If the number on your bathroom scale seems to be rising faster than the national debt, and if you repeatedly find yourself piling food onto your oversized plate in an almost reckless manner at all-you-can-eat buffet lines, could you be captive of a "food addiction"?
Most people know that the physically addictive properties of caffeine can make giving up your first (and second and third) cup of coffee in the morning a harrowing way to start the day. But some doctors believe that people are also driven to eat foods like beef and cheese with just as much compulsion, and the reason may be an unrecognized food addiction.
Neal Barnard, MD, for example, says he believes that cheese, meat, chocolate, and sugar are addictive foods in the diets of millions of Americans. Barnard, the author of Breaking the Food Seduction and president of the Physicians Committee for Responsible Medicine, says that these foods contain chemical compounds that stimulate the brain's secretion of opiate-like, "feel-good" chemicals like dopamine, which drive our cravings for them.
Alan Goldhamer, DC, co-author of The Pleasure Trap and director of TrueNorth Health Center in Rohnert Park, Calif., agrees. "A large percentage of the population is vulnerable to the effects of this hyperstimulation [from foods that trigger dopamine production], and they get caught up in an addictive cycle," he says. But unlike the addiction to drugs, which is widely acknowledged, this problem remains largely unrecognized, according to proponents of the food addiction theory.
Food Addiction: Where's the Beef?
Not long ago, when ads for a potato-chip manufacturer were teasing consumers with the challenge, "Betcha can't eat just one!", they may have really meant it!
Food manufacturers have done an exquisite job of recognizing and tapping into our cravings, using persuasive ads and alluring packaging to keep their products tumbling into our shopping carts. "There are so many processed foods that are not only calorically dense, but they also stimulate dopamine production that makes us feel good," says Goldhamer.
On the other hand, many nutritional experts believe that there are more important risks associated with processed foods that have nothing to do with addictions. "The problem with processed food is that you digest it so quickly that it's out of your stomach in no time and you still feel hungry," says Michael Roizen, MD, author of Cooking the Real Age Way. "If you take the fiber out of food, you get a lot of empty calories."
While lobbyists for food manufacturers may minimize the risks of plates brimming with meat, cheese, and other high-fat items, Roizen says he believes that eating more than 20 grams a day of bad fats such as saturated fats and trans fats can contribute to breast and prostate cancers, as well as what he calls "arterial aging," which may lead to heart disease, stroke, impotence, memory loss, and even skin wrinkling.
The same goes for sugar, says Roizen, professor of medicine and anesthesiology at the State University of New York College of Medicine in Syracuse. "The main reason to avoid sugar is that it ages your arteries," he says. Add to that the recent lawsuits against fast-food chains for contributing to obesity and chronic illnesses, and the food industry may feel it is under a siege of supersized proportions.
Getting to Be a Habit
When words like "food addiction" are bandied about, there are plenty of skeptics who hesitate to put foods like cheese and chocolate into the same category as widely acknowledged addictions such as cocaine or alcohol. But Barnard asks, "What other term would you use for a woman who gets into her car at 11:30 at night and drives six miles to the 7-Eleven to get a chocolate bar, and does it every night? She's gaining weight, she feels profoundly guilty afterward, and though she resolves to stop this behavior, she does it every night, night after night? That's a food addiction."
The proponents of this food addiction theory point to possible differences between the sexes in their compulsions. Women may be more susceptible to chocolate, particularly in the premenstrual period. While some men may have a sweet tooth, many more say that the one food they're least likely to give up is steak. Barnard points to an April 2000 survey of 1,244 adults, which concluded that one in four Americans wouldn't give up meat for a week even if they were paid a thousand dollars to do so. "It sounds an awful lot like an addiction to me," he says.
In an animal study at Princeton University in 2002, researchers found that after rats binged on sugar, they showed classic signs of withdrawal (such as "the shakes," anxiety, and changes in brain chemistry) when the sweets were removed from their diet, suggesting that sugar may have addictive properties.
Yet many doctors and dietitians remain unconvinced that the drive to eat certain foods is a true food addiction. "People do crave three basic tastes -- fat, salt, and sugar," says Keith Ayoob, EdD, RD, associate professor of pediatrics at the Albert Einstein College of Medicine and a spokesman for the American Dietetic Association. "Infants as young as a few days old do have a preference for sweeter foods. But when you say that a particular food is addictive, you imply that it's out of your hands. I don't buy that. I'm not aware of any evidence that chocolate is addicting. People like it because it tastes good.
"Yes, people do get into habits," adds Ayoob. "But the good part is that habits can be changed."
Breaking the Food Addiction
If food addictions are real, how difficult is it to break them? Clinical psychologist Douglas Lisle, PhD, says that at the TrueNorth Health Center in Rohnert Park, Calif., where he is director of research, patients have had the most success through "therapeutic fasting" -- in essence, rebooting the "hard drive" in their brain through a period of water-only fasting in a medically supervised setting, followed by the introduction of a diet emphasizing fresh fruits, vegetables, whole grains, beans, nuts, and seeds. (The process is described at TrueNorth's web site, www.healthpromoting.com).
But if your stomach is already growling at the mere thought of a total fast, try making a complete break just from the foods you crave -- a process that Barnard says works much better than trying to eat them in moderation. He argues that staying completely away from a food item for three weeks often resolves the problem. "At the end of three weeks, your tastes will have changed," he says. "You won't want the food as much anymore."
When you get rid of the sugar or chocolate from your diet "cold turkey," don't expect any of the withdrawal symptoms that are often associated with other addictions. "Occasionally, a person does say to me, 'When I stop consuming sugar, I feel lethargic and depressed,'" says Barnard, an adjunct associate professor of medicine at George Washington University School of Medicine. "But withdrawal symptoms are not essential to the definition of a food addiction."
Also, don't be surprised if you backslide. "You can expect to fall off the wagon into the waiting arms of chocolate," says Barnard. "Just like an alcoholic, you may relapse before making the break permanently."
Originally published April 19, 2004.
Medically updated September 2006.