It is frequently difficult to distinguish between “compulsive overeating” and “food addiction,” especially since many recovering people as well as the professionals who support them use the terms interchangeably.
At ACORN, we have come to use the terms “compulsive eating” and “addiction to food” to define two distinctly different problems. We use the term “compulsive overeating” to identify what is now called “binge eating disorder” by psychologists. This psychological disorder derives from unresolved trauma and family dysfunction as well as a lack of cognitive feeling and behavioral skills to deal with difficult emotions.
We use the term “food addiction” to refer to biochemical dependency on food. This problem is described as a person relating to specific food(s) or food in general in a different way than normal people. Food addicts experience physical craving, mental obsession, and a distortion of basic instincts and will.
Ten years ago there was little scientific research proving that food addiction actually existed, much less any research explaining a biochemical basis. Today, because of new genetic science, advances in brain scan research and billions of dollars invested in finding a medication that addresses the obesity epidemic, there is an abundance of studies in a wide variety of academic and medical fields that support a diagnosis of food addiction.
These studies overwhelming support the theory that many of the severely obese and those with advanced eating disorders are also chemically dependent on food. In fact, as a substance disorder, food addiction could be the primary medical problem in those cases.
The amount of specialization in scientific research and the fact that professional journals didn’t allow the use of the term “food addiction,” (because it was not yet confirmed as a medical or mental health disease) has made it difficult to assemble all the research and correlate all the data about chemical dependency on food across sub-disciplines of science. Still, there are peer-reviewed professional journal articles establishing:
1. A sample of obese people who were not alcoholic or drug addicted and who binged on dense carbohydrates had the same D2 dopamine gene marker as is found in alcoholics and drug addicts.
2. Dozens of PET scans of binge-eating obese people show the exact same brain image problems as alcoholics and drug addicts.
3. Definitive research that animals in experimental studies can become addicted to sugar.
The question is, what are the differences between these two food-related problems, binge eating and food addiction? Is the treatment for these two issues the same or different?
It is probably helpful to begin by saying that in many of cases of food addiction there may also be an underlying psychological eating disorder based on unresolved trauma. Moreover, there is often a misdiagnosis by a health professional, usually because they do not recognize the symptoms of, or are unwilling to identify, a real chemical dependency on food.
The vast majority of those we see in ACORN were either given diets by professionals who did no follow-up to confirm the effectiveness of the diet and/or were treated therapeutically for psycho-dynamic eating disorders. Usually, professionals have not considered whether their client needed to completely abstain from certain food(s).
One of the most effective ways of determining if someone is food-addicted is to take a “food history.” Does the person have a history of dieting, then gaining back the same amount of weight, or more? Has the person done serious work in psychotherapy, only to find that their bingeing was unaffected? Are there foods that the person feels they cannot live without and are unwilling to forego? Are there foods that the person is unable to stop eating, even though they may have tried many times?
These questions are remarkably similar to many that are asked of alcoholics and drug addicts at the beginning of treatment. As most alcoholics and drug addicts are frequently unable to disentangle themselves from their substances without help, many people that are food-addicted require additional medical assistance and Twelve Step support to withdraw from their “drug of choice.”
© Phil Werdell, M.A.