Food addiction is a disease which causes loss of control over the ability to stop eating certain foods. Scientifically, food addiction is a cluster of chemical dependencies on specific foods or food in general; after the ingestion of high palatable foods such as sugar, excess fat and/or salt, the brains of some people develop a physical craving for these foods. Over time, the progressive eating of these foods distorts their thinking and leads to unwanted negative consequences. Despite this, they still cannot stop overeating. In Early Stage food addiction there is moderate, often infrequent, loss of control. This could express itself in occasional food binges, a slight increase in volume of food eaten, or snacking more frequently. Externally, it can look almost identical to the behavior of a normal healthy eater indulging in occasional excesses. Internally, the early-stage food addict can be lying, isolating and/or feeling guilty. At this stage, the food addict could stop the progression of the disease simply by no longer eating the offending foods, but the negative consequences at this time are seldom sufficient to justify such radical action. By the Middle Stage of the disease, most food addicts will have gained unwanted weight, dieted, and then regained the weight. Some will have done this more than once. Many find themselves hoarding particular foods, taking others’ food, stealing money to buy food, or outright lying about food – not their normal behavior in other matters. A few begin deliberate periods of restricting, over-exercising or purging. There is often a sense of guilt or shame about not being able to control their weight and treating food like a drug stash, though they may not think of it in this way. Some join a food-related 12-Step group and find this to be the right solution, but others are unwilling to completely abstain from binge foods or do the internal work suggested. As with alcoholics at this stage, these food addicts often “want to want to stop.” They are in denial that they are really food addicted or that a chemical dependency on food actually exists. They remember the times they were able to diet at least temporarily, or they simply cannot accept the idea that they cannot control something as basic as food. The Late Stage food addict is usually quite clear that they have no control over food. While still experiencing deep shame, they often see any attempts to diet as hopeless – even though they might continue to try. Many have tried therapy to deal with their weight and/or eating disorder – some for many years. While there are often many emotional and spiritual benefits from talk therapy, they find that learning to control their eating is not one of them. Others are so ashamed of their lying about food or so accustomed to doing so that they do not tell their doctor, dietician or therapist the full truth about their eating. They may be unable to tell the full truth about their behavior with food because they are in deep biochemical denial. In late stage food addiction, there are major medical consequences and serious psychological, social, economic and spiritual losses. Besides obesity or an advanced eating disorder, they often have high blood pressure, diabetes, heart disease, depression, anxiety and other serious issues. Frequently, the medical professional will treat the secondary problem because that is what they know how to do, but the underlying substance use disorder with food is completely neglected, and the food addict just lives to overeat again. The diabetes, heart disease, depression or other secondary medical illness returns, often growing worse. There are now a growing number of food addicts in the Final Stage of the disease. This includes many in the new medical category of Extreme Morbid Obesity. Also included are many anorexic and bulimics who have been in treatment several times, but have not yet been diagnosed as also being chemically dependent on food. In final stage food addiction, secondary medical diseases are often so advanced that treatment is only possible in a hospital where the food addicted patient’s problems can be monitored and treated. It is not unusual for food addicts at this stage to be too overweight for some residential treatment programs which are able to treat food as a substance use disorder. (Tragically, there currently are no primary hospital- based treatment programs for food addiction.) Bariatric surgery can be helpful to many who are extremely obese, but if their food addiction is advanced, they are likely to start overeating again within a year, often losing surgery’s benefits as they regain the weight. All obese people are in danger of dying five to ten years earlier than they would have if they had been at a normal weight. Those who are morbidly obese and in the final stage of food addiction can expect an even earlier death or a very painful life if their chemical dependency is not effectively treated. © Philip Werdell, 2011

Cravings for more and/or particular foods, such as those that contain sugar, flour/grain/starch, salt, and/or fat. Thinking one “cannot live” without favorite foods. Preoccupation with planning, buying, or eating food—even after having just eaten. Eating in secret or alone. Continued over/under eating despite adverse physical, mental, emotional, and/or spiritual consequences. Compulsive eating episodes that become more frequent and demand increased quantity to get the same effect. Emotional or physical withdrawal symptoms when stopping or reducing specific types of foods.

Food addiction is a brain disease like alcoholism and drug addiction which causes loss of control over the ability to stop eating certain foods as the body has become dependent on them. Scientifically, food addiction is a cluster of chemical dependencies on specific foods or food in general. After the ingestion of highly palatable foods such as sugar, excess fat, flour, grains and/or salt, the brains of some people develop a physical craving for these foods. Over time, the progressive eating of these foods distorts their thinking and despite negative consequences they are unable to stop the behavior. Food addiction is a DIFFERENT disease than non-substance dependent obesity and eating disorders. Food addiction requires a DIFFERENT approach to treatment. While all of the overweight and obese are not food addicted, chemical dependency (addiction) is one of the driving forces of the obesity epidemic. Food addiction is a more complex and difficult problem and requires special, addiction informed care in order to be properly and successfully treated.

What is Food Addiction? Answered in video is H. Therese Wright explaining what food addiction is. On youtube, https://youtu.be/2kaVqie1p6U Video created by Gabriela Arocha Prego

Seek help. Find a support group or health care practitioner to provide encouragement and guidance. Make a list of binge foods. Eliminate sugar, flour/grain/starch, salt, and trans fat from your home and work environments, even if these foods are not yet on your list. Plan and write down your meals and meal times. Keep a journal to identify feelings or circumstances which act as triggers to reach for food. Make a list of healthier ways to self-soothe (i.e. walk or bicycle, talk to a friend, practice deep breathing, be mindful, or get a massage). Don’t skip meals. Eat at regular intervals. For more information, tips, support, and additional resources, explore our website, become a member, get professional support and training, join our community and earn credits for spreading the word about the distinctions of food addiction.

