The Science Behind Food Addiction,
and Helpful Tools on the Path to Recovery
July 12, 2015
Story at-a-glance
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Certain food products, notably the refined and
processed “hyperpalatable” sugary, fatty and salty
food combinations, hijack the reward center in your
brain, causing brain changes identical to those in
drug addicts and alcoholics.
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Addiction also affects your frontal cortex,
impairing your ability to control impulsivity,
irritability, impatience, and other states
associated with withdrawal and addiction.
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Abuse, neglect, and other self-perceived trauma
during the formative years of childhood, adolescence
and young adulthood, can profoundly affect your
frontal cortex and epigenetically influence your
genetic expression, thereby making you more
susceptible to addiction.
By Dr. Mercola
Refined sugar and processed foods are an important component
of food addiction and your inability to follow a heathy diet.
Dr. Pamela Peeke, an internationally recognized physician and
expert in integrative medicine, nutrition and fitness discusses
this, and more, in her New York Times bestselling book,
The Hunger Fix: The Three-Stage Detox and Recovery Plan for
Overeating and Food Addiction.
In this interview, she shares some of the science behind food
addiction and, more importantly, simple measures that can make a
dramatic difference in your ability to achieve and maintain
lifelong recovery from food addiction.
Before embarking into natural medicine, Dr. Peeke was a
senior science research fellow at the National Institutes of
Health (NIH)—probably the most prestigious and well-respected
research institute in the US.
The NIH coordinates a lot of very good research and is funded
by the federal government. It was here that Dr. Peeke came to
understand the nature of food addiction, and the path to
recovery.
Yes, Food Addiction Is Real
While, like nearly all doctors, she did not receive any
training in nutrition during medical school, she went back and
became a Pew Foundation Scholar in Nutrition and Metabolism at
the University of California, Davis after spending several years
working in critical care and trauma.
"From there, I came to the National Institutes of
Health where I set up a laboratory with my wonderful mentor,
Dr. George Chrousos, looking specifically at the
relationship between stress and fat," Dr. Peeke says.
"We were the ones who laid the golden egg in trying
to put together the toxic stress-belly fat connection,
showing what happens to fat distribution when you're
undergoing toxic stress: ongoing high levels of stress
associated with helplessness, hopelessness, and defeat.
When we started putting this together, we discovered
that: no wonder you're packing on a lot of belly fat! As a
result, I became kind of known as 'the belly doctor.'"
Around that same time the NIH established the Office of
Alternative Medicine (OAM), and the first director of that
office, Dr. Joseph Jacobs, asked her to join him as a senior
research scientist, to look at issues pertaining to nutrition.
"From there, I started peering into this whole
relationship between specific kinds of food and what they do
to the body," she says. "That's when I stumbled
upon refined, processed foods, especially what we now call
'the hyperpalatables.'
[These are] sugary, fatty, and salty food
combinations that seem to hijack the reward center in the
brain, and literally, have it undergo changes that are
absolutely identical to the changes that happen in all
addiction.
These include drugs, alcohol, and other process
addictions like sex and gambling. Food is unique in that it
is both a substance and process addiction. Over time, we
built enough scientific evidence to be able to say that food
addiction is real."
Her book, The Hunger Fix, grew out of this research,
and is the consumer level complement of the first professional's
textbook on the subject, titled Food and Addiction: A
Comprehensive Handbook, which was published one month prior
to the launch of The Hunger Fix.
The Role of Dopamine in Food and Drug Addiction
The correlation between food addiction and recreational drug
addiction is quite striking, and probably stronger than most
people suspect. A critical player in all forms of addiction is
the neurotransmitter dopamine.
The groundwork for these revelations was laid by the current
director of the National Institute on Drug Abuse (NIDA), Dr.
Nora Volkow, an addiction psychiatrist with a compulsive
fondness for chocolate.
"She's reed thin, runs six miles a day, admits to being
delightfully compulsive and has always been fascinated with this
pull to eat chocolate," Dr. Peeke says, noting that a lot
of great research begins when an investigator decides to look
into something that affects them personally.
This was the case with Dr. Volkow, whose curiosity about her
own compulsions led her to piece together exactly what happens
in the brain during addiction. Her first seminal paper on this
subject was published in 2002.
