At the recent annual assembly of the American Psychiatric Association, Dr. Kelly Brownell of Duke University and Dr. Robert Lustig of the University of California at San Francisco spoke on how food addiction is affecting the United States.
Brownell remarked that a growing scientific literature indicated that processed foods negatively affect the brain. “This is a game-changing concept… because it’s true that food can hijack the brain, you can imagine how parents are going to feel about this when their children are exposed to these ‘substances’. It could come down to helping us protest children’s food environments, much like we try to do with tobacco and alcohol.”
Brownell suggested that we not focus on food addiction, which is experienced by a small percentage of the population and goes to the morality or pathology of the individual, but instead on ”food and addiction because that destigmatizes the person and puts the focus on the substance(s) instead.” He asked the question, “If there is an addictive impact of food on the brain, what does that say about the accountability of the food industry for intentional manipulation of ingredients, what kind of advertising is permitted, and what products should be permitted for sale in schools?”
Brownell pointed out that food in its natural state has never been known to create a public health hazard, and outlined the criteria to determine whether legal action against some food processors might be appropriate. “A product must be safe with its intended use. When injury occurs, this duty is breached. The liability is enhanced if the product is addictive. Did the manufacturers knowingly modify products? Were the consumers warned?”
The social policy issues outlined by Brownell warrant investigation, but when Brownell implicitly says, “Forget those who are food addicted. We can do more good focusing on those in earlier stages of the problem,” it is a subtle form of food addiction denial. Yes, we want to help people who can still help themselves and their children, but we also must support those who have reached a critical stage of the disease to challenge food addiction denial and get help.
Lustig, meanwhile, demonstrated how food additives such as refined sugar and high fructose corn syrup increase appetitive hormones and “reward” feedback in the brain while reducing the brain chemicals responsible for controlling food intake. This amounts to creating “craving for more food, while the body’s ability to detect satiety is simultaneously suppressed.”
Lustig said that of the roughly 600,000 food items sold in America, 80 percent have refined sugar, for which there are 56 names. “So how do you reduce consumption if you don’t even know you’re eating it?” Lustig said his data indicate that the additives’ disruption of the brain’s signaling system contribute to rising obesity and patterns of processed-food consumption that “fits the DSM-IV criteria for addiction.”
Lustig concluded that “Medicare in 2024 will be broke if we don’t approach this as a public health crisis.”
Brownell, formerly director of the Rudd Center for Food Policy and Obesity at Yale University, is the author of Food Fight and co-editor of Food and Addiction: A Comprehensive Handbook, the first medical text on the science of food addiction.
Lustig is a pediatric endocrinologist and author of Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease.