Rethinking Food Addiction
By Mikalina Kirkpatrick with Hilary Kinavey & Dana Sturtevant
Food addiction is a phrase you’ve probably heard. It’s been used in a wide variety of contexts, with increasing frequency over the past 40 years, to invoke many of the same ideas believed about drug addiction. New science finds, though, that many widely held beliefs about what we call addiction—to drugs, food or many other things—are actually incorrect and harmful.
We believe it is important that as society unlearns dangerous misconceptions about drug addiction that we not repeat the same mistakes in our efforts to help people heal their relationship with food.
We advocate for flexible, accessible eating. Any rhetoric that invites dietary restraint and restriction, and/or makes it more difficult for people to feed themselves and their loved ones regularly, does more harm than good.
The following are some of our thoughts about addiction, the idea of food addiction, the demonization of sugar, and relevant physical and social science research.
People say sugar addiction is like drug addiction.
When we pay attention to how people talk about food and bodies, it’s easy to notice the strong societal propensity to reference how people can become “addicted” to certain foods, especially those deemed “junk food” by the culture. They talk about it in the same way people talk about those addicted to drugs.
Medical professionals, 12-step programs, so-called “health and lifestyle gurus,” and highly reputable academic institutions are using the addiction model to talk about how people relate to food. Sugar, in particular, gets demonized as its own category of “addictive substances”, and people are being warned about the “addictive properties” of all kinds of highly palatable foods (or foods that tend to have high proportions of fat, salt, and sugar). It has become fairly common for people to talk about certain foods as ‘addictive’ in casual conversation. Thinking about food as addictive is reinforced in advertising when commercials for chips warn about how hard it is to stop eating their products once you start. We are internalizing a strong message that food can be overpowering and dangerous to our systems and these messages reinforce unnecessary vigilance, which is not supportive to health or well-being.
The phrases “food addiction” and “drug addiction” have had an interesting relationship in books, as well. English language authors first began using the phrase “food addiction” in 1970, and the phrase grew in popularity for the next 25 years, tripling in use between 1980 and 1995 (according to Google nGram data). Drug addiction, on the other hand, began its current 40 year decline in books that same year, 1970. Our thinking about these two ideas is very related.
The way we think about addiction is incomplete.
In mainstream American culture, addiction is viewed and treated through a criminal lens—people are punished for their addictions. The criminalization of addiction is rooted in racism. At “best” it’s seen through a medical lens, where people are pitied for their diseases. In reality, substance use and addiction are multi-layered, complex, biopsychosocial issues.
Traditional addiction models tend to focus on behavior change—whether a person is “using” or “abstinent.” A lot of the rhetoric around recovery talks about admitting one’s “powerlessness” over the “physical dependency” on the substance. Guilt and shame are used as motivators for “getting clean”, even if you have to “white knuckle it.” We see many of these concepts reproduced in diet culture.
Thankfully, evidence that this model of addiction is deeply flawed has gained widespread visibility in recent years. Johann Hari’s popular Ted Talk, which has now been viewed more than 10 million times since 2015, synthesized decades of research and evidence into an accessible narrative format. It opened up a new international conversation that challenged the traditional addiction treatment model.
There’s a body of evidence to suggest addiction is often a state of being that evolves from long term attempts to cope with unbearable emotional discomfort, which often stems from trauma. Gabor Maté, a renowned speaker and bestselling author highly sought after for his expertise on addiction, stress and childhood development, says, “There is trauma without addiction, but there is no addiction without trauma.” We would be better stewards of healing if we…
- Offered empathy for people’s pain instead of shaming them
- Honored the wisdom in these methods of coping
- Provided opportunities for real connection
- Helped create the space to develop other ways to cope
One of the most popular anecdotes from Hari’s Ted Talk and his book, Chasing the Scream, The First and Last Days of the War on Drugs, is about a laboratory study done in the 1970s. In the study, lead by researcher Bruce Alexander, rats who lived in isolated, stark living conditions—the proverbial cold empty cage—were given access to both cocaine-laced and untainted water. They quickly became deeply addicted to cocaine to the point of death. However, when the rats were given comfortable, stimulating, and highly social living conditions, and the same amount of cocaine was available, the rats mostly shunned the cocaine-laced water bottles.
Similar relationships between substance overuse and emotional isolation have been found over and over in humans. There is compelling evidence that, as Hari puts it:
The opposite of addiction is not sobriety.
The opposite of addiction is connection.
We’re repeating the same mistakes in the ways we think about food as an addiction.
Food preoccupation issues such as overeating, emotional eating, binge eating, and eating disorders have complex etiologies and cause people a lot of distress because they are often misunderstood in our culture. When people seek help for their complicated, often painful, relationships with food, many helping professionals collude with diet culture and exacerbate the symptoms. We think it’s time to take a look at some of the misconceptions and myths around both addiction and food preoccupation to untangle some of the dominant discourse and illuminate kinder, more sustainable ways to take care of our bodies and ourselves.
You’ve probably heard the common scare tactic “sugar lights up the same brain pathways as heroin and cocaine.” Yes, this is true, but you know what else does? Listening to live music, falling in love, receiving a hug, and being recognized for an achievement. Some of these things are socially acceptable and others are pathologized and/or criminalized. All animals have pathways designed for increasing pleasure and reducing pain. People turn to a variety of things to soothe, numb and cope, including food, sex, over-achieving, gambling, drugs and alcohol. When people haven’t found other ways to relieve emotional pain, many experience the “whack-a-mole” effect, where they eliminate one coping behavior only to find another pop up. For example, it’s not uncommon for bariatric surgery patients to find they turn to alcohol, gambling or sex to get the relief food and eating once provided.
