Food Addiction

Binge Eating Disorders & Food Addiction

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:

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.
Dozens of PET scans of binge-eating obese people show the exact same brain image problems as alcoholics and drug addicts.
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.”

Sugar: Addictive Substance for Food Addicts

As food addicts, most of us find we have to pay a great deal of attention to what is in the content of the food we eat. Unlike alcoholics and drug addicts, we cannot just “stop eating.” However, we do have to surrender our binge foods and addictive eating habits as part of our recovery.

After making a list of our binge foods, we can identify the substances that we are addicted to in order to surrender them to our Higher Power so that we don’t have to eat them anymore.

“Surrender,” in this context, means doing something we don’t want to do in order to recover. Many of us are not able to surrender our binge foods without the structure and support of other abstinent food addicts.

Despite what we are doing to our bodies because of our food addiction, many of us are unable to remember what the addiction is actually doing to us. We can only remember how “good” it tastes. This is called “euphoric recall,” and is a classic symptom of addiction.

How do you know if you are addicted to sugar or flour?

The simplest way is to use the test provided by the book Alcoholics Anonymous, written eighty years ago. We can just change the text from using “alcohol” to using “food:”

Try some controlled eating. Step into a bakery and have one piece of candy, one donut, one piece of binge food, and then stop. Stick to a diet and maintain your weight loss.

Try it more than once. If you are like us, you will no more be able to do this than an alcoholic can step into a bar and have one beer.

Check out our self-assessment questions on Am I a Food Addict? Also read about different types of eaters so you can come to your own conclusions.

If you think you might be a food addict, then you need to know a lot more about what foods are the most likely to be addictive, even though you may not want to give them up. Most food addicts don’t want to give up their binge foods; they just want to avoid the consequences of eating.

For the purposes of this article, we will address sugar and flour, the two most common substances that food addicts become addicted to. Although some food addicts report addictions to fatty, salty and volumes of food we will address those substances in a later article.

Sugar

Sugar is a carbohydrate, and we often think of it only as the white or brown stuff, but sugar is also a natural part of many other foodstuffs such as lactose in milk, maltose in grain, fructose in fruit, sucrose (refined sugar), and more.

The simple refined carbohydrate, crystalline table sugar, is first extracted from sugar cane with the bulk and fiber being left behind. It is then purified, filtered, concentrated, and boiled down to sugar crystals produced out of the syrup. Substances such as sulfur dioxide, milk of lime, carbon dioxide, charcoal from charred beef bones, and calcium carbonate are used in this industrial refining process as purifying agents.

Flour is also a refined carbohydrate, and for many of us who are addicted to sugar, we find that flour acts in our bodies the same way sugar does: it gives us a “high.” Often flour and sugar come together in a food package – equivalent to high-quality crack cocaine to a food addict.

Brown sugar is simple white sugar with a bit of molasses added back in, or colored with caramel.

The food industry has developed enormous sidelines of “diet” food, usually labeled “Sugar-Free” and “Fat-Free.” Given the many different varieties of sugar, derivations of sugar such as Splenda, sugars formed from alcohol (not surprisingly, these can be very addictive), chemical sweeteners, (the “polys”) artificial sweeteners such as aspartame, saccharine, etc., the label “Sugar-Free” usually means the food industry is simply using a different kind of sugar. For some food addicts, these non-sugars can have the same impact as refined sugar: the inability to eat reasonable amounts.

Conversely, it is worth noting that many of the foods labeled “Fat-Free” are loaded with sugar. And “Fat-Free” certainly doesn’t mean calorie-free.

Sugar is rapidly converted in the blood to fat (triglycerides), which increases obesity, heart disease, and diabetes. It is devoid of vitamins, minerals, or fiber; it is an empty food. Its main purpose in the food industry is a stabilizer, flavor enhancer and appetite stimulant.

In 1973, the per capita consumption of sugar and other highly refined sweeteners (such as high-fructose corn syrup) was 126 pounds a year. Today, it’s 158 pounds – an increase of 26 percent. During the same time period, the percent of overweight Americans increased by nearly 20 percent.

Here is a list of types of sugar that are commonly found in foods we find in most grocery stores. Many labels list more than one kind of sugar; only the total grams of sugar give a true idea of how much is actually in the package. Although some artificial sweeteners have no caloric value, their impact on our bodies can be just as deadly as those with calories, if we cannot stop eating it.