The breakthrough came with the introduction of high-detail
brain imaging devices like functional magnetic resonance imaging
(MRI) and positron emission tomography (PET) scanning, which
offered high quality views of the brain.
To understand addiction, first you need to understand the
basics of pleasure and reward. There are two types of pleasure
and reward that are deeply primal. One is sex and the other is
food. Both are absolutely essential for survival.
Your brain can secrete dopamine simply by looking at a
picture of a loved one or a beautiful sunset. But while studying
the the brain's reward center, Dr. Volkow realized that you will
not feel pleasure or reward unless dopamine binds with its
receptor, called the D2 receptor.
D2 receptors are located all throughout the reward center in
your brain. When dopamine links to this receptor, immediate
changes take place in brain cells and then you experience a
"hit" of pleasure and reward.
Now, how come eating a delicious apple will make you feel
pleasure but is unlikely to lead to addiction, whereas eating
cake can, in vulnerable brains, lead to over-the-top pleasure
and a driving compulsion to eat more cake—again, and
again, and again?
Dr. Peeke explains:
"If the birthday-cake-type experience, which is
something that involves a food far sweeter than an apple,
takes place, your brain can handle it. But
what happens when birthday cake is available 24/7?
Now we have a problem... People who are
vulnerable---have had an early history of any kind of abuse
or trauma--- have mood issues, or a history of addiction
themselves and/or genetically in their family, these people
are at much higher risk to now develop an addictive-like
eating behavior.
This is especially when they regularly consume what we now
call "the hyperpalatables" – refined, processed sugars,
fats, and salt."
Addictive eating behavior, by current estimates, affects to
some degree 1 in 12 adults. There's a wide spectrum of addictive
eating, from people who are mildly affected but can control with
modified lifestyle habits, to people who are seriously
compulsive overeaters and are suffering with significant health
consequences.
As well, addictive eating is experienced by men and women of
all sizes. Dr. Peeke notes that one of her most challenging
patients was a size 4 woman who only ate a discreet amount of
cookie dough on a daily basis. So, you don't have to be severely
overweight to be addicted to food.
"It's not just about weight. Some of my toughest
addictive-eating behavior people are very small people,"
Dr. Peeke says. "They struggle every day.
Addictive-like eating actually covers the entire gamut of
the weight spectrum."
How Addiction Develops
The primary directive of your mind and body is survival, and
it will go through some interesting adaptations to survive. When
you indulge in too much of these hyper-stimulators—be it
cocaine, sugar, alcohol, or sex—your brain's reward center notes
that you're overstimulated, which the brain perceives as not
good for your survival, and so it compensates by decreasing your
sense of pleasure and reward.
It does this by downregulating your D2 receptors, basically
eliminating some of them. But this survival strategy creates
another problem, because now you don't feel anywhere near the
pleasure and reward you once had when you began your addiction,
no matter whether it's food or drugs. As a result, you develop
tolerance which means that you want more and more of your fix
but never achieve the same "high" you once had. There's no
period at the end of the sentence. And, all the while, the
addictive cravings grow stronger.
"Dr. Volkow, through her extraordinary work...showed
that the reason why people who have addiction continue with
their addiction has very little to do with the pleasure or
reward they're getting out of it; it has to do with the pain
and the angst of withdrawal, and they don't want that,"
Dr. Peeke says.
Dr. Volkow's work revealed that the changes taking place in
the brains of drug addicts are identical to those
occurring in people addicted to food. Regardless of the source
of the addiction, you see very little dopamine bonding with its
D2 receptors in the brain, as their numbers have been
drastically decreased due to continued exposure to the addictive
substance/process.
"In the normal brain's PET scan of the reward center,
you see a beautiful red-orange because it's all lit up where
the dopamine is bonding with the D2 receptors. You show them
a sunset or something pleasurable, and you can see beautiful
binding going on. What do you see in the addictive brain?
Not a whole lot; almost no orange there. For that matter,
those D2 receptors are so low in number that these people
are in angst. They crave more and more and more of whatever
that fix is.
