Parallels between obesity and drug addiction include patterns of behavior and biological changes (Shriner et al., 2014). Overeating and drug addictions have compulsive behavior in common (Volkow et al., 2013). Understanding the biology and psychology of compulsive behavior and addiction could offer insight into overeating and treatment of obesity.
How Overeating Resembles Addiction
Behavior in response to certain foods, for some individuals, resembles the compulsiveness of drug addictions (Volkow et al., 2013; Shriner & Gold, 2014). Similarities between overeating and addiction include the following:
- Both food and drug addictions are characterized by brain dysfunctions in areas involved in pleasure and self-control (Shriner et al., 2014; Volkow et al., 2013).
- As with drug-seeking, certain foods are sought for their stimulating effect on opioid and dopamine levels. This is why paired high fat / high sugar foods, both of which raise opioid and dopamine levels, are particularly problematic (Shriner et al., 2014).
- As with drugs, food is sometimes used as a way of coping with stress or mood. Therefore, the underlying psychological diagnoses, stressors, and problematic coping patterns need to be addressed before a weight loss plan will be successful.
The Food Addiction Cycle
The addictive-like behavior of excessive eating is cyclical as is drug addiction behavior:
- High fat / high sugar foods raise dopamine levels.
- These foods are sought out and even “craved” for their stimulating effect on opioid and dopamine levels (Gearhardt et al., 2011; Shriner & Gold, 2014).
- The positive effect becomes muted in a response resembling drug tolerance (Gearhardt et al., 2011).
- Individuals consume more or even binge in order to experience the pleasure they once received (Gearhardt et al., 2011).
- As with drug addiction, people may feel unpleasant “withdrawal” when they go without high fat or sugar foods. A low mood may be a part of these symptoms.
- Eating the desired food helps raise the mood.
- The response by opioid receptors is further muted like drug tolerance
This leads back to step 1, repeating an indulgence in high sugar and high fat foods, and then continues in cyclical pattern.
Which Foods Are Most Addictive?
Foods and food attributes that are implicated in addictive-like eating were identified in research with 120 undergraduates identified (Schulte et al, 2015). Foods at the top of the list were:
- Processed foods
- Foods high in fat and glycemic load (for example, potato chips, ice cream, and pizza)
The authors noted that highly-processed foods share certain characteristics with abused drugs: concentrated dose and rapid rate of absorption.
How Can The Cycle Of Food Addiction Be Broken?
Common approaches to treatment of addiction and obesity are being explored, both pharmacological and behavioral. For example, naltrexone, a drug used to counteract the effects of opioids, is one component of the FDA-approved weight-loss medication Contrave® (FDA, 2017). Furthermore, approaches to counseling that are effective for addiction, such as Motivational Interviewing, have been shown to be effective for treating obesity (DiLillo & West, 2011).
- People struggling with an addiction-like relationship to food may benefit from working with counselors to think about how they feel about foods they over-consume and notice their eating patterns.
Pharmacological treatments may help break the addiction-like cycle, or at least decrease it enough so that patients can experience more success in weight loss. Some medications affect the reward center and others work on appetite-regulating hormones.
It may be better to make slow, periodic changes rather than sudden abstinence (Shriner & Gold, 2014). The sudden removal of a food source from the patient’s usual diet may trigger binge-eating in compensation, which has an overall negative effect on weight loss.
- DiLillo V, West DS. Motivational interviewing for weight loss . Psychiatric Clinics of North America . 2011; 34: 861-869. Available at: http://www.ncbi.nlm.nih.gov/pubmed/22098809 Accessed on: 2017-08-16.
- FDA. FDA approved products: Contrave. 2017. Available at: https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&applno=200063 Accessed on: 2017-08-16.
- Gearhardt AN , Yokum S , Orr PT. Neural correlates of food addiction . Arch Gen Psychiatry. 2011; 68: 808-816. Available at: http://archpsyc.jamanetwork.com/article.aspx?articleid=1107239 Accessed on: 2017-08-16.
- Schulte EM , Avena NM , Gearhardt AN . Which foods may be addictive? The roles of processing, fat content, and glycemic load. PLOS. 2015. Available at: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0117959 Accessed on: 2017-08-16.
- Shriner R, Gold M. Food Addiction: An Evolving Nonlinear Science. Nutrients. 2014; 6(11): 5370–5391. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4245594/ Accessed on: 2017-08-16.
- Volkow ND, Wang GJ, Tomasi D, Baler RD. Obesity and addiction: neurobiological overlaps. Obes Res. 2013; 14(1): 2-18. Available at: http://www.ncbi.nlm.nih.gov/pubmed/23016694 Accessed on: 2017-08-16.