Our government and food industry both encourage more "personal responsibility" when it comes to battling the obesity epidemic and its associated diseases. They say people should exercise more self-control, make better choices, avoid overeating, and reduce their intake of sugar-sweetened drinks and processed food. We are led to believe that there is no good food or bad food, that it's all a matter of balance. This sounds good in theory, except for one thing...
New discoveries in science prove that industrially processed, sugar-, fat- and salt-laden food -- food that is made in a plant rather than grown on a plant, as Michael Pollan would say -- is biologically addictive.
Imagine a foot-high pile of broccoli, or a giant bowl of apple slices. Do you know anyone who would binge broccoli or apples? On other hand, imagine a mountain of potato chips or a whole bag of cookies, or a pint of ice cream. Those are easy to imagining vanishing in an unconscious, reptilian brain eating frenzy. Broccoli is not addictive, but cookies, chips, or soda absolutely can become addictive drugs.
The "just say no" approach to drug addiction hasn't fared to well, and it won't work for our industrial food addiction, either. Tell a cocaine or heroin addict or an alcoholic to "just say no" after that first snort, shot, or drink. It's not that simple. There are specific biological mechanisms that drive addictive behavior. Nobody chooses to be a heroin addict, cokehead, or drunk. Nobody chooses to be fat, either. The behaviors arise out of primitive neurochemical reward centers in the brain that override normal willpower and overwhelm our ordinary biological signals that control hunger. Consider:
- Why do cigarette smokers continue to smoke even though they know smoking will give them cancer and heart disease?
It is because these substances are all biologically addictive.
Why is it so hard for obese people to lose weight despite the social stigma and health consequences such as high blood pressure, diabetes, heart disease, arthritis, and even cancer, even though they have an intense desire to lose weight? It is not because they want to be fat. It is because certain types of food are addictive.
Food made of sugar, fat, and salt can be addictive. Especially when combined in secret ways that the food industry will not share or make public. We are biologically wired to crave these foods and eat as much of them as possible. We all know about cravings, but what does the science tell us about food and addiction, and what are the legal and policy implications if a certain food is, in fact, addictive?
The Science and Nature of Food Addiction
Let's examine the research and the similarities between high-sugar, energy-dense, fatty and salty processed and junk food and cocaine, heroin, and nicotine. We'll start by reviewing the diagnostic criteria for substance dependence or addiction found in the bible of psychiatric diagnosis, the DSM-IV, and look at how that relates to food addiction:
- Substance is taken in larger amount and for longer period than intended (a classic symptom in people who habitually overeat).
Few of us are free from this addictive pattern. If you examine your own behavior and relationship with sugar, in particular, you will likely find that your behavior around sugar and the biological effects of overconsumption of sugar match up perfectly. Many of the criteria above are likely to apply to you.
Researchers from Yale's Rudd Center for Food Policy and Obesity validated a "food addiction" scale.(i) Here are a few of the points on the scale that are used to determine if you have a food addiction. Does any of this sound familiar? If it does, you may be an "industrial food addict."
- I find that when I start eating certain foods, I end up eating much more than I had planned.
Based on these criteria and others, many of us, including most obese children, are "addicted" to industrial food.
Here are some of the scientific findings confirming that food can, indeed, be addictive(ii):
- Sugar stimulates the brain's reward centers through the neurotransmitter dopamine, exactly like other addictive drugs.
Remember the movie Super Size Me, where Morgan Spurlock ate three super-sized meals from McDonald's every day? What struck me about that film was not that he gained 30 pounds or that his cholesterol went up, or even that he got a fatty liver. What was surprising was the portrait it painted of the addictive quality of the food he ate. At the beginning of the movie, when he ate his first supersized meal, he threw it up, just like a teenager who drinks too much alcohol at his first party. By the end of the movie, he only felt "well" when he ate that junk food. The rest of the time he felt depressed, exhausted, anxious, and irritable and lost his sex drive, just like an addict or smoker withdrawing from his drug. The food was clearly addictive.
This problems with food addiction are compounded by the fact that food manufacturers refuse to release any internal data on how they put ingredients together to maximize consumption of their food products, despite requests from researchers. In his book The End of Overeating, David Kessler, M.D., the former head of the Food and Drug Administration, describes the science of how food is made into drugs by the creation of hyperpalatable foods that lead to neuro-chemical addiction.
