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Why Is Food "Addiction" So Controversial?

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  • ahoy_m8
    ahoy_m8 Posts: 3,053 Member
    I just caught upon this thread and thoroughly enjoyed, especially the bits on cheese and WWII eating. The discussion seems to show that at least one reason for controversy is the lack of a single definition of addiction that is clear and that everyone is using.

    Is “alcohol addiction” or “alcoholic” even in the DSM-5? I thought those terms were replaced with “alcohol use disorder” because psychologists also struggled to give definitions precise enough to be helpful (I.e. to pinpoint when a patient had crossed the line into addiction). “Alcohol use disorder” gives practitioners a spectrum of behaviors that are more flexible and descriptive, and hence easier to use.

    If we go with the “disordered” language, we can see similarities in some eating disorder behaviors and substance use disorder behaviors, but we can also see that the spectrum of behaviors can be much more extreme and destructive with disordered use of alcohol and drugs.
  • iFartMagic
    iFartMagic Posts: 21 Member
    Food addiction is 100% a thing. It does not matter if you need it to live or not, it is a mental disorder to eat beyond what you need to live to such an excess that it is extremely unhealthy. A food addicted person will just be on auto pilot and eat until they are sick even.

    People DO use it as an excuse sometimes and are not actually addicted, and it has to be diagnosed, but it is the same class as any other eating disorder.
  • ahoy_m8
    ahoy_m8 Posts: 3,053 Member
    33gail33 wrote: »
    I'm not really sure, but maybe there is a distinction between alcohol use disorder and addiction? Physical addiction to alcohol is dangerous, if you are physically addicted you shouldn't even attempt to quit (on your own) because it can kill you. But you can certainly have alcohol use disorder without physical addiction.

    Again, someone can correct me if terminology is incorrect, but I think the term more commonly used for the bolded above is "physical dependence." As mentioned upthread, people can be "addicted" to something without physical dependence, and they can be physically dependent on something without being addicted, showing that "addiction" (the controversial word) and physical dependence aren't the same.
  • 33gail33
    33gail33 Posts: 1,155 Member
    ahoy_m8 wrote: »
    33gail33 wrote: »
    I'm not really sure, but maybe there is a distinction between alcohol use disorder and addiction? Physical addiction to alcohol is dangerous, if you are physically addicted you shouldn't even attempt to quit (on your own) because it can kill you. But you can certainly have alcohol use disorder without physical addiction.

    Again, someone can correct me if terminology is incorrect, but I think the term more commonly used for the bolded above is "physical dependence." As mentioned upthread, people can be "addicted" to something without physical dependence, and they can be physically dependent on something without being addicted, showing that "addiction" (the controversial word) and physical dependence aren't the same.

    Yes I meant physical dependence, you are right you can be addicted to something without physical dependence. So "alcohol use disorder" is the equivalent of the old "addiction" term. And physical dependence means that you would have physical withdrawal symptoms.

    This is from the American Society of Addiction Medicine. So yeah according to this it seems to me that food to also be in the addiction category.

    Definition:
    Addiction is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences.

    Prevention efforts and treatment approaches for addiction are generally as successful as those for other chronic diseases.

    Adopted by the ASAM Board of Directors September 15, 2019


  • lemurcat2
    lemurcat2 Posts: 7,885 Member
    ahoy_m8 wrote: »
    33gail33 wrote: »
    I'm not really sure, but maybe there is a distinction between alcohol use disorder and addiction? Physical addiction to alcohol is dangerous, if you are physically addicted you shouldn't even attempt to quit (on your own) because it can kill you. But you can certainly have alcohol use disorder without physical addiction.

    Again, someone can correct me if terminology is incorrect, but I think the term more commonly used for the bolded above is "physical dependence." As mentioned upthread, people can be "addicted" to something without physical dependence, and they can be physically dependent on something without being addicted, showing that "addiction" (the controversial word) and physical dependence aren't the same.

    Right. And to elaborate on the "alcohol use disorder" point, it replaced what previously (DSM IV) was "alcohol abuse" and "alcohol dependence" and combined the two, with subclassifications for mild, moderate, and severe.
  • lemurcat2
    lemurcat2 Posts: 7,885 Member
    As long as we are on the psychological/psychiatric approach, I found this interesting: https://www.psychiatry.org/patients-families/addiction/what-is-addiction

    "Substance use disorder (SUD) is complex a condition in which there is uncontrolled use of a substance despite harmful consequence. People with SUD have an intense focus on using a certain substance(s) such as alcohol, tobacco, or illicit drugs, to the point where the person’s ability to function in day to day life becomes impaired. People keep using the substance even when they know it is causing or will cause problems. The most severe SUDs are sometimes called addictions.

    People with a substance use disorder may have distorted thinking and behaviors. Changes in the brain’s structure and function are what cause people to have intense cravings, changes in personality, abnormal movements, and other behaviors. Brain imaging studies show changes in the areas of the brain that relate to judgment, decision making, learning, memory, and behavioral control.

    Repeated substance use can cause changes in how the brain functions. These changes can last long after the immediate effects of the substance wears off, or in other words, after the period of intoxication. Intoxication is the intense pleasure, euphoria, calm, increased perception and sense, and other feelings that are caused by the substance. Intoxication symptoms are different for each substance."

    There is also a list of related disorders including "gambling disorder": "This reflects research findings that gambling disorder is similar to substance-related disorders in many ways. Recognizing these similarities will help people with gambling disorder get needed treatment and services, and may help others better understand the challenges."
  • JustaNoob
    JustaNoob Posts: 147 Member
    With 7 pages of comments, I doubt anyone is really missing my opinion lol, but I'll write a thought I have.

    I think, in general, social media and tv has been used to "normalize" many things. In some cases, this has been really good to bring awareness to taboo topics that maybe have been swept under the rug in the past. However, in bringing that awareness and acceptance, it's sort of become the norm for everyone to identify as having something.

    I think of anxiety, for example. I feel like everyone I know has anxiety.... but do I feeeel like some REALLY have serious, constant, anxiety and others are maybe just struggling through a season? Yes. But who the heck am I? Maybe some people are really good at wearing a mask. I don't want to be a part of the problem in sweeping anxiety under the rug. So I just let people tell me what they mean.