For some, food ingredients (including sugar, flour/grain/starch) can produce brain changes and reactions similar to what happens in those who have other addictions. The treatment required for food addiction (substance use disorder or food dependency) is fundamentally different from moderation. Moderation may be appropriate for treating other food-related disorders. For people with food cravings, abstinence or refraining from trigger foods and behaviors is essential because of the following: The brain develops a stronger preference for foods that are calorie-dense (i.e. foods containing sugar, flour/grain/ starch, salt, and/or fat). Consuming these foods activates the brain’s reward system and triggers the release of the “pleasure hormone” dopamine in the same way other addictive substances do. The brain then calls for more and more. The rewarding nature of these foods can sometimes encourage eating whether one is hungry or not. The behavior that results is not considered “normal” eating.

It must be pointed out that most health professionals received little or no training in food addiction screening, diagnosis or treatment during their graduate and professional school training. Many have even been taught that food addiction does not exist. So it is important to have the following criteria in mind, at a minimum, when selecting a therapist, dietitian or other professional for food addicted patients. ​ Ask the following questions when looking for a healthcare provider: Has the provider successfully helped others struggling with food addiction? Does the provider offer an abstinence-based approach? Does the provider understand the importance of identifying addictive foods and finding ways to enjoy eating without them? Does the provider offer regular contact for patients challenged with food addiction? Does the provider have a professional certification and training in food addiction informed treatment?

Absolutely! Recovery from food addiction requires the same approach as recovering from any addiction. Complete abstinence of that substance is required. Recovery starts by identifying which foods you are addicted to and eliminating them from your diet. Recovery from food addiction cannot be done alone and will require support. Look into professional and peer group support. Become a member of the Food Addiction Institute to join our communities, connect to support and professional treatment.

No. If a food addict has tried diets and controlled eating and is still struggling with food, weight, and cravings, then they may be trying to solve the wrong problem. They may be a food addict and thus require abstinence from their trigger foods. Moderation of ‘favorite binge foods’ is only a solution for people who are NOT food addicted. A food addict needs to find a health care provider that understands food addiction and how to treat it, who is a Certified Food Addiction Professional, and has training in food addiction informed treatment. In addition, they will need further extensive peer group support. Join the Food Addiction Institute to access our community, support networks, and treatment resources.

If you eat when you really do not want to, or if you persistently eat more food than your body needs, or if you eat in a way that you know is not good for you, you may be a food addict. Some characteristics of a food addict include; physical craving, loss of control, withdrawal, tolerance dependency, and denial.

Cravings (i.e. insatiable desired for more food or specific foods) Feelings of guilt/shame/remorse about eating Lying to self or others about eating behaviors Stealing food Distress or difficulty functioning due to behavior related to eating (i.e. fatigue, headaches/migraines, foggy brain, and/or aching joints) Thinking about food almost all the time and wanting more Food obsessions which impair normal functioning whether an over/under eater Uncomfortable symptoms of withdrawal occur when problematic foods are removed

Weight gain and obesity can be caused by many things -- being chemically dependent on foods is one of those things. Approximately 20% of normal weight people are food addicts. 30% of overweight people, and 50% of obese people are chemically dependent to certain foods, most often sugar, fat, flour and processed foods. Some people are also addicted to the process of eating large volumes of food or other foods, such as grains.

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Food addiction is often confused with other food disorders. Many people have more than one food disorder, but the cause and treatment of these medical conditions is significantly different. Food addiction is a brain disease like alcoholism and drug addiction food addiction causes loss of control over the ability to stop eating certain foods the body of a food addict has become dependent on certain foods Scientifically, food addiction is a cluster of chemical dependencies on specific foods or food in general. After the ingestion of highly palatable foods such as sugar, excess fat, flour, grains and/or salt, the brains of some people develop a physical craving for these foods. Over time, the progressive eating of these foods distorts their thinking and despite negative consequences they are unable to stop the behavior. Food addiction is a DIFFERENT disease than non-substance dependent obesity and eating disorders. Food addiction requires a DIFFERENT approach to treatment. While all of the overweight and obese people are not food addicted, chemical dependency (addiction) is one of the driving forces of the obesity epidemic. Food addiction is a more complex and difficult problem and requires special, addiction informed care in order to be properly and successfully treated. Watch this informative video with FAI Board Members Marty Lerner and Cynthia Myers-Morrison

Early Stage In the early stage, food addicts are often unaware that they have a problem. Food often seems more like the solution than the problem. The main problem usually begins with a lack of good education about food addiction. Middle Stage By the middle stage, food addicts have tried a number of diets or other more extreme strategies to control their eating; they are suffering negative consequences being overweight, depressed, leading a secret life, feeling guilt or shame about both, but the consequences do not seem severe enough to justify giving up entirely the foods they like the most, much less asking for help to do this. Late Stage In late stage, food addicts know their problem is critical but they find their situation hopeless; they know that they are powerless to stop by themselves, but commercial weight loss, therapy on underlying issues, and sometimes even 12-Step programs alone are not sufficient to get them abstinent and in stable recovery. Most food addicts at this stage need professional treatment. Final Stage In the final stage of food addiction, there are usually very serious medical complications. This could be morbid obesity, failing joints, advanced diabetes, progressive heart disease, and much more including a desire for death. Paradoxically, eating has often become the most important thing in their lives, and while it is causing an early and painful death, it can also be the only thing that they believe makes life worth living. Treatment at this stage must often be primary, following the addiction model and be hospital-based. There currently are no such programs. Tragically, knowing that food addiction is a serious, progressive disease is often insufficient to break food-addictive denial.

