Is it Food Addiction or a Biological Response to Deprivation?
TW/CW: Some of the studies cited include stigmatizing language
A CHILDHOOD OF LIMITED ACCESS
I noticed early on that my family’s snack cupboard had different options than that of many of my friends. My siblings and I snacked on pistachios, chips and salsa, certain types of cereal, and, when we were lucky, Nilla Wafers or animal crackers. (The five of us kids always finished those two quickly.) Several of my friends, on the other hand, seemed to have unfettered access to what my parents called “junk food.” Their cupboards had Fruit by the Foot, Gushers, Lays potato chips, Doritos, Chips Ahoy!, Oreos, and other brightly-branded snacks that I longingly walked past with my parents at the grocery store.
When I began sleeping over at my best friend’s house in elementary school, her mom always let me pick breakfast the following morning. Without fail, I selected Eggo Waffles with Aunt Jemima’s maple syrup. My friend and her mom would laugh about how many I’d eat — my record was 13 syrup-drenched waffles in one sitting. (I suspect the reaction would’ve been different if I wasn’t a naturally thin kid.) At home we only ever had whole wheat waffles and Vermont maple syrup, so I felt like I needed to take full advantage of the novelty option when I had the chance. Around this time, I also began babysitting for some of the younger kids in my neighborhood. After I put the kids to bed, I’d raid my neighbors’ snack cabinets — taking a few of many different items so that the deficit would be less obvious. When I was done eating, I’d hide the wrappers at the bottom of their trash can. Sometimes I’d go back for more. Iterations of these behaviors continued through high school and into college.
I felt immense shame about my eating urges — like I had no control. When I started experiencing negative body image in high school, I began to experiment with dieting. It would work until it didn’t, and I inevitably gorged on the foods I’d forbidden myself to eat. The cycle continued and ultimately escalated into an eating disorder.
RESTRICTION LEADS TO BINGEING
Looking back, none of what I experienced — the restrict and binge cycle, dieting, and, ultimately, a full-blown eating disorder — is surprising. In fact, it perfectly tracks with what science tells us happens when we restrict food.
Bingeing is a very common result of food restriction. When food is restricted, whether intentional (limitations set by your parents or dieting) or not (food insecurity), our brain senses danger and sets off a series of biological responses to protect us from the perceived famine. As registered dietician, Christy Harrison, MPH, RD explains in her book Anti-Diet: Reclaim Your Time, Money, Well-Being, and Happiness Through Intuitive Eating, our bodies reduce the production of our “fullness hormones” known as leptin, peptide YY, and cholecystokinin. They also increase the production of our “hunger hormone” ghrelin, as well as slow down our metabolism, lower overall energy expenditure, reduce activity in the thyroid and sympathetic nervous system, and increase food thoughts. Basically, we start feeling hungry and thinking about food all the time, our body feels more sluggish, and our metabolism slows down. So, when we finally do eat, it’s common to “lose control” and swing to the other extreme, eating past comfortable fullness because our brain is telling us to stock up on extra food now before the next famine comes. We blame ourselves for being addicted to food, but as Christy Harrison, MPH, RD clarifies, “It’s physiological — a survival impulse encoded into your body.”
To make matters more complex, our brains can’t tell the difference between physical and mental restriction. So even if you are physically allowing yourself to eat foods you deem bad, by telling yourself “I shouldn’t be eating this,” “I’ll work this off at the gym later,” “today’s a cheat day,” or “I can only have a little,” your brain will feel threatened by a possible upcoming famine and set into motion the same biological changes listed above to protect you.
We also know that dieting is a major risk factor for the development of eating disorders. Research from the Department of Family and Community Medicine at the University of Arizona shows that 35% of “normal dieters” progress to pathological dieting, and 20-25% of those individuals develop eating disorders. However, this 20-25% stat doesn’t account for all of the people who are suffering from an eating disorder but do not meet the outdated, harmful diagnosis criteria that is currently set by the DSM-5 to diagnose eating disorders. At least one in ten people in the U.S. will be diagnosed with an eating disorder in their lifetime. However, some experts suggest that eating disorders affect up to half of the American population, and disordered eating affects the vast majority. So many more people are “sick enough” for diagnosis and treatment than are actually getting it.
DEBUNKING FOOD ADDICTION CLAIMS
It’s absolutely possible to feel addicted to food — I certainly used to — but the existing landscape of nutrition-related research does not support the concept of food addiction. In fact, there is no conclusive research identifying any specific foods, nutrients, or food substances as addictive; nor any research that supports the theory that sugar can induce hyperactivity or any other kind of “high.”
Proponents of food addiction have made inflammatory claims that sugar is as addictive as stimulant drugs, like cocaine. They’ve pointed to the (true) fact that sugar lights up the same reward center in our brain as taking drugs, causing the release of feel-good hormone, dopamine. However, they often don’t also mention that seeing a puppy, holding a baby, or hugging a loved one lights up our brain’s reward center in the same way.