What Dr. Volkow's study was able to show was: 1) food
addiction is real and 2) that the changes that take place in
the brain's reward center are identical across the board for
all addiction. It doesn't matter what the addiction is so
long as it's truly an addiction and it meets criteria. This
is huge. She also showed that 3) the reward center is just
one brain center that is affected. The other one is the
frontal cortex, right behind the forehead.
That means you have an impairment of the 'CEO of the
brain' in its ability to rein in impulsivity, irritability,
impatience, and all of the things associated with withdrawal
and addiction. You can't stay vigilant. It's hard to pay
attention. You can't be mindful. You can't plan, organize,
or strategize. Basically, you're out of control. Now, you
have an out-of-control CEO of the brain and you've got a
hijacked reward center. What you have, is a full-on
addiction."
Early Trauma 'Primes' Your Brain for Future Addiction
Experiencing abuse (e.g. physical, emotional, sexual),
neglect, or other trauma during the formative years of
childhood, adolescence and young adulthood can significantly
affect your frontal cortex, thereby making you more susceptible
to addiction. Dr. Susan Mason at Harvard University, working
with the Nurses' Health Study II, showed that women who had the
highest levels of abuse during childhood had a 90 percent
increased incidence of food addiction. In her book, Dr. Peeke
also talks about the role of epigenetics, noting there's a
"sweet spot" between the ages of eight and 13 when your genome
is particularly vulnerable to epigenetic influence.
"That means each of your genes has almost like an
on-off switch, a dimmer switch. You're turning things on and
off, and leaving molecular markers based upon what happens
to you. A lot of these then influence how you self-soothe
and whether or not you're self-destructive. These follow you
into adulthood, which is precisely why it's so important to
remember that you need to address all of these issues.
You're not a robot... That's why you have to look at the
mental, spiritual, and psychodynamic of all of this... There
lies so much of what goes on.
Even for people lacking a distinct history of abuse
and trauma there are conditions that set us up for
self-soothing and often self-destructive addictive behavior.
Dr. Volkow herself says that as much as she has very high
levels of self-regulation and compulsivity...When she's
stressed and when she is sleep-deprived – the two S's –
she'll cave to the crave.
She also showed that, believe it or not, it's not the
consuming of the food that actually results in the highest
levels of dopamine release in the brain; it's the cues and
the triggers...Just by showing people pictures or getting
them triggered, they have very high levels of dopamine
secretion. The thing is when they actually consume,
especially if they're addictive, they're not experiencing
the level of reward that anticipating the fix will provide."
If you're wondering whether you may have an issue with food
and addiction, there is now a published and credentialed
assessment you can take called the Yale Food Addiction Scale.
Dr. Peeke provides a short and long version of this test in The
Hunger Fix, as well as a quick and easy online version
www.drpeeke.com/PopQuiz.htm. addiction.
So, there are those who meet criteria, but Dr. Peeke believes
the majority of people struggling with addictive eating behavior
fail to exactly meet the criteria for the Yale Food Addiction
Scale. They fall into an "almost" category and include people
who binge (at any level). Regular binge eating and food
addiction have a 100 percent correlation because when you binge,
it's almost always on the hyperpalatables---refined sugar and
processed fats.
"This is a moving target right now. The vast majority
of people who subjectively binge do not meet the criteria
for actual binge-eating disorder. I think there's large,
large number of people out there struggling with
addictive-like eating behavior, and some actually meet full
on criteria for food addiction," she says.
Confronting Cross Addiction
The origin of food addiction includes any combination of
genetic family history of addiction, mental health conditions,
trauma, abuse and an environment that is filled with
hyperpalatable foods. But there's also another critical source
of addictive eating--- cross addiction. As people are detoxing
from alcohol, drugs, nicotine or other process addictions (sex,
gambling), they often transition from one addictive behavior to
another.
This cross addiction process often follows a hierarchy of
getting clean from the most illicit fixes to ones that are may
be "legal" but very problematic. For instance, a very common
pattern observed is for detoxing alcoholics to stop drinking
their calories, and instead seek their sugar from every kind of
sweet. As well, smoking and drinking large amounts of caffeine
are typical recovery behaviors, all clearly leading to their own
mental and physical health fall-out. As well, recent studies
have shown that approximately 30% of compulsive food addicts who
have undergone bariatric weight loss surgery become alcoholics.
