Understanding Obesity & Food Addiction

Something that I have learned over the years in my work as a Behavior Therapist and Addictions Specialist is that issues with food and eating are often lurking in the shadows of other problems, including alcohol dependence, drug abuse, problems with anger and impulse control, and difficulties with overwhelming emotions.

When I assess a new client in my Philadelphia or Chester County based office, I find it immensely important to understand their daily habits of living as they generally complete the picture in understanding the presenting issue and what is keeping it going. Lack of proper sleep, exercise and nutrition exacerbate mental and physical health concerns making them worse.  Energy drinks, take-out food, protein bars, pizza and coffee are not staples of a healthy diet. They do create poor eating and food habits and distance from what is normal and healthy via reinforcing impulsive and “on the fly” eating.

Most people want to be healthy, but struggle with making the changes needed to establish balance in their relationship with food and eating.  First, a person must understand their own tendencies with food along with how they deal with stress, emotions and people, as well as making sure there are no medical concerns (endocrine, etc.) which may be negatively impacting ones’ behavior with food.

I have found that obesity and food addiction are related much of the time.  I also find it curious, however, that issues with weight – obesity are not challenged and inquired about as much as one would think, despite the increase in health risks- That many people silently suffer food addiction.

Obesity

Obesity is at the forefront of today’s health concerns and warrants focus, because it is linked to many health problems. Did you know that that approximately 65% of adult Americans are overweight and 30% are obese? It is also estimated that roughly 80% of obese adults have at least one of more conditions such as: cardiovascular disease, diabetes, hypertension, sleep apnea, arthritis, and cancer. There is then another tier of problems which includes depression, substance abuse, and chronic pain that can develop as a result of those issues. Studies show that 25-50% of obese individuals binge eat and that there is a 75-95% recidivism rate to obesity among formerly obese individuals who have undergone treatment. Obviously, this points to a significant epidemic. It also raises a question, “What happened to our relationship with food?” “What went wrong?”

Food Addiction?

The medical community, insurance and food industries all encourage consumers to exercise “personal responsibility" when it comes to preventing obesity, addiction, and chronic health problems. Self-control, better choices, avoidance of over-indulging/over-eating, and staying away from packaged, high fat, carbohydrate, sugary foods is emphasized and encouraged. Seems simple, right? Being informed and then choosing? No! 

Food, like alcohol and drugs, is biologically addictive. Food is a substance.

There are specific biological mechanisms that drive addictive behavior. Addictive behaviors are fueled via primitive neurochemical reward centers in the brain that override one’s ability to exert reason, self-control, manage cravings, stop eating and to recognize biological signals of true hunger, appetite, and satiation.

Liking vs. Wanting.  Research shows that obese individuals are similar to non-obese individual in their “liking” of foods, but that they have a stronger “wanting” / desire/ drive for the foods they want. They are also willing to go to great lengths to obtain and consume them. It is noted that this may be due, in part, to neurological changes that cause a blunted psychological reward response to food – Much like how a drug addicted person might crave their drug or “want” it very strongly, long after they stopped enjoying or “liking” it.

Craving vs. Addiction. We all crave certain foods from time to time. Women are notorious for craving chocolate.  Some other common cravings include fat, sugar, or carbs. Food cravings are important because they play a role in over or compulsive eating – as they serve as “trigger foods.” It is said that our industrialized society ripens the opportunity for obesity, due to the availability and exposure to addictive food substances: sugar, fat, sweeteners, refined carbohydrates, salt and caffeine -- eroding at self-control and ability to regulate consumption of these foods.  “Loss of control” is both a term and behavior associated with addiction.

Do You?...

* Eat when you're not really hungry or eat as a result of emotional triggers

* Feel guilt or shame after eating

* Eat alone, in secret or hiding the amount of food your eat from others

* Feel out of control and/or can't stop eating

* Crave certain foods only as part of binge eating

* Get a feeling of relief from emotions when eating certain foods

Evidence in Support of Food Addiction

According to a report from the National Center on Addiction and Substance Abuse (CASA) at Columbia University, up to one half of individuals with eating disorders (including bingeing) abuse alcohol or illicit drugs, compared to 9% of the general population. Conversely, up to 35% of alcohol and illicit drug abusers have eating disorders, compared to 3% of the general population.

A direct correlation has also been established between the dramatic increase of obesity and overweight population and the aggressive marketing, increased availability, and consumption of foods over the same period (similar to tobacco).

• People who are addicted to food tend to exhibit many of the same characteristics as those addicted to alcohol and drugs:Exhibit behavior in times of transition or stress
• Common family history
• Common brain chemistry (decreased sensitivity of dopamine-reward system)
• Low self-esteem, depression, anxiety, impulsivity
• History of sexual, physical, or emotional abuse
• Obsessive preoccupation, cravings, and secretive rituals
• Experience mood altering effects from use of substance

- National Center on Addiction and Substance Abuse (CASA) at Columbia University

There is help available – One does not need to suffer.  Counseling for eating disorders coupled with professional nutritional guidance and self- help programs such as Overeaters Anonymous and Eating Disorders Anonymous are the basis of a well-structured plan.  If you are concerned about your relationship with food and eating but not sure if you are addicted and or not quite sure if you are ready to make any big changes, help is still available. Effective counseling allows room to sort through issues and make new choices.

About the Author

Paula Tropiano is a Licensed Professional Counselor and Addictions Specialist providing holistic – skills based counseling and therapy to adults in Chestnut Hill, Philadelphia, and West Chester, PA. She specializes in chronic health conditions, depression, chronic stress and anxiety, substance addictions, food and weight problems and relationship issues. 

(610) 692-4995. www.myintegratedtx.com

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