Pat Hartman | Childhood Obesity News

Inherency and Food Addiction — More Wrinkles

Pat Hartman May 10, 2022 No Comments

The subject is still the validity of food addiction as a concept, and now we’re talking about the intentionality of it. Dr. Pretlow once wrote,

Dr. Wang […] commented […], “We make our food very similar to cocaine now.” [CNN, 2010]. He added, “We purify our foods,” which concentrates the pleasurable ingredients, just as cocaine producers purify the coca leaves to make cocaine.

This attitude is capsulized in the famous potato chip commercial, “Bet you can’t eat one!” By which the manufacturers meant, “You can’t eat just only one; you won’t be able to stop.” And they were more right than they knew. Apparently, back in the 1950s, Lay’s was the first corporation to advertise snack food on TV! In those days, potato chips pretty much stood alone, because the lavish variety of chips had not been developed yet.

As chip after chip flooded the market in the ensuing years, they all followed the lucrative pattern of proving to customers that the darn things were so enticing, that to close the bag before it was empty would be a painful sacrifice.

Youse ain’t prove nuttin’

H. Ziauddeen and P. C. Fletcher wrote,

The hyperpalatable foods that are thought to be addictive are widely available and widely consumed. To consider that they may become addictive in some individuals will require the characterization of a specific feature (or several features) of these foods that acts in concert with certain individual vulnerabilities.

That was almost 10 years ago, and while universal agreement that people can become addicted to the natural substances in foods has not been arrived at, considerably more experts have made the case that a certain something can be, and is, built into many processed foods — a characteristic that very closely resembles addictiveness. As Dr. Pretlow has said, “The sensory aspects of food are engineered to encourage consumption.”

In the debate over whether food addiction is a valid and useful concept, this is a very considerable wrinkle indeed. Nowadays, we’re talking about overdoses of ingredients that may be fine in small amounts, like salt; plus a vast assortment of chemical additives; and who-knows-what other tricks of the trade.

Addiction specialist Dr. Vera Tarman, the co-author of Food Junkies: The Truth about Food Addiction, self-identifies as one of the many who have struggled with overeating in her own life. She draws the distinction between natural foodstuffs and “manipulated” products. There, she describes some of the measures that nature put in place to safeguard against overindulgence, the built-in boundaries that formerly kept a leash on the human craving for mouth pleasure:

While a non-addicted eater may be able to ‘relearn’ how to curb the use of their favorite foods, the food addict cannot. For those in the population who are more vulnerable to the ‘quick fix’ potency of processed foods – foods that act as if they are a drug – eating a favorite food, however small the portion, is a trigger, a tease. The food addict’s ‘stop’ switch has become battered. In the same way that a type 2 diabetic has developed insulin resistance, the food addict can be regarded as having developed a dopamine resistance. Relapse inevitably follows.

Your responses and feedback are welcome!

Source: “Is food addiction a valid and useful concept?,” NIH.gov, January 2013
Source: “Guest Post: Food Abstinence for Food Addicts: Deprivation or a New Freedom?,” DrSharma.ca, February 2015
Image by Marcu Ioachim/Public Domain

Inherency and Food Addiction, a Wrinkle

Pat Hartman May 9, 2022 No Comments

Recent posts have rehashed the points made by various authorities about whether food, or some components of food, or components of some foods, can be physically addicting in the same way as heroin, cocaine, alcohol, nicotine, etc. Or maybe, the situation is that people who are genetically or psychologically vulnerable can be physically addicted by these components, while others are untouched. All these questions took a back seat when the makers of food products accepted the challenge of proving that food can, indeed, be addictive, or at least something very close to it.

In a paper previously quoted here, one significant phrase sticks out like a sore thumb:

Humans who overeat usually do not restrict their diets to specific nutrients; instead the availability of a wider range of palatable foods appears to render prone subjects vulnerable to overeating.

Of course, “palatable” just means pleasant, acceptable, or satisfactory; and hopefully, most foods fulfill those qualifications. It seems apparent that what they meant is closer to “hyperpalatable,” a description that Childhood Obesity News has covered extensively.

