Andrew Siegel, M.D. Blog # 61
The sudden thoughts of the substance will rise unbidden like bubbles in a toddler’s bath. The key is to just let the thoughts go—let them come as they will, but do not entertain them.
(Paraphrased from Infinite Jest by David Foster Wallace)
Food for thought: Why is it that cookies, ice cream, candy and cake are so addictive, yet Brussel sprouts are not?
Because eating is—for many of us, including myself—such a stimulating and pleasurable experience, it is easily and readily liable to over-indulgent behavior. A chemical dependence on food satisfies the criterion for an addiction. There are many addictions that humans can succumb to including alcohol, drugs, sex, gambling and eating. Unlike behaviors that involve habits that we can live without, food is unique in that we are all dependent upon it for our survival. So, we are all food addicts to some extent since without it we would not survive for very long. We are all physically dependent upon food, such that symptoms of withdrawal will occur if levels of blood of glucose fall and engender hunger and cravings. Additionally, because food can stimulate our pleasure centers, it can be thought of as a mood-altering drug leading to compulsive use.
And how easy it is for us to be compulsive abusers—addicts—of food. Food is relatively cheap, it is readily available, and we do not need a dealer or involvement in surreptitious business arrangements or clandestine meetings to get our supply. We don’t need to snort it, smoke it, or inject it into our veins. A food addiction is condoned by society and it is often pursued in the company of others in orgies of overindulgence.
Big Food has created an abundance of highly processed, attractively packaged foods laden with fat, sugar, and salt that are convenient fodder for our addiction. In contrast to wholesome, slow-digesting, unrefined foods that contain abundant fiber—which slows and regulates glucose absorption and leaves us feeling full and satisfied—these nutritionally void substances promote addiction. For example, enriched wheat flour (wheat grain strip-mined of bran and germ)—is a pulverized, super-fine, silky white powder that appears much like cocaine or heroin. This “pre-chewed,” “pre-digested,” melts-in-your-mouth, adult baby food is absorbed amazingly rapidly because of the fiber-stripping and refinement process, much akin to mainlining glucose into our bloodstream. And that is just the refined grain component— juice this up with the right combination of sweeteners and fats and you have ingested a fix—the physiological result of which is a sugar rush causing a rapid spike in insulin to get the sugar load into our cells. This quick fix of sugar is not particularly filling because of the absence of fiber—it is a short-lived satisfaction that begs for more consumption, establishing a vicious cycle. The result is a push in the direction of weight gain, insulin-resistance, obesity, diabetes and heart disease.
There are biochemical mechanisms that drive addictive behaviors no matter what the object of the addiction is, whether it is drugs, alcohol, sex, gambling, junk food, etc. After exposure, reward centers of the brain are stimulated to release a veritable pharmacy of pleasure-mediating chemicals that can override the normal mechanisms that would limit such behaviors. Food scientists employed for Big Food have mastered the art of concocting hyper-palatable foods consisting of highly processed fat, sugar and salt; these can lead to “hijacking” the brain via neurochemical addiction, engendering obesity for the individual and a public health crisis for society.
There are many features in common between addictive drugs including opiates and alcohol and fat-sugar-salt processed junk. Like addictive drugs, such foods cause the release of the neurotransmitter dopamine and endogenous opiates from brain reward centers. PET scan imaging demonstrates that these reward centers light up after eating such foods. Drug addicts and obese people actually have less dopamine receptors, making them more likely to crave the very items that release dopamine. Medications used for opiate addicts that block brain receptors have a collateral effect of reducing junk food consumption. Like drugs and alcohol, we develop a tolerance for fat-sugar-salt, requiring more and more to gratify ourselves. Additionally, like drugs and alcohol, we develop withdrawal symptoms when cut off from the object of our addiction. After an initial period of gratification, the user consumes it not to get “high,” but just to feel “normal.” Many fat-sugar-salt addicts continue to be a slave to their addiction, just as drug and alcoholic addicts do, despite their knowledge of its deleterious health consequences and their desire to end their addiction.
