So Close, And Yet So Far

So this article on “food addiction” as an explanation for compulsive overeating would almost be good, if not for — as usual — the reporting. The lede informs us right off the bat that this is not an article about eating disorders, it’s an article about why people are fat — and the answer is, as always, it’s usually their fault.

Obesity has long been blamed on weak willpower, overeating, genetics and lack of exercise. Now scientists increasingly are seeing signs that suggest there may be an additional contributor: food addiction.

Ooh, there may be an additional contributor to that oh-so-comprehensive list! Who knew?

And that right there sets us up for what’s wrong with the whole article.

I’ve written about this before, but it seems to be coming up a lot lately, so let me recap my stance on this issue. Binge eating and compulsive overeating are forms of disordered eating. As such, they are rare. They are utterly devastating to the relatively few people who suffer from them, just as any eating disorder is, and they deserve the full attention of researchers who specialize in eating disorders. The current “treatments” available — dieting, 12-stepping, and trying to figure out “what’s eating you” — are woefully inadequate. People who eat this way need help, and they’re not getting it.

A big part of the reason they’re not getting it is that these disorders (which are increasingly being lumped together as “Binge Eating Disorder,” though compulsive eating and binge eating are somewhat different behaviors) are commonly seen as the usual eating habits of fat people. All fat people are fat because they eat too goddamned much, says the crowd, even though that’s patently false:

“Most obese people are no different from non-obese people,” [Dr. Albert] Stunkard says. They are not eating because they are depressed or because they have a pathological relationship to food or to their parents. If all you had was their scores on psychological tests — if you could not actually see the people you were testing — you would not be able to decide who was fat and who was not.

Maybe the obese eat differently, gulping their food or skipping breakfast only to binge later in the day? But no, that also turned out not to be true. Some overweight people eat quickly, some slowly. Some binge, some do not. Some eat when they are stressed; some lose their appetites in those circumstances. And, in every case, thin people are just as likely as the obese to exhibit those behaviors. There