The Health Profession and Food Addiction

Untitled by Sarah McD

Here’s an interesting and disturbing fact. When The Obesity Society sent out word to its members to line up speakers for its annual scientific meeting in October, abstracts were requested in four tracks or categories: Molecular Mechanisms of Obesity, Neuroscience and Integrative Biology of Obesity, Clinical Studies, and Population Studies.

We notice two peculiar omissions: What about food addiction? What about psychology in general? Psychology certainly plays a big part in motivating people to overeat, and eat the wrong things. And the food addiction paradigm very much needs to be considered. Seriously. By The Obesity Society.

Often, change is slow to come, especially in the medical profession. In a way, of course, this is good. In fact, many medical innovations should have been given a great deal more thought before their implementation. We can all think of examples. Often, however, change is for the better. Dr. Ignaz Semmelweis is a hero to those who advocate useful change. He has figured out that fewer patients would die from infections if doctors washed their hands. “Well, duh!” We say that now, but, for many years, Semmelweis was a lone voice crying in the wilderness.

There are early adapters who recognize change when it comes and gracefully accommodate it. Early adapters engage life in a dance, or, if not that, at least they go with the flow. There are early adopters who look around for what is not simply new, but new and better, and appropriate it unto themselves. Early adopters seize the day before anybody else wakes up and notices the sunrise.

Fortunately, not all doctors have bad attitudes toward the food addiction paradigm. Drew Pinsky, M.D., for instance, has been around for a while, making a name for himself as an addiction specialist, running a chemical-dependency unit, and hosting a TV show called Celebrity Rehab.

We’re looking at the interview with Dr. Pinsky, conducted by Dr. Sanjay Gupta, who outlines some of the criteria by which addiction is recognized. Dr. Gupta mentions compulsive behavior, the need for a substance on a regular basis, going to extreme lengths to obtain it, and failing in attempts to stop abusing the substance. He also mentions a study indicating that smelling and tasting food causes brain activity similar to that observed in cocaine addicts. So, can a person be addicted to food?

Dr. Pinsky suggests that food addiction doesn’t happen without a precursor. First, there has to be a pharmacological addiction, causing changes in the brain. He says,

And once those extra physiological changes have been induced, then the drive systems can become out of control. And food can be one of those things people turn to, to try to satisfy those drives.

Dr. Pinsky seems to want to reserve the addiction label to cases where medical consequences are already manifesting:

If somebody is diabetic, somebody’s having vascular disease, somebody’s having medical problems from food and still can’t contain it, that’s when it really sort of meets the criteria of an addiction.

In an article written by Dr. Pinsky, he defines addiction as a specific biological disorder with a genetic basis, a disorder of the brain’s reward systems. He talks about motivational priorities. Namely, the addict’s priorities will change to encompass progressive use of the addictive substance, even in the face of adverse consequences. The obese person faces adverse consequences all day long — in the areas of health, relationships, work, school, etc. Which seems to bring food into the realm of addictive substances. Dr. Pinsky says,

Addiction is a biological switch having been thrown in the deep regions of the brain. For the most part emotional disregulation is why people go to drugs in the first place: Difficulty regulating feelings, trying to feel better, seeking solutions to emotional states, and inadvertently throwing that switch.

Emotional disregulation is, of course, very frequently the reason why people turn to food.

Your responses and feedback are welcome!

Source: “Call for Abstracts,” The Obesity Society on Facebook, 03/09/10
Source: “House Call with Dr. Sanjay Gupta,” CNN Transcripts, 05/05/05
Source: “Addiction: Do You Need Help?,” MedicineNet, 11/06/03
Surgeon image by Sarah McD, used under its Creative Commons license.
Lens image courtesy of Dr. Pretlow; used with permission.

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