Shape Your Life
Start and maintain a healthy relationship with food
KKatie Allen, 28, knows this much about her sweet tooth: It demands attention every day. If she makes even a half-hearted attempt to ignore it—and that’s a big “if”—she gets headachy and can’t concentrate. So she makes sure she’s never caught empty-handed, keeping a stash of granola bars at work and stocking her pantry at home with bags of candy, along with all the ingredients necessary to whip up her favorite chocolate cake with peanut butter frosting. Homemade cookies, cupcakes, and ice cream crowd out everything else in her freezer. “I’ll come home from the gym after a hard workout and eat handfuls of chocolate chips—for some reason, I think of that as better for me than an actual candy bar,” says Katie, who works as a communications specialist in Manhattan. “Or I’ll fill up on whatever sweets are around and decide that’s ‘dinner.’ I tell myself, ‘A calorie is just a calorie, no matter where it’s from.’ I know that’s not a healthy approach, but it’s like I can’t control myself.”
Who hasn’t had those moments when a craving strikes and something more powerful than rational thinking seems to override selfcontrol? The trigger can be anything—a bad day at work, a fight with your significant other, or even a positive experience, like Katie’s tough workout—and suddenly you find yourself devouring an entire pint of ice cream. And if these pig-outs are not rare but instead happen more regularly than you’d like to admit, you’ve probably guiltily chalked them up to a lapse in willpower.
Recently, though, some experts have defined this kind of chronic behavior not as impulsive or “weak,” but instead as a sign of addiction, similar to the overwhelming urge for a cigarette, a cocktail, or an illicit drug. Now that scientists have various ways of peering into the brain, they’re starting to turn up evidence in support of that idea.
One small but widely publicized study presented at the Society for Neuroscience conference last year suggested that eating certain cookies triggers the brain’s addictive process in the same way (and to the same degree) as cocaine and morphine. In fact, researchers found that consuming the cookies activated even more neurons in the brain’s pleasure center than exposure to the drugs.
A growing number of studies bolster the argument that, in everyday life, such reactions translate to a constellation of compulsive symptoms. These include elevated cravings and strong desires to eat in response to food cues (e.g., you see a TV ad for cheesy pizza or smell warm pretzels at the mall and
must have one); feeling out of control when eating something indulgent; and, when tested, showing brain activity in response to food that mimics that of addicts.
In a study out of Harvard, published recently in the American Journal of Clinical Nutrition, more than 8 percent of middle-aged women showed addictive responses to food; another study, published in Appetite, found that 11 percent of young women met the criteria for food addiction. In addition, more than half—56 percent— of obese people who suffer from binge-eating disorder also show the telltale symptoms of addiction.
But not everyone agrees that devouring half a dozen doughnuts qualifies as a bona fide compulsion or compares in any real way to craving a hit of heroin. These naysayers concede that there are overlaps between addictive-like eating patterns and substance-related addictive disorders like alcoholism, but they believe it’s overreaching to use the “addiction” label.
“Clearly the evidence is building that food can be as addictive as drugs of abuse, but many people feel they need to see more research before they can support this notion,” says Joseph Frascella, Ph.D., director of the Division of Clinical Neuroscience and Behavioral Research at the National Institute on Drug Abuse. “Others think food addiction may be a real phenomenon, but only for a limited number of obese individuals.”
Indeed, addiction as a concept has morphed in recent years from a substance-based problem to a label for virtually anything done in excess—shopping, exercise, sex, gambling, even texting. But food addiction is unique, falling into a category of its own, since you can’t “kick” eating the way you would smoking. Like many of the so-called “soft” addictions, the key isn’t abstinence but learning to manage your compulsions.
All of these issues make some experts wonder whether addiction is even the right paradigm to use for overeating. Are our brain signals really prompting us to over-respond to food cues, or do our “out-of-control” eating events boil down to a behavioral issue? Either way, what is the takeaway message for the woman gazing into an open refrigerator at 11 o’clock on Sunday night?
Hooked and hungry
The idea of food addiction gained traction in 2009, when researchers at the Yale Rudd Center for Food Policy & Obesity developed the Yale Food Addiction Scale ( YFAS). In a study later published in JAMA Psy
chiatry, the researchers used the YFAS questionnaire to ask 48 otherwise healthy women to respond to a series of 27 statements regarding their eating habits in the past year, including “I have had physical withdrawal symptoms, such as agitation and anxiety, when I cut down on certain foods” and “Eating the same amount of food does not reduce negative emotions or increase pleasurable feelings the way it used to.” The women’s responses were evaluated to determine whether they met the criteria for food addiction.
The researchers then conducted brain scans while the subjects looked at pictures of a milkshake, and as they later consumed it. While viewing the shake, the women who rated high on the YFAS, whether they were obese or lean, showed high levels of activity in areas associated with craving and motivation. When they drank the shake, they had low levels of activity in the region that affects self-control. In real-world terms: The food-addiction group felt powerful cravings when exposed to food, and when they gave in to them they didn’t want to stop. Not only were their behaviors similar to alcoholics and drug addicts, but so were the biological underpinnings driving them.
“When we engage in enjoyable activities like eating and sex, the brain signals pleasure, which in turn tends to motivate us to repeat these behaviors,” explains Frascella. So what makes a healthy act like eating go fundamentally haywire? Some feel it may be the kinds of things many people are putting in their mouths these days, specifically socalled “hyper-palatable” processed foods that are high in fat, sugar, and salt.