Other cross addictions include stimulant (nicotine, cocaine,
methamphetamine, Adderall) addicts who compulsively overeat
during recovery. Finally, many people are detoxing from more
than one addiction (alcoholic who smokes cigarettes and pot and
gambles), further complicating treatment. Therefore, it is
essential that the treatment of food addiction must include an
acknowledgement of the powerful and challenging cross addictions
that can occur when undergoing treatment for other addictive
behaviors.
Intermittent Fasting May Help Cut the Ties That Bind You to
Food...
From personal experience, I've found
intermittent fasting to be a highly effective tool that
helps your body to shift from burning sugar to burning fat as
its primary fuel, and with that change, food cravings have a
tendency to simply vanish. So is it possible to differentiate
between a craving resulting from metabolic dysfunction (insulin
resistance) as opposed to some other more deep-seated food
addiction that may not respond to intermittent fasting?
That question remains unanswered, for the time being, as
intermittent fasting has not been tested specifically for people
meeting the criteria of food addiction. Still, Dr. Peeke agrees
that such results are "provocative and compelling," and from my
perspective, if you're struggling with food addiction, I believe
giving it a try would certainly be worthwhile.
"One of the things... I write about in The Hunger
Fix, [is to create] a platform for being able to get a
better grasp of how to eat better—do your physical activity,
do your spiritual checking-in, confront and get help with a
history of abuse and trauma, meditation, etc. One of the
things I like to do is just say, 'Okay, let's take a breath
here. Make it simple,' right? The majority of people out
there are just lost.
They're getting hammered with temptation, cues, and
triggers for self-destructive eating. In a way, cocaine
addiction is a bit easier. I'm not giving you a moderate
diet of cocaine; you're done [with cocaine], that's it.
Whereas when it comes to foods and beverages, it gets more
complex, especially since refined sugars are ubiquitous.
They're in salad dressings. They're in ketchup. They're
everywhere. You have to be much more vigilant, and you have
to pay attention...
In Michael Moss' book
Salt Sugar Fat: How the Food Giants Hooked Us, he
looked at corporate America and the food industry. He was
able to tease out something called 'the bliss point.'
Millions of dollars have been spent trying to figure out
what the bliss point is. That is, for every refined,
processed food out there, which one can most rapidly ignite
the reward center in the brain?"
Are You Addicted to Food?
Dr. Peeke created a short and easy to use synthesis of the
Yale Food Addiction Scale. Simply answer these two questions for
any given food or beverage you think you may have a problem
with:
- If I consume this, will I feel loss of control?
- If I consume this, will I feel shame, blame, and guilt?
"Overeating and binging are highly associated with
feelings of loss of control, as well as shame, blame, and
guilt, so if you answer yes, one of the things you have to
do is just say these simple words: 'This just does work for
me'," Dr. Peeke says.
"Take it and put it in a virtual shelf. We'll come
back and revisit that when the smart part of your brain, the
frontal cortex, is more healed, enlightened, educated, and
has had more practice at being able to work with whole
foods, and with better ways of eating, whether it's
intermittent fasting or whatever else. But you're going to
put more tools in that frontal cortex toolbox...
Remember, I said the D2 receptors were downregulated
and the D2 receptor population came down? Well, I've got
great news for you: the D2 receptor population grows back.
You're able to actually feel more reward when you look at
the sunset or you have a relationship with someone [once you
break your addiction], because people with full-on addiction
have almost no joy and almost no feeling of reward or
pleasure with anything. Within the first six months or
within the first month, you're able to feel it starting to
come back again. That's part of the healing process."
Dr. Peeke's treatment approach in The Hunger Fix includes an
individualized and customized approach honoring each person's
unique journey. The overall goal is to achieve and maintain a
sustainable recovery based upon the practice of Recovery
Lifestyle habits and behaviors. The plan incorporates elements
from a wide range of resources, cognitive learning, meditation,
spirituality, 12-step, epigenetic nutrition, and physical
activity.