Early Stage In the early stage, food addicts are often unaware that they have a problem. Food often seems more like the solution than the problem. The main problem usually begins with a lack of good education about food addiction. Middle Stage By the middle stage, food addicts have tried a number of diets or other more extreme strategies to control their eating; they are suffering negative consequences being overweight, depressed, leading a secret life, feeling guilt or shame about both, but the consequences do not seem severe enough to justify giving up entirely the foods they like the most, much less asking for help to do this. Late Stage In late stage, food addicts know their problem is critical but they find their situation hopeless; they know that they are powerless to stop by themselves, but commercial weight loss, therapy on underlying issues, and sometimes even 12-Step programs alone are not sufficient to get them abstinent and in stable recovery. Most food addicts at this stage need professional treatment. Final Stage In the final stage of food addiction, there are usually very serious medical complications. This could be morbid obesity, failing joints, advanced diabetes, progressive heart disease, and much more including a desire for death. Paradoxically, eating has often become the most important thing in their lives, and while it is causing an early and painful death, it can also be the only thing that they believe makes life worth living. Treatment at this stage must often be primary, following the addiction model and be hospital-based. There currently are no such programs. Tragically, knowing that food addiction is a serious, progressive disease is often insufficient to break food-addictive denial. Answered by Phil Werdell © copyright Phil Werdell, Bariatric Surgery & Food Addiction: Preoperative Considerations, 2008

The main symptoms of Food Addiction include craving and bingeing on unhealthy foods without being hungry and an inability to resist the urge to eat these foods. ------ There is no blood test to diagnose food addiction. As with other addictions, it’s based on behavioral symptoms. Here are 8 common symptoms**:** frequent cravings for certain foods, despite feeling full and having just finished a nutritious meal starting to eat a craved food and often eating much more than intended eating a craved food and sometimes eating to the point of feeling excessively stuffed often feeling guilty after eating particular foods — yet eating them again soon after sometimes making excuses about why responding to a food craving is a good idea repeatedly — but unsuccessfully — trying to quit eating certain foods, or setting rules for when eating them is allowed, such as at cheat meals or on certain days often hiding the consumption of unhealthy foods from others feeling unable to control the consumption of unhealthy foods — despite knowing that they cause physical harm or weight gain If more than four to five of the symptoms on this list apply, it could mean there’s a deeper issue. If six or more apply, then it’s likely a food addiction.

The genes people are born with account for about half of a person’s risk for addiction. Under certain circumstances, gender, ethnicity, and the presence of other mental disorders may also influence risk for food and other addictions. A person’s environment includes many different influences, from family and friends to economic status and general quality of life. Factors such as peer pressure, physical and sexual abuse, early exposure to these foods (think sugar), stress, and poor parental guidance can greatly affect a person’s likelihood of having food and other addictions. Genetic and environmental factors interact with critical developmental stages in a person’s life to affect addiction risk. Although eating addictive foods to excess at any age can lead to addiction, the earlier that food is introduced (again, think about kids and their consumption of sugar), the more likely it can progress to addiction.

Everyday in casual conversation, we hear people say: ​ I'm a food junkie. I'm a chocoholic. I need my sugar fix. ​ It can be difficult for people to take “food addiction” seriously. However, for anyone who is currently struggling with “true food addiction” (aka food dependency or a food-related substance use disorder) it can be very serious. For most, the road has undoubtedly been long and difficult. Today, the vast majority of people, including those in the medical community, don’t understand why or how people can become addicted to certain foods. Happily, this is changing as more and more scientific evidence becomes available. ​ Most people automatically assume that those who struggle with their weight lack willpower and that they just need to eat less and exercise more. This implies that without much effort people can simply choose to stop eating quite so much. In reality, food addiction, as with all addictions, is a complex disease. Changing what and how you eat usually takes much more than good intentions or a strong will. Once addicted, eating certain foods changes the brain in ways that make abstaining from one’s “trigger foods” very hard, even for those who desperately want to. Fortunately, we continue to learn more about how food addiction affects the brain. And treatments have been identified that can help people recover from food addiction and lead productive lives that they never imagined were possible for them.

Enjoying food is definitely not the same thing as being addicted to food. Our brains are wired to enjoy food – that is a primal survival mechanism. In fact, we enjoy foods that are high fat and high sugar for that very reason – these foods are energy dense and ensure our survival by making us want to eat more for immediate energy and storage purposes. Even the food addict who is in recovery still enjoys their food. What makes the enjoyment addictive is the key question. When the enjoyment has become so large that it dominates other natural pleasures, a problem is flagged. We are either in a deficit (so we need the excess food i.e. very hungry) or we are in a disordered pattern of eating. The natural ebbs and flows of pleasure are misaligned: Notice that when you are hungry, the plate of Brussels Sprouts and glass of water is very enjoyable, but when you are full, you no longer desire them. The desire to eat ebbs when it is no longer necessary to ‘fuel up’. But when you still desire to eat, and you are not hungry – something else is operating that keeps you wanting to continue to eat or to ‘enjoy’ the food. There are many neurochemical and hormonal reasons for this disorder, and one of them is the neurochemistry of addiction. The person may be rooted into an addiction loop that makes them crave food even when they no longer need it, in fact, even when they are no longer enjoying it. They still want it anyway. The major way an addiction doctor can determine if a person has a food addiction (versus is just enjoying food), is by looking at the eating patterns and food behavior. The doctor is looking for a dysfunction in the normal ‘ebbs and flows’ of wanting and not wanting food. We use questions from the DSM IV which determine addiction. Here are just a few: Do you crave and obsess over food, even when not hungry? Have you tried to abstain from food and found that you could not (i.e. a diet)? Have you ever eaten foods that you know are bad for your health? Even when your health is deteriorating (i.e. Diabetes)? Have you ever found that you could not control your food intake? Could not stop after the first bite? An excellent questionnaire that you can use is the 20 questions that the Food Addicts in Recovery group uses. If you answer yes to just a few of these, you might be a food addict, rather than just enjoying your food. 1. Have you ever wanted to stop eating and found you just couldn’t? 2. Do you think about food or your weight constantly? 3. Do you find yourself attempting one diet or food plan after another, with no lasting success? 4. Do you binge and then “get rid of the binge” through vomiting, exercise, laxatives, or other forms of purging? 5. Do you eat differently in private than you do in front of other people? 6. Has a doctor or family member ever approached you with concern about you’re eating habits or weight? 7. Do you eat large quantities of food at one time (binge)? 8. Is your weight problem due to your “nibbling” all day long? 9. Do you eat to escape from your feelings? 10. Do you eat when you’re not hungry? 11. Have you ever discarded food, only to retrieve and eat it later? 12. Do you eat in secret? 13. Do you fast or severely restrict your food intake? 14. Have you ever stolen other people’s food? 15. Have you ever hidden food to make sure you have “enough?” 16. Do you feel driven to exercise excessively to control your weight? 17. Do you obsessively calculate the calories you’ve burned against the calories you’ve eaten? 18. Do you frequently feel guilty or ashamed about what you’ve eaten? 19. Are you waiting for your life to begin “when you lose the weight?” 20. Do you feel hopeless about your relationship with food? Questions: Copyright © 2000-2010 Food Addicts in Recovery Anonymous This Question was answered by Dr. Vera Tarman on https://addictionsunplugged.com/ For more information and support, check out the following resources, including my recurring online course “Adapt Your Life — Sugar and Food Addiction”

