The Hunger Fix
Food Addiction is Real
• What have scientists discovered about food addiction? Dr. Nora Volkow, director of the National Institute of Drug Abuse at the National Institutes of Health has been a leading scientist exploring the relationship between food and addiction, along with her colleague Dr. Gene Jack-Wang, of the Brookhaven Labs. Their teams found that it was primarily the continuous exposure to the “hyperpalatables”—sugary/fatty/salty foods, often refined and processed—that caused profound changes in the brain’s reward center, resulting in a decreased number of receptors for the reward/pleasure neurotransmitter dopamine. This then leads to a vicious cycle of overeating and bingeing.
Dr. Volkow used tools such as PET scans and functional MRIs of the brain to determine that cues in the environment (such as ads on TV and radio, as well as smells and visuals) trigger an unstoppable yearning for a food. Scientists have added to these findings by showing that the prefrontal cortex, the center for executive function, was impaired during active addiction. As a consequence, the ability to use willpower and make the right decision was grossly hampered. Thus, two essential parts of the brain undergo significant organic changes leading to the perpetuation of food addiction. Food addiction, then, involves a serious psychobiological challenge.
• How many people have food addiction? A recent study of 652 men and women in which researchers used the Yale Food Addiction Scale to assess the prevalence of the addiction, found that:
- Around 1 in 20 people (5 percent of the general population) met the criteria for food addiction
- There are a large number of people who don’t meet all of the criteria but who demonstrate a strong association between food and addictive behavior—the “almost addicted”
- Those with food addiction were heavier and had higher body fat percentages
- Women were more affected than men.
This is one of the first studies to provide a glimpse into the magnitude of this problem in the general population. It’s important to note that people who struggle with food addiction span the range of body sizes, from skinny to obese. The difference is in controlling the total daily number of calories ingested and expended.
• Am I a food addict? There’s a validated and peer-reviewed assessment you can take to find out if you have or are on the verge of food addiction. Known as the Yale Food Addiction Scale, this quiz is used by scientists for clinical and research work. You can take the full 27-item assessment, which is provided in The Hunger Fix, or complete the shorter version. Food addiction is indicated when there are three or more symptoms present within the past 12 months and the individual experiences serious functional impairment or distress in his or her daily life.
• What’s the relationship between food addiction and binge eating?Researchers have found a significant crossover between these two conditions. Yale researcher Ashley Gearhardt published data noting that those who experience binge eating and meet the criteria for food addiction are more likely to experience a higher level of mental and physical distress than binge eaters who do not meet the criteria. What exactly is binge eating? It’s the most common form of disordered eating and involves at least 30 percent of the population. Standard criteria for the diagnosis of binge eating include the presence of recurring episodes (at least once per week) of eating much more food than normal in a short period of time, often when not hungry, followed by feelings of being out of control, as well as shame, blame, and guilt. You can clearly see the overlap with food and addiction.
An exciting recent development is the inclusion of binge eating disorder in the fifth edition of Diagnostic and Statistical Manual of Mental Disorders (the DSM-V). This means that those seeking help for weight management who have issues with binge eating and its often-associated food addiction will soon have insurance coverage for inpatient and outpatient treatment programs.
• How do you treat food addiction? The Hunger Fix is the first consumer book to provide readers with both the science and the solution for overeating and food addiction. There is a range of options—from 12-step to cognitive behavioral therapy—to tackle the problem of food addiction. I have found that most people cherry-pick from many of these resources to customize a plan that works best for them. The book will help guide you through this process.
The over-arching goal is to create a new strategy for lifelong recovery. Food addiction presents a unique challenge. It’s unlike an addiction to drugs or alcohol in that you need food to live. You’re surrounded by cues to eat 24/7, as well as the daily stresses that drive overeating. The recovery strategy has to include a healthy lifestyle to provide the mental, nutritional, and physical activity elements that will support lifelong recovery. The Hunger Fix lays down a framework for healing and strengthening the brain’s reward and executive function centers. In three stages—Detox and then Beginner and Master Recovery—you’ll learn how to substitute False Fixes (the hyperpalatables, people, places, and things that enable your overeating) with Healthy Fixes (whole foods, stress resilience, and mental and physical fitness).
The ultimate reward, once you reclaim your brain as well as your life, is the joy and happiness you’ll feel pursuing cherished dreams. That’s a hunger you can spend a lifetime satisfying.
How to Bust Your Binge
Pizza and ice cream are calling. Here’s how to avoid their tempting siren songs.