    With food addiction, I don't know if it is a thing or not. If someone tells me they have a food addiction, then I'm just going to believe them and let them tell me what that means to them.
  • Speakeasy76
    Speakeasy76 Posts: 961 Member
    lemurcat2 wrote: »
    As long as we are on the psychological/psychiatric approach, I found this interesting: https://www.psychiatry.org/patients-families/addiction/what-is-addiction

    "Substance use disorder (SUD) is complex a condition in which there is uncontrolled use of a substance despite harmful consequence. People with SUD have an intense focus on using a certain substance(s) such as alcohol, tobacco, or illicit drugs, to the point where the person’s ability to function in day to day life becomes impaired. People keep using the substance even when they know it is causing or will cause problems. The most severe SUDs are sometimes called addictions.

    People with a substance use disorder may have distorted thinking and behaviors. Changes in the brain’s structure and function are what cause people to have intense cravings, changes in personality, abnormal movements, and other behaviors. Brain imaging studies show changes in the areas of the brain that relate to judgment, decision making, learning, memory, and behavioral control.

    Repeated substance use can cause changes in how the brain functions. These changes can last long after the immediate effects of the substance wears off, or in other words, after the period of intoxication. Intoxication is the intense pleasure, euphoria, calm, increased perception and sense, and other feelings that are caused by the substance. Intoxication symptoms are different for each substance."

    There is also a list of related disorders including "gambling disorder": "This reflects research findings that gambling disorder is similar to substance-related disorders in many ways. Recognizing these similarities will help people with gambling disorder get needed treatment and services, and may help others better understand the challenges."

    Given this definition, I think it's possible that for some people they do have a substance use disorder with food. It would be difficult for me to say whether or not certain kinds of food can have an "addictive" quality to them, but what about video gambling (which there is not video gambling addiction in the latest DSM) is addictive in and of itself? Or is it that it's lighting up some neural pathways in some people's brains, releasing high levels of dopamine in those that are prone to addiction? I know video games are designed to be addictive. Even my 11-year old son--who I honestly believe could be prone to this if we didn't monitor it--is able to recognize this. However, there is some research that says certain foods do in fact light up pleasure centers in the brain. I also believe some people use the mouth as a calming mechanism---look what babies and kids do to calm themselves? I think that's why some people who quit smoking then replace that with food and become overweight. It's also while some people still bite their nails.

    Anyway, I just kind of went on a tangent there, but I still think it's a possibility for food addiction. I don't necessarily like the idea of admitting "powerlessness" over it like they do in OA, because I feel that could turn into a kind of "oh well, I can't control so might as well do nothing about it." I definitely know that's not the intended message at all (having gone to those meetings themselves), but I think there are other approaches out there that could be beneficial.
  • lemurcat2
    lemurcat2 Posts: 7,885 Member
    Given this definition, I think it's possible that for some people they do have a substance use disorder with food.

    Yes, as I said upthread it seems possible to me too, although I think it might be more like a process addiction to eating (as with the gambling and gaming ones). But I don't think it's "people who eat so much they become and stay overweight are 'addicted'" as sometimes portrayed, and I certainly don't think it's "sugar is analogous to heroin" (sigh) or that any individual food is addictive in and of itself. But I think humans are able to become "addicted" to various things and dependence isn't required (as I said way above, and we've been talking about again).

    When I read about or see interviews with at least some morbidly obese people, they sound like addicts to me, and I think that rises to the level discussed at the site I linked. I also think there's probably a connection between various disordered eating behaviors even for people not that far gone.
  • ahoy_m8
    ahoy_m8 Posts: 3,053 Member
    cwolfman13 wrote: »
    ahoy_m8 wrote: »
    I just caught upon this thread and thoroughly enjoyed, especially the bits on cheese and WWII eating. The discussion seems to show that at least one reason for controversy is the lack of a single definition of addiction that is clear and that everyone is using.

    Is “alcohol addiction” or “alcoholic” even in the DSM-5? I thought those terms were replaced with “alcohol use disorder” because psychologists also struggled to give definitions precise enough to be helpful (I.e. to pinpoint when a patient had crossed the line into addiction). “Alcohol use disorder” gives practitioners a spectrum of behaviors that are more flexible and descriptive, and hence easier to use.

    If we go with the “disordered” language, we can see similarities in some eating disorder behaviors and substance use disorder behaviors, but we can also see that the spectrum of behaviors can be much more extreme and destructive with disordered use of alcohol and drugs.

    I started cognitive behavior therapy in January for my alcohol use (she uses "alcohol use disorder"). It has been a true game changer, and I am also now even more careful with the term "addiction" or "addict". I won't go in to all of the ins and outs and whatnots of what I'm doing as it would be long, and I also don't want to be that guy who's just excited and high on life right now, so much so as to be annoying to those who don't have the same enthusiasm.

    But with this therapy and my readings and journaling that I do daily, I have figured out why I could never really buy into AA, having gone to quite a few meetings over the last couple of years. Meetings start out by basically labeling yourself as an alcoholic...and verbally saying you are flawed and powerless. It was a constant negative feed back loop and negative self-speak that caused this constant battle between the willpower of my conscious mind and my deeply held beliefs about alcohol deep down in my subconscious.

    As I said, I'm much more careful than ever now with the word "addiction"...you put yourself in a box...you are putting a label on yourself...a negative one. You are essentially saying you are somehow flawed and powerless. I'm definitely no long hauler when it comes to sobriety at the moment, but I have been sober now longer than I have ever been in the past 20-25 years. I didn't have a quit date...I had a start date, as in the start of something new and something better. I'm not focused on what I'm giving up...I'm focused on what I'm gaining. In therapy we've been diving deep into my subconscious beliefs around alcohol and analyzing whether or not those beliefs are actually true...news flash, most of them are not true at all and in fact, quite the opposite of what I've held to be true.