Are you unable to stop eating foods that you know contribute to your struggles with your weight or health? Do you find yourself craving or obsessing over certain foods? If you start eating a favorite food, do you find it hard to stop? If you answer yes to these questions, or to more behaviors described below, you may have a food addiction. How do you know if you have a food addiction? If you are not sure, questionnaires and surveys can help you figure it out. Foodaddicts.org has a 20-point questionnaire that asks about various behaviors and feelings of shame, guilt, and lack of control around food. The 35 questions of the Yale Food Addiction Scale is a validated research tool used by addiction clinicians and researchers to specifically identify those who are most likely to be exhibiting markers of food addiction. However, I have found a simple way to tell. Generally, food addiction can be identified by five key signs. These signs are the criteria of ANY addiction, whether it is food, drugs, alcohol, or behavioral. These five signs have to do with the way addictive substances work on our brain’s reward center and neurotransmitters, especially the neurotransmitter called dopamine. 1. Cravings and obsessions Do you crave specific foods? Do these foods (or food) intrude or obsessively occupy your thoughts? Do you neglect better foods in favor of your cravings or obsessions? Even when not around the food, are you obsessing about where and when you might be able to get it next? If you see this food, do you obsess over having it and usually give in and eat it? Cravings and obsessions are usually a sign that the dopamine in your brain is low and your brain is seeking ways to increase it. 2. Tolerance Do you need to eat more of your trigger foods to get the same effect? Do you try to get to a moment of satisfaction from the food that never seems to happen? Do you binge even if you wish you could stop just to try to feel “normal” again? Do you eat to the point of feeling sick just to feel “normal”? Tolerance is a sign that dopamine receptors in your brain have downregulated. A surge of dopamine, caused initially by the addictive substance, causes the brain to reduce its dopamine receptors in order to maintain homeostasis. This means you need more of the trigger food now to get the same effect. In addiction, this “never enough” feeling when trying to attain that initial euphoria is called “chasing the dragon.” 3. Lack of control Do you find you simply can’t stop at just one or two of your favorite foods? Do you eat in secret? Are you embarrassed about the way you eat? Are you unable to moderate or regulate your behavior or consumption around trigger foods? The neurobiology of addiction, especially changes to dopamine levels and receptors, reduces the ability for voluntary self-control around trigger foods. 4. Impairment Are you suffering consequences to your health, your weight, or your relationships but you continue eating foods that you know you should not eat? Do you have obesity, diabetes, high blood pressure, fatty liver, or other health conditions that you know could be improved if you changed how you eat? Do you feel depressed or have self-loathing about the way or what you eat? Are relationships, social events, or work situations negatively impacted by your eating? If you are unable to stop eating certain foods despite knowing they are bad for your health, your life, or your relationships, your brain reward circuits are likely overriding your ability to control your urges. 5. Dependence When you try to stop, do you find it too hard and then give up? When you try to stop, do your cravings get worse or intolerable? When you stop, do you experience withdrawal, such as agitation, anxiety, insomnia, anger, or irritability? Do you feel foggy, tired, or low energy? Can you not imagine your life without your trigger food(s)? Would you do anything, even steal, to get your special food rather than stop? Dependence on addictive foods, especially when they are all around us, can make it feel like it is impossible to avoid our trigger food and make us feel hopeless that we will ever be free of our addictive eating patterns. Note: You don’t have to have all five signs to be a food addict. Even just a few of them are enough to tell you that a certain type of food may have you caught in an addictive cycle and may be undermining your health or your ability to lose weight. If you do have all five signs then you should definitely consider yourself a food addict and treat your trigger foods as if they are as potent as an addictive drug for you. 6. Denial There is a sixth, bonus sign that you may have an addiction to specific foods. That’s denying or diminishing the power that these foods are exerting in your life. In addiction medicine, we always say “addiction tells a lie.” Do you tell yourself it isn’t that bad, even though you know it is? Do you promise yourself you will stop tomorrow? Do you minimize the health or weight impacts of your trigger foods or the consequences of eating it? Do you hide your food so others won’t see what you are eating? Or, so that you don’t really register to yourself how bad it is? Studies show that people with addiction often lack self-awareness or are in denial about the impact of their addiction on their life. This can reduce the chance that they seek appropriate help, prolong the addictive cycle, or increase the risk that they will relapse. The good news is the fact that you are reading this article, and figuring out whether or not you have a food addiction, is the first step to overcoming denial. It will start you on the path to getting the effective help you need. This Question was answered by Dr. Vera Tarman on https://addictionsunplugged.com For more information and support, check out the following resources, including my recurring online course “Adapt Your Life — Sugar and Food Addiction”

