One of the most common problems I encounter with patients is that of the sweet tooth. “I’m addicted to sugar!” many patients report.
Do you experience sweating, agitation, tremors when you’re without them? OR could it be that you’re addicted to the habit of getting sweets?
I don’t deny that there are addictive components to manufactured foods. There are great books like Sugar, Salt, Fat by Michael Moss and The End of Overeating by Dr. David Kessler who provide excellent evidence for the science that goes behind manufacturing food that is hyperpalatable, aiming for consumers to reach a “bliss point”. Research has shown that these very foods hijack the brain’s reward system that mirror the neurological pathways of substances such as cocaine, heroine etc. Without boring you with details, repetitive insults to this neurological pathway can result in learned behaviors that result in higher motivation to seek these foods. It has been tough to delineate whether this “addiction” that people describe is related to a behavioral addiction or a substance (in this case, sugar) addiction.
The importance of this distinction is that management approaches differ. In the event of a behavioral addiction, one should dissect the very routine and environment at which food seeking occurs. Behavioural issues tend to very responsive to regular counselling on behavioural change using a technique called cognitive behavioural therapy (CBT). This is my area of interest in tackling weight management.
The very rough plan of action is as follows:
- Paying attention to the scenario and external cues that might provoke wanting (ie. couch, tv, evening = CHIPS!),
- Listening to the internal dialogue (ie. “I worked out today, I deserve a bowl of chips”)
- Reflecting on your feelings after the behaviour (ie. “I feel kind of sick, bloated”)
- Using these reflections as facts in the face of future impulses (ie. “I remember last night when I ate that bowl of chips before bed, I felt really sick. I think I’ll hold off tonight”)
Food addiction, on the other hand, is a growing area and hasn’t yet been widely recognized as a formal diagnosis. This is in large part to the fact that there has been little clinical research performed in humans thus far. It also might be related to the fact that it’s management plan of abstinence from sugar contradicts the plan of established conditions that have overlapping diagnostic criteria like Binge Eating Disorder. Many primary care physicians aren’t comfortable advising a patient to eliminate a whole food group from their diet which can be unsustainable and/or dangerous. If you’re interested, Dr. Vera Tarman is a Toronto-based addictions specialist who has a strong online following and wrote a book that discusses this area and chronicles her clinical experiences with patients she has diagnosed with Food Addiction and how she has helped them.
I hope this helps clear up any confusion between behavioural addiction versus food addiction.
In good health,
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