The point being, while there may be little evidence for the presence of addictive substances in natural foods, the food industry has a few tricks up its sleeve. And that’s the wrinkle in this particular debate — namely, very powerful corporations work extremely hard to change natural foods into chimerical potions designed to hook people and keep them hooked.

Here are some words from an organization that has looked deeply into these matters:

[I]t appears that the reward value of food can overwhelm the body’s energy balance mechanisms that otherwise regulate feeding, leading to intake of calories beyond hunger and nutritional requirements. In our obesogenic environment, we are surrounded by inexpensive palatable foods that are high in sugar, fat and calories.

For years, this problem has been discussed from all angles. Senior reporter Anna Almendrala wrote for HuffPost.com,

Is food addiction real, and should food industries be held accountable for engineering hyper-palatable sugar-salt-fat bombs that override feelings of fullness? Or is it more accurate to describe overeating as an eating addiction — a disordered relationship to all foods that can and should be brought to heel by the individual?

In this area, one word makes an expensive difference. If engineered food is, in and of itself, potentially addictive, then manufacturers should be held liable. If the obese customer’s addiction is to eating, well sorry, it’s all on them. Almendrala quoted clinical psychologist Ashley Gearhardt:

Humans have been eating food since we’ve been in existence, but we haven’t seen this boom in eating-related problems, binge eating and obesity until very recently…

She cites the “vast amount” of interest and attention this matter has been receiving, concerning differential brain responses and the eating behaviors associated with engineered foodstuffs, saying,

[W]e need to keep evaluating […] our understanding of how our food environment is potentially negatively impacting us as a society — especially children.

Your responses and feedback are welcome!

Source: “’Eating addiction’, rather than ‘food addiction’, better captures addictive-like eating behavior,” ScienceDirect.com, November 2014
Source: “The Biology Behind ‘Food Addiction,” undated
Source: “Food Addiction vs. Eating Addiction: Why A Single Word Makes All The Difference,” HuffPost.com, 09/23/14
Image by dschmieding/CC BY 2.0

Inherency and Food Addiction, Some Interesting Points

Pat Hartman May 6, 2022 No Comments

In the previous posts on the debate over whether food can have inherent or intrinsic addictive properties, we mentioned the final report summary from NEUROFAST on “The Integrated Neurobiology of Food Intake, Addiction and Stress.” This document summed up the findings from five years of extensive and multidisciplinary studies.

For a comprehensive list of key findings, plus explication, see the report, but these are some interesting highlights:

1B: Different eating disorders have different patterns of association with substance
abuse disorders.

1C: [There is] evidence for pathways involved in the relationship between eating and substance
disorder onset.

3B: Reward consumption activates brain regions conventionally thought to be involved in homeostatic control of food intake.

Once again, the multifactorial nature of a problem is clear. There are a number of different recognized eating disorders (and maybe even one or two as yet unidentified.) The struggle that some individuals have with food and eating certainly resembles addiction in many respects.

Yet the basic contradictions, as previously described, still persist. If some foods are addictive, why isn’t everyone hooked on them? Is it the food itself, or the more subtle rewards of handling internal and external conflict with displacement behaviors? In the realm of treatment, how do we get past the irrefutable fact that nobody can quit eating?

Meanwhile, here are some of the chemically interesting facets of the integrated neurobiology of food intake, addiction, and stress:

6E: Sweet taste and postingestive effects of food both support motivation for food. The postingestive effects of carbohydrates increase the motivation for food through an incentive learning mechanism.

3A: Ghrelin, a metabolic signal, modulates the rewarding value of food.

3C: Central kappa opioid receptors are a suitable drug target for the treatment of obesity and some associated co-morbidities.

3F: Different neural circuitry is implicated in different aspects of addictive behaviour… [D]ifferent neuropeptides specifically modulate addiction-related behaviors.

6B: In rodents, the hypothalamic oxytocin system is promptly and robustly activated by intragastric delivery of high calorific food.

In the section labeled “Limits to Our Understanding,” an interesting question is posed. If it is shown that some foods are particularly addictive, could it be that other foods are protective against this reaction?

