Addicted to food

High-calorie food cravings similar to alcoholism, study finds

3/6/2011
BY CYNTHIA BILLHARTZ GREGORIAN
ST. LOUIS POST-DISPATCH

ST. LOUIS -- Robin Oliver, 48, of Imperial, Mo., has lost and regained 40 pounds several times over the last 12 years.

She loses the weight by following Weight Watchers. But when she goes off the point-system eating plan, the lure of sweet foods grows strong. If there are brownies in her kitchen, she said, she'll wake in the morning thinking about them. She sometimes wonders if she's hypoglycemic.

"I think it's an addiction to that sugar high," she said. "You eat the sugar and feel almost elated and good. Then your sugar level drops and you think, 'When I had that sugar I felt great.' So you're drawn to it again, just like alcohol."

Oliver, it seems, has concluded on her own what a growing number of researchers are finding in laboratories: High-fat, high-calories foods can mess with parts of our brain, making us crave more.

Researchers at Washington University recently compared alcoholism and obesity data and found that women who had a parent or sibling with a history of alcohol problems, had 49 percent higher odds of obesity than those without a family history. The association was significant for men too, though not as strong, said Dr. Richard A. Gruzca, assistant professor of psychiatry at Washington University and head of the study.

They also found that the link became most prominent between the early 1990s and early 2000s, when junk food and fast food proliferated the fastest.

Dr. Gruzca and his team were prompted to compare the data after learning about other studies linking obesity to pleasure centers of the brain.

Researchers at The Scripps Research Institute in Florida found that when rats ate large amounts of high-calorie food, it triggered addiction-like responses in their brains. Eventually, the rats grew fat and had decreased levels of a specific dopamine receptor, a chemical in the brain that allows a feeling of reward. Human drug addicts also have decreased levels of the dopamine receptor.

In addition, at least one drug company, Orexigen Therapeutics Inc., successfully has treated compulsive eating in obese people using a drug called Contrave, during clinical studies. Contrave combines an anti-depressant with an addiction drug. But the FDA won't approve it until the company does further safety studies.

Not all people who are overweight or obese are addicted to overeating, Dr. Gruzca said. Ms. Oliver is convinced she's not.

Likewise, having a parent or sibling who's an alcoholic, doesn't mean you're destined to be obese.

If you never binge drink you probably won't become alcoholic, even if your mother was. Same goes for compulsive overeating.

Steer clear of stuffing yourself with foods like Big Macs and Ding Dongs, and you shouldn't have a problem, the experts say.

"But it's a risk that's there now that wasn't 10 years ago," Dr. Gruzca said. "And it shows how our environment can channel our risk."

He and other experts point to The End of Overeating: Taking Control of the Insatiable American Appetite by David Kessler, which describes in detail how restaurant chains and processed food companies began combining sugar, fat, and salt into highly engineered foods that target the pleasure centers of the brain during the 1980s.

Dr. Gruzca believes more cross-talk between alcohol and addiction researchers and those who study obesity might help find new ways of treating it.

Drugs like Contrave might begin addressing the brain's reward system which causes food cravings.

Getting social support might hel, too.

"People who make a commitment to others that they'll alter their behavior are usually more successful," he said.

Committing to "sponsors" is a method used by Overeaters Anonymous, a 12-step program that formed in 1960 and is patterned closely after Alcoholics Anonymous.

At a meeting in Kirkwood, Mo., one evening, four women sat around a table, talking about their issues with food. One described how she learned a few days earlier that a co-worker had died. Her first instinct, she said, was to eat potato chips.

She described staring at a bag of them for several minutes, much like an alcoholic might stare at a bottle of liquor when struggling to stay on the wagon.

She finally talked herself down and went to commiserate with other co-workers.

Participants at Overeaters Anonymous are encouraged to admit their powerlessness over food, then practice abstinence by creating specific eating plans and, in some instances, eliminating foods that trigger bingeing.

But a lot of eating disorder experts aren't comfortable with banning "trigger" foods.

"As soon as you say I'm never ever going to eat that food, you've now made it the most desirable food in the world, and you can't stop thinking about it," said Randall C. Flanery, director of Webster Wellness Professionals.

Specialists at the eating disorders group in Webster Groves, Mo., prefer to help clients with compulsive eating issues cope with underlying feelings and structure their environment for healthy eating.

Mr. Flanery believes "trigger" foods often have personal significance to the overeater.

"We all have our comfort foods which we think of when we're stressed to soothe ourselves," he said. "But how much is due to the nutritional composition of food and how much is due to the meaning and past associations with that food?"

He recommends eating "trigger" foods when you're not hungry and are better able to stop after a small portion.

Experts only can speculate right now why women seem more susceptible to compulsive overeating than men. But they have some theories.

"We see much higher rates of depression and rumination disorders with women," said Rob Welch, assistant professor of psychiatry at Washington University. "They tend to be more focused on failures and problems they might have or relational difficulties."

Food, particularly high-calorie, high-fat ones, can be soothing in those instances, he said. That's why we call stuff like macaroni and cheese and mashed potatoes comfort food.

He also said that men might turn to alcohol more readily than women.

"If you have 3-year-old children running around the house and you're half in the bag, that's frowned upon," he said. "It's much more socially acceptable to overeat than drink."