Shape Your Life

Start and main­tain a healthy re­la­tion­ship with food

Shape (Malaysia) - - CONTENTS - By Kim­berly Goad

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

Di­ets Fail.

To get an idea of whether you’re sus­cep­ti­ble, take the YFAS quiz at

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.

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