The authors will go so far as to acknowledge an evident link between eating disorders and other disorders based on reward-seeking, such as substance abuse. But when it comes to common susceptibility factors, they cite a “critical ‘missing link’ in human data.” Nor do we have a good understanding of the common neurobiological substrate from which the mechanisms common to food reward and chemical drug reward originate. Also incompletely understood is “the relationship between psychopathology, stress, body weight and stimulatory behaviors of the reward system.”

Your responses and feedback are welcome!

Source: “Final Report Summary — NEUROFAST (The Integrated Neurobiology of Food Intake, Addiction and Stress.),” Europa.eu, January 2016
Image by Andrew Malone/CC BY 2.0

Inherency and Food Addiction, Continued

Pat Hartman May 5, 2022 No Comments

The previous post mentioned some of the authorities who have a hard time justifying a scientific basis for the intrinsic addictiveness of foodstuffs. But always, there is just enough evidence to make the possibility tantalizingly attractive to many parties, for various reasons.

The title “The Biology Behind ‘Food Addiction‘” puts the loaded term in quotation marks, and discusses the activation of reward systems:

[T]he activity of the endogenous, natural, opioid system is influenced by ingestion of palatable diets, and […] changes in the activity of the system in turn affect behavior, feeding and, perhaps, diet preference.

Similarly, both dopamine release and dopamine receptor levels are affected by palatable diets. From this it is apparent that dysfunction of these systems has the potential to contribute to overeating and the pathophysiology of obesity.

The authors explain that brain reward systems evolve to reinforce natural behaviors that are advantageous to the individual. Addictive substances connect up with the same reward systems and subvert them, making their existence a liability rather than an asset. Still, this does not constitute convincing proof that foods or food components should be considered addictive in the same sense as, for instance, cocaine.

The same organization published in 2016 a multi-faceted report on their investigations into “clinical, basic, and epidemiological research exploring the neurobiological interface between food intake, reward and stress.” They found slender evidence to support the idea that food or isolated ingredients can cause addiction in the same sense as addictive drugs.

Sugar probably presents the strongest case for thinking of a food as addictive, but the notion of sugar addiction left this team unmoved for a number of reasons:

[W]e find little evidence to support “sugar addiction.” Indeed, in animal studies we found divergence regarding brain pathways involved in reward behavior for a sweet reward from those that specifically modulate addiction-related behaviors.

The authors went on to speak of the importance of interactions between the brain’s reward pathways and the regulatory circuitry in the body that pertains to feeding. They mention the poor understanding of the neural substrate that makes this all happen, or not happen, as the case may be. It is known that the hormones leptin and ghrelin signal for other things to occur, but lining up their actions with the origin and persistence of eating disorders was nowhere near complete enough to be positive about anything.

In summation,

There is a reasonable expectation that this interaction is key to the addictive properties of specific food components and the emergence of disordered eating. But it is poorly understood how food components affect the reward circuitry, and to what extent hormones provide the link between ingestion of food and reward, and we have a poor understanding of the addictive properties of individual food components.

Your responses and feedback are welcome!

Source: “The Biology Behind ‘Food Addiction'”, Cordis.europa.eu, undated
Source: “Final Report Summary — NEUROFAST (The Integrated Neurobiology of Food Intake, Addiction and Stress.),” Cordis.europa.eu, January 2016
Image by Robin Stickel on Unsplash

Inherency and Food Addiction

Pat Hartman May 4, 2022 No Comments

Debate continues about whether some foods can be addictive in the same sense as, for instance, heroin. Is the addictiveness inherent in the food, or in the person? Or does it have to be both, two variables with the potential to cause damage, and when they meet up, the person is doomed to a lifetime of struggle?

A 2020 paper by Dr. Pretlow and three co-authors says,

There is increasing interest in whether overeating/obesity stems from an addictive process, although this notion is controversial… Food addiction (FA) connotes a substance dependence on ingredients in food, e.g., sugar, and is comparable to drug and alcohol dependence. The FA construct involves addictive eating of certain foods, which are craved, sought out, and eaten in excess.

At the same time, there is “a dearth of evidence supporting substance dependence on food ingredients.” For starters, all foods do not have the same power over people, which opens the way for facetious questions like, “Why there are so many chocolate addicts and so few broccoli addicts?” To complicate matters even further, legit substance dependencies like drug and alcohol addiction also have behavioral components. Even years ago, an important point was being made:

Labeling a food or nutrient as “addictive” implies that it contains ingredients and/or possesses an inherent property with the capacity to make susceptible individuals addicted to it, as is the case for chemical substances of abuse.