Food addiction can show itself in many different ways. We thought we lacked willpower or self-discipline. Many of us had self-discipline in other areas of our lives, but not with food. Or if we sometimes restrained our eating while on a diet, it never lasted very long. We heard people express feelings of low self-esteem, fear, doubt, insecurity, shame, guilt, and hopelessness around their relationship with food. We hated to admit that we had a problem and that we were not “normal” with food. Over time we became aware that these were symptoms of food addiction. To answer this question, ask yourself the following questions and answer them as honestly as you can. Have you ever wanted to stop eating and found you just couldn't? Do you constantly think about food or your weight? Do you find yourself attempting one diet or food plan after another, with no lasting success? Do you binge and then "get rid of the binge" through vomiting, exercise, laxatives, or other forms of purging? Do you eat differently in private than you do in front of other people? Has a doctor or a family member ever approached you with concern about your eating habits or weight? Do you eat large quantities of food at one time (binge)? Is your weight problem due to your "nibbling" all day long? Do you eat to escape from your feelings? Do you eat when you're not hungry? Have you ever discarded food, only to retrieve and eat it later? Do you eat in secret? Do you fast or severely restrict your food intake? Have you ever stolen other people's food? Have you ever hidden food to make sure you will have "enough?" Do you feel driven to exercise excessively to control your weight? Do you obsessively calculate the calories you've burned against the calories you've eaten? Do you frequently feel guilty or ashamed about what you've eaten? Are you waiting for your life to begin "when you lose the weight?" Do you feel hopeless about your relationship with food? If you answered YES to any of these questions, you may be a food addict. YOU ARE NOT ALONE This Question answered by Food Addicts in Recovery Anonymous™ Food Addicts in Recovery Anonymous™ offers hope through a long-term solution for food addiction. Food Addicts in Recovery Anonymous (FA) is a program based on the Twelve Steps of Alcoholics Anonymous (AA). There are no dues, fees, or weigh-ins at FA meetings. FA is a fellowship of individuals who, through shared experience and mutual support, are recovering from the disease of food addiction. https://www.foodaddicts.org/am-i-a-food-addict

Someone struggling with a food addiction might exhibit the following symptoms: Frequent cravings for specific foods, even if they have just eaten or are not actually hungry. The inability to stop eating the sought-after food or consuming more than intended. Regularly eating to the point of being uncomfortably full. Feeling guilty after eating certain foods, but continuing to do so again and again. Occasionally excusing their behavior, justifying the practice of giving into cravings. Unsuccessful, repeated attempts to cease eating certain foods, or otherwise creating rules and regulations on if/when such foods are allowed, such as cheat days. Secretive behavior surrounding eating habits or concealing/lying about their unhealthy food consumption. Feeling helpless or unable to control/quit eating junk food, despite consequences such as weight gain or changes in overall physical health.

The common image of food addicts is that they are overweight. A majority of those for whom the disease of food addiction has progressed certainly are obese – and/or morbidly (i.e., life threateningly) obese. Yet there are many food addicts who are a normal weight. Some of these healthy looking food addicts are bulimic. Others just have a metabolic system that keeps them appearing “normal,” even when they are bingeing abnormally. There is also a small but important group of food addicts who are dangerously thin. Most of these are food addicted and anorexic. Even some overly thin folks who are unable or unwilling to eat enough to come up to a healthy weight are also chemically dependent on food and have a history of progressive food addiction which much be addressed before they can have a full, healing long-term recovery. How can an anorexic know if they are food addicted? One obvious sign of food addiction is a history of out of control eating – usually bingeing, sometimes purging and almost always becoming overweight by traditional medical standards. Restricting food begins as a way of compensating for a binge. Then regular fasting becomes a strategy for periodic weight loss after gaining by overeating. It is only as the anorexia progresses that such a person stays thin – and then becomes unhealthily thin – and begins to “look like an anorexic.” A second indication that an anorexic is also chemically dependent on food is a desire to eat a lot more than they are eating – especially sweets and “junk foods” – as well as the strong desire to control their weight and body size by undereating. If there is a history of craving sugar, flour, and fat, this is a reason to consider the possibility of food addiction as a second diagnosis. These cravings can be current, but do not have to be. All anorexics obsess about their bodies and greatly fear getting fat. It is less known that many anorexics also obsess about food. This often manifests as calorie counting, a list – often quite long – of “bad food” and a preoccupation with eating in a way that they can control what they do – and more importantly, do not – put in their mouths. What is less common is a constant or frequent obsession about wanting to eat sweets, snack foods or just “more” of any food. Especially if this sometimes gets so strong that it seems like “I just have to have it,” there is good reason to assume this person is food addicted as well as anorexic. Of course, anorexics should use the whole range of diagnostic indicators of food addiction to ascertain if they are chemically dependent on food. There are the traditional indicators of food addiction denial: lying to others and themselves about what they eat, breaking their own moral code – e.g. stealing food or stealing to get food, seeing their powerlessness over food progress over time, feeling numb or high or drugged after eating, experiencing symptoms of detoxification – e.g. anxiety, depression, sleepiness, inability to sleep – when eliminating a binge food altogether. Few food addicts have all of these symptoms; at least they are not able to see them in their own experience at first. So, just one or two obvious signs of food addiction are enough to at least investigate further. Anorexia is traditionally understood as a psycho-social disorder. It is now also being treated effectively as an addictive disease. In this view of anorexia, the drug which becomes addictive is the illusion of control. Whether being treated as a primarily psychological problem or a more complex addictive illness, the anorexic needs to learn to counter irrational thinking about body image and food and address unresolved trauma from the past. Many – if not most – anorexics that are treated in either modality are not food addicted. Those who are chemically dependent on food can best be seen as having more than one illness. Those who are addicted need to abstain from their food drug(s) of choice as well as become willing and able to eat more food and often a wider variety of foods. If they have a history of bingeing on sugar, it is questionable for them to try to learn to eat sweets in moderation. On the other hand, many anorexic food addicts who were addicted to fat, go to the extreme of not eating anything with fat in it at all. Since everyone needs some fat in their diet to enable them to digest other foods, these food addicted anorexics do need to learn to eat fat in moderation. The recovery of those with both food addiction and anorexia can be quite complicated and difficult. In general, it is our experience that people with advanced anorexia and food addiction need more time and support in recovery than those who are only chemically dependent on food. Anorexia has its own denial, and the food addicted anorexic can have special problemS breaking food addictive denial. The illusion of control in anorexia – and often bulimia – makes it doubly difficult to accept real powerlessness over food. There are also many cases of people who were anorexic and bulimic in their youth and then became compulsive overeaters. If they are food addicted, they often need a great deal of help to break through their biochemical food dependent denial. There are mutual support fellowships for pure anorexics. There is also a growing welcome for anorexics and bulimics in the oldest and largest food related 12 Step fellowship, Overeaters Anonymous (OA) There are also Twelve Step fellowships separate from OA that focus just on people with eating disorders; besides Anorexics and Bulimics Anonymous (ABA), there is the newer Eating Disorder Anonymous (EDA). All of these fellowships tend to suggest food plans which include all food in moderation, though ABA very specifically supports those who abstain from specific foods, i.e., food addicts. This is the key to those who are dually diagnosed with anorexia and food addiction: they need to surrender control of both their obsession with not “getting fat” and their specific food drugs. They need to learn to not restrict and to not overeat. They need to eliminate and detoxify from food(s) upon which they have become chemically dependent and deal with unwanted feelings and irrational thoughts that lead them to starve themselves. Moreover, as physical recovery begins, there are always deeper emotional and spiritual issues which, if not dealt with thoroughly, can lead to relapse down the line. Food addicts come to ACORN because they are aware of their food addiction and know ACORN’s history of support for food dependency recovery. Some are often surprised when they discover they are also anorexic. It is hard for this group to understand that all anorexics are not dangerously thin. In fact, we find that there is at least a little bit of anorexia under most progressed food addicts. It is the part of their illness in which they have spent so much time trying to control their eating. It is the part of their recovery which stays rigid and perfectionistic long after the first year of abstinence. The lack of joy and true happiness in this “controlled physical recovery” leads many to relapse after a few years. More difficult is the anorexic food addict who is dominated by the restrictive side of their eating disorder. For some it takes much longer than five days – the length of the ACORN residential Primary Intensive© – to be able eat a healthy amount and mix of food. If they are willing to try, we will often accept them and support them as long as they do not need hospitalization or direct medical supervision. One suggestion we have for those who think they might fit into this category is to read the first 137 pages of Anorexics and Bulimics Anonymous; if you are willing to try this approach to dealing with your anorexia and abstain from your likely addictive foods, the Primary Intensive© will probably be helpful. © Phil Werdell, M.A.