amasake
apple sugar
Barbados sugar
bark sugar
barley malt
beet sugar
brown sugar
brown rice sugar
buttered syrup
evaporated cane juice, or cane-juice crystals (non-FDA approved terms for sugar)
cane sugar
caramel
carob syrup
chicory syrup (non-FDA approved terms (non GRAS and non-CFR compliant) for high fructose syrup)
corn sweetener
corn syrup
corn syrup solids
date sugar
dextrin
dextrose (refined corn sugar)
diatase
diastatic malt
Diglycerides
Disaccharides
D-tagalose
ethyl maltol
Florida crystals
fructan
Fructooligosaccharides (FOS)
fructose
fruit juice
fruit juice concentrate
Galactose
Glucitol
Glucoamine
Gluconolactone
glucose
glucose solids
Glucose polymers
Glucose syrup
Glycerides
Glycerine
Glycerol
Glycol
Hexitol
golden sugar
golden syrup
grape sugar
high-fructose corn syrup
honey
inulin syrup (non-FDA approved terms (non GRAS and non-CFR compliant) for high fructose syrup)
inversol
invert sugar
isomalt
invert sugar
karo syrup
lactose
lactitol ++
levulose
malt syrup
malted barley
maltodextrin (derived from the corn “wet refining” process)
maltose ++
malitol ++
mannitol ++
maple syrup
microcrystalline cellulose
molasses
Monoglycerides
Monosaccarides
Nectars
Pentose
Polydextrose++
Powdered sugar
Raisin juice
Raisin syrup
raw sugar
refiner’s syrup
rice malt
rice syrup
saccharides
sorbitol ++
sorghum
Sorghum syrup
Sucanat
Sucanet
sucrose (from cane or beet)
sugar cane
trisaccharides
turbinado sugar
xylitol ++
yellow sugar
zylose

++ Sugar alcohols aren’t sugars or artificial sweeteners. The name “sugar alcohols” comes from the fact that their structure resembles sugar, and they’re chemically similar to alcohol. They’re typically genetically modified from corn or wheat.

Those food addicts who are also addicted to or have an allergy to wheat receive a double impact from sugar alcohols.

Experts say that sugar alcohols can cause stomach cramps, bloating, diarrhea, and anal leakage, because our bodies poorly absorb them. In large quantities, they’re non-GRAS (Generally Recognized As Safe) and some research shows that they can cause cancer.

Foods with average added sugars

Applesauce contains 11 g
Peanut Butter contains 18g
Flavored Yogurt contains 23g
Fruit drinks contain 40g

A single can of soda contains 12 teaspoons of added sugar. That’s 120 percent of the USDA’s recommended daily intake of sugar.

In 2005, researchers examined the impact of sugar on the immune system. A published study at the National Institute of Health documented the impact of sugar intake on the immune system: Sugar steals the ability of white blood cells to destroy bacteria. White blood cells are known as “phagocytes” and phagocytic tests show that a couple of teaspoons of sugar can sap their strength by 25 percent. A large helping of pie and ice cream renders your white cells 100 percent helpless. This effect lasts from 4 to 5 hours. Consider a 900 ml serving of processed and packaged orange juice or one 683 ml of cola—either of these will depress the immune system by 50 percent, 30 minutes after ingestion and this will last for hours! Consider if you have sugar at every meal, which many do by eating processed foods alone, that the immune system is constantly ineffectual.

For food addicts, who binge on enormous amounts of sugar, eat meals consisting of large amounts of processed food, or diets consisting almost totally of binge foods, the impact could be exponential. For us, to eat this way is to die.

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.

First, look at your own eating experience and identify foods and eating behaviors to which you may be addicted.
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.
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.

The Process of Abstinence is Surrender

The initial surrender necessary for recovery from food addiction is to accept completely that you are a food addict. This means that you have a progressive disease that is physical, mental-emotional and spiritual in nature. Because it is a disease of the mind, there are times when you cannot trust your own thinking, so you need to rely on a Power beyond yourself. What does this look like specifically?

Physically

Physically, it means – A surrender of one’s specific binge foods, i.e.foods to which you are addicted. If one is addicted to volume, surrender to weighing and measuring or to some other external form of portion control.

This is most commonly done by surrendering to a food plan. A food plan defines the general content of abstinence. Food addicts need to be specific about what it means to be abstinent. What foods can you eat? What foods can you not eat? How much do you eat? How do you determine nutritional balance? It is common for food addicts who are new to recovery or are having difficulty getting abstinent to make this decision with someone who understands food addiction. If this person is not medically trained, it is also important to consult with a doctor, dietitian, or other health professional.

It also may mean to surrender to more structure and support until you are able to be food abstinent and stay abstinent. This might mean physically being in meetings, physically eating with other recovering food addicts, even staying with other abstinent food addicts 24/7. It might also mean putting oneself in a professionally-led recovery group, workshop, or in-patient treatment.

Mentally

Mentally it means – Surrendering to not making decisions about your food by yourself. Since most food addicts are not able to do this alone, it is common to make day-to-day decisions with a food sponsor. In the 12-Step fellowships, this is called committing your food to a sponsor. It also means accepting direction and support to surrender your food specifically one day a time.