To support their claims, food addiction proponents generally cite rodent studies in which rats developed addiction-like symptoms to sugar water (eating huge quantities or compulsively and repeatedly pressing a lever to make more food appear), but these behaviors only occurred after the rodents were given intermittent access to sugar. So, as registered dietitian Kristin Draayer, MS, RDN clarifies, “When given free access to sugar alongside adequate access to food and water, the rodents did not binge, suggesting that it's the deprivation, not the sugar itself, that triggers this response.” Plus, rodent studies cannot be used to make any definitive claims about humans. At best, they can only be used to guide further research on human subjects. Proponents also point to several human studies utilizing the Yale Food Addiction Scale (YFAS and recently the YFAS 2.0); but in these studies, researchers do not reliably ask about or control for a history of dieting. As we’ve already covered above, restriction (dieting) leads to bingeing (feeling out of control and “addicted” to food). These studies have also not established conclusive evidence that any overarching “food addiction” symptoms are not instead symptoms of Bulimia Nervosa or Binge Eating Disorder.
Journalist Virginia Sole-Smith also points out in her book Fat Talk: Parenting in the Age of Diet Culture, that “We don’t tend to crave straight sugar, eaten from the bag with a spoon; we are more often drawn to foods that provide a combination of sugar, fat, and salt because they offer us a certain blend of taste, texture, and mouthfeel.” Do you know many people struggling with drug or alcohol dependency that intentionally dilute their substance of choice because it makes the experience more pleasurable? As someone who’s now seven years sober from alcohol, has extended family members who are actively struggling with alcohol dependence, and previously dated someone who went to detox and rehab for an opioid addiction, I’ll also say this: food consumed in large amounts will not alter your memory, cause you to lose consciousness, make you more likely to engage in high-risk behaviors (e.g., unprotected sex, needle sharing, or driving under the influence), require higher doses to achieve the desired effect (a “high”), lead to financial ruin, or result in life-threatening withdrawal symptoms. Food and drugs are not the same, and it’s harmful to people who have struggled with actual substance addiction to claim that they are. (Learn more about the DSM-5’s Substance Use Disorder diagnosis criteria.) And, as we’ll learn below, the cure for “food addiction” is a lot different than abstinence-based treatment for alcohol, opioids, or any other drug addiction.
HOW TO HEAL “FOOD ADDICTION”
The cure to “food addiction” is a mentally uncomfortable one: abundance. If you feel out of control around food, you need to give yourself unconditional permission and access to those foods. This can feel really scary, but it works.
I’ve been in eating disorder recovery for over a decade, and have gone through this process for many different foods I felt out of control with. For several consecutive months in 2016, I had nachos for dinner multiple nights a week. 2017 was The Year of the Oreo™. (I had Oreos every single day for over a year and decided this chapter of my healing journey needed a title.) Next came french fries and chipotle mayo, then SunChips, Gushers, and most recently, Kettle salt and vinegar chips. In order to feel comfortable around each of these foods, I had to regularly buy them, keep them stocked in my kitchen, eat them whenever I craved them, and trust that eventually they’d lose their seemingly never-ending appeal. I do want to acknowledge that there is privilege in this process. People struggling with food insecurity and/or who live in food apartheids will probably not be able to buy whatever food whenever they want.
Once your brain learns and trusts that you’re no longer in danger of a famine — whether a famine of all foods or a famine of Oreos, specifically — the aforementioned biological changes will subside. Food you previously felt addicted to will lose its heightened appeal and just become food.
Today, I no longer feel addicted or remotely out of control around food. If I crave something, I eat it. While at the grocery store, I’ll shop from my list AND buy a few bonus items I come across that sound tasty. Sometimes I crave french fries (like the night I’m writing this), and other times I crave roasted broccoli. Earlier tonight, I felt satisfied before I finished all of the fries, so I put the remainder in a tupperware for tomorrow. It didn’t feel like I was depriving myself by not finishing them. I felt full and am allowed to eat french fries whenever I want, so I had no desire to eat past comfortable fullness. Nowadays, my brain and body are partners, and I’ve relearned to trust my natural (and diverse) food cravings. It’s pretty sweet — pun very much intended.
LEARN MORE
Anti-Diet: Reclaim Your Time, Money, Well-Being, and Happiness Through Intuitive Eating, by Christy Harrison
Fat Talk: Parenting In the Age of Diet Culture, by Virginia Sole-Smith
Sugar Rush: Science, Politics, and the Demonisation of Fatness, by Karen Throsby
Sugar and Food Addiction: A Health at Every Size-Aligned Resource Guide, compiled by Lindley Ashline
“Food Addiction” Treatment Isn’t Science-Backed: Here’s What’s Really Going On, by Caroline Young, MS, RD, RYT
The Trouble with Sugar, Maintenance Phase Podcast by Aubrey Gordon and Michael Hobbs
What If You Can’t Stop Eating When Food Tastes Good?, Rethinking Wellness Podcast by Christy Harrison
Can We Be "Addicted" To Sugar? (Revisited), The Full Plate Podcast with Abby Atwood, MS
The Truth About "Food Addiction" with Marci Evans, Food Psych Podcast with Christy Harrison
Intuitive Eating, 4th Edition, by Evelyn Tribole MS, RD, and Elyse Resch MS, RD, FADA