Food addiction is just like drug and alcohol addiction. Addiction means the body has become chemically dependent on one or more substances and needs these substances to function “normally”. When ingested, sugar, flour, grains (and any other addictive foods) light up the brain’s “reward circuit” by flooding it with the chemical messenger dopamine. This reward system controls the body’s ability to feel pleasure and motivates a person to repeat behaviors needed to thrive, such as spending time with loved ones, physical intimacy or achieving a goal. Overstimulation of the dopamine reward circuit can cause an intensely pleasurable “high” that can lead people to eat these foods again and again. When a person continues to compulsively eat these foods, the brain adjusts to the excess dopamine by making less of it and/or reducing the ability of cells in the reward circuit to respond to it. This reduces the high that the person feels compared to the high felt when first eating these foods—an effect known as “tolerance.” One then eats more of the food, trying to achieve the same dopamine high. It can also cause less pleasure to be accessed from other things once enjoyed, like social activities. Long-term compulsive eating also causes changes in other brain chemical systems and circuits as well. So when we are talking about a specific food as potentially being a substance of abuse, we are saying that the body has become dependent on a particular food or eating behavior. The most common addictive foods are foods high in sugar, flour, fat, grains and salt or some combination of these. The most common addictive eating behaviors are bingeing, purging and volume eating. Food Addiction is a chronic and progressive disease characterized by our seeking the foods or food behaviors we are addicted to, eating/doing them compulsively and having a great deal of difficulty controlling these urges despite harmful consequences. ​ When we initially consumed these same foods as children, we might have had the choice of when and how much to eat them. But repeated use can lead to brain changes that trick the mind, challenge an addicted person’s self-control and/or interfere with the ability to resist consuming these foods or engaging in unwanted, harmful behaviors. These brain changes are persistent. This is why food addiction can be complicated to treat. People can often go on a “diet” for a while and think they’re fine: “See I can quit eating _________(fill in the blank). I am fine, I’m not an addict.” However once someone is addicted, “dieting” for a period of time is rarely a successful long term solution.