In practice, the most common way of surrendering with a sponsor works like this:

Write down your food before you eat it. This means you let go of or surrender spontaneity regarding food. You have to plan ahead. There is a slogan that goes with this principle, “Failing to plan is planning to fail.”
Read what you wrote to your sponsor. This means you give up or surrender self-sufficiency and making decisions about your food alone. It means you give your word regarding your food. The slogan is, “Commit what you eat, and eat what you commit. Nothing more, nothing less.”
Don’t change your commitment (unless there is a health emergency). This means let go of or surrender grazing or snacking between meals. It means let go of or surrender making decisions about food impulsively.
Afterwards, be rigorously honest with your sponsor. This means let go of or surrender of your self-sufficiency and pride. If you are abstinent, say to your sponsor that you are. If you are not abstinent, i.e., made changes, eaten something you didn’t commit to eat, skipped a meal or forgot to eat something, be rigorously honest about how you are not abstinent and develop a surrender plan for the next day. The principle is again summarized in a fellowship slogan, “You are as sick as your secrets.”

This practice of rigorously surrendering one’s food daily with a fellow recovering addict may sometimes seem drastic, but it also seems to be what works for most of the thousands of food addicts who have found abstinence and recovery in the various food 12-Step fellowships. A common response about committing one’s food and/or weighing and measuring is as follows: “No, while I sometimes don’t want to do it, I no longer see it as a burden. It gives me a freedom regarding my food and my life that I never had before.”

Spiritually

Spiritually, it means – Surrender your food and your will to the care of a Power greater than yourself. This usually means surrendering to the practice of making conscious contact with God (as you understand God). This might be as simple as praying for help with your abstinence and life each morning, and saying” Thank You” at the end of the day. It might mean taking time each day for spiritual reading and/or silent meditation.

For someone having trouble with the God idea or with having a personal relationship, it means surrendering to work through the Twelve Steps rigorously from beginning to end (or some other effective spiritual practice).This is best done with a sponsor – or in a group. The bottom line is to have an effective spiritual awakening; a change in personality that enables us to live soberly without using food addictively.

Finally, the ultimate spiritual act for a food addict is surrendering to regularly helping another food addict. This is at once the most practical way to stay food abstinent when all other things do not work and the best way to assure there will continue to be a spiritual community to help you if and when you need it. In the end, often in spite of themselves, abstinence is a way of life for food addicts in that they surrender to being with and serving God.

There are, of course, as many ways of looking at surrendering one’s food as there are paths to God. This is just one that works for many food addicts. Thank God.

Practical Reasons for Weighing and Measuring Your Food

While every food addict does not need to weigh and measure their food, there are some very compelling reasons for doing so:

Weighing and measuring simplifies portion control. There is no question of how much of each food to eat.
For the food addict who is weighing and measuring, it is always clear exactly what surrender means.
If the amount of food in your plan has the amount of calories to be your ideal weight, you will eventually reach it and maintain this weight.
For those who sometimes – or always – have a distorted concept of food volume, weighing and measuring is like wearing glasses with the corrected prescription.
Weighing and measuring is a gentler and a much less expensive alternative to intestinal bypass surgery.
For volume addicts – who almost always want more food – weighing and measuring assures that you are getting enough to eat.
Weighing and measuring eliminates the need for all the head talk about “how much is enough today?”
Being committed to weighing and measuring assures that you know there is one important way you are remembering that you are a food addict.
No one gets hurt– including the food addict – by a practice of weighing and measuring.
When a food addict weighs and measures in public, there is always the chance another food addict will be helped by seeing and talking about this practice.

Diet vs. Food Plan

Why Use the term Food Plan?

Since most of us have been unable to eat or diet like normal eaters, we choose not to use the word “diet”. To us, diets mean something we can follow by reason and will power alone. We have come to accept that we cannot manage our food by self-control alone. Willpower failed us utterly, so we surrender to our powerlessness over food. The purpose of the food plan is to make this surrender more specific.

Few compulsive eaters chose a food plan because this is always the way they want to eat the rest of their life. Rather, we chose to surrender to a specific food plan because we have admitted we are powerless over food. There is real choice in deciding to use a food plan and what specific plan to use, but the first and most important decision is choosing to use a food plan – and practice surrendering to it – that works for the specific ways we are addicted to food.

Most abstinent food addicts have an abundance of choice regarding what they eat. There are over two hundred different foods in most grocery stores, and only a handful are foods most of us find addictive. However, there is no choice about which food plans or principle will work and which will not. If you are addicted to a specific food, for example, it is not likely you will be able to include this food in your plan and have an abstinence that works.

Most compulsive eaters would like to be able to eat everything they want, exactly the way that they want, and suffer no consequences. Most of us would like to eat like normal eaters, but this choice is simply not available to us if we also want recovery. There is no such thing as surrendered food abstinence without giving up foods and ways of eating that your disease has long been wanting dearly.

By Phil Werdell, M.A.