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Eating Disorders & Food Addiction

Binge Eating Disorders & Food Addiction

© Phil Werdell, M.A.

Compulsive Overeating vs. Food Addiction

It is frequently difficult to distinguish between “compulsive overeating” and “food addiction,” especially since many recovering people as well as the professionals who support them use the terms interchangeably.

At ACORN, we have come to use the terms “compulsive eating” and “addiction to food” to define two distinctly different problems. We use the term “compulsive overeating” to identify what is now called “binge eating disorder” by psychologists. This psychological disorder derives from unresolved trauma and family dysfunction as well as a lack of cognitive feeling and behavioral skills to deal with difficult emotions.

Chemical Dependence on Food

We use the term “food addiction” to refer to biochemical dependency on food. This problem is described as a person relating to specific food(s) or food in general in a different way than normal people. Food addicts experience physical craving, mental obsession, and a distortion of basic instincts and will.

Ten years ago there was little scientific research proving that food addiction actually existed, much less any research explaining a biochemical basis. Today, because of new genetic science, advances in brain scan research and billions of dollars invested in finding a medication that addresses the obesity epidemic, there is an abundance of studies in a wide variety of academic and medical fields that support a diagnosis of food addiction.

These studies overwhelming support the theory that many of the severely obese and those with advanced eating disorders are also chemically dependent on food. In fact, as a substance disorder, food addiction could be the primary medical problem in those cases.

The amount of specialization in scientific research and the fact that professional journals didn’t allow the use of the term “food addiction,” (because it was not yet confirmed as a medical or mental health disease) has made it difficult to assemble all the research and correlate all the data about chemical dependency on food across sub-disciplines of science. Still, there are peer-reviewed professional journal articles establishing:

  1. A sample of obese people who were not alcoholic or drug addicted and who binged on dense carbohydrates had the same D2 dopamine gene marker as is found in alcoholics and drug addicts.
  2. Dozens of PET scans of binge-eating obese people show the exact same brain image problems as alcoholics and drug addicts.
  3. Definitive research that animals in experimental studies can become addicted to sugar.

Treating Binge Eating vs. Food Addiction

The question is, what are the differences between these two food-related problems, binge eating and food addiction? Is the treatment for these two issues the same or different?

It is probably helpful to begin by saying that in many of cases of food addiction there may also be an underlying psychological eating disorder based on unresolved trauma. Moreover, there is often a misdiagnosis by a health professional, usually because they do not recognize the symptoms of, or are unwilling to identify, a real chemical dependency on food.

The vast majority of those we see in ACORN were either given diets by professionals who did no follow-up to confirm the effectiveness of the diet and/or were treated therapeutically for psycho-dynamic eating disorders. Usually, professionals have not considered whether their client needed to completely abstain from certain food(s).

Taking a Food History

One of the most effective ways of determining if someone is food-addicted is to take a “food history.” Does the person have a history of dieting, then gaining back the same amount of weight, or more? Has the person done serious work in psychotherapy, only to find that their bingeing was unaffected? Are there foods that the person feels they cannot live without and are unwilling to forego? Are there foods that the person is unable to stop eating, even though they may have tried many times?

These questions are remarkably similar to many that are asked of alcoholics and drug addicts at the beginning of treatment. As most alcoholics and drug addicts are frequently unable to disentangle themselves from their substances without help, many people that are food-addicted require additional medical assistance and Twelve Step support to withdraw from their “drug of choice.”

Bulimia & Food Addiction

Food addiction begins with physical craving, evolves into mental obsession, and, ultimately, becomes a whole life of spiritual illness. It is also a physical disease of chemical dependency upon one or more foods or on volumes of food in general.

Bulimia is a psychological illness, a mental-emotional problem usually rooted in unresolved trauma from before the earliest incident of purging.

It is fairly straight forward to know if you are bulimic. Do you binge and purge?

Do you keep doing this after you decided to stop? More specifically, do you physically vomit food that you have eaten when you are not sick? Or do you use pills, ipecac, laxatives or diuretics to try to take off weight? Or do you exercise excessively – sometimes to the point of hurting yourself – to try and control weight? Do you use highly restrictive dieting over and over again? These are the most common physical symptoms of bulimia. If you are not sure if you are bulimic, you can ask a doctor or eating disorder specialist for a diagnosis.

How does a bulimic know if they suffer from food addiction?

