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August 30, 2017

Food Addiction: What is it? – Ralph Carson

help for food addictionWhen someone says they are “addicted to food,” what they are probably saying is that they feel a loss of control of their eating habits.

“Food addiction” is a frequently overused cliché and a very complex concept to explain.

Today, I’d like to clarify how the term “food addiction” is perceived in the world of eating disorders. I also share some possible consequences of the term’s misuse.

Losing control over eating

I like to consider loss of control (LOC) eating as being on a spectrum or a continuum. This spectrum includes a number of entities, including the following:

Binge eating disorder — Bulimia nervosa — Other specific eating and feeding disorders (OSFED) (this may include BED at a low frequency and/or limited duration, grazing or night eating syndrome) — Pre- and post- bariatric surgery care — Compulsive overeating (“food addiction”) — Emotional eating

There is also a type of eating we call habituated indulgence. If we consider those who might often experience a loss of control over eating, we typically see the following:

Emotional eaters — Emotional eaters overeat inappropriately when triggered by stress. They often use comfort foods to avoid pain, numb their feelings and for self-soothing purposes.

Compulsive eaters — Those who eat compulsively indulge in highly palatable foods despite negative consequences and regardless of how they feel. Compulsive eaters can be happy and still binge  The latter individual is the person that may be labeled as, or self-identify as, being “addicted to food.”
 
[Note: Binge eaters can be both emotional and compulsive eaters.]

What is food addiction? 

The truth is that I really don’t like to use the term “food addiction.” An addiction implies that — to achieve recovery — one must permanently abstain from any offending “trigger food(s).” Trigger foods are those items that have special individual appeal and set off an internal desire to overconsume — ultimately resulting in binge eating behavior.
 
Further, if you are addicted to a food, it means that you can never manage to eat that food in moderation for the rest of your life. The only options you will have are to either 1) avoid every food you enjoy or 2) simply consider yourself as a failure if you slip up.
 
Saying one is addicted to food also brings up outdated theories. It says that the condition results from either a 1) character defect or 2) lack of willpower. This can give one a sense of hopelessness and deprivation — rather than truly addressing the underlying problems and changing behaviors.
 
When we say that a person is addicted, we mean that this person will always have to abstain from the trigger foods enjoyed in the past. We are saying that there is no hope to reintroduce these foods back into one’s diet. We are saying that this person cannot have a healthy relationship with food. 
 
I prefer to tell patients this: you are not addicted to food; you are a compulsive eater, treatment is available and there is hope.

What is compulsive eating? 

A compulsive eater is someone who continues to overeat despite negative consequences. For instance, the eating may result in low self-esteem or physical health issues.
 
Here’s what a compulsive eater is not: someone who others perceive as one who overeats, one whose size lies outside the medical establishment’s definition of a healthy weight (as rated by their BMI), one who is happy with life and loves their body.
 
If someone is confident in their size, enjoys pleasurable foods, experiences no health consequences as a result of their eating or weight, is happy and enjoys their life’s circumstances, I would not call them a compulsive eater. 

Compulsive eating treatment 

So here’s the good news: whether we call it food addiction or compulsive eating, treatment is available at eating disorder clinics nationwide; there is hope.
 
At the Binge Eating Treatment Recovery Program (BETR), we focus on doing what is best for every patient in the long-term. Our goal is to help improve every patient’s quality of life. In treatment, individuals can learn and apply therapeutic tools to address eating behaviors. Here are some examples:
 
  • Learning to accept and eventually ignore cravings that lead to overeating, resulting in mental and physical duress
  • Consuming “trigger foods” without suffering negative consequences.
  • Understanding that abusing trigger foods in recovery can lead to a resurgence of old habits 
Compulsive eating treatment involves changing the way we think — not just avoiding all foods that taste good.

Recovery is not easy but it is possible. 

Getting help for overeating 

I understand that many people who struggle with compulsive eating habits may prefer to use the term “food addiction.” Ultimately, what matters most when it comes to labeling types of binge eating is this: whatever label we use, we must provide effective treatment!
 
Many who struggle with loss of control eating correctly acknowledge that it’s not their fault; labeling the problem as an addiction may increase self-compassion and reduce self-blame. But, use of the term “addiction” can also make people feel like they will never be able to stop overeating certain foods. We certainly want people to believe there is hope and that they will be able to control their eating.
 
How do you know if you need help for compulsive eating? Essentially, it comes down to the degree you feel that you lose control of yourself during a binge-eating episode. Consider these questions:
 
  • Do you tell yourself you won’t lose control while eating certain trigger foods — but you do — and experience significant distress as a result?
  • Do you find it very hard not to keep eating certain foods, even though you aren’t hungry and you know you should stop?
  • Do you feel pain, suffering or distress for an extensive time period after a binge?
  • Are you paying for a lot of medications due to health problems that would be eliminated if you were in control of your eating?
  • Does boredom, stress, anxiety, depression, or poor self-esteem set off binges that lead to negative consequences?
  • Do you struggle with mobility, find yourself frequently out of breath and experience severe joint & muscle pain that could be mitigated by modifying your lifestyle?
  • Is the pain of where you are (isolated, embarrassed, out of control, unhealthy) greater than the pain to change (entering treatment, changing old habits, admitting there is a problem, committing to recovery)?
 
People can change negative habits, develop resilience, and identify and learn the skills necessary to deal with compulsive overeating. Time-tested therapeutic tools can positively affect one’s quality of life, relationships, food appreciation, physical mobility, sleep quality, work, emotional and physical health, self-esteem and more.
 
If you see a sign that a problem is occurring, don’t ignore it. Take action to solve the problem and please let us know if you need help.
 
Ralph Carson, RD, PhD, is a nutritionist and exercise physiologist with over 40 years of experience. He is currently Vice President of Science and Innovation for Eating Recovery Centers (ERC) and the Binge Eating Treatment and Recovery Program (BETR) in Chicago and other locations. BETR focuses on loss of control and binge eating. Dr. Carson is an active member on the board of the International Association of Eating Disorder Professionals (iaedp) and author of The Brain Fix: What’s the Matter with Your Gray Matter.
 
 
 
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