    Given how much I was drinking, I was actually surprised to have pretty minimal physical withdrawal symptoms. I wasn't a 2 or 3 beers a night kind of guy...I was at least a pint of vodka and 2 or 3 beers to chase it down with guy, and more on weekends. It was more rare, but there were occasional weekend days that I would pretty much wake up and get my coffee and get started on my booze cruise right away if I didn't really have anything planned for the day. Withdrawal wise, I was a little irritable and grumpy the first three or four days. On my second day sober, I woke up feeling a bit under the weather...like I was coming down with some kind of mild flu and curled up on the couch wondering how I was going to get through this or if it would just be the same old same old. Upon further reflection, part of that was probably a bit of physical withdrawal...but a big part of it was a psychosomatic response...I more or less felt physically fine after that day except for maybe being a bit snippy and kind of lost as to what to do with myself since my brain wasn't being "entertained" by booze.

    In talking to my therapist, severe withdrawal symptoms can occur...and you here about them a lot, but thankfully, they occur in only about 10% of heavy drinkers, most of whom are drinking sun up to sun down for many years. I was thankful to here that most drinkers, even fairly heavy drinkers experience only mild to moderate withdrawal symptoms.

    At any rate, I think cognitive behavior therapy can help with many things, not just alcohol...smoking...food issues...gambling...you name it. And if you truly have issues, having a therapist to help you dig around in your brain is extremely helpful.

    I’m on board with the idea in your 1st bolded bit above. The personal example that leaps out for me is the belief that alcohol reduces stress. That messaging is reinforced all over the place. But I noticed in myself somewhere along the line that alcohol actually ramps up my anxiety the next day. I can’t remember how/why I first started noticing this. maybe the way I respond to alcohol changed as I aged, or maybe it always amplified anxiety but I didn’t correlated it. If I have 2 drinks spread over 2 hours, I don’t feel anything the next day. If I have more I will. Being fully aware of that (vs the subconscious belief) has made it easier to change habits. I get how the idea of debunking (or at least calibrating) beliefs applies to food habits, too. My big one there is more isn’t always more satisfying.

    Regarding the 2nd bolded bit, if you are willing to share and no worries at all if you’re not, I’m wondering what were some of the cognitive distortions you discovered (all-or-nothing thinking, fortune telling, etc). It sounds interesting.
  • LunaTheFatCat
    LunaTheFatCat Posts: 237 Member
    People that claim they are addicted to sugar have probably never dealt with a real addiction like drugs or alcohol. For me, quitting added sugar was a piece of cake compared to quitting cigarettes or alcohol.

    I love alcohol, live in Ireland and (in normal times) everything happens in the pub. But I'm fairly sure I'll be able to give up alcohol more easily than sugar. I've done alcohol free Januarys for example, but right now people give up chocolates or sweets for lent, and I've never been able to do that.

    Suppose it's different for everyone. And even is sugar addiction isn't technically an addiction, does is matter? I bloody wish I could crack that stupid habit properly.
  • lemurcat2
    lemurcat2 Posts: 7,885 Member
    There's just no mechanism whereby one could be addicted to sugar and have it manifest as a problem with specific types of sweets (in most cases also containing fat and various other ingredients) and not fruit. And if it is an issue with fruit, one could still mostly mitigate any problems by just switching to fruit and making sure to also eat a balanced diet.

    That's why I see the question of "sugar addiction" or, say, "cheese addiction" as different from the broader question of whether there can be a food/eating addiction (or perhaps more properly "food/eating disorder," with it recognized that has similarities to other use disorders).

    I think this is relevant since it might have something to say about how to address habits of overeating specific foods, which are very common, even when the foods in question aren't sugary.

    I'm open to trying to understand why claiming that "sugar" is the problem is perceived as helpful, however, and wonder if those who perceive themselves as addicted to sugar think they ought to quit eating sugar, because of how detrimental it is to their lives.

    For me, whether or not one can give up something for a relatively short period of time is less related to the question of whether it's an addiction as what happens when one is consuming/using whatever it is -- how that affects the overall life. I love naan with curry and when I eat it I have trouble sticking to my plan to eat just a small amount and have basically given up on even trying to do that, but that has no negative effects on my life (other than occasionally some regret after). On the contrary, when I was activity drinking to excess regularly (and IMO was struggling with alcohol addiction), I could quit it for periods of time, and did. In fact, one year I quit it for Lent. But the problem was I'd always go back, and when I was drinking I was really screwing up my life in all kinds of significant ways related to my obsession with alcohol. I think that does happen with eating disorders too, at least at the extreme, but rarely is it limited to specific food items from what I've seen/read.
  • 33gail33
    33gail33 Posts: 1,155 Member
    lemurcat2 wrote: »
    There's just no mechanism whereby one could be addicted to sugar and have it manifest as a problem with specific types of sweets (in most cases also containing fat and various other ingredients) and not fruit. And if it is an issue with fruit, one could still mostly mitigate any problems by just switching to fruit and making sure to also eat a balanced diet.

    That's why I see the question of "sugar addiction" or, say, "cheese addiction" as different from the broader question of whether there can be a food/eating addiction (or perhaps more properly "food/eating disorder," with it recognized that has similarities to other use disorders).

    I think this is relevant since it might have something to say about how to address habits of overeating specific foods, which are very common, even when the foods in question aren't sugary.

    I'm open to trying to understand why claiming that "sugar" is the problem is perceived as helpful, however, and wonder if those who perceive themselves as addicted to sugar think they ought to quit eating sugar, because of how detrimental it is to their lives.

    For me, whether or not one can give up something for a relatively short period of time is less related to the question of whether it's an addiction as what happens when one is consuming/using whatever it is -- how that affects the overall life. I love naan with curry and when I eat it I have trouble sticking to my plan to eat just a small amount and have basically given up on even trying to do that, but that has no negative effects on my life (other than occasionally some regret after). On the contrary, when I was activity drinking to excess regularly (and IMO was struggling with alcohol addiction), I could quit it for periods of time, and did. In fact, one year I quit it for Lent. But the problem was I'd always go back, and when I was drinking I was really screwing up my life in all kinds of significant ways related to my obsession with alcohol. I think that does happen with eating disorders too, at least at the extreme, but rarely is it limited to specific food items from what I've seen/read.

