What Obesity And Addiction Have In Common
While "food addiction" is a widely used term in the dieting vernacular, scientists are torn on the matter of whether food addiction is a true addiction or not. Of course, some of the similarities between the two conditions are obvious.
For instance, both seem to arise from connections between underlying genetic vulnerabilities, like "thrifty genes," and environmental opportunities that allow those vulnerabilities to manifest, like access to mood-altering substances or access to high-fat and high-sugar foods.
Likewise, in both cases, earlier exposure invites a worse outcome. Having your first drink at a younger age drastically increases your risk of alcoholism, and childhood obesity mightily raises your risk of remaining obese as an adult.
Food and drug addiction can also both wreak havoc on nearly every area of a sufferer's life, potentially leading to depression, disability, feelings of shame or guilt, problems fulfilling responsibilities, sexual and relationship problems, and social isolation.Both behaviors also seem to have a physiological basis. One rat study found that "addicted" rats would approach highly palpable food even when they received a foot shock as they were doing so, a finding which researchers noticed was strikingly similar to the results of an earlier rat study that found a similar pattern when rats were given cocaine.Other research suggests that food and drug addictions may have similar psychological and neurological underpinnings. For instance, one study showed that a family history of alcoholism raised one's risk of obesity, and others have shown that both addicts and the obese tend to display personality traits like lower self-control and reward sensitivity and higher negative emotionality and neuroticism.
MRIs of the brains of addicts and obese people also revealed shared differences in reward processing and an attentional bias in response, respectively, to drug or food cues.
One interpretation of these findings is that addicts and obese people may experience less reward from their environment than non-addicts do, driving them to overeat or abuse substances just to feel as satisfied as more neurotypical people naturally would without these "unnatural" rewards.Another theory is that overly palatable food could "hijack" the brain's reward system in a similar way to which addictive drugs do, making the brain extra-sensitive to those foods in the environment. This could in turn lead to intense cravings and prompt food addicts to lose control around such foods.
Unfortunately, eating excess amounts of food to reduce addiction-based "hunger" or abusing substances in an attempt to satisfy the craving for them is like trying to put out a fire with gasoline; the more you eat or abuse substances, the more desensitized your brain's reward system becomes.Though some scientists don't believe obesity is an addiction because of the absence of drug-specific phenomenons like "tolerance" and "withdrawal," others are of the view that such effects do exist, albeit in a less extreme form than with drugs and alcohol. Many dieters who are "detoxing" from sugar report physical symptoms like headaches, nausea, fatigue, and dizziness as well as psychological disturbances.
Others hold the view that what actually defines addiction is not physical dependency but psychological processes, in which case obesity and other "behavioral addictions" that don't involve quite the same physical "high" as substances (sex, gambling, internet, video games, et cetera) would also qualify.Obesity and substance abuse are also both linked to inflammation and metabolic abnormalities, but the cause and effect of this can become perilously muddled. For example, does drug abuse or living an unhealthy lifestyle set off inflammatory processes, or did a heightened tendency towards inflammation leave them excessively vulnerable to falling into such a lifestyle?
Other evidence that obesity and addiction are physically linked includes that medications that suppress the reward system, such as endorphin blockers, which are occasionally used to reduce drug and alcohol abuse, have also been found to reduce "hedonic overeating" (overeating for pleasure). However, the side effects of these drugs can be so unpleasant that they are not often used except in extreme circumstances.Studies have also shown that while smoking in general seemed not to be correlated with a higher BMI, obese young adults had the highest rates of smoking, and heavier smokers were more overweight, indicating that the type of person driven to smoke excessively may be the same type driven to eat excessively.Social factors are also definitely at play in how addictive tendencies might manifest in a given individual. For instance, alcoholism seemed to have a stronger correlation with being overweight in men then in women, which suggest that while men usually simply add alcohol calories to their diet, women may cut out food calories to compensate, a practice that in its extreme form has been nicknamed "drunkorexia."
Additionally, more than twice the number of potential bariatric surgery patients reported a lifetime history of substance abuse as compared to a sample of the general population, but only a minuscule fraction of those patients reported suffering from a substance abuse disorder in the preceding year.In such cases, it appears quite likely that food replaced previous substances of abuse. This phenomenon can also work in reverse; some bariatric surgery patients have been found to turn to drugs, alcohol or other behavioral addictions post-surgery, once they have been physically prevented from indulging in food the way they once did.
Of course, overeating and abusing substances still have important differences. Some people who have struggled with both substance abuse and overeating find food addiction harder to control because they cannot cut out the substance completely; after all, we all have to eat!Addictive tendencies to food can actually be exacerbated by extreme dieting that relies on fasting or drastically cutting calories instead of replacing problematic indulgences with whole, healthy foods, making dieters feel even hungrier and even more out of control around food than they did before.Unfortunately, though a term like addiction may help convey the seriousness of the struggle obese people experience to control their weight, it's also a word that can also invite unnecessary stigma and fatphobia by falsely suggesting that food "addicts" have no control over their behavior.
That's why twelve step programs designed to help people who suffer from addiction, make a point of distinguishing between powerlessness and helplessness. After all, the majority of people with addiction do eventually recover, not having eliminated their desire to use substances but having found ways to manage it and to avoid acting on it.Some of the same therapies have also proved useful for treating both overeating and addiction, like cognitive behavioral therapy and self-help groups. For example, some obese people have found relief in Overeater's Anonymous (OA), a twelve-step program modeled on Alcoholics Anonymous (AA) that preaches "abstinence" from foods that trigger a loss of control over eating.OA advises a strategy of "eating food prescribed by a pre-designated food plan at specified meal times during the day" (which wouldn't preclude a structured weight-loss plan like the 123Diet.) Combined with OA's suggestions of other proven addiction management strategies like writing to explore one's problematic thoughts and behaviors and its role as a source of social support for over-eaters can often lead its participants to significant weight loss.
Finally, while few specialists would advise a former alcoholic to take up drinking, since food is less physiologically addictive than drugs and alcohol, it is potentially possible for a former food addict to gradually reintroduce trigger foods in moderate amounts once they have achieved a healthy weight and dealt with their addiction's psychological underpinnings.The same way that addicts experience an identity shift from “being an addict” to “being an addict in recovery,” once a former food addict starts to see themselves as someone who is capable of managing their weight and is mindful of their health, their old ways may be behind them for good!