Before eating a plate of donuts, ask yourself two important questions. There’s a scene in “Sex and the City” where Miranda comes home from a particularly rotten day, takes a distressing phone call and then whips up a batch of brownies, gobbling one after the other. Disgusted with herself, she tosses the rest into the garbage. Hearing more bad news from another call, she stumbles back into the kitchen, grabs the trash can and does a full-on dumpster dive, stuffing her mouth with whatever brownies she can retrieve. Now, consumed with shame, she calls her best friend Carrie and solemnly declares her need to be admitted to the Betty Crocker rehab center. Sound familiar?
The Oxford dictionary defines a binge as “a short period devoted to indulging in an activity to excess, especially eating.” Miranda qualifies. It’s funny how tuna on a bed of greens doesn’t quite do it when you’re anxious and want to soothe yourself. Instead, it’s a bingeable food/beverage product which, in my book “Fight Fat after Forty,” I have defined as any food that:
- Can be eaten in large quantities during a single sitting;
- Often comes in family-sized bags, boxes or cartons;
- Is grab-and-go, usually not requiring extensive or, for that matter, any cooking;
- Can be any food product but typically involves a “hyperpalatable:” sugary/fatty/salty food combinations;
- Does not include arugula.
In “The Hunger Fix: The Three Stage Detox and Recovery Plan for Overeating and Food Addiction,” I noted that science has demonstrated that bingeing is highly associated with addictive eating behavior. It’s no surprise that research has also shown that the top 10 addictive bingeables include pizza, chocolate, chips, cookies, ice cream, French fries, cheeseburgers, sugared sodas, cake and cheese. The problem is that we’re surrounded with 24/7 temptation and often feel helpless, hopeless and defeated as we try to navigate the ubiquitous, multimedia bingeable land mines without overeating.
Here’s a simple guide to help you avoid the bingeables’ tempting siren songs, and stay on track to optimize your health and wellness.
1. Always ask these two questions before you consider eating.
Since bingeing is so highly tied to addictive eating, these two simple yet powerful questions help ground you as you contemplate whether to eat at all.
- If I consume this food/beverage, will I feel loss of control?
- If I consume this food/beverage, will I feel shame, blame and guilt?
If the answer to each question is “yes,” then you’re sitting in front of a bingeable. Say to yourself, “this doesn’t work for me,” and leave it. Out of sight, out of mind.
2. HALT before you cave to the crave.
Make the connection between mood and food by using the acronym HALT and asking yourself if, when you feel like overeating, you’re really:
- Hungry ? if it’s truly time to eat your meal or snack, then do so.
- Anxious or Angry ?
- you need to confront your feelings, not eat.
- Lonely ? you need bonding and connection, not food.
- Tired ? sleep is the answer, not food.
3. Here’s your license to chill.
Sleep deprivation will impair the ability of your hunger and appetite hormones (ghrelin and leptin) to function properly making controlling your eating mission impossible. Start prioritizing high-quality sleep, and you’ll be rewarded with a greatly improved ability to say “no” to temptation.
4. Stressed spelled backwards is desserts.
Toxic stress is associated with feelings of helplessness, hopelessness and defeat. When that happens, people want to feel soothed and comforted, and kale’s not going to do it. Learning how to become more stress resilient is key. Staying centered with mindful living and meditation and mind-body modalities like yoga is essential to avoiding self-destructive behaviors like bingeing.
5. Ditch the m’nage a trois.
There you are in bed, late at night watching another “Law and Order” marathon with your two best friends, Ben and Jerry. Ditch these guys and get some real people in your life. Bag the loneliness, and reach out to help others by volunteering, connecting with others and getting out of yourself and into someone else’s needs.
6. Stay mindful, and beware of cues and triggers to binge.
Science shows that it’s actually the cues to overeat, not the act of eating, that cause the highest levels of the pleasure brain chemical (dopamine) to be secreted. The anticipation of bingeing is really what’s driving you to binge. Protect yourself by being very aware of, and trying to avoid if possible, the persons, places and things that are likely to trigger you to cave and overeat.
7. Eat crave killers.
Combine healthy protein with fiber to feel full and satisfied, thus decreasing the need to binge. For snacks, try nut butter on apple or banana slices, yogurt with walnuts and berries or carrots and hummus.
8. Try a smarter soothing strategy.
Create a repertoire of ways to soothe yourself without bingeing. If you really want something sweet, throw together a fruit smoothie or yogurt parfait with fresh blueberries. Non-food strategies can include getting up and walking outside to breathe some fresh air and move away from a stressor. Calling a friend to unload a problem helps. Prayer and meditation can keep you grounded. And don’t forget the power of a truly soothing bath.
Throw these tips and techniques into your mental tool box and grab ’em as needed. Consider yourself locked and loaded, prepared to bust an oncoming binge anytime.