Exercise and Mindfulness—Two Helpful Adjuncts on the Road to
Recovery
Physical activity prompts neurogenesis and
neuroplasticity, so by exercising you're allowing a more
rapid healing to take place in your frontal cortex and reward
center. Similarly, meditation has been shown to epigenetically
turn off inflammatory gene groups, and to turn on genes that
increase neurogenesis. So both are extremely critical when
addressing successful long term recovery from any kind of
addiction.
"This all goes hand in hand with healing the
microbiome and the gut," Dr. Peeke says. "It
goes hand in hand with healing throughout the body, to
reduce insulin sensitivity, to decrease all the signs and
symptoms of metabolic syndrome, and to reverse them. When
you do what I call 'mind, mouth, and muscle,' –the three
pillars I used when I established this program in The
Hunger Fix—what you're able to do is an integrative,
more holistic approach.
In the mind, it's checking in with one's self, being
able to augment the mental capacity to be able to say yay or
nay. Organize. Strategize. To be able to decrease
impulsivity, irritability, and impatience. To be able to
heighten vigilance and mindfulness. Mindfulness is king
here. When you're mindful, you take it hour by hour, moment
by moment, so that what you're able to do is stay on track.
People who have addictive-like habits tend to want to just
speed it along. They're like, 'Come on, let's get this over
with.' You can't do that. Take a breath. You can do this.
With physical activity, with every step you take
you're able to change gene expression along the entire
spectrum of the metabolic syndrome to be able to augment
brain health and brain healing from the entire addictive
process... Now, with nutrition, there's no question, you
absolutely can't keep hammering yourself with addictive
products for which you say yes (to loss of control) and yes
(to feeling shame, blame, and guilt). Instead, you're going
to substitute what I call false fixes (the addictive
products) with healthy fixes."
For example, if you're addicted to sugary soda, clear out all
sodas and replace them with beautiful glass decanters filled
with pure water and float combinations of slices of fruit,
berries, citrus, cucumbers and mint leaves. "Everyone can do
this at home," Dr. Peeke says. Her book is filled with many more
options and substitutes like this, which have evolved over years
of experimentation in addiction centers.
You can also experiment with imagery, which can be very
potent. Keep in mind you have options. Some do well with
negative imagery, such as imagining a skull and crossbones on an
addictive food. Others respond better to positive imagery
attached to a healthier, recovery-friendly food choice. Here's
another helpful exercise:
"I ask every single person to sit down and to develop
something I call 'The Power Why.' Why do I want to do this
at all? Why don't you just continue whatever addictive
behavior you've got? Why? And you got to dig deep. You can't
just say, 'Well, I want to be healthy.' What else is
important in your life? You want to be here to do what? What
is gnawing at you? You really need to take a moment. Close
your eyes and go deep.
I'll give you an example. One of my most successful
women is a woman who was once pushing 300 pounds. She'd
struggled with figuring out her Power Why. It wasn't the
obvious---health consequences. One day, she was told she was
going to receive a national award for the work she had done
in her community. She's a huge activist in the community.
She was going to be on stage to receive the award with her
entire family in attendance. It was going to be a year away.
Something clicked in her brain. She said, 'I want to
be proud of myself. I want to walk the talk. If I'm
promoting health and well-being, I got to live it.' That's
what did it. A year and 150 pounds later and mentally and
physically fit she stood proudly before the audience and
accepted her award---not just for community service, but for
achieving and maintaining food addiction recovery. That was
12 years ago and she's still living the recovery lifestyle."
More Information
If you suffer with weight issues and suspect food addiction
might be an issue, I highly recommend reading Dr. Peeke's book,
The Hunger Fix: The Three-Stage Detox and Recovery Plan for
Overeating and Food Addiction. I think it will help a
lot of people to release their food addictions and achieve long
term recovery. Because it's not just about understanding food.
It's becoming enlightened about why addictive eating happens and
how to create a food addiction recovery lifestyle that you can
live long term. It's about having practical strategies that
allow you to actually apply that knowledge and make the critical
and sustainable changes to break the addiction cycle once and
for all. You can connect with Dr. Peeke on
Facebook or
Twitter, and also find more information on her website,
DrPeeke.com.
© Copyright 1997-2015 Dr. Joseph Mercola. All Rights Reserved.
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