Can you really be addicted to food? Research remains divided, but for the estimated 12 million people who suffer from it, it's very real. Photo / Getty Images
Can you really be addicted to food? Research remains divided, but for the estimated 12 million people who suffer from it, it's very real. Photo / Getty Images
"There hasn't been a day of my life where I haven't thought about problems with food," said broadcaster Richard Osman this week, of his world since the age of nine. "As soon as you have an addictive behaviour you know … [mine] has always been food."
Speaking on popular British podcast, Desert Island Discs, the best-selling novelist added: "It will be with me for the rest of my life. I know that. I am either controlling it or not controlling it at any given time." He said that food addiction "does not have any of the doomed glamour of drugs or alcohol", but that he considers the afflictions "identical".
This is a parallel rarely drawn. Yes, everyone can overdo their food intake, but can you really be addicted to something you need to survive? Research remains divided, but for the estimated 12 million people in the grip of food addiction, its existence is unequivocal.
Food addiction was defined in the International Journal of Neurobiology in 2016 as "hedonic eating behaviour involving the consumption of foods high in salt, fat and sugar, in quantities beyond homeostatic energy requirements." It is otherwise classified as Binge Eating Disorder (BED), which the NHS describes as "regularly eating large portions of food all at once until you feel uncomfortably full, and then often upset or guilty."
UK writer Richard Osman says that food addiction "does not have any of the doomed glamour of drugs or alcohol", but that he considers the afflictions "identical". Photo / Getty Images
Consider that the UK is now Europe's third-most obese nation, where weight-related conditions such as heart disease and type 2 diabetes cost £27 billion per year (NZ$53 billion), while New Zealand has been ranked as high as 22nd in the world, one of the only developed nations to make the top 30.
The pandemic has made things more challenging still. research out of the UK found that 40 per cent of adults had gained weight since restrictions began, averaging 3 to 4kg. Might better understanding how and why addiction to food occurs be the key to finally bringing these numbers down?
Ashley Gearhardt, associate professor of psychology at the University of Michigan, created the Yale Food Addiction Scale to quantify the depths of individuals' dependency on what we eat. She lays the blame at the door of ultra-processed food - which now accounts for more than half of our diets. That may be crisps or pizza but it extends far beyond: to salad dressings and bread, yoghurt, cereal, dips - three quarters of products we buy at the supermarket now includes sweeteners, often without our realising.
In the same way alcoholics feel relief from that first sip, then cannot moderate the ones that follow, some, Gearhardt says, react in the same way when they eat. "My lab still stands pretty firmly without science to refute it that the compulsive eating behaviour we see around these junk foods is that there is something important about the type of food… these foods have been engineered and processed to be so highly, highly rewarding."
In 2017, the British Medical Journal argued that consuming sugar produces effects similar to that of cocaine "altering mood, possibly through its ability to induce reward and pleasure." Studies in mice found sugar was deemed a preferable reward to cocaine 94 per cent of the time, while neurological research has shown the brains of obese individuals react to food in the same way a drug addict's brain would to a toxic substance.
Still, there has been no recognised medical conclusion as to whether this addiction is behavioural – like gambling or shopping – or whether it is equal to its substance-based forebears. Like alcohol and drugs, continued exposure to junk foods ups our tolerance to it, meaning each next hit has to be more potent to feel as good, fuelling the vicious cycle further still.
Total food abstinence is not feasible, of course. Osman knows that others don't need to employ the same "zero tolerance policy" he takes to junk, noting that if he was to visit a friend's house, "and there were crisps or chocolate bars or anything untouched in the fridge, I would be 'How? What? How are they untouched?'" He can have bottles of booze in the house no problem, he added, further solidifying his belief that addiction to food and toxic substances is identical: "the secrecy of consuming these things; the shame behind them."
Many believe overeating can be managed with willpower, but sufferers say this fails to acknowledge how differently they feel, chemically, on eating certain things. Photo / Getty Images
The results of that shame – feeling unable to seek help, and relying more on your consumable of choice for comfort instead – not only isolates but aggravates the problem.
It's a spiral Anna Swift, 42, knows well. "Around this time each year my willpower seems to collapse," she says. "I'll start bingeing junk food a little bit, a little more, a lot more… I'll binge eat to where I'm lying on my bed sweating, in a lot of pain, can't get to sleep, and then I'll just do that again the next day." These compulsive spells sometimes last a few days; at their worst, months.
Swift is only ever able to break the cycle after several consecutive days come without an overwhelming urge to consume everything she can. "When that happens, it tends to remind me that I can feel so much better if I just say no to myself," she says. While many believe all problems around eating can be managed with willpower, sufferers say this fails to acknowledge how differently many feel, chemically, on eating and indeed overeating certain things.
Treatment for food disorders tends to focus more on abstinence from the foods that create the addictive response, rather than identifying what they are and whom they hit hardest. Eric Stice, of the Oregon Research Institute, conducts brain imaging studies charting why we eat as we do - and one major hurdle remains, he believes. Beyond giving participants "a chocolate milkshake and a [brain] scanner," mapping just how the addiction works is impossible - and even one exposure to a milkshake can be the catalyst for seeking out more junk. "It's eating the high-calorie foods that messes the brain reward circuitry up."
Swift is "still struggling" with food - namely because so few treatment methods are an option. There is Overeaters Anonymous, which follows the same 12-step pattern as the substance help groups. There have been a series of drugs, more recently including Plenity - approved by the US Food and Drug Administration but not yet available in NZ - a hydrogel tablet that expands in the stomach to make you feel fuller; a medical blockade to overeating. There is bariatric surgery and cognitive behavioural therapy and the regular talking kind, too, though no one clear path to success.
Tim Bauer, a "reformed" food addict who "no longer finds comfort in the microwave and in the freezer", believes that a bigger mindset shift is required to "change who you are on a deeper level, and how you interact with food." Aged 31, he weighed 200kg, and set about on a mission to "rewire" his habits. "What was different this time was that I just didn't give up," he says of the flour and sugar-free diet he has now, which has remained little changed over the last decade. That, and regular exercise, means he has maintained a weight loss of just over half his body weight – the kind of long term commitment he says all sufferers must accept in order to overcome food addiction for good. "You've got to change the way that you behave forever."