The truth: people need space to explore the pattern(s) of coping they’ve developed to survive in the world. Our coping is often an available and, at the time, wise way to get through living in a situation when you have been invisibilized, treated inequitably over and over again, are experiencing pain and harm with little acknowledgement and support, survived trauma, or have been extended few other options for getting through living, etc. It takes time and adequate support to get acquainted with our inner landscapes and learn how to ride the waves of uncomfortable emotional states without being harmful to ourselves and others. And unlike drug and alcohol use, which usually come much later in life, food is something we can begin to use to soothe and cope and numb before we are even verbal.
Dietary restraint and food restriction are sure-fire ways to “feel addicted.” Eating disorder experts know restriction leads to food preoccupation. The minute a human being is told we can’t have something, chances are we will want it even more (even if we never wanted the thing in the first place!). For many, just thinking certain foods are “off limits” is enough to create a “craving”. And while you may think you allow yourself to eat what you want when you want it, chances are you are not giving yourself unconditional permission to eat and enjoy food. These so-called eating indiscretions are often done in secrecy and are riddled with guilt and shame, which triggers the making of a plan not to do it again. Then the “last supper” eating ensues and this amplifies the feelings of being addicted.
The way out of this predictable pattern is not to pull the reins tighter, which is what most 12 step programs—centered around the concept of food addiction and compulsive eating—recommend. This is when normalizing, harm reduction, and destigmatizing information about diet culture and the body’s physiological responses to food restriction and dietary restraint, would be appropriate and supportive, instead of reinforcing harmful ideas that propagate the need for more monitoring, more control, more rigidity, and stricter rules. This harmful collusion with the dieting and/or eating disorder mindset is routinely happening in 12-step programs and some eating disorder treatment centers.
The bottom line: food is rewarding. It’s our body’s way of ensuring we’re motivated enough to seek out the nourishment and fuel we need in order to stay alive! Allowing for—and even prioritizing—pleasurable eating that is attuned to our bodies’ signals encourages a long term, balanced relationship with food that allows for consistent, flexible nourishment without rigidity and restriction. The truth: pleasure heals!
New science makes it very clear that the mainstream addiction model isn’t appropriate for food either. A meta-analysis across available literature, published in the European Journal of Nutrition in 2016, said researchers found “little evidence to support sugar addiction in humans.” What evidence there was of sugar addiction in animals suggested bingeing behaviors, which are the behaviors that are considered “addiction-like,” appeared to be most connected to “intermittent access” to sugar and highly palatable foods. So enforced food restriction, rather than regular access and choice, leads to bingeing behaviors in animal studies. Sound familiar?
Another major flaw repeatedly and unethically overlooked in the few studies endorsing the “food addiction treatment model” is that these studies have not considered and controlled for peoples’ history with food, chronic dieting behaviors, and disordered eating. Binge Eating Disorder (BED) is NOT an impulse control disorder, even though some researchers and treatment centers want to reframe it as such. Most eating disorder professionals know that the most effective way to treat any eating disorder, including BED, is by reducing restriction and dieting behaviors, allowing for more flexible eating, and reincorporating once “off limits” foods back into normal eating. This, coupled with destigmatizing larger bodies and offering support to HEAL relationship with food and body, is a less pathologizing and more supportive and liberatory approach.
The opposite of bingeing is not restriction.
The opposite of bingeing is flexible, accessible eating.
The danger of conflation.
It’s dangerous to conflate our relationships with food with addiction to substances that are non-essential, just because both are sometimes used outside of what’s most health supportive.
We need sugar. Glucose, a form of sugar, is the primary source of energy for every cell in the body. If we don’t eat sugars in some form, whether it’s fruits, candy, or complex carbohydrates, our bodies have to work hard to convert what we eat into sugar. Because our brain is made up of such an incredible number of neurons (nerve cells) that are always firing, the brain is the most energy-demanding organ, using one-half of all the sugar energy in the body. Also, it’s notable that carbohydrate restriction has been found over the long term to substantially increase multiple causes of death, including heart disease, stroke, and cancer, according to new research presented in November of 2018.
From the perspective of controlling blood sugar and reducing risk of diabetes, sugar is not something we need to abstain from. THIS IS A MYTH…an extremely common myth. Sugar does not cause diabetes and there are strategies people with diabetes, and those at risk for diabetes, can use to incorporate sweets into their life. We love these resources about intuitive eating and diabetes:
- A Health at Every Size Guide to Managing Diabetes Without Food Restriction by Linda Bacon, PhD and Judith Matz, LCSW
- Mindful Eating for Prediabetes and Diabetes by Michelle May, MD
So where do we go from here.
As you can see, there’s a long list of reasons why talking about food addiction is dangerously misleading. There’s so much that we don’t know, and we must be willing to sit in the discomfort of not knowing. There is also value in asking questions like:
Who benefits from the framing of this as addiction? Who makes money off your shame?
Who are the people asking the research questions and are they willing to consider a weight-inclusive approach?
Who are the people deciding what research gets funded?
What role is fatphobia playing in the way we approach healing?
What do we, as a society, have to face if we give up this ideology?
We urge you to reject this inaccurate model and replace it with a more up-to-date and ethical paradigm. If you are a health care provider or helping professional, you are bound by an ethic to do no harm. Do your research. Challenge the status quo. Your voices and advocacy are needed.
Recommended Reading and Resources