The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) defines substance dependence as having the following characteristics:
1. Persistence of use despite problems related to the use of the substance
2. Compulsive and repetitive use
Can we classify food as an addiction? Persistent use despite problems related to the use of the substance... check. Compulsive and repetitive use... check. Cravings... check. Withdrawal? There is certainly withdrawal -- just ask anyone who has tried to change his or her diet cold turkey. This is why it is so difficult to make healthier food choices and cut off the foods that we crave.
The hypothesis that food is an addiction is currently being studied by the Yale Rudd Center for Food Policy and Obesity. Research is showing that there are similarities in the way the brain responds to drugs and highly-palatable foods. Certain neurotransmitters in the brain, including dopamine and serotonin, are released in response to certain drugs, and the same pathways seem to be cross-linked with certain foods.
The addictive nature of foods is important to understand because we are sometimes too eager to blame obesity on lack of willpower or fortitude. Yes, we make choices, we can choose not to smoke, we can choose not to take drugs, but we cannot choose "not to eat." If we are genetically susceptible to addiction and we are given the right trigger, such as an overwhelming stressor in our life that causes us ongoing anxiety, then we will connect certain foods to those pathways in the brain that release those "feel good" neurotransmitters and we have a full-blown addiction.
The thing about food addiction is that, unlike drugs, alcohol or smoking, food addiction is not yet frowned upon by society. It's still "okay" to be addicted to food, plus it's cheap, readily available in large quantities, it's packed with high density carbs and fats, it's promoted all over the media, and it is legal! What an ideal substance to abuse, right?
In my many years of treating people with weight problems and with my own experience as a recovering binge eater, I identified certain recurrent factors that affect overeating. These factors fit together in a specific order to create a cycle that explains why we overeat and why it's so hard to break the habit. If we never manage the triggers, we're bound to repeat this cycle. Even after a "successful" diet, we'll gain the weight back.
The "Cycle of Obesity," as I call it, is a cycle that begins with a life-changing stressor, perhaps the death of a loved one, an unhappy marriage, a job that is highly stressful or a do-it-all mom that never has time for herself, a perfectionist personality, an abusive spouse, physical or sexual abuse as a child, the list goes on. But it is usually one or two major events, and those who have it usually know what it was that started it.
This life-changing event causes severe ongoing anxiety, which eventually may lead to depression. Some method to offset this then follows, usually in the form of food because it's legal and easy to get. We then feel better and start making that connection with certain "feel good foods." We then develop guilt as we gain weight and experience failure and loss of control. The guilt adds to the anxiety that we already have and more depression sets in... we eat more! The cycle is then complete: anxiety, depression, overeating, guilt, anxiety, depression, overeating, guilt...
What I found is that if we just treat the overeating part of this cycle and we do not address the rest of it, we are destined to fail any diet and even surgery; we will find a way to gain the weight back! You have to get to the root of the problem. I know this works, I use it all the time with my patients and I used it with myself to keep my weight off.
Now bear with me here, because I am going to reveal another interesting observation. If you take the cycle of obesity and replace the overeating portion with any other addiction such as alcohol, drugs, gambling, sex, or any others, you will see that this is really a cycle of addiction! Think about it; all the key ingredients are there. All you need to do is change the addictive substance. How do you pick your addiction? Is it just a matter of opportunity, what's available? This may be an explanation, in part, of why we have an obesity epidemic in this country. The substance of opportunity now is different than what it was 20 years ago, people used to turn to cigarettes and alcohol, which was more acceptable back then. Now, it's food that is readily accessible, socially acceptable, and legal.
If you look closely at this cycle of addiction it explains why people gain weight when they quit smoking or become alcoholics when they conquer their obesity. If you don't manage the cycle and treat the root causes, all you do is replace one vice for another! The cycle will continue because it was never broken.
Ignoring the real issues will not lead to long-term results in any case of addiction. It's just like putting a band-aid on a large bleeding gash. Yes, some deep root problems will require counseling and long-term resolutions, but others really don't. You would be surprised how time-management, relaxation, exercise, building up your self-confidence and learning to accept failure can have a profound effect on minimizing or breaking the cycle. You just have to be honest with yourself, find the real emotional cause, then treat it appropriately. Understand the cycle of obesity and use it as a road map to break your own addictions and help others break theirs.