The American Society of Addiction Medicine has formally recognized food addiction. You may find reading their most recent ASAM statement of addiction helpful as you reflect on the question on whether or not you, personally, are struggling with an addiction to one or more foods or to volume eating. The short version of their statement reads as follows: Addiction is a primary, chronic disease of brain reward, motivation memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors. Addiction is characterized by the inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death. Long version

The American Society of Addiction Medicine (ASAM) has formally recognized food addiction. Despite its apparent prevalence, food addiction hasn’t been officially recognized as a real addiction, disorder or diagnosis in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, the handbook used by health care professionals as the authoritative guide to diagnosing mental disorders. The American Psychiatric Association allows that some of those with eating disorders also present with characteristics of substance use disorders, i.e. food addiction, but the APA is still formulating a formal description of the disease. The body of research on food addiction has only recently gotten to the point where it can support a proposal for inclusion in the DSM, Gearhardt said, but she’s currently working on one she expects to submit within the year. “If you simply just look at the studies, they’re still at the place where they’re saying, ‘We need more research,’ but if we use these criteria that are similar to what we have for (addictions to) tobacco and alcohol, they’re seeing a lot of similar correlations,” Kirkpatrick said. Because food addiction isn’t in the DSM, health providers can’t diagnose someone with it, Gearhardt said. But as research in this area continues, some medical professionals and nutritionists have come to acknowledge the condition — and the need to address it. “It’s not a standard part of our diagnostics training that we do,” Gearhardt added, but “people who are reporting this addiction to highly processed foods are suffering.” Most people seeking treatment for food addiction are probably diagnosed with binge eating disorder “because that’s the closest thing that we have to it, that we can offer a diagnostic code for so that they can receive treatment,” Avena said. But the type of treatment that would be offered for food addiction would be very different, because not everyone who reports having food addiction is binging, and the underlying neurology of food addiction and binge eating disorder aren’t the same.

The brain chemistry that drives the addict to seek pleasure beyond the point of satiety is similar, whether the user favors Jack Daniels or Jack-in-the-Box. On a functional MRI, which can show what is happening to brain chemicals, the results are fundamentally the same whether or not the substance is cocaine, sugar, alcohol, donuts, ice cream, or heroin. It all happens deep within our brain in a set of linked structures called the limbic system. The limbic system contains the brain’s reward circuits, or reward pathway, and is involved in our behavioral and emotional responses, especially when it comes to behaviors we need for survival. This linked set of structures, often called the ancient mammalian brain, controls and regulates our ability to feel pleasure. Feeling pleasure motivates us to learn and repeat behaviors. Eating, and other activities that encourage our survival — such as sex, social interaction, and exercise — are all driven by the same pool of neurochemicals in our brains. Dopamine, serotonin, and endorphins travel specific neural pathways to influence our moods and give us feelings of pleasure, excitement, comfort, and joy. Dopamine is involved with feelings of wanting, craving, motivation, and learning. I call it the chemical of “want” and it drives us to seek out rewards. Serotonin is associated with happiness, comfort, and calmness. I call it the chemical of “satisfaction” that makes us feel safe and content. Endorphins are involved with pain relief, stress reduction, and improving a sense of well-being that can sustain us through periods of stress or pain. It numbs us and makes us feel good through the tough times. While some drugs act on only one neurochemical (for example opiates act on endorphins) research shows that sugar, refined carbohydrates, and combinations of fat, sugar, and salt, act on and release all three chemicals. No wonder food is addictive. It covers all angles of our pleasure and comfort! Hormonal chemicals, such as leptin and grehlin, are also involved in helping us regulate our food intake by controlling our appetite. Food addiction can override those hormones. Food addiction results when the enjoyment of food has become so euphoric and so entrenched in our brain chemistry that it dominates our natural impulse to stop when we feel full and when our appetite is satiated. So, in short, our brains are wired to enjoy and feel pleasure from food as a primal survival mechanism. We likely enjoy foods that are high in fat and sugar — which are both high in energy — because getting enough calories and storing them as fat ensured our survival in times of famine. A brain mechanism that was very beneficial thousands of years ago is now a detriment when energy-dense, highly palatable food is all around us. In fact, modern processed food companies knowingly exploit these brain reward pathways to engineer food — specifically ultra-processed foods high in sugar, refined carbs, fat, and salt — that we find irresistible. They make good profit from our ancestral vulnerabilities that keep us coming back for more. And some of us are more vulnerable than others. What distinguishes addictive behavior is the degree to which a person is compelled to eat these foods and unable to control their intake. Some people are merely tempted, giving in occasionally. Others are more at risk for a full addiction. This Question was answered by Dr. Vera Tarman on https://addictionsunplugged.com For more information and support, check out the following resources, including my recurring online course “Adapt Your Life — Sugar and Food Addiction”

Food addiction is compulsive eating. That could be over or under, usually it’s compulsive overeating that is uncontrollable, which is the compulsive part that causes disturbance to the person. There’s an impairment that happens and they’re not able to control it — which is what addiction is to anything, like gambling or alcohol or cocaine. When we talk about compulsivity, there’s a sort of obsessiveness about the person’s behaviour around food so they can’t stop thinking about it. It takes over a lot of mental real estate, which we call in the addiction world, “craving” or “obsession.” So that’s the first piece. The second piece is that it’s usually targeted towards what we call trigger foods, but it can actually be behaviour as well, so it could be just the act of eating. You can be addicted to eating normal foods, but generally, it’s trigger foods that are typically sugar and flour, processed food and processed carbohydrates. Then that obsessive behaviour gets in the way of regular life. They’ll eat, they’ve made a plan to go out, but they’re so full now, or they would rather eat than go out. So they start cancelling activities. They may not even go into work. They might be spending more money on food or doing things like stealing food or eating food that’s not appropriate, for example, like they just saw it on a restaurant table. Food addiction has signs that definitely goes outside of the realm of normal behaviour. People who are new to the concept will recognize this by, ‘I’m gaining weight and I know I should stop, but I’m still eating and now I’ve got diabetes for God’s sake.’ There’s an impairment there, but with an inability to stop.

