As the obesity epidemic continues to grow throughout the world, including in South Africa, both the public, the media, and certain researchers have started referring to a condition called "food addiction" and also classifying some foods as "poison" or "addictive substances" (Avena et al, 2011; Leith, 2012). There have also been calls to ban sugar, high-fat and highly refined foods as stringently as tobacco and alcohol. So what is this storm in the sugar bowl all about?
Does 'food addiction' actually exist?
The public often refer to food addiction in the messages they post on the DietDoc Message Board, but until recently the medical and nutrition fraternities did not use this concept. Now, it seems, that medical doctors, psychiatrists, psychologists and nutritionists are starting to acknowledge that there may well be a condition which can be classified as "food addiction".
The theory that has been proposed, is that high palatable (tasty) foods may be "addictive" for some individuals (Avena et al, 2011), because certain brain circuits which underlie addictive behaviour and overeating, tend to overlap.
When this team of researchers at the Psychiatry Department of the University of Florida investigated data obtained with animal studies of binge eating, they found that the “addiction-like behavioural changes” observed in response to overeating were similar to those neurochemical changes that are observed when such experimental animals are exposed to addictive drugs (cannabis, tobacco, alcohol, etc) (Avena et al, 2011). An article published by Davis and coauthors (2011) in the journal Appetite, also states that “There is growing evidence of ‘food addiction’ (FA) in sugar- and fat-bingeing animals".
The Yale Food Addiction Scale (YFAS)
Davis and her team (2011), at York University in Toronto, Canada, also investigated if the YFAS (Yale Food Addiction Scale), which is the first tool developed to identify individuals with food addiction, was a valid measuring instrument. They found that results obtained with 25 obese adults aged between 25 and 45 years, supported the validity of the YFAS and that the subjects who met the diagnostic criteria for food addiction had the following characteristics:
Davies and her coworkers (2011), concluded that this study supports the use of the Yale Food Addiction Scale as a tool to identify obese individuals who are particularly vulnerable to environmental risk factors. It may also open the doors to new treatment options for the thousands of individuals who struggle with overeating, weight gain and obesity in the modern word.
Why is food addictive?
According to Corsica and Pelchat (2010), at the Rush University Medical Centre in Chicago, changes in neurochemistry involving dopamine and so-called "endogenous opioids", as well as changes in the neuroanatomy of the limbic system in the brain, and self-medication behaviours, all support the theory that certain foods have addictive properties.
The foods in question are:
Sweets, and refined carbohydrates
Sweet and fatty food combinations
Highly processed foods
(Corsica & Pelchat, 2010)
In the meanwhile the American endocrinologist, Dr Robert Lustig, has been calling for laws to restrict sugar as stringently as tobacco and alcohol (Leith, 2012).
The following characteristics have been listed as danger signals that potential food addicts should be aware of:
Obsession and/or preoccupation with food
Lack of self-control when faced with selecting and eating food
Suffering from a food compulsion where eating triggers a cycle of bingeing no matter how negative the effects may be
Associating a sense of pleasure or comfort with food and being helpless to stop using food to create these feelings of pleasure and comfort
Developing pronounced physical cravings which force you to eat
At present there is still a measure of controversy surrounding the classification of certain individuals who gain weight or become obese as food addicts. On the one hand, some experts working in the fields of psychiatry and psychology believe that overeating is a type of addiction, while other members are of the opinion that "addiction" only applies to psychoactive substances which produce tolerance and withdrawal. But other researchers argue that sugar and fat have similar effects to psychoactive substances and that food can actually produce opiates in the body (Hartney, 2012).
So far the concept of "food addiction" and all its ramifications have not been included in the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is used by the American Psychiatric Association as the benchmark for the diagnosis of mental disorders. However, it is perfectly feasible that "food addiction" will be included in future editions of the DSM and that overweight, obese and bingeing individuals will be classified as suffering from a mental disorder.
How can you combat food addiction?
The most important steps to take to combat food addiction, are to seek help as soon as possible from a dietician, a medical doctor, a psychologist or at a Eating Disorder Clinic. In the USA supportive organisations similar to the AA have already been started. Overeaters Anonymous (OA) in America provide support for individuals with food addiction. Tips that may also assist you in overcoming food addiction, include:
Identify which situations trigger your cravings, and avoid them if at all possible
Drink clean, safe water when you are overcome by the urge to eat, BUT do NOT overdo water drinking either
Try to do exercise every day
Learn to relax by means of deep breathing exercises, yoga or meditation
Learn to distract yourself when the cravings arise by doing something positive instead (going for a walk, working or helping a friend)
Hopefully organisations such as Overeaters Anonymous will also be formed in South Africa to give support to patients who suffer from a compulsion to eat and who crave food to soothe their pain.
- (Dr IV van Heerden, DietDoc, June 2012)
(Photo of man overeating bread from Shutterstock)
Any questions? Ask DietDoc
(Avena NM et al, 2011. Overlaps in the nosology of substance abuse and overeating: the translational implications of “food addiction”. Curr Drug Abuse Rev, Vol 4(3):133-9; Chakraburtty A, 2010. Mental Health & Food Addiction. http://www.webmd.com/mental-health/mental-health-food-addiction; Corsica JA, Pelchat ML, 2010. Food addiction: true or false? Curr Opin Gastroenterol, Vol 26(2):165-9; Davis C et al, 2011. Evidence that ‘food addiction’ is a valid phenotype of obesity. Appetite, Vol 57(3):711-7; Hartney E, 20120. What is Food Addiction? http://addictions.about.com/od/lesserknownaddictions/a/foodadd.htm; Leith W, 2012. The bitter truth about sugar. Pretoria News, 1 April 2012.)
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