    It's interesting because a few people have pointed out the sugar/fruit thing - so like you can't be addicted to sugar because otherwise you would over eat fruit etc. But the study analysis that I linked earlier (below) came to the opposite conclusion. That the substance was the more important component in the equation, rather than the behaviour. Basically how I am reading this is that they concluded that the addiction is to certain (highly palatable) foods, and not to eating itself.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946262/

    "The results of the current systematic review generally support the validity of food addiction as a diagnostic construct, particularly as it relates to foods high in added sweeteners and refined ingredients. The majority of studies in the current review reported evidence for symptoms related to neurological changes and impaired control, with fewer studies evaluating preoccupation, chronicity, relapse, social impairment, and risky use. Behavioral and substance-related aspects of food addiction appear to be intertwined, but we suggest that the substance (highly-palatable food) component may be more salient to the diagnostic classification of this phenomenon than the behavior (eating). We propose that the food addiction construct merits serious attention in regard to its presentation, prevention, and treatment in humans."
  • lemurcat2
    lemurcat2 Posts: 7,885 Member
    edited February 2021
    33gail33 wrote: »
    lemurcat2 wrote: »
    There's just no mechanism whereby one could be addicted to sugar and have it manifest as a problem with specific types of sweets (in most cases also containing fat and various other ingredients) and not fruit. And if it is an issue with fruit, one could still mostly mitigate any problems by just switching to fruit and making sure to also eat a balanced diet.

    That's why I see the question of "sugar addiction" or, say, "cheese addiction" as different from the broader question of whether there can be a food/eating addiction (or perhaps more properly "food/eating disorder," with it recognized that has similarities to other use disorders).

    I think this is relevant since it might have something to say about how to address habits of overeating specific foods, which are very common, even when the foods in question aren't sugary.

    I'm open to trying to understand why claiming that "sugar" is the problem is perceived as helpful, however, and wonder if those who perceive themselves as addicted to sugar think they ought to quit eating sugar, because of how detrimental it is to their lives.

    For me, whether or not one can give up something for a relatively short period of time is less related to the question of whether it's an addiction as what happens when one is consuming/using whatever it is -- how that affects the overall life. I love naan with curry and when I eat it I have trouble sticking to my plan to eat just a small amount and have basically given up on even trying to do that, but that has no negative effects on my life (other than occasionally some regret after). On the contrary, when I was activity drinking to excess regularly (and IMO was struggling with alcohol addiction), I could quit it for periods of time, and did. In fact, one year I quit it for Lent. But the problem was I'd always go back, and when I was drinking I was really screwing up my life in all kinds of significant ways related to my obsession with alcohol. I think that does happen with eating disorders too, at least at the extreme, but rarely is it limited to specific food items from what I've seen/read.

    It's interesting because a few people have pointed out the sugar/fruit thing - so like you can't be addicted to sugar because otherwise you would over eat fruit etc. But the study analysis that I linked earlier (below) came to the opposite conclusion. That the substance was the more important component in the equation, rather than the behaviour. Basically how I am reading this is that they concluded that the addiction is to certain (highly palatable) foods, and not to eating itself.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946262/

    "The results of the current systematic review generally support the validity of food addiction as a diagnostic construct, particularly as it relates to foods high in added sweeteners and refined ingredients. The majority of studies in the current review reported evidence for symptoms related to neurological changes and impaired control, with fewer studies evaluating preoccupation, chronicity, relapse, social impairment, and risky use. Behavioral and substance-related aspects of food addiction appear to be intertwined, but we suggest that the substance (highly-palatable food) component may be more salient to the diagnostic classification of this phenomenon than the behavior (eating). We propose that the food addiction construct merits serious attention in regard to its presentation, prevention, and treatment in humans."

    I think the claim that highly palatable foods are "addictive" is separate from and actually quite different from the claim that "sugar" is addictive (and so called highly palatable foods aren't inherently sugary -- I know pizza scores high on many of those tests and french fries (potatoes with fat and salt) score high whereas plain potatoes (mostly carbs) score very low). From your cite: "The evidence further suggests that certain foods, particularly processed foods with added sweeteners and fats, demonstrate the greatest addictive potential. Though both behavioral and substance-related factors are implicated in the addictive process, symptoms appear to better fit criteria for substance use disorder than behavioral addiction." (I.e., it is not about sugar per se.)

    I don't actually think the highly palatable idea is well-supported/convincing either -- studies are all over the place and the ones I have found most convincing tend to focus on the eating behavior, and other factors that tend to result in losses of control around foods (i.e., this can happen because you decide you cannot eat a food and then when you do have an all or nothing response). The hyper palatable concept basically is that people report such foods as harder to control and more pleasurable, which is not all that surprising (even if I personally think many of them aren't nearly as tasty as foods that aren't supposed to be hyper palatable). But is having a desire to overeat something because it tastes super good to you "addiction"? I think that's a misnomer, although I do think it is relevant to why people tend to overeat. (Although I do think that eating such foods a lot may well cause one to crave them, something that can be changed by changing the palate by eating different foods. One could argue that that's addiction, although most of the time it seems to fall far short of what is normally characterized as a "use disorder.")

    I would expect that people who want to eat gravitate toward foods they find extra palatable when those are available, sure, and that those are therefore often the foods that get associated with eating for comfort or various other eating behaviors that can easily become disordered in some way. And I would also agree that to some extent hyperpalatability may overwhelm your sense of fullness in a way that foods that one finds less rewarding (or which take more time to eat, often) will not. But is that analogous to the types of things that relate to a "use disorder"? It can be, but I think it gets used quite casually normally, and not strictly in that way, and I think it ignores the fact that binge eating disorder will often involve whatever foods are around (hyperpalatable or no) and the like with some of the super morbidly obese people who seem to be giving up everything for food/eating -- it's probably not just if the food is extra palatable. But this is all a separate question, the main point is the "it's extra palatable foods" thing doesn't support "sugar addiction."

    One question I would ask, and I'm undecided, is assuming that food/eating can be part of an addictive chain, which I think it certainly could be, why would it most commonly be manifested through so called hyper palatable foods (which are not limited to sugary ones and could certainly be traditional comfort foods like buttery mashed potatoes, say)? Is it because the foods themselves are so addictive? Or is it because food is pleasurable/comforting and if seeking pleasure/comfort one would likely seek out the most desirable foods in one's mind, and then the habit that forms tends to be related to those foods even if other ones (eating more generally) could do if those were not available? I suspect the latter, and therefore that it is not addiction to a specific substance or even the non substance that is "hyper palatable."

