Trading Drug Addiction for Food Addiction

Marissa kicked heroin, but picked up another addiction in the process: food.

“Basically, my story is one addiction to another,” said Marissa, 25, who chose not to use her real name for this story.

“I was an opiate and heroin addict and when I finally got clean, food was the next addiction to come into my life. I probably always had food addiction and binge-eating habits but the drugs kept me skinny,” she said.

Marissa’s story is tragically common. The similarity between food and drug addiction is the very reason why the National Center on Addiction and Substance Abuse announced it is expanding its focus beyond drugs, and into “behavioral addictions”—mainly, the murky waters of food addiction, which until recently had yet to gain momentum in the scientific community.

“The food addiction model, like that of substance addiction, describes the ways in which certain food properties or ingredients can produce addiction in individuals who are susceptible to their effects and who consume them in a manner that induces the addictive process (i.e., eating certain types of highly palatable, calorie-dense, and nutrient-poor food),” NCASA wrote in its report, Addressing Food Addiction: A Science-Based Approach to Policy, Practice and Research.

In the report’s press release, where NCASA announced food addiction will become a new, primary area of research, they write, “The rising obesity epidemic across the nation has propelled scientists to investigate the many ways in which individual vulnerabilities interact with our current food environment to promote excessive and unhealthy eating.”

It’s about time that food addiction is addressed in conjunction with the current climate wherein big industries stack the deck against people like Marissa. If you’re surviving on a low income, there are not many avenues toward a healthy diet. Your options are reduced to snacks that are essentially corn drenched in oil. It’s clear that these salty, fatty, sweet foods are addicting in much the same way drugs are.

In a world inundated with hedonistic advertising, where the average human drinks 92 Coke products per year, scientific inquiry into food addiction, including these contextual factors, is desperately needed.

The approach to studying food addiction is similar to how the effects of drugs have been researched. For instance, like drugs, it’s known that eating engages the reward system. In rodent studies, for example, after a month of rats being deprived of food for 12 hours and then given 12-hour access to chow and sugar, they began to binge and show signs of craving, withdrawal, and developed a sensitivity to sugar. The same way rodents (and people) develop sensitivities to heroin and cocaine.

Diagnoses will be arrived at via the Yale Food Addiction Scale. While not a recognizable disorder in the Diagnostic Statistical Manual of Mental Disorders (DSM-5), food addiction shares many of the same criteria with drug addiction, such as intense cravings, failure to fulfill major role obligations, interpersonal problems, and use in physically hazardous conditions.

There is also, of course, the dreaded hangover. Marissa described the next day after a food binge: “I’m obviously bloated, but I’m still exhausted,” she said. “I usually have no motivation to do anything and sometimes feel ill. Stomach pains and bathroom troubles, usually.” Sounds a lot like a night after Red Bull and vodka. That this happens from merely binging on food, which unlike drugs our body needs to survive, should concern us all.

Sadly, it doesn’t.

“Food addiction is not taken seriously by health professionals in the way other addictions are,” said Dr. Julie Friedman, an assistant professor at Northwestern University Medical School, and also the VP of Binge Eating programming at InSight Behavioral Health in Chicago. “If you go to your primary care doctor and say, ‘I’m binging three to four times per week,’ they’ll tell you to go to Weight Watchers.”

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Furthermore, food addiction and binge eating are often done in secret, which doesn’t help reduce stigma. “I mean, I definitely get embarrassed and I don’t allow myself to binge in public,” says Marissa.

Families often don’t understand either, said Dr. Friedman, who says her clients often feel alienated from relatives who just want them to stop and eat healthy. “[But] if you look at the neurobiology of food addiction, people cannot simply avoid trigger foods. They have increased cue responses,” said Friedman. Meaning, the experience of a sensation becomes accelerated, and temptation becomes confused with necessity. Willpower is factored out of the equation.

“It’s shameful,” said Donna (not her real name), 64, who described herself as both a binge-eater and a food addict, during an interview. “It’s not something I want to do, it’s something I’m compelled to do.”

Marissa and Donna both described being trapped in a condition outside of their own volition and agency. “I’m very conscious about how it isn’t healthy, and that I shouldn’t do it,” said Marissa. “But you get so down and depressed about it that it just continues. It’s a vicious cycle. I almost think I have a harder time with it than I did quitting heroin.”

Which makes sense, according to Friedman, given that food is a necessity. Whereas people can abstain from heroin, no one can abstain from eating.

“I think for me,” said Donna, “that recurring cycle has been so damaging in terms of not only my health, but my feelings of failure. Failure to follow through on resolve, failure to be a strong person, failure to live up to my intellectual expectations of myself. Binge eating completely throws your intellectual as it defies your own understanding of yourself.

It’s a baffling condition that is in no way caused by lack of willpower or a failing in moral fiber. Stigma results from people lacking education on the subject, who are blind to the nuances and complexities of the behavior, often placing unnecessary fault on others to make themselves feel superior.

It’s possible that food addiction will become accepted the way drug addiction has in recent years. Slowly but surely, public opinion surrounding drug addiction has changed for the better. This is especially true since the hegemony—white, middle-class men and women—has been affected by the opiate epidemic. The problem must become personal and close in order for people to change their attitudes.

The way this also happens is through education and research, which NCASA aims to do as part of its plan to tackle food addiction. Promoting research and disseminating results will hopefully be the beginning of re-framing food addiction from a moral failing to an actual medical condition, one that deserves collective compassion.

“I think that having the substance abuse community identify this issue as a related disorder gives food addiction more credibility,” said Friedman.