Can a Person Really Be Addicted to Food?

By Hugh C. McBride
Once applied primarily to abusers of alcohol and other drugs, the term "addiction" has become a much more prevalent term in modern American society. Sex, gambling, video games, and even the Internet itself are among the myriad objects, substances, and activities that have been the subjects of addiction diagnoses in recent years.

Though the concept of addiction has evolved considerably since it was first used to describe opium users in the early 1900s, questions remain about whether the word can be applied to one of humankind's most fundamental needs: Can a person be addicted to food?

Defining the Term

Though a clinical term, addiction is often interchanged in common conversation with words ranging from commitment and dedication to obsession and compulsion. People talk about being "addicted" to a sports team or a favorite television show, when in reality their behavior (for example, making an effort to be home in front of the television at certain times on certain days) merely indicates that they enjoy tracking a team's success or following a fictional family's foibles and frustrations.

In the case of alcohol or other drugs, addiction can involve both physical and psychological components. Once exposed to certain substances, the body craves them – and withholding them can cause severe physical reactions, which are commonly referred to as withdrawal symptoms. According to the Mayo Clinic, addicted individuals "compulsively [seek] to use a substance, regardless of the potentially negative social, psychological and physical consequences."

All humans need food, and failing to eat will result in considerable physical and psychological stress. But can we really describe individuals who don't exert sufficient portion control as "addicted" to food? According to Howard J. Shaffer, Ph.D., C.A.S., of the Cambridge Health Alliance Division on Addictions, the answer to that question is "yes."

Though some schools of thought hold to the belief that addiction is the result of a person's genetic predisposition to the "addictive" qualities of certain substances, Shaffer says his research has led him to consider a wider sphere of influences when attempting to make a diagnosis.  

In an essay that appeared on the CHA Division of Addictions website, Shaffer wrote that addictions are complex patterns of action that can involve genetic, social, and behavioral influences. "As we understand more about the biology of addiction, social and cultural influences become more – not less – important," Shaffer wrote. "Social and psychological forces will remain very important in determining who does and who does not develop addictive behaviors."

To those who wonder how a substance as apparently innocuous as a sandwich could be the focus of behavior more commonly associated with heroin or cocaine, Shaffer expresses his belief that the determining factor in addiction is often found in neither the substance nor the individual, but rather in the dynamic that exists between the two.

"Addiction results from the relationship between a person and the object of their addiction," he wrote. "Drugs certainly have the capacity to produce physical dependence and an abstinence syndrome (e.g., neuroadaptation). New evidence suggests that neuroadaptation also results from addictive behaviors that do not require ingesting psychoactive substances."

Additional research has attempted to identify key components of the relationship between food addicts and the objects of their obsession. For example, an Aug. 10, 2007, article distributed by the NewScientist news service described insights into the influence that a hormone called leptin may have on suppressing (or failing to suppress) a person's appetite.

According to the NewScientist article, medical professionals at the University of Cambridge (United Kingdom) performed brain scans on two obese teenagers who exhibited the desire to eat non-stop. The researchers discovered that the teens – a 14-year-old boy who weighed more than 225 pounds and a 19-year-old girl who weighed just over 280 pounds – both had an extremely rare genetic disorder that rendered their bodies unable to produce leptin.

Discovered in 1994, leptin is produced by fat cells in the body to signal the brain to reduce appetite. Unlike the rare genetic status of the two British teenagers, researchers have theorized that in most cases an overproduction of the hormone in obese people can cause their brains to become immune to leptin's effects, effectively shutting off the body's natural appetite-suppressant switch.

More support for identifying compulsive eating as an addiction can be found in a paper that was published in the Feb. 1, 2001, edition of Psychiatric Times. In this article, Caroline Davis, Ph.D., notes that some researchers have postulated that "eating disorders are, themselves, a form of drug addiction since their characteristics satisfy all the clinical and biological criteria for conventional addictions such as smoking, alcoholism and cocaine abuse."

Davis, a professor with the University of Toronto, also alludes to studies that have documented the exhibition of classic addictive behaviors by compulsive eaters. For example, "with continual exposure, [food addicts] typically require more of the behavior to produce the same reinforcing effect," she writes. "They also tend to experience an obsessively increasing craving for the behavior that can persist even after a long period of abstinence."