“Our bodies are designed to be sensitive to these nutrients,” says Ashley Gearhardt, Ph.D., assistant professor for the Department of Psychology at the University of Michigan, who played a key role in developing the YFAS. “When we eat something that is pumped up with higher levels of these substances than are found in nature, our reward systems don’t know how to respond.” Hyperpalatable foods “hijack similar brain pathways to those affected by drugs, which then leads to either compulsive drug-seeking or compulsive eating,” explains Frascella. With addictive substances, in other words, the brain’s built-in reward system goes into a dangerous overdrive.
Pam Peeke, M.D., author of The Hunger Fix, calls these sugary/salty/fatty foods “false fixes.” Instead of promoting feelings of satiety, they just kick-start more cravings. Think of a fast-food burger with its high-fat, salty meat nestled in a soft, sweet bun; the combination is near-irresistible. “Eating food that’s been designed—through ingredients, preparation, and portion size—to manipulate our brain chemistry with a dopamine surge and an opium-like rush of pleasure strengthens our addiction to the false fix,” Peeke explains.
Addiction or cravings?
Whether or not all of this makes Katie Allen a food addict, however, is up for debate. Three years ago, she gave up a steady diet of cheeseburgers, fried chicken, French fries, and sweets, and began exercising regularly. She ended up losing 22 kilograms, hardly the picture of an out-ofcontrol addict. She has maintained the weight loss, but, at 5 feet 7 inches and 65 kilograms, she’s hoping to tone up even more—a goal that feels stymied by what some would call a sugar compulsion and others might merely describe as a sweet tooth.
“Some foods are so delicious that we simply find it hard to resist them or stop eating once we start,” says Hisham Ziauddeen, Ph.D., a psychiatrist and neuroscientist at England’s University of Cambridge, who researches the brain basis of behaviors like overeating. “It’s possible to imagine eating such foods without being able to control ourselves. But even if we end up giving in to that temptation now and again, it doesn’t mean these foods are addictive.” Ziauddeen and other skeptics feel that labeling normal (if unhealthy) behavior like overeating “addiction” can lead to overdiagnosis and overtreatment or, at the very least, to self-blame and stigmatization.
Stephanie Jones, a 36-year-old manager at a communications firm in
Indiana, is one who is prone to self-blame. She works out at least three times a week and eats well 80 percent of the time, but she struggles with bouts of overindulging. “I think it has to do with my monthly cycle,” she says. “It also happens when I’m stressed or when my husband, a state trooper, works evening shifts, because I worry about him. I’ve been known to blow through an entire bag of Cheese Nips, Pringles, or nacho chips in one sitting.”
Does that make her an addict? “Who wouldn’t prefer to eat food that is tasty rather than bland?” asks Ziauddeen. “I’d rather have cake than boiled cabbage.” The problem he sees with focusing so intently on hyper-palatable foods is that it underplays what he considers an important fact about addiction: “It’s the combination of a susceptible person with that substance that leads to addiction. It’s not universal. For instance, less than 20 percent of people who experiment with drugs end up becoming addicted to them.”
Those who support the theory of food addiction concede that more research is needed, but they also believe that examples like Ziauddeen’s miss the point. People have always liked eating a piece of cake, but it isn’t ordinary, simple sweets that hijack the brain, Gearhardt says. “It’s the engineered products high in salt, fat, sugar, and sometimes artificial sweeteners that are very hard for anyone to resist.”
Megan Kimble, a 27-yearold editor and writer in Tucson, Arizona, ended up swearing off these foods for that very reason. She
“Food was my medication— the solace I turned to when I had to cope with anything emotional, good or bad.”
exercises six times a week but, even with her lanky 6-foot-1-inch frame, found herself struggling to keep weight off. “I used to binge on ‘diet’ desserts, because I love sweets,” says Megan. “I’d make brownies using a sugar or wheat substitute and then eat the whole pan.”
Those patterns stopped when she went cold turkey on all processed foods two years ago and noticed a significant change in her appetite and cravings. “I found that if I ate natural things, like nuts or dried fruit, my stomach hurt if I had too much—which stops me from overdoing it,” she says.
Breaking the cycle
Wondering if you might qualify as a food addict, or if a periodic pig-out raises your risk of becoming one? A look in the mirror won’t help: While food addiction is associated with a higher body mass index, research has shown that averageweight or even underweight women can struggle with it too. Not having a “sweet tooth” or a fast-food habit doesn’t exclude you either. “Sugar is so common in our food—and can even be hidden in many products that are considered healthy— that many of us are at risk of developing patterns of eating that may resemble substance dependence,” says Nicole Avena, Ph.D., a neuroscientist and addiction expert at Columbia University and coauthor of Why
To get an idea of whether you’re susceptible, take the YFAS quiz at shape.com/
foodaddiction. Then, depending on your results, try some or all of Peeke’s tips, below.
Get rid of any false fix
Purge your fridge and pantry of processed foods, and spend at least a day noting all the ways you’re enabling your habit when you’re not at home (for instance, driving past your favorite burger joint after Spin class for a “reward”).
Dial down stress
You’re most vulnerable to cravings when you’re feeling frantic, says Peeke. Find ways to head it off, perhaps using meditation: An analysis recently published in
JAMA Internal Medicine shows that meditating 30 minutes a day provides as much relief from anxiety as medication.
Break a sweat
As few as 10 half-hour sessions of moderate treadmill walking over two weeks cut marijuana smoking among regular users in half, according to a study at Vanderbilt University. “Researchers believe the exercise altered the brain’s reward circuits to the point that exercise replaced the marijuana,” says Peeke. “Working out also decreased their cravings, compulsiveness, and emotional ups and downs.”
FOOD ON THE BRAIN Certain highly processed
items—say, cheese curls—can affect your brain circuits in a similar
way to illicit drugs.