Today's Washington Post raises some interesting questions on the issue of eating. There has long been argument over the question of compulsive eating. Is the compulsion to overeat a bad habit, an addiction, emotional or comfort eating, or a response to biological factors such as hormones?
At Brookhaven National Laboratory, psychiatrist Nora D. Volkow and her colleagues map receptors on brain cells for dopamine. This powerful neurotransmitter plays a key role in addiction. Dopamine systems in the brain are disrupted by addictive drugs, from alcohol to methamphetamine, which hijack the control of volition and the brain's quest for rewards.
It turns out that food also affects the brain's dopamine systems. When Volkow, who is also director of the National Institute on Drug Abuse, and her colleagues compared brain images of methamphetamine users with obese people, they found both groups had significantly fewer dopamine receptors than healthy people. Even more interesting: The higher the body mass index, the fewer the dopamine receptors -- a finding that may open the door to a better understanding of why it is so difficult for some people to lose weight and keep it off.
What role dopamine may play in obesity -- and how eating affects it -- is still to be determined. No one knows when the obese people in the study lost their dopamine receptors in the brain or if that loss could be reversed with weight loss. Are some people more susceptible to the effects of eating sugary, high-fat fare because they start out with lower levels of dopamine receptors in the brain? Or could eating those foods decrease dopamine receptors?
The article also refers to the challenges that individuals who feel "addicted" to food face compared with other addictions, such as smoking, drugs and alcohol, which can be eliminated from the diet. Abstinence from addictive substances is a philosophy espoused by Overeaters' Anonymous, which recommends eliminating all sugar and white flour from the diet, to reduce food cravings. In my discussions with people who have been abstinent from sugar and white flour, most have found that this successfully curbs their food cravings, with the proviso, that a life without sugar and flour isn't always practical or desirable.
3 comments:
Talia,
I realize that many people do suffer from over-eating and compulsive eating. Additionally, I'm no doctor or expert.
What I have trouble with is the fact that addiction is a physical, mental, and emotional illness (and recognized as such by the medical profession). It involves the addict being completely powerless and unable to resist the substance (alcohol or drug) that they're addicted to. It also generally results in an addict's life being completely unmanageable, and, if left untreated, will eventually lead to institutionalization (jail, hospital, rehab facility, etc.) or death.
Although eating disorders or excesses often carry some of these consequences, I'm not certain that an addiction to food (or chocolate or meat) carries with it the grave, and rapid, consequences of an alcohol or drug addiction.
Hi David and thanks for your comments
As I mentioned in the opening paragraph this issue is one of ongoing debate. My perspective in my work dealing with those who struggle with compulsive eating is that they show many of the same symptoms as those with alcohol addiction. Whether it is addiction is more difficult, but some of the people I work with do meet all the criteria.
Those at the extreme end of overeating (ie compulsive overeaters) do experience the same physical, emotional and mental issues including risk of hospitalisaion or death.
They spend all their time thinking about food. They put food ahead of their family, themselves, their work and their friends. Their entire life revolves around planning when they can their next fix. Many of them have rituals, lie to family and friends about their habit. Some will fish food out of the rubbish bin to satisfy cravings. They can also experience physical signs of withdrawal symptoms. Brain scans show that the same reward mechanisms are in play as in gambling and other addictions.
One expert (a bariatric surgeon) believes that the morbidly obese have similar life satisfaction and mobility issues as those in wheelchairs. I don't agree with this assessment but it's indicative of the wide range of opinions on the subject!
I personally believe most people can be helped with food cravings by restructuring their beliefs, thinking patterns and learning new coping techniques.
One point to keep in mind is that some people switch addictions, so they quit smoking or alcohol and then become compulsive shoppers or eaters.
Hi David:
Thanks for taking the time to comment.
I defer to Talia's expertise in the area of problematic relationships with food. But as the resident addictions specialist, I have to jump in with a few thoughts.
I too, David, have concerns that we as a society are too quick to label certain behaviors as "addiction." I think that often people use the disease concept to excuse unhealthy decisions and are simply unwilling to take responsibility for their actions.
But Talia is right that eating disorders often do meet the criteria for addiction and can be as devastating to the patient and their families as drug or alcohol dependence. Anorexia, for example, is very difficult to treat and has a very high fatality rate.
I strongly believe that there are addictive personalities. In my work with chemically dependent women in early recovery in particular, I have often seen a "transfer" of the addiction to food.
Thanks again, David, for your comments. You brought up some very valid points.
Nancy
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Talia & Nancy.