One simple indication is if they were obsessing about and/or bingeing out of control on commonly addictive foods before they started purging. The “food drug” to which people most often become addicted is sugar in one of its myriad forms. The second most common “food drug” is flour and other refined carbohydrates which metabolize quickly into simple sugars. Further addictive food substances may include: chocolate, excess fat, wheat, artificial sweeteners, salt, caffeine and a large volume of any food.

Sometimes addiction to volume is simply another form of sugar addiction, but there is also a separate process in which people do not have the normal bio-chemical sensation of satiation.

If someone was binge-eating before they became bulimic, it is usually clear that this is a primary mental-emotional complication of bulimia nervosa. But is this binge-eating due to psychological problems? Or is it the beginning of chemical dependency? Or is it both?

This is sometimes less easy to discern. One possible indication of food addiction is that there are symptoms of detoxification when specific binge foods are completely eliminated. If the person has food cravings soon after abstaining and wants to eat to deal with the cravings, this is an even stronger sign of addiction to that particular food.

Not all bulimics are food addicted, but, for the many who are, understanding and treating their chemical dependency on food is essential to long term recovery from bulimia. Abstinence and recovery helps develop better emotional skills and enables healing of primary trauma.

If you do not want to abstain from all binge foods completely, there is another way of seeing if you are food addicted. When you try to eat all foods in moderation and find that you still want to binge even when you work at dealing with underlying feelings, this could be because you are also chemically dependent on food. It will take some time to be sure about this, of course, for it can take months or years of intensive work to develop strong emotional skills and work through all unresolved trauma.

One test: have you been doing therapy for a year or more for your eating disorder and are you still bingeing and purging? If so, it might be useful to look more seriously at food addiction, because you may not just be medicating feelings; you may also be biochemically addicted.

Treating Food Addiction

To treat food addiction, it is important to begin by detoxifying from all binge foods and eliminate the physical cravings for them. This means abstaining from all trigger foods completely. You can identify the foods you are addicted to and get support for detoxification exactly like other food addicts, though the bulimic often commits to abstaining from purging as well as specific foods. The Twelve Step fellowships (such as Overeaters Anonymous and Food Addicts Anonymous) are excellent support programs for this process. ACORN workshops are designed to help those who need additional professional help.

We have a number of people working in ACORN who are bulimic and have spent a year – sometimes several years – in therapy for their eating disorders. These bulimics said that although they had been helped in dealing with their feelings, their eating was still out of control. Often their therapist had said that they “should” be able to eat in moderation or that the rigor of committing food to a sponsor every day and weighing and measuring was “too rigid.” However, when they tried treating themselves as if they were addicted, their cravings diminished. They were better able to deal with difficult feelings, and they came to see that they had a food addiction.

There is a lot of misunderstanding about food addiction – even in the medical community. It is not taught at all in many medical schools or graduate programs for dieticians and the differences between bulimia and food addiction are seldom clarified for counselors and therapists.

Questions for Bulimics to Ask

Do I ever think of purging without bingeing first?

If you always plan on bingeing – especially if the binge is on addictive foods – before you purge, then the primary problem may be the food, and the underlying problem may well be chemical dependency. Food addiction is a primary disease, just like addiction to alcohol or drugs. If someone is drinking out of control and depressed, the alcoholic must begin by putting down the drink and accepting that he or she is an alcoholic. If one is medicating feelings with pot or some prescription medication, the drug addict must first put down the drug. For most, there is usually much more emotional and spiritual work to do, but this is not possible while still self-medicating with an addictive substance. It is the same with food addiction.

Another basic question helps you see the difference: Would you suggest to an alcoholic or drug addict that they work on underlying therapeutic issues while they are still using alcohol, cocaine, or some other drug of choice? Well, some foods have exactly the same opiates as in these more socially identified addictive drugs.

The best way for you to tell if you are addicted to food is to treat yourself as if you are food addicted for six months to a year.

  1. First, look at your own eating experience and identify foods and eating behaviors to which you may be addicted.
  2. Second, get the support – from peers and or professionals – to eliminate those foods entirely and to make abstinence the number one priority in your life.
  3. Third, continue to work on any difficult feelings, irrational thoughts and deeper spiritual issues that pull you back to the food.

If you are able to stay abstinent – or, if you make substantial improvement in dealing with food – it’s likely that you are food addicted. If you are not, you are still making progress.