SALT LAKE CITY — The theory of food addiction is controversial. Despite what mainstream media or some health gurus may have led you to believe, the research to date is inconclusive.
As I was doing research for this article, it became overwhelmingly apparent that the reasoning many look into food addiction or are concerned with possible food addiction behaviors is deeply rooted in fighting the "obesity epidemic." While I recognize that food behaviors are influenced by both genetics and environment, this is extremely concerning and exposes the first flaw in how we address this potential issue.
The reality is that weight stigma — or stereotyping based on a person’s weight — is positively correlated with body dissatisfaction and disordered eating. Conventional thought is that body discontent may motivate someone toward healthier behaviors. Mounting evidence and clinical practice find the opposite — body discontent is associated with disordered eating patterns, binge eating, lower levels of physical activity and increased weight gain over time.
One common assumption made about those living in larger bodies is that they eat more. The individuals themselves may even internalize that belief and blame themselves for eating amounts that are actually adequate and no different than those in thinner bodies. However, studies conducted on free-living adults at a variety of body mass indexes show little difference, on average, in calorie consumption. But there's a considerable difference for calorie intake within each BMI group, with many people with a lower BMI eating more than those with a higher BMI. It’s important to challenge this assumption since I do believe it fuels the idea that calorie restriction is necessary or even healthy for those classified as “overweight” or “obese.”
The food addiction model has two specific drawbacks:
- It was adapted from screening tools for drug and alcohol addiction.
- It doesn’t account for restrained or restrictive eating patterns.
These are huge red flags. We can encourage abstinence from drugs and alcohol, but we shouldn't encourage abstinence from food because you still need to eat. I suppose the idea of being able to say "no" and never eating whatever you feel addicted to again could make you feel "in control," but in my experience, the opposite is true. Most people feel controlled by the food rules they’ve adopted and shame if and when they disobey those rules.
The food addiction scale assesses individuals based on their self-reported experiences with food. For example, some of the questions read as follows:
- "I have found that I have elevated desires for or urges to consume certain foods when I cut down or stop eating them."
- "My behavior with respect to food and eating causes significant distress."
- "There have been times when I avoided professional or social situations where certain foods were available because I was afraid I would overeat."
These statements, and others on the scale, could apply to someone with an eating disorder or someone with a history of dieting and food restriction. What they may actually be assessing is disordered eating behaviors because of restricted and restrained eating patterns. I worry that we may be pathologizing very normal appetites for food when throwing around the idea of sugar addiction so carelessly.
You may have also heard reports of studies on rats and how certain food ingredients lit up the same neural pathways as cocaine. But further inspection into those studies showed this only occurred when rats underwent forced restriction — much like a human on a diet. Deprivation increases the reward response from food, but it doesn’t make the brain dependent on it.
There could be a case made for having an "addictive brain." This means individuals predisposed to addiction could find they act impulsively around food or substitute its use when abstaining from other substances. However, there’s a difference between using food as a way to consistently numb uncomfortable emotions and a legitimate addiction.
Proper treatment depends on proper diagnosis. As far as the research is concerned, it might be more helpful to encourage alternative coping strategies for dealing with uncomfortable emotions or difficult life stressors rather than abstaining from certain foods. Linda Bacon, author of Health At Every Size, says, “Food is a wonderful source of pleasure, but it will get you into trouble if it’s the only source of pleasure you have in your life.”
A surefire way to make yourself preoccupied and obsessed with food is to restrict its consumption. Alternately, food habituation studies show the more often you see a food, the less of it you may eat (particularly when using mindful eating practices).
I believe that the root issue isn’t a lack of ability to self-moderate food intake, but rather internalized weight bias. I believe we're encouraging compulsive behaviors, like binge-eating, by making weight the issue. Weight stigma, "fat phobia" and the concern for obesity has led many of us to label individuals as addicts versus actually trying to identify the true source of someone’s pain. Compulsive behaviors might not actually be symptoms of addiction but rather symptoms of distrust for your body, the fear of gaining weight or a brain stuck in the diet mentality.
I want to make clear that I validate what may feel like food addiction. There may be some of you reading who feel deeply troubled by your food behaviors, and if that's the case, then I encourage you to seek professional help.
While never eating certain foods again may feel like the easiest and most logical solution, you can make peace with food without restriction. That process can be strategic, can include boundaries and can take your vulnerabilities into account.
If your food intake feels out of balance, then you can learn how to self-moderate without swinging to the opposite extreme. That approach could include embracing your natural body size, using curiosity with food over judgment about food, and ensuring adequate food patterns for a well-fed brain and body (regardless of its size).
An all or nothing mentality is never helpful. Labeling foods or ingredients as “unhealthy,” “toxic” or “addictive” can easily lead to extremes in eating, which is more unhealthy than any one food. Balance, variety and flexibility is key to adequate nutrition. Ultimately, giving yourself full permission to eat puts you back in charge of your food choices.
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