The Problem of Cross Addictions Let us begin by looking at the easier part of the problem: food addicts who are cross addicted and already abstinent and in recovery from other chemical dependent substances. Three of those most frequently encountered are nicotine, alcohol and street drugs. Smokers and Food Addiction A very common issue of cross-addiction that is usually not talked about in these terms is “shifting” from nicotine to food as a drug of choice. We see it all the time. Someone works hard to put down cigarettes. It might take more that one, maybe as many as a dozen attempts. As soon as there is a period of abstinence from cigarettes, though, the prior smoker starts to gain weight. Some go back to smoking to keep cigarettes as a part of their weight control regime. If they have a commitment to their health that moves them to stop smoking again, then their weight becomes a problem again. While there was still an argument about whether or not cigarettes were addictive – much less dangerous to your health, almost no one noticed the cross addiction “shift” from nicotine to food. With the major changes in consciousness and in public health policies about smoking, there are more and more people getting the support they need to stop smoking. Health professionals working in chemical dependency treatment are more likely to be conversant with the addictive nature of nicotine. We can now see that the weight gain that sometimes follows abstinence from cigarettes may be a cross addiction. One small fact that is seldom mentioned is that tobacco is often cured in sugar. This makes it a natural entry-level drug for sugar addiction. Alcoholics who are also Food Addicts There are many who come to Overeaters Anonymous (OA) from other 12 Step programs, especially Alcoholics Anonymous (AA), that have substantial time sober from alcohol and other addictive substances. In fact, they often come to OA or one of the other food–related 12 Step fellowships because they find themselves reacting to food just like they had reacted to alcohol or their drug of choice many years before. In early recovery, many AA’s are often counseled by their sponsors to not worry if they are craving sugar or gaining weight. In fact, the recovery text, Alcoholics Anonymous suggests that a newly sober drinker carry come candy in their pockets to help relieve urges to drink. Especially if their chemical dependency on alcohol or drugs had been progressing for years, it certainly looked like drugs and alcohol could killed them long before food. Food addiction also progresses as a chemical dependency, so the dangers of addictive eating can easily increase over time. Many recovering alcoholics first try to work on their eating within AA. just as they work on other life problems using the 12 Steps, and many are successful. Many are not. Often they will identify sugar, flour or fat as a substance that is acting in their bodies like a narcotic. They do this just because of their long time experience using and recovering from alcoholism and/or drug addiction. However, when they decide to abstain from their self-assessed food addiction, they are not able to do it. It is difficult to move from the “all or nothing” model of no alcohol to a structured eating plan. This is doubly a problem for those who have already decided to recover from nicotine addiction. This group has special problems, some of which are addressed in Judi Hollis’s excellent publication When AA’s go to OA. It is humbling to come into a new fellowship with years of sobriety in AA and have to start recovery over from the beginning in OA. It is confusing when the AA newcomers observe a large variety of food plans and perspectives on abstinence in OA. We think there is another problem: for many alcoholics: food is an earlier and primary addiction. What is alcohol but grain and a form of sugar? The most common addictive foods are sugar and flour. A majority of these sober alcoholic food addicts can quickly remember using and abusing food years before they picked up alcohol. Not only does this mean that their detoxification from food is likely to be worse than their detox from alcohol, it means that they have to deal on a whole new level with mental-emotional and spiritual developmental problems that began earlier. It is often said that emotional development stops – or is at least serious curtailed – from the age that a person begins using a substance addictively. Thus, early developmental issues such as trust vs. mistrust must be revisited as one begins to recover, and there are often very basic emotional skills which were stunted in infancy and now must be developed as an adult. When raw emotions came up in early alcohol recovery, one could still use food to cope. Now, for many, there is nothing. It is true that when the alcoholic says they don’t drink, they do drink water, fruit juice, coffee, tea and other beverages. This is more like the food addict’s abstinence: no binge foods, but other foods are OK. However, the person addicted to food in volume does have a qualitatively different problem being abstinent. This is why many food addicts commit their entire meals daily – sometimes even meal by meal – to their sponsors. Food abstinence is different from abstinence from other substances in that the food addict still needs to eat several times a day. It is not possible to just “not be around food” the way it is possible to avoid alcohol or smoking. Drug Addicts who are also Food Addicts Some alcoholics put on a “beer belly,” but there are few heroin or cocaine addicts who are overweight. So, it is often a surprise to a recovering drug addict when they cross over and start eating and putting on weight out of control. As we shall see, foods can break down in the digestive symptom into bio-chemical compounds that are similar to the opioids in narcotics. The dosage and effect of using morphine, heroin or cocaine is much stronger, but once these are out of their blood, some physically sober drug addicts can get high and chemically addicted just by using more and more food. Not all narcotics users get hooked on food when they become drug free. In fact, a majority do not, at least at first. For those who do, though, this is a very serious problem. Not only do they then engage all the medical risks of obesity – and of bulimia and anorexia with they try to purge or restrict to control their weight, but active food addiction can be a trigger back into hard drugs. Then there is the case of marijuana. While there is an argument yet about whether or not this drug is physically addictive, it clearly can be psychologically addictive, and for many it triggers the well known “munchies” and minimizes resistance to a variety of acting out behaviors. For the food addict whose disease is advanced, this is a serious problem. Often they cannot stay food abstinent unless they abstain from marijuana, too. For those unwilling or unable to do this, this means they are likely to eat, and addictive eating for a food addict means to die. Food Addicts Not Yet Abstinent in Another Addiction There is a different – and equally important – set of problems that occur when a food addict is actively using other substances or processes while being abstinent from food. For some food addicts, this is not a large issue. For example, many food plans ask for abstinence from alcohol or caffeine. There are food addicts who can tell immediately that they are not normal drinkers of alcohol or caffeine, but they are not as important “food drugs” for them as, possibly, sugar, flour, fat or volume. So, these food addicts are quick to accept abstinence from liquor and coffee. Other food addicts are much more attached to these other edible addictions. They are, at first, not willing to even consider putting down alcohol or caffeine. As they do consider the possibility, they are in the stage of bargaining. “I’ll just have an occasional glass of wine with diner.” “I need my cup of coffee in the morning.” If and when they do become willing to abstain, they fall off the wagon on this one food substance over and over. For some food addicts this is a grave problem because alcohol or caffeine – another addiction – can turn into a “gateway drug” leading to serious food bingeing and long periods of relapse. © Phil Werdell, M.A.