Recognizing the Signs

Individual findings aside, as with all types of compulsive behavior, food addiction is a complex disorder for which no simple diagnostic test exists.
In a paper published on the recovery resource website AnonymousOne, Scott McCann compares attempting to recognize a food addict with trying to differentiate between a heavy drinker and an alcoholic.

"The moderate and heavy drinker can stop or moderate their drinking when the alcohol affects their daily living. The alcoholic cannot. They develop a physical, mental and emotional phenomenon of craving and a chemical addiction to alcohol," McCann writes. "Similarly … many overeaters can moderate and reduce their weight through a change in their diet and exercise. The food addict cannot. They develop the same physical, mental, emotional craving and chemical addiction to food."

Food Addicts in Recovery Anonymous, a support group based upon the 12-step principles of Alcoholics Anonymous, characterizes its members as individuals who have experienced difficulties in their lives because of their obsession with food and their inability to control their eating habits. According to a questionnaire on the FA website, the following signs could indicate that a person is suffering from a food addiction:

• Wanting to stop eating, but being unable to do so.
• Overeating (or bingeing), often followed by attempts to purge via vomiting, laxatives, or excessive exercise.
• Thinking or talking about food (or one's weight) constantly.
• Eating to escape from negative feelings.
• Eating in secret, or eating differently in private than in front of others.
• Stealing other people's food or hiding food to be sure that a ready supply is always available.
• Feeling ashamed of one's weight and/or feeling helpless about one's relationship with food.

Overeaters Anonymous, another food-related 12-step recovery support program, offers a similar list, with "look[ing] forward with pleasure and anticipation to the time when you can eat alone" as one of several signs of potential food addiction.

Treating the Disorder

Among the most destructive aspects of addiction is an inability to control one's behavior, which results in a reduced quality of life for themselves and, often, others (usually family members and close friends). As with the diagnosis of the disorder itself, regaining this control can be a complex process for which no "one size fits all" approach exists.

Some food-addicted individuals opt for AA-type 12-step recovery support groups, while others have found success through residential treatment programs or individual therapy.

Regardless of the approach, most treatments for food addiction aim for outcomes similar to the following:

• Identifying and addressing means for overcoming triggers, temptations, and other influences that precede addictive behaviors.
• Treating any physical disorders that may cause or exacerbate addictive actions.
• Adopting a healthy lifestyle of appropriate eating and regular exercise.
• Achieving and maintaining a healthy weight.
• Developing strategies to help the recovering individual deal with daily challenges.
• Establishing a network of support to ensure continued recovery.

Ultimately, treatment for food addiction aims to allow the addicted individual to regain control of his life. Though she was writing about overcoming her addiction to alcohol and drugs, Christina Thompson could have been expressing the emotions of a recovering food addict when she posted the following reflection on the Faces and Voices of Recovery website: "I no longer do the things I used to do when I was obsessed with the getting and using and finding ways and means to get more. I have learned respect for myself and to respect others. … I am genuinely loving to my family and contribute to society by helping others who are like I was find a new way of life."

Sources
Davis, Caroline Ph.D. "Addiction and the Eating Disorders." Posted Feb. 1, 2001. (http://www.psychiatrictimes.com/display/article/10168/54311)

Food Addicts in Recovery Anonymous. "Are You a Food Addict?" Accessed May 22, 2008. (http://www.foodaddicts.org/quiz.html)

Khamsi, Roxanne. "Some of us really are addicted to food." Posted Aug. 10, 2007. (http://www.newscientist.com/article/dn12465-some-of-us-really-are-addicted-to-food.html)

Mayo Clinic Staff. "Drug Addiction." Posted May 7, 2007. (http://www.mayoclinic.com/health/drug-addiction/DS00183)

McCann, Scott. "What is Food Addiction?" Accessed May 23, 2008. (http://www.anonymousone.com/faq195.htm)

Overeaters Anonymous. "Are You A Compulsive Overeater?" Accessed May 23, 2008. (http://www.oa.org/is_oa.html)

Shaffer, Howard J. "What is Addiction? A Perspective." Last updated July 3, 2007. (http://www.divisiononaddictions.org/html/whatisaddiction.htm)

Thompson, Christina. "Our Stories." Accessed May 23, 2008. (http://www.facesandvoicesofrecovery.org/resources/story_thompson.php)