In practical terms, inherency means that no matter how expensive a substance may be, people will buy it. They will stick a hypodermic syringe between their toes to get it into their bloodstream, and risk imprisonment and disgrace. In food terms, they would eat it whether they were hungry or not, and even if the stuff tasted awful. If it meant going to jail, they would do it anyway. In all honesty, it would be difficult to name a food with those properties.

A 2014 paper encouraged professionals in the field to begin thinking in terms of “Eating Addiction.” Even though in practical terms, such foods as corn, wheat, coffee, milk, eggs, and potatoes do a very good job of making a case for addictiveness, there seems to have been difficulty in identifying any chemical or “substance-based” causative agent.

Officially, this was the state of affairs at the time:

The currently available evidence for a substance-based food addiction is poor… Humans who overeat usually do not restrict their diets to specific nutrients; instead the availability of a wider range of palatable foods appears to render prone subjects vulnerable to overeating.

The new DSM-5 (APA, 2013) currently does not allow the classification of an “Overeating Disorder” or an “Addictive Eating Disorder” within the diagnostic category Substance-Related and Addictive Disorders; indeed, the current knowledge of addictive eating behaviors does not warrant such a diagnosis.

[T]here is currently insufficient scientific evidence to label any common food, ingredient, micronutrient, standard food additive or combination of ingredients as addictive.

Your responses and feedback are welcome!

Source: “Treatment of the sensory and motor components of urges to eat (eating addiction?): a mobile-health pilot study for obesity in young people,” Springer.com, 01/14/20
Source: “’Eating addiction’, rather than ‘food addiction’, better captures addictive-like eating behavior,” ScienceDirect.com, November 2014
Image by whologwhyCC BY 2.0

Some Wrinkles in the Food Addiction Concept

Pat Hartman May 3, 2022 No Comments

Many aspects of the food addiction (FA) concept can be discussed extensively, including whether we are talking about a substance addiction or a behavioral addiction, or both, or neither; and even whether there are more than two main camps.

Discussing FA is tricky because a good argument can be made that it is a behavioral addiction to one or more of an assortment of displacement behaviors including biting, chewing, licking, sucking, crunching, swallowing, etc. Yet at the same time, it is undeniable that what these people eat is food. Sure, in a few exotic cases people cannot stop eating styrofoam or mattress stuffing. But for the vast majority, what they are eating is food (or at least it is marketed as such).

One belief is that what is called food addiction is actually a subset of drug addiction. While some edible substances apparently have a drug-like effect on the brain, this is by no means a blanket truth. The conditions characterized as sex addiction and love addiction also produce endogenous chemicals like oxytocin, but relating this to someone who scarfs down a pound of potato chips at one sitting is a stretch.

In “The View from Rat Park,” Bruce Alexander explained how rats who had morphine available consumed a lot more of it when they were isolated:

This fact definitely undermined the supposed proof that certain drugs irresistibly cause addiction. [T]he drug only becomes irresistible when the opportunity for normal social existence is destroyed.

Under such conditions, both rats and people consume too much of whatever drug is made easily accessible to them. [I]t is not too early to be sure that the old theory that addiction is a problem caused by addictive drugs is far too simple…

Moreover, it has become absolutely clear that drug and alcohol addiction is only a corner of a much larger addiction problem!

A basic difficulty in this type of study is that lab subjects and lab conditions are very different from real life. Of course, lab conditions must be strictly controlled, and much discipline must be observed. Some argue that there is no way to know what rats are feeling, which is a good point. We can only presume from the way they act. Rat Park showed that the closer the conditions are to real life — i.e., replete with variables — the more difficult it becomes to tease out meaningful differences in response to any single stimulus.

When trying to measure or observe something, a slew of variables will definitely complicate matters. Rat Park showed what happens when variables are introduced. A creature with the potential to become a junkie is presented with the opportunity to take another path. There are toys, frisky playmates, and intriguing corners to hide in. When the environment contains things other than a morphine dispenser, the world is a different place, and you get a different kind of rat.

