Sunday, April 24, 2011

Is Food an Addiction?

The Diagnostics and Statistical Manual (DSM IV-tr) lists a few levels of what we have come to know as addiction. Substance ABUSE and DEPENDENCY…  

The criteria for substance abuse as listed in the DSM IV-tr is... 

A maladaptive pattern of abuse leading to clinically significant impairment or distress, as manifested by one or more of the following, occurring within a 12-month period:
  1. Recurrent use resulting in failure to fulfill major role obligations at work, school, or home.
  2. Recurrent use in situations in which it is physically hazardous. 
  3. Recurrent related legal problems.
  4. Continued use despite persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance.
  5. These symptoms must never have met the criteria for substance dependence.
Ok so I can easily stretch food to fit into the above description of substance abuse… I say STRETCH because realistically, most of these wont happen to a foodie. Perhaps we may meet the criteria in Number 4 but I am willing to bet that most if not ALL of us can cancel out Food ABUSE because we meet the Criteria for dependence. 

The criterion for Substance DEPENDENCE however, I don’t need to stretch at all to fit. The criteria for substance dependence as listed in the DSM IV-tr is...

A maladaptive pattern of use, leading to clinically significant impairment or distress, as manifested by three or more of the following seven criteria, occurring at any time in the same 12-month period:

  1. Tolerance, as defined by either of the following:
    1. A need for markedly increased amounts to achieve intoxication or desired effect. (check)
    2. Markedly diminished effect with continued use of the same amount of substance. (When I was little I ate a cookie, pre-op I ate a whole damn box!)
  2. Withdrawal, as defined by either of the following:
    1. The characteristic withdrawal syndrome… Substance is taken to relieve or avoid withdrawal symptoms. (Check: I know I am a bitch when carb detoxing and even worse when sugar detoxing)
  3. Substance is often taken in larger amounts or over a longer period than was intended. (Check)
  4. There is a persistent desire or there are unsuccessful efforts to cut down or control substance use. (CHECK!! Every failed diet in the last 15 yrs!)
  5. A great deal of time is spent in activities necessary to obtain substance, use substance or recover from its effects. (Check! How many of us have spent countless hours thinking about whats for lunch, where we are going to go out to eat, what we will eat when we get there and how we will burn off the meal afterwards)
  6. Important social, occupational, or recreational activities are given up or reduced because of substance use. (Check: I know I didn't want to be seen at certain social functions at 391lbs. The clothing selection was limited, what would people think, would I be able to walk there from the car etc... etc…)
  7. Substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance (Check! So many of us continue our negative eating patterns knowing we may die from our high cholesterol, high blood pressure, diabetes etc etc)
Ok so just saying, to qualify as substance dependence, you need 3!!! I got ALL 7!!!! How many did you get??

**The criteria above was taken word for word as the criterion for Alcohol.

So are you convinced yet that food is an addiction? No of course you aren't! You want the SCIENTIFIC PROOF! Ok Ok. As always I come prepared! I am sure you have heard me rant about this before. Research shows that carbohydrates and sugar react with the same neuron receptors as OPIATES! Opiates are drugs like:
  • Opium
  • Morphine
  • Codeine
  • Heroin
Don't believe me... read it for yourself HERE and HERE. And here are a few quotes from a a few studies I have used in the past. I cannot link to because I got it through my Adelphi Library. But you can find the study if you would like to pay for it. 

Research done by Bruinsma and Taren (1999), shows that, chocolate may evoke similar psychopharmacologic and behavioral reactions in susceptible persons as opiates. A review of the literature on chocolate cravings indicates that the hedonic appeal of chocolate (fat, sugar, texture, and aroma) is likely to be a predominant factor in such cravings. Other characteristics of chocolate, however, may be equally as important contributors to the phenomena of chocolate cravings. Chocolate may be used by some as a form of self-medication for dietary deficiencies (eg, magnesium) or to balance low levels of neurotransmitters involved in the regulation of mood, food intake, and compulsive behaviors (eg, serotonin and dopamine). Chocolate cravings are often episodic and fluctuate with hormonal changes just before and during the menses, which suggests a hormonal link and confirms the assumed gender-specific nature of chocolate cravings. (p. 1249) Another interesting finding on Chocolate suggests that addiction for chocolate may stem from the same receptors in the brain as opiates. Naloxone, found in chocolate attaches to opiate receptors in the brain. “Endogenous opiates, are involved in drug addictions and are responsible for the body's response to pleasure, stress, and pain. A study investigating this hypothesis found that infusions into rats of the opiate antagonist naloxone diminished taste preferences for high-fat and sweet foods and selectively suppressed consumption of these foods; in contrast, rats infused with morphine, an opiate agonist, increased their fat intake.”
** Bruinsma, K., & Taren, D. L. (1999). Chocolate: Food or Drug? Journal of the American Dietetic Association, 9

Avena, Rada, and Hoebe (2008), shows that intermittent sugar access also acts by way of opioids in the brain. There are changes in opioid systems such as decreased enkephalin mRNA expression in the accumbens. Signs of withdrawal seem to be largely due to the opioid modifications since withdrawal can be obtained with the opioid antagonist naloxone.(p.887)
**Avena, N. M., Rada, P., & Hoebel, B. G. (2008). Evidence for sugar addiction: Behavioral and neurochemical effects of intermittent, excessive sugar intake. Neurosci Biobehav Rev, 32(1), 20-39.

Withdrawal symptoms of opiates include:
  • Agitation
  • Anxiety
  • Muscle aches
  • Increased tearing
  • Insomnia
  • Runny nose
  • Sweating
  • Abdominal cramping
  • Diarrhea
  • Dilated pupils
  • Goose bumps
  • Nausea
  • Vomiting
Which ones do you get? I get Anxiety and Agitation big time. But I have also had the Muscle Aches and Diarrhea. We are not created equal. 

So how about now... I have given you solid evidence and research to back my claim that food IS an addiction... What are your thoughts?

Sleeve Pixie

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