    I'm not sure this matters, I just find it interesting. I think my current theory is that there's some combination of a behavior and substance addiction (which I'd argue is the same with alcohol too), but that you can't fence of any such problem as being 100% limited to so-called hyperpalatable foods, and if someone had a significant issue and they were unavailable, I bet other foods would be alternatives.

    Question for you: if we did determine that hyperpalatable foods have the potential for addiction in a way that other foods do not (including sugar-filled foods like fruit, say!), what do you think this would mean? That the solution is to give up 100% hyperpalatable foods?
  • 33gail33
    33gail33 Posts: 1,155 Member
    lemurcat2 wrote: »
    33gail33 wrote: »
    lemurcat2 wrote: »
    There's just no mechanism whereby one could be addicted to sugar and have it manifest as a problem with specific types of sweets (in most cases also containing fat and various other ingredients) and not fruit. And if it is an issue with fruit, one could still mostly mitigate any problems by just switching to fruit and making sure to also eat a balanced diet.

    That's why I see the question of "sugar addiction" or, say, "cheese addiction" as different from the broader question of whether there can be a food/eating addiction (or perhaps more properly "food/eating disorder," with it recognized that has similarities to other use disorders).

    I think this is relevant since it might have something to say about how to address habits of overeating specific foods, which are very common, even when the foods in question aren't sugary.

    I'm open to trying to understand why claiming that "sugar" is the problem is perceived as helpful, however, and wonder if those who perceive themselves as addicted to sugar think they ought to quit eating sugar, because of how detrimental it is to their lives.

    For me, whether or not one can give up something for a relatively short period of time is less related to the question of whether it's an addiction as what happens when one is consuming/using whatever it is -- how that affects the overall life. I love naan with curry and when I eat it I have trouble sticking to my plan to eat just a small amount and have basically given up on even trying to do that, but that has no negative effects on my life (other than occasionally some regret after). On the contrary, when I was activity drinking to excess regularly (and IMO was struggling with alcohol addiction), I could quit it for periods of time, and did. In fact, one year I quit it for Lent. But the problem was I'd always go back, and when I was drinking I was really screwing up my life in all kinds of significant ways related to my obsession with alcohol. I think that does happen with eating disorders too, at least at the extreme, but rarely is it limited to specific food items from what I've seen/read.

    It's interesting because a few people have pointed out the sugar/fruit thing - so like you can't be addicted to sugar because otherwise you would over eat fruit etc. But the study analysis that I linked earlier (below) came to the opposite conclusion. That the substance was the more important component in the equation, rather than the behaviour. Basically how I am reading this is that they concluded that the addiction is to certain (highly palatable) foods, and not to eating itself.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946262/

    "The results of the current systematic review generally support the validity of food addiction as a diagnostic construct, particularly as it relates to foods high in added sweeteners and refined ingredients. The majority of studies in the current review reported evidence for symptoms related to neurological changes and impaired control, with fewer studies evaluating preoccupation, chronicity, relapse, social impairment, and risky use. Behavioral and substance-related aspects of food addiction appear to be intertwined, but we suggest that the substance (highly-palatable food) component may be more salient to the diagnostic classification of this phenomenon than the behavior (eating). We propose that the food addiction construct merits serious attention in regard to its presentation, prevention, and treatment in humans."

    I think the claim that highly palatable foods are "addictive" is separate from and actually quite different from the claim that "sugar" is addictive (and so called highly palatable foods aren't inherently sugary -- I know pizza scores high on many of those tests and french fries (potatoes with fat and salt) score high whereas plain potatoes (mostly carbs) score very low). From your cite: "The evidence further suggests that certain foods, particularly processed foods with added sweeteners and fats, demonstrate the greatest addictive potential. Though both behavioral and substance-related factors are implicated in the addictive process, symptoms appear to better fit criteria for substance use disorder than behavioral addiction." (I.e., it is not about sugar per se.)

    I don't actually think the highly palatable idea is well-supported/convincing either -- studies are all over the place and the ones I have found most convincing tend to focus on the eating behavior, and other factors that tend to result in losses of control around foods (i.e., this can happen because you decide you cannot eat a food and then when you do have an all or nothing response). The hyper palatable concept basically is that people report such foods as harder to control and more pleasurable, which is not all that surprising (even if I personally think many of them aren't nearly as tasty as foods that aren't supposed to be hyper palatable). But is having a desire to overeat something because it tastes super good to you "addiction"? I think that's a misnomer, although I do think it is relevant to why people tend to overeat. (Although I do think that eating such foods a lot may well cause one to crave them, something that can be changed by changing the palate by eating different foods. One could argue that that's addiction, although most of the time it seems to fall far short of what is normally characterized as a "use disorder.")

    I would expect that people who want to eat gravitate toward foods they find extra palatable when those are available, sure, and that those are therefore often the foods that get associated with eating for comfort or various other eating behaviors that can easily become disordered in some way. And I would also agree that to some extent hyperpalatability may overwhelm your sense of fullness in a way that foods that one finds less rewarding (or which take more time to eat, often) will not. But is that analogous to the types of things that relate to a "use disorder"? It can be, but I think it gets used quite casually normally, and not strictly in that way, and I think it ignores the fact that binge eating disorder will often involve whatever foods are around (hyperpalatable or no) and the like with some of the super morbidly obese people who seem to be giving up everything for food/eating -- it's probably not just if the food is extra palatable. But this is all a separate question, the main point is the "it's extra palatable foods" thing doesn't support "sugar addiction."

    One question I would ask, and I'm undecided, is assuming that food/eating can be part of an addictive chain, which I think it certainly could be, why would it most commonly be manifested through so called hyper palatable foods (which are not limited to sugary ones and could certainly be traditional comfort foods like buttery mashed potatoes, say)? Is it because the foods themselves are so addictive? Or is it because food is pleasurable/comforting and if seeking pleasure/comfort one would likely seek out the most desirable foods in one's mind, and then the habit that forms tends to be related to those foods even if other ones (eating more generally) could do if those were not available? I suspect the latter, and therefore that it is not addiction to a specific substance or even the non substance that is "hyper palatable."