Some researchers have invested a great deal of credence in the idea that there is an orderly and inevitable progression from trying a substance for the first time to becoming a bona fide addict. As H. Ziauddeen and P. C. Fletcher put it,

Seminal models of drug dependence have characterized a set of core processes involved in the transition from drug taking to drug dependence. There is little consistent data across these various studies and the findings thus far do not support an addiction model or indeed any one model of altered brain function in obesity.

In “Is food addiction a valid and useful concept?” the authors concluded that evidence for its existence in humans is actually rather scarce, and it is “clear that an addiction model has a limited, if any, place in understanding obesity.”

Your responses and feedback are welcome!

Source: “Addiction: The View from Rat Park,” BruceKAlexander.com,
Source: “Is food addiction a valid and useful concept?,” NIH.gov, January 2013
Image by Matt/CC BY-SA 2.0

Different Schools of Thought

Pat Hartman May 2, 2022 No Comments

Late in 2014, a lengthy contribution was added to the conversation about terminology. ” ‘Eating addiction’, rather than ‘food addiction,’, better captures addictive-like eating behavior” is the title of a report published by Neuroscience & Biobehavioral Reviews. The authors (13 in number) note that some people believe their relationship with problem foods constitutes an addiction, and if they seek help, they look to the addiction sector of therapeutic possibilities.

They also mention that food addiction means different things to different people, who are talking about either substance addiction or behavioral addiction, or both, and this ambiguity causes confusion. They prefer “eating addiction,” and proceed to explain why.

Observations

First, they say there is no evidence that it is a substance use disorder. Sure, there have been indications that the brain equally welcomes a rush from cocaine and an ecstatic experience from the chocolate sauce. But by and large, it has been difficult to pinpoint addictive substances in the food itself, although, of course, some results have been quite clear. But no one has tried to make the case that drug-like substances are in every type of food that obese people eat.

While they scoff at the idea that the substance use disorder category of the DSM-5 will ever recognize “Glucose/Sucrose/Fructose Use Disorder” as a diagnosis, they also concede that both rodent and human data are consistent with the existence of addictive eating behavior. Landing somewhere in the middle, they agree with contemporary experts who say it is “premature to conclude validity of the food addiction phenotype in humans from the current behavioral and neurobiological evidence gained in rodent models.”

Let’s roll with it

But for the time being, and because it works adequately for educational purposes, they will go with “eating addiction” because it highlights the behavioral component. The point of this paper is to discuss, from the behavioral, clinical, and neurobiological angles, how addiction and overeating are both the same and different.

And again, the terminology becomes the subject. Where is the line between occasional overeating and binge eating? In what ways does an eating addiction resemble binge eating (or not)? How do we make sense of addictive disorders that are not even substance-related?

Like so many other problems, overeating is multifactorial. The pros have to look at the severity, the degree of compulsiveness, and the “clinically significant level of personal impairment.” These authors regret that Binge Eating Disorder has become conflated with food addiction, for this reason:

The impaired control over eating behavior in “eating addiction” does not necessarily require that the affected individual experiences a sense of lack of control over eating during a single episode of overeating.

Your responses and feedback are welcome!

Source: “‘Eating addiction’, rather than ‘food addiction’, better captures addictive-like eating behavior,” ScienceDirect.com, November 2014
Images by Jesse Case and CC Runs via Twitter

Moderation Is or Is Not the Answer

Pat Hartman April 29, 2022 No Comments

Dr. Pretlow says,

A central barrier to the success of treatment for obesity that is distinct from drug addiction, is the fact that food consumption is essential for survival; thus, abstinence is not a feasible or appropriate treatment goal.

But what about moderation? In discussions of addiction and recovery, one of the first principles is that moderation fits in there somewhere. However, some believe it works, and others say it is impossible.

People in the eating disorder community, or the diabetes community, are all about eating normally. That is their goal. But an alcoholic can’t pursue the goal of “normal” social drinking, like two cocktails a week or whatever, because addiction does not work that way. “Harm reduction” or “moderate drinking” does not work for addicts.