This binging leads to profound physiological consequences that drive up calorie consumption and lead to weight gain. In a Harvard study published in the Journal of the American Medical Association, overweight adolescents consumed an extra 500 calories a day when allowed to eat junk food as compared to days when they weren't allowed to eat junk food. They ate more because the food triggered cravings and addiction. Like an alcoholic after the first drink, once these kids started eating processed food full of the sugar, fat, and salt that triggered their brain's reward centers, they couldn't stop. They were like rats in a cage.(iv)
Stop and think about this for one minute. If you were to eat 500 more calories in a day, that would equal 182,500 calories a year. Let's see, if you have to eat an extra 3,500 calories to gain one pound, that's a yearly weight gain of 52 pounds!
If high-sugar, high-fat, calorie-rich, nutrient-poor, processed, fast, junk food is indeed addictive, what does that mean? How should that influence our approach to obesity? What implications does it have for government policies and regulation? Are there legal implications? If we are allowing and even promoting addictive substances in our children's diets, how should we handle that?
I can assure you, Big Food isn't going to make any changes voluntarily. They would rather ignore this science. They have three mantras about food.
- It's all about choice. Choosing what you eat is about personal responsibility. Government regulation controlling how you market food or what foods you can eat leads to a nanny state, food "fascists," and interference with our civil liberties.
Unfortunately, this is little more than propaganda from an industry interested in profit, not in nourishing the nation.
Do We Really Have a Choice About What We Eat?
The biggest sham in food industry strategy and government food policy is advocating and emphasizing individual choice and personal responsibility to solve our obesity and chronic disease epidemic. We are told that if people just didn't eat so much, exercised more, and took care of themselves, we would be fine. We don't need to change our policies or environment. We don't want the government telling us what to do. We want free choice.
But are your choices free, or is Big Food driving behavior through insidious marketing techniques?
The reality is that many people live in food deserts where they can't buy an apple or carrot, or live in communities that have no sidewalks or where it is unsafe to be out walking. We blame the fat person. But how can we blame a two-year-old for being fat? How much choice does he or she have?
We live in toxic food environment, a nutritional wasteland. School lunchrooms and vending machines overflow with junk food and "sports drinks." Most of us don't even know what we're eating. Fifty percent of meals are eaten outside the home, and most home-cooked meals are simply microwavable industrial food. Restaurants and chains provide no clear menu labeling. Did you know that a single order of Outback Steakhouse cheese fries is 2,900 calories, or that a Starbucks venti mocha latte is 508 calories?
Environmental factors (like advertising, lack of menu labeling, and others) and the addictive properties of "industrial food," when added together, override our normal biological or psychological control mechanisms. To pretend that changing this is beyond the scope of government responsibility or that creating policy to help manage such environmental factors would lead to a "nanny state" is simply an excuse for Big Food to continue its unethical practices. Here are some ways we can change our food environment:
- Build the real cost of industrial food into the price. Incude its impact on health care costs and lost productivity.
We can alter the default conditions in the environment that foster and promote addictive behavior.(v) It's simply a matter of public and political will. If we don't, we will face an ongoing epidemic of obesity and illness across the nation. For more information on how we can manage the food crisis in this country, see the diet and nutrition section of drhyman.com.
To your good health,
Mark Hyman, M.D.
(i) Gearhardt, A.N., Corbin, W.R., and K.D. 2009. Brownell. Preliminary validation of the Yale Food Addiction Scale. Appetite. 52(2): 430-436.
(ii) Colantuoni, C., Schwenker, J., McCarthy, P., et al. 2001. Excessive sugar intake alters binding to dopamine and mu-opioid receptors in the brain. Neuroreport. 12(16): 3549-3552.
(iii) Volkow, N.D., Wang, G.J., Fowler, J.S., et al. 2002. "Nonhedonic" food motivation in humans involves dopamine in the dorsal striatum and methylphenidate amplifies this effect. Synapse. 44(3): 175-180.
(iv) Ebbeling CB, Sinclair KB, Pereira MA, Garcia-Lago E, Feldman HA, Ludwig DS. Compensation for energy intake from fast food among overweight and lean adolescents. JAMA. 2004 Jun 16;291(23):2828-2833.
(v) Brownell, K.D., Kersh, R., Ludwig. D.S., et al. 2010. Personal responsibility and obesity: A constructive approach to a controversial issue. Health Aff (Millwood). 29(3): 379-387.