    I'm not sure this matters, I just find it interesting. I think my current theory is that there's some combination of a behavior and substance addiction (which I'd argue is the same with alcohol too), but that you can't fence of any such problem as being 100% limited to so-called hyperpalatable foods, and if someone had a significant issue and they were unavailable, I bet other foods would be alternatives.

    Question for you: if we did determine that hyperpalatable foods have the potential for addiction in a way that other foods do not (including sugar-filled foods like fruit, say!), what do you think this would mean? That the solution is to give up 100% hyperpalatable foods?

    Re: the bolded section. Couldn't you say the same about alcohol though? Except in cases of physical dependence isn't this the mechanism for all addiction?
  • ahoy_m8
    ahoy_m8 Posts: 3,053 Member
    edited February 2021
    I am going to disagree with the findings in that paper on 2 points. Here they are:

    1) I have not felt a strong dopamine rush in response to anticipating a highly palatable food, but I have felt it with alcohol so I know how that feels and I do not doubt some people feel it with certain foods. The crazy thing about it is the dopamine release happens before, in anticipation of, the reward.

    Hence, IME, it is not the substance itself, it is the anticipation of it that triggers brain chemicals. I think THAT is the phenomenon these paper authors are observing. And the specific reward that triggers the response can be different for different people. For me it might be chardonnay. For you it might be oreos. But the anticipatory dopamine rush is similar, and that is what the dudes are observing.

    2) To the assertion that the substance matters more than the eating behavior for diagnosis, that may be true in a narrow set of cases these dudes examined but it I reject the idea that it applies to all cases. Any of us who have experienced a binge (raises hand) have experienced scarfing anything at hand -- anything -- to shove in the maw. That behavior is certainly disordered. And it is not limited to a specific substance.

    So here I apologize in advance for repeating myself in this thread. I think the controversial thing is the word addiction. DSM authors must agree because they replaced the word with "disorder" and defined a spectrum of behaviors (IMU). Some of the behaviors may look similar if not identical across eating disorders and substance use disorders. But other behaviors that reach into the extremes of destructiveness are the unique provence of substance use disorders. I really do think drugs/alcohol have a far more powerful impact on brain chemistry than dopamine alone which is the main thing going on with food responses.

    ETA: the dopamine pathway explanation makes sense for other behavioral "addictions" like gambling and porn. They light up the brain's reward circuits but obviously there is no intake of a substance/food that acts on brain chemistry. No doubt these compulsive behaviors have had ruinous consequences on lives.
  • lemurcat2
    lemurcat2 Posts: 7,885 Member
    edited February 2021
    33gail33 wrote: »
    lemurcat2 wrote: »
    33gail33 wrote: »
    lemurcat2 wrote: »
    There's just no mechanism whereby one could be addicted to sugar and have it manifest as a problem with specific types of sweets (in most cases also containing fat and various other ingredients) and not fruit. And if it is an issue with fruit, one could still mostly mitigate any problems by just switching to fruit and making sure to also eat a balanced diet.

    That's why I see the question of "sugar addiction" or, say, "cheese addiction" as different from the broader question of whether there can be a food/eating addiction (or perhaps more properly "food/eating disorder," with it recognized that has similarities to other use disorders).

    I think this is relevant since it might have something to say about how to address habits of overeating specific foods, which are very common, even when the foods in question aren't sugary.

    I'm open to trying to understand why claiming that "sugar" is the problem is perceived as helpful, however, and wonder if those who perceive themselves as addicted to sugar think they ought to quit eating sugar, because of how detrimental it is to their lives.

    For me, whether or not one can give up something for a relatively short period of time is less related to the question of whether it's an addiction as what happens when one is consuming/using whatever it is -- how that affects the overall life. I love naan with curry and when I eat it I have trouble sticking to my plan to eat just a small amount and have basically given up on even trying to do that, but that has no negative effects on my life (other than occasionally some regret after). On the contrary, when I was activity drinking to excess regularly (and IMO was struggling with alcohol addiction), I could quit it for periods of time, and did. In fact, one year I quit it for Lent. But the problem was I'd always go back, and when I was drinking I was really screwing up my life in all kinds of significant ways related to my obsession with alcohol. I think that does happen with eating disorders too, at least at the extreme, but rarely is it limited to specific food items from what I've seen/read.

    It's interesting because a few people have pointed out the sugar/fruit thing - so like you can't be addicted to sugar because otherwise you would over eat fruit etc. But the study analysis that I linked earlier (below) came to the opposite conclusion. That the substance was the more important component in the equation, rather than the behaviour. Basically how I am reading this is that they concluded that the addiction is to certain (highly palatable) foods, and not to eating itself.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946262/

    "The results of the current systematic review generally support the validity of food addiction as a diagnostic construct, particularly as it relates to foods high in added sweeteners and refined ingredients. The majority of studies in the current review reported evidence for symptoms related to neurological changes and impaired control, with fewer studies evaluating preoccupation, chronicity, relapse, social impairment, and risky use. Behavioral and substance-related aspects of food addiction appear to be intertwined, but we suggest that the substance (highly-palatable food) component may be more salient to the diagnostic classification of this phenomenon than the behavior (eating). We propose that the food addiction construct merits serious attention in regard to its presentation, prevention, and treatment in humans."

    I think the claim that highly palatable foods are "addictive" is separate from and actually quite different from the claim that "sugar" is addictive (and so called highly palatable foods aren't inherently sugary -- I know pizza scores high on many of those tests and french fries (potatoes with fat and salt) score high whereas plain potatoes (mostly carbs) score very low). From your cite: "The evidence further suggests that certain foods, particularly processed foods with added sweeteners and fats, demonstrate the greatest addictive potential. Though both behavioral and substance-related factors are implicated in the addictive process, symptoms appear to better fit criteria for substance use disorder than behavioral addiction." (I.e., it is not about sugar per se.)