Billi Gordon, Ph.D., who was a Research Associate at UCLA’s Center for the Neurobiology of Stress and Resilience, was never shy about sharing his own experiences, including his weight which at one point reached almost 1,000 pounds. In a Psychology Today piece called “Moderation — Strategy or Fantasy?” he wrote,

I am a food addict — and barbecue is my favorite fix… My ultimate comfort food.

In other words, his #1 problem food. This was because of childhood memories of social approval and attention at family gatherings, and particularly of time shared with his father. As he aged, this need for connection did not fade, but became stronger:

[T]he dependence on the symbolic interaction with the comfort food grows. So finding replacements that completely satisfy the needs your symbolic interaction with comfort foods only partially satisfied, is how you achieve moderation…

Sure, on one or more holidays he tried saying no to barbecue, and the results were severe depression and bingeing. Apparently, such an iconic comfort food cannot be replaced, as nothing else is capable of satisfying the symbolic interaction need.

In addition, Dr. Gordon had looked up behavioral studies on goal achievement, which showed that the more specific a goal is, the more achievable it is. He concluded that moderation is “very unspecific and determined by what one’s brain considers as normal,” a goal too nebulous to be effectively pursued. He wrote, “I need a strategy, not a fantasy, and moderation is a fantasy — at best.”

Dr. Gordon wrote extensively on the similarity between binge eating and compulsive eating, and drug addiction. He suggested an “underlying neurobiological process similar to addiction.” Dopamine, of course, is involved, activating the brain’s reward areas, and repeated indulgence in stress-relieving problem foods alters the dopaminergic pathways. He wrote:

[D]rug and food stimuli cause the same type of conditioned gene expression and neuronal plasticity in the mesolimbic-cortical pathway (reward circuitry) and regions associated with learning and memory, e.g., the ventral striatum, where habit formation occurs. Dopamine and endogenous opioids are implicated in adaptations to reward circuitry in compulsive overeating, as well as drug usage.

Your responses and feedback are welcome!

Source: “Moderation – Strategy or Fantasy?,” PsychologyToday.com, 07/06/16
Source: “Christmas Cookie Blue,” PsychologyToday, 12/06/13
Image by Kirt Edblom/CC BY-SA 2.0

Obesity and Addiction Debate Points

Pat Hartman April 28, 2022 No Comments

There are first principles that anchor the various concepts about addiction as it relates to obesity. Often there is no exact agreement on the principle itself; only on the importance of taking the matter into consideration.

One principle is inevitability, the conviction that if something in the environment is capable of causing addiction, people will get hooked. And sure, some do. But some don’t. This is one of the variables that can knock holes in theories. A closely related concept is that some foods are just inherently junkie fodder. In other words, an addictive food will be the downfall of anyone who is exposed to it. This view is held by some and contested by others. On both sides, the evidence is out there. Some people, confronted by the most delicious treats, are unmoved.

In “Addiction: The View from Rat Park,” Bruce K. Alexander threw shade on the Skinner box research “which once appeared to show that all rats and people who use addictive drugs become addicted.” Then along comes a doubter who asks why everybody isn’t addicted. Someone else says, if we look closely enough, they probably are, to something. A 2013 paper on the validity of the food addiction concept said,

The hyperpalatable foods that are thought to be addictive are widely available and widely consumed. To consider that they may become addictive in some individuals will require the characterization of a specific feature (or several features) of these foods that acts in concert with certain individual vulnerabilities.

Dr . Vera Tarman has pointed out that while anybody can become an addict, surprisingly, not everyone does — either to a substance that many are susceptible to, or under circumstances where others buckle. These are two of the anomalies that mess up attempts to achieve consensus. She has also posed many questions, like:

How about vegetables, fruits, meats and fish? For most people, even end-stage food addicts, these foods are not addictive.

She states that humans are programmed to want food when hungry, along with a complementary instruction to be satisfied when we have extracted the stored energy from the food. But that only works in relation to “the foods our body was metabolically designed to eat and enjoy with satisfaction.” When the border is crossed into the area of weird, manipulated food, however, that is another story. We live in an environment that creates food addicts on purpose.

In the words of Billi Gordon, Ph.D.,

You can never get enough of something that’s almost satisfying.

