickly skip the ads since it’s now under your control.
    4. Keep your eating simple: Plan what you’ll eat each day. Avoid refined and processed foods which are the most addictive. Parsnips don’t cue you up to overeat. People who wing it will fall prey to food cues.
    5. Create the right support system: You need to eliminate or minimize your time with any enablers in your life. This is a tough one as it involves family and friends. But, they’re not helping if they continually push food at you when you make it very clear that this is not working for you. Hang out with health and fitness minded folks who get it with you and are there to support you.
    6. Stay vigilant: Watch out for hidden surprises throughout the day. The girl scouts show up at your door. Buy the cookies and never ever let them into your home. Immediately march to a skinny neighbor with football playing sons and hand them off. You have to think fast on your feet. When you’re thrown a food cue from left field, say your refocusing mantra to yourself right away. Take a deep breath and move on. You have to be alert and vigilant. One slip and you’re sliding into another binge.
    Be Patient:
    This is work. I never said it was easy. But come on, what worthwhile thing in your life have ever done that didn’t require work? So, every day, practice these skills. You’ll have good days as well as funky ones. That’s normal. Just keep practicing. The reward is to know you have the inner power to do what it takes to pass up that junk food and instead achieve the mental and physical fitness, energy and vitality you so richly deserve.

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