Common mechanisms likely underlie obesity and drug addiction. The Scripps Research Institute conducted a study, published in Nature Neuroscience by Paul Kenny and Paul Johnson, showing that compulsive eating shares the same addictive biochemical mechanism as does cocaine and heroin. Using laboratory rats fed high-calorie, high-fat foods, the development of obesity coincided with a progressively deteriorating chemical balance in parts of the brain that deal with reward and pleasure, confirming the addictive nature of junk foods. When offered healthy food alternatives, the rats in the study displayed no interest whatsoever and essentially starved! Conclusions of the study were that “over-consumption of highly pleasurable food triggers addiction-like neuro-adaptive responses in brain reward circuitries, driving the development of compulsive eating. ”
Bottom line: Habitual consumption of highly palatable calorie-dense foods—especially sugary, fatty, salty processed glop—prompts brain responses that can parallel drug addiction. The release of neurotransmitters including dopamine and endogenous opiates will make us consume more, sabotaging normal satiety signals and reinforcing future behavior.
Solutions to Food Addictions
• Understand the specific cues that trigger the craving for certain foods. Factors such as stress, fatigue, depression, mood swings, loneliness, boredom, feelings of deprivation, the need for immediate gratification, etc., beg for a convenient and immediate source of relief. Make an effort to deal with these cues in a less maladaptive way.
• Activity swapping is a means by which eating behavior that is driven by cravings is exchanged for an alternative behavior that has an equivalent soothing effect. This substitute activity for eating might be sleep, exercise, reading, phoning a friend, getting out of our home, taking a walk, bathing or showering, doing household work or errands—anything to get our minds off the craving. Distracting ourselves with alternative activities will allow the craving to float away. Exercise is a particularly great alternative that will burn calories instead of storing them, and is capable of releasing dopamine and endogenous opiates.
• Mind the specific trigger foods that drive overeating. The trigger could be the scent of food, an advertisement, the sight of someone else indulging, or even your own thoughts about food. As difficult as it may seem, try to avoid getting into situations that expose you to such trigger foods.
• Access control is a helpful strategy because of the simple reason that whatever is handy is readily eaten and whatever is not handy is not readily eaten. In other words, in sight leads to a greater chance of consumption, hungry or not! So keep trigger foods at bay.
• Vaccinate and inoculate—take a small piece, a teeny but satisfying taste, a vaccination if you will—a small dose that will preclude us from coming down with the disease— the obesity disease. There are some who have such a profound addiction to certain trigger foods that even a small exposure to that food can set off a cascading cycle that demands more and more of that particular food. For this subset of the population, total avoidance is the key, being similar to an alcoholic not being able to have even one drink. The food addict must simply practice abstinence. When liberated from addictive trigger foods, it is very possible to lose urges and desires for them.
• Food swapping is a very useful means of substituting a healthy, low-calorie food for an indulgence that is laden in calories, fat, sugar and salt. Find highly palatable healthy foods to substitute for the objects of your addiction—a juicy apple, a succulent peach, a handful of mixed nuts, etc.—that are capable of satisfying cravings. Try to get addicted to healthy foods!
• Oral alternatives. Eating is all about oral stimulation. Chewing gum, sucking candy or breath mints can provide low-calorie oral stimulation that is an alternative to eating.
• STOP before it gets out-of-control. The enemy of good is perfect. If we foul up, it is not the end of the world. It’s okay to lose a battle as long as we win the war. We are humans, subject to all the imperfections, weaknesses and foibles that are characteristic of our species. If we fall off the wagon, we can get back on without losing ground. When we think with a long-term perspective, we understand that a little detour off the pathway need not affect the outcome of our journey. To quote comedian Jeff Garlin: “Slip ups are speed bumps on the road to recovery.” We need to be aware and attentive, focused and mindful, and simply halt, stop and desist before matters get out of hand.
Andrew Siegel, M.D.
Author of Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with Food
Now available on Amazon Kindle