If this subject is to be debated thoroughly, there are a lot of side roads. One of the ironies is that, according to people who devote their lives to figuring out the best way to eat, there is an available way to fill the emptiness. They will affirm that something like a bowl of brown rice and beet greens can make a person “feel fed” in a way that cannot be described, but once felt, is unmistakable. The eating part itself may not provide quite the same thrill as a bag of cheese puffs, but the body as a whole really does receive the message: “Hey! I got some nutrients! I can quit eating for a while!”

Your responses and feedback are welcome!

Source: “Addiction: The View from Rat Park,” BruceKAlexander.com, 2010
Source: “Is food addiction a valid and useful concept?,” NIH.gov, January 2013
Source: “Guest Post: Food Abstinence for Food Addicts: Deprivation or a New Freedom?,” DrSharma.ca, February 2015
Source: “Moderation — Strategy or Fantasy?,” PsychologyToday.com, 07/06/16
Image by emanoellers/CC BY 2.0

Obesity and Addiction Debates

Pat Hartman April 27, 2022 No Comments

One of the first things that people need to do is figure out if they are even talking about the same thing. This is especially true if they are using the same word while maintaining different mental pictures of what it means. One choice would be to bring in a different word, but then the people who are talking about that word already might take offense because they mean something different by it. Hashing out the differences is important, and can be exhausting.

It appears to Dr. Pretlow, as well as to leaders in addiction science, that addiction and obesity both stem from one source. They both “reflect the consequences of ingestive behavior gone awry.” This is apparent from the core similarities shared by the two conditions:

First, in terms of clinical diagnostic features, both addiction and obesity result from repetitive foraging and ingestion behaviors that intensify and persist despite negative and (at times) devastating health and other life consequences.

Second, only a subset of individuals who are exposed to substances with addictive potential develop addictive behaviors, just as not all people who are exposed to foods and diet patterns that pose difficulties with weight control become obese.

The first item includes the words “behaviors that intensify and persist.” Classically, intensification and persistence are hallmarks of addiction. So it feels natural to include people who can’t or won’t stop eating, no matter what. But then, other questions arise. What exactly are they addicted to? A substance, a certain ingredient in certain foods? Or to the fundamental physical satisfactions, and the ceremonies, of eating itself?

One hallmark of addiction is that it tends to continue, and get worse over time. To proponents of either substance addiction or behavioral addiction, this is a primary tenet, part of the definition.

But then along came studies that pointed out an unexpected trait in at least two groups of people, returning Vietnam vets who had been “self-medicating” while stationed overseas, and many stateside patients who had been legitimately medicated after surgeries. A large number of individuals in each category were found to be able to give up opioids with the ease of shaking the dust off a hat. Until somebody figures out that kind of mystery, how can dialogue about substance versus behavior even be initiated?

Subset of individuals

The second item covers part of that same ground. Not only are some people able to easily abandon what appeared to have been addictions; some people never catch habits in the first place. As Dr. Pretlow points out, not all who are exposed to potentially addictive substances will develop addictive behaviors — “just as not all people who are exposed to foods and diet patterns that pose difficulties with weight control become obese.” The surprising Rat Park studies revealed that, given alternative activities and some kind of basically satisfying lifestyle, even lab rodents might turn down the opportunity to become addicted to hard drugs.

The existence of so many anomalies is the source of unease in both the Food Addiction and the Behavioral Addiction schools of thought. It becomes tempting to ask, only half-facetiously, “Maybe the people are addicted to neither food as a substance, nor eating as a behavior, but to obesity itself?” Because on some days, that seems to make as much sense as anything else.

Your responses and feedback are welcome!

Image by Jason Wilson/CC BY 2.0

Inherency and Food Addiction — More Wrinkles

Youse ain’t prove nuttin’

Inherency and Food Addiction, a Wrinkle

Inherency and Food Addiction, Some Interesting Points

Inherency and Food Addiction, Continued

Inherency and Food Addiction

Some Wrinkles in the Food Addiction Concept

Different Schools of Thought

Observations

Let’s roll with it

Moderation Is or Is Not the Answer

Obesity and Addiction Debate Points

Obesity and Addiction Debates

Subset of individuals

Profiles: Kids Struggling with Weight

The Book

About Dr. Robert A. Pretlow

Presentations

Food & Health Resources