Be careful, your food can get you in a soup

 

Be careful, your food can get you in a soup

Binge eating can have the behavioural characteristics of substance addiction.

By Kari Anderson

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Published: Wed 19 Jun 2019, 7:54 PM

Last updated: Wed 19 Jun 2019, 10:04 PM

Never has food and weight evoked such emotion and been such a moral issue. As part of the "war on obesity" some have blamed food addiction as the cause of increasing weight of Americans - and sugar is being compared to Big Tobacco. There are even grumblings of a class action suit against food industry giants who include this "addictive" substance in their products. Meanwhile, the focus on obesity perpetuates bias against larger bodies which -combined with messaging that certain foods are dangerous and addictive - fuels food phobia that contributes to eating disorders.
But is sugar - or any food for that matter - truly addictive? And, is treating eating issues such as binge eating disorder as an 'addiction' helpful or harmful?
The reward system in the brain is very powerful. We certainly are pleasure seekers, and certain types of food entice more cravings than others - those foods that are highly palatable, those that contain sugar, refined flour and fat (a cookie) can light up the midbrain dopamine receptors. In early food addiction brain imaging studies, many researchers argued that the brain "on sugar" looks just like the brain on cocaine.
The key here is pleasure. Pleasure has profound reinforcing qualities, and singling out any one category of foods is problematic given that we need food to survive. We can avoid drug substances, but how far do we go with sugars and other carbohydrates? Ask someone with orthorexia (a term for health-food obsession gone bad) who reads labels so closely that they know every single different word for "sugar".
A recent study shows that the addictive qualities of cheese may be more powerful than those of sugar. Do we now avoid all dairy? There go two food groups! It's this type of black and white thinking that fuels the 65-billion-dollar diet industry.
Many a person enters my office and says, "Doctor, I need help, I'm addicted to food!" After nearly 30 years as an eating behaviour specialist, I must keep in mind what really works. Or rather, what doesn't work. An addiction model of abstinence doesn't work, in fact, we now know that restriction induces binge eating. Forbidden foods are the foods that my clients binge on.
In many ways binge eating has the behavioural characteristics of substance addiction: Loss of control, increasing amounts of food to get the same reward effects, unsuccessful attempts to cut back as seen in yo-yo dieting, continuing to binge eat despite severe health consequences, increased social isolation due to stigma, and behaviours that are accompanied by a feeling of shame and self-loathing.
An overview of the food addiction research suggests that it may not be the actual food that is addictive, but rather a restriction/binge pattern of consumption. Increased dietary restraint and avoidance of forbidden foods do increase binge incidence - and it is this intermittent gorging that appears to create the addiction like process.

Because of this, treatment of binge eating disorder has taken a moderate, "all foods fit" approach that focuses more on making peace with food and the body dissatisfaction that drives the binge-and-restrict behaviour.
The struggle is real: Some people who have had prolonged exposure to high-sugar and high-fat foods have decreased dopamine receptors making them more vulnerable to pleasurable stimuli. This heightened sense of anticipation for reward increases their risk for using food for self-medication whether conscious or subconscious.
When explaining this to my clients, I use the metaphor of a fighter plane such as in the movie Top Gun that has technology that "locks in" the target for a missile launch. By the time your brain "locks in" on food, you're toast unless you use some very skilled flying to change your trajectory. Once triggered, these types of cravings activate reward-seeking behaviours. Behaviour is influenced by stress. Food exposure combined with stressful stimuli, including prolonged food deprivation may activate this painful pull.
For those with binge eating disorder, unfortunately the wanting is more powerful than the liking of the actual food or experience. There is evidence of dissociative processes during a binge that interestingly make it hard to fully enjoy the "reward" the person was seeking.
There is also now evidence that it's not just the mid-brain that creates cravings. Some cravings might belong to our "second brain" in our gut. There are 10 trillion bacteria in the gut, producing chemicals that talk to each other and communicate to our brain through our Vagus nerve, the long cranial nerve that wanders through all our bodily organs from the brain to the gut.
There is evidence that we can change our gut bacteria to decrease cravings by cutting back on high sugar and high fat foods. In the event of a stomach bypass, we know that a completely different microbiota forms and creates completely different cravings. Which also means patients can change it back based on the diet that they adopt post-surgery, bringing light to the fact that even altering our plumbing isn't a permanent solution.
We know that a full abstinence model doesn't work in the long run since restrict-binge cycles are a primary factor in eating disorders as well as subclinical yo-yo dieting.
In working with my clients using a mindful eating framework, I've found that it is important to first address emotional and biological food insecurity - fear of not getting enough food - as a priority. This means untangling the diet rules mentality and allowing for all foods fitting.
One must instill the truth that all foods are permissible before suggesting that some foods might not be beneficial. Choice and self-determination are the driving forces of making this work.
Create structure and train hunger with regular meals, much like getting yourself on a good sleep schedule, is important in taming cravings.
Allow for favourite foods in a safe, supportive and mindful environment.
Learning mindfulness skills aimed at keeping one in their "right mind" and implementing a self-care focus for decreasing stress may lead toward intrinsically led choices-choices where the goal is for feeling good, rather than being good or looking good.
Adding fibre-rich whole plant foods and lean proteins to balance blood sugar and "feed" healthy microbiota which will turn down cravings.
Understanding that eating foods for pleasure, not just fuelling their bodies, are important for long term recovery!
Psychology Today, Kari Anderso is in private practice in Arizona, US, offering counselling, coaching and consulting services.



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