    I don't actually think the highly palatable idea is well-supported/convincing either -- studies are all over the place and the ones I have found most convincing tend to focus on the eating behavior, and other factors that tend to result in losses of control around foods (i.e., this can happen because you decide you cannot eat a food and then when you do have an all or nothing response). The hyper palatable concept basically is that people report such foods as harder to control and more pleasurable, which is not all that surprising (even if I personally think many of them aren't nearly as tasty as foods that aren't supposed to be hyper palatable). But is having a desire to overeat something because it tastes super good to you "addiction"? I think that's a misnomer, although I do think it is relevant to why people tend to overeat. (Although I do think that eating such foods a lot may well cause one to crave them, something that can be changed by changing the palate by eating different foods. One could argue that that's addiction, although most of the time it seems to fall far short of what is normally characterized as a "use disorder.")

    I would expect that people who want to eat gravitate toward foods they find extra palatable when those are available, sure, and that those are therefore often the foods that get associated with eating for comfort or various other eating behaviors that can easily become disordered in some way. And I would also agree that to some extent hyperpalatability may overwhelm your sense of fullness in a way that foods that one finds less rewarding (or which take more time to eat, often) will not. But is that analogous to the types of things that relate to a "use disorder"? It can be, but I think it gets used quite casually normally, and not strictly in that way, and I think it ignores the fact that binge eating disorder will often involve whatever foods are around (hyperpalatable or no) and the like with some of the super morbidly obese people who seem to be giving up everything for food/eating -- it's probably not just if the food is extra palatable. But this is all a separate question, the main point is the "it's extra palatable foods" thing doesn't support "sugar addiction."

    One question I would ask, and I'm undecided, is assuming that food/eating can be part of an addictive chain, which I think it certainly could be, why would it most commonly be manifested through so called hyper palatable foods (which are not limited to sugary ones and could certainly be traditional comfort foods like buttery mashed potatoes, say)? Is it because the foods themselves are so addictive? Or is it because food is pleasurable/comforting and if seeking pleasure/comfort one would likely seek out the most desirable foods in one's mind, and then the habit that forms tends to be related to those foods even if other ones (eating more generally) could do if those were not available? I suspect the latter, and therefore that it is not addiction to a specific substance or even the non substance that is "hyper palatable."

    I'm not sure this matters, I just find it interesting. I think my current theory is that there's some combination of a behavior and substance addiction (which I'd argue is the same with alcohol too), but that you can't fence of any such problem as being 100% limited to so-called hyperpalatable foods, and if someone had a significant issue and they were unavailable, I bet other foods would be alternatives.

    Question for you: if we did determine that hyperpalatable foods have the potential for addiction in a way that other foods do not (including sugar-filled foods like fruit, say!), what do you think this would mean? That the solution is to give up 100% hyperpalatable foods?

    Re: the bolded section. Couldn't you say the same about alcohol though? Except in cases of physical dependence isn't this the mechanism for all addiction?

    Yeah, sure, to some extent, although I largely agree with ahoy_m8 too (and I don't think dependence is particularly important). I think you are missing the distinction I'm trying to make (probably my fault).

    I'm saying that food is comforting and pleasurable, so has the potential to be addictive same as many other things.

    On average, people likely gravitate to foods that are easily available (which tend to be hyperpalatable ones) and ones that stand out in their minds as super delicious (same), especially within the context of our culture. So, those tend to be the ones they gravitate to. When those aren't available, though, I suspect they could get the same response from other foods (or eating activity, whichever it is -- I think a combination), so they could use those. Also, assuming a world where none of these supposedly hyperpalatable foods existed, could the same type of addiction response happen under the right circumstances? I think so, because -- again -- food and eating is comforting and pleasurable.

    Thus, is it really that the addiction is a response to hyperpalatable foods specifically or just that for understandable reasons given our specific society that they tend to be the foods that people with these types of food issues will gravitate to, but that others would also work as well given the right circumstances (or the absence of other easily available foods)?

    (This is setting aside the fact that of course many people have trouble moderating or occasionally overeat specific foods they enjoy without it meeting the threshold of the kind of use disorder that we are discussing and focusing on those who do meet that threshold.)
  • ahoy_m8
    ahoy_m8 Posts: 3,053 Member
    33gail33 wrote: »
    lemurcat2 wrote: »
    33gail33 wrote: »
    lemurcat2 wrote: »
    There's just no mechanism whereby one could be addicted to sugar and have it manifest as a problem with specific types of sweets (in most cases also containing fat and various other ingredients) and not fruit. And if it is an issue with fruit, one could still mostly mitigate any problems by just switching to fruit and making sure to also eat a balanced diet.

    That's why I see the question of "sugar addiction" or, say, "cheese addiction" as different from the broader question of whether there can be a food/eating addiction (or perhaps more properly "food/eating disorder," with it recognized that has similarities to other use disorders).

    I think this is relevant since it might have something to say about how to address habits of overeating specific foods, which are very common, even when the foods in question aren't sugary.

    I'm open to trying to understand why claiming that "sugar" is the problem is perceived as helpful, however, and wonder if those who perceive themselves as addicted to sugar think they ought to quit eating sugar, because of how detrimental it is to their lives.

    For me, whether or not one can give up something for a relatively short period of time is less related to the question of whether it's an addiction as what happens when one is consuming/using whatever it is -- how that affects the overall life. I love naan with curry and when I eat it I have trouble sticking to my plan to eat just a small amount and have basically given up on even trying to do that, but that has no negative effects on my life (other than occasionally some regret after). On the contrary, when I was activity drinking to excess regularly (and IMO was struggling with alcohol addiction), I could quit it for periods of time, and did. In fact, one year I quit it for Lent. But the problem was I'd always go back, and when I was drinking I was really screwing up my life in all kinds of significant ways related to my obsession with alcohol. I think that does happen with eating disorders too, at least at the extreme, but rarely is it limited to specific food items from what I've seen/read.

    It's interesting because a few people have pointed out the sugar/fruit thing - so like you can't be addicted to sugar because otherwise you would over eat fruit etc. But the study analysis that I linked earlier (below) came to the opposite conclusion. That the substance was the more important component in the equation, rather than the behaviour. Basically how I am reading this is that they concluded that the addiction is to certain (highly palatable) foods, and not to eating itself.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946262/

    "The results of the current systematic review generally support the validity of food addiction as a diagnostic construct, particularly as it relates to foods high in added sweeteners and refined ingredients. The majority of studies in the current review reported evidence for symptoms related to neurological changes and impaired control, with fewer studies evaluating preoccupation, chronicity, relapse, social impairment, and risky use. Behavioral and substance-related aspects of food addiction appear to be intertwined, but we suggest that the substance (highly-palatable food) component may be more salient to the diagnostic classification of this phenomenon than the behavior (eating). We propose that the food addiction construct merits serious attention in regard to its presentation, prevention, and treatment in humans."

    I think the claim that highly palatable foods are "addictive" is separate from and actually quite different from the claim that "sugar" is addictive (and so called highly palatable foods aren't inherently sugary -- I know pizza scores high on many of those tests and french fries (potatoes with fat and salt) score high whereas plain potatoes (mostly carbs) score very low). From your cite: "The evidence further suggests that certain foods, particularly processed foods with added sweeteners and fats, demonstrate the greatest addictive potential. Though both behavioral and substance-related factors are implicated in the addictive process, symptoms appear to better fit criteria for substance use disorder than behavioral addiction." (I.e., it is not about sugar per se.)

    I don't actually think the highly palatable idea is well-supported/convincing either -- studies are all over the place and the ones I have found most convincing tend to focus on the eating behavior, and other factors that tend to result in losses of control around foods (i.e., this can happen because you decide you cannot eat a food and then when you do have an all or nothing response). The hyper palatable concept basically is that people report such foods as harder to control and more pleasurable, which is not all that surprising (even if I personally think many of them aren't nearly as tasty as foods that aren't supposed to be hyper palatable). But is having a desire to overeat something because it tastes super good to you "addiction"? I think that's a misnomer, although I do think it is relevant to why people tend to overeat. (Although I do think that eating such foods a lot may well cause one to crave them, something that can be changed by changing the palate by eating different foods. One could argue that that's addiction, although most of the time it seems to fall far short of what is normally characterized as a "use disorder.")

    I would expect that people who want to eat gravitate toward foods they find extra palatable when those are available, sure, and that those are therefore often the foods that get associated with eating for comfort or various other eating behaviors that can easily become disordered in some way. And I would also agree that to some extent hyperpalatability may overwhelm your sense of fullness in a way that foods that one finds less rewarding (or which take more time to eat, often) will not. But is that analogous to the types of things that relate to a "use disorder"? It can be, but I think it gets used quite casually normally, and not strictly in that way, and I think it ignores the fact that binge eating disorder will often involve whatever foods are around (hyperpalatable or no) and the like with some of the super morbidly obese people who seem to be giving up everything for food/eating -- it's probably not just if the food is extra palatable. But this is all a separate question, the main point is the "it's extra palatable foods" thing doesn't support "sugar addiction."

    One question I would ask, and I'm undecided, is assuming that food/eating can be part of an addictive chain, which I think it certainly could be, why would it most commonly be manifested through so called hyper palatable foods (which are not limited to sugary ones and could certainly be traditional comfort foods like buttery mashed potatoes, say)? Is it because the foods themselves are so addictive? Or is it because food is pleasurable/comforting and if seeking pleasure/comfort one would likely seek out the most desirable foods in one's mind, and then the habit that forms tends to be related to those foods even if other ones (eating more generally) could do if those were not available? I suspect the latter, and therefore that it is not addiction to a specific substance or even the non substance that is "hyper palatable."

    I'm not sure this matters, I just find it interesting. I think my current theory is that there's some combination of a behavior and substance addiction (which I'd argue is the same with alcohol too), but that you can't fence of any such problem as being 100% limited to so-called hyperpalatable foods, and if someone had a significant issue and they were unavailable, I bet other foods would be alternatives.

    Question for you: if we did determine that hyperpalatable foods have the potential for addiction in a way that other foods do not (including sugar-filled foods like fruit, say!), what do you think this would mean? That the solution is to give up 100% hyperpalatable foods?

    Re: the bolded section. Couldn't you say the same about alcohol though? Except in cases of physical dependence isn't this the mechanism for all addiction?

    No. This is not the mechanism for all addictions. Opioids have an entirely different mechanism.
  • ahoy_m8
    ahoy_m8 Posts: 3,053 Member
    It's all good insights. Thanks for sharing it!
  • 33gail33
    33gail33 Posts: 1,155 Member
    @cwolfman13 OK I will defer to your knowledge - I don't know that much about the technicalities of it. Weirdly alcohol doesn't help me sleep at all, I fall asleep OK, but I don't sleep through the night. Mind you that is my sleep (insomnia) pattern anyway. Fall asleep when my head hits the pillow - and wake up 3-4 hours later and toss and turn the rest of the night. I quit drinking in December, hasn't seemed to help me, so my sleep issues must be non alcohol related. (I was drinking probably 10-14 drinks a week before that - so probably less than one might consider problematic anyway.)
  • ahoy_m8
    ahoy_m8 Posts: 3,053 Member
    edited February 2021
    To continue on the cognitive work of changing behaviors.... I am lingering over the recognition that there is a difference between:
    - identifying subconscious beliefs, evaluating whether they are actually true, and recalibrating them
    - the 12 (or so) cognitive distortions defined in the Beck CBT model. https://en.wikipedia.org/wiki/Cognitive_distortion

    Good examples of reexamined beliefs above (alcohol is good for sleep, relaxation, etc.) I am also curious about cognitive distortions folks may have recognized (all-or-nothing thinking, overgeneralizing, filtering, etc.) and found it helpful to change.

    Lots of MFP-ers have commented on all-or-nothing thinking, i.e. "I've ruined the day/week/year by eating one meal off plan so I might as well go off plan for everything else." That's a distortion. The reality is every little bit you do counts, so getting right back on plan would result in a small bump in the road, not a catastrophe. Other examples (I'm making these up now):
    - overgeneralizing: "sugar always makes me overeat" vs reality which might be something like "I don't overeat fruit so I'm able to moderate some foods with sucrose/fructose"
    - filtering: dwelling only on failures instead of recognizing some success plus some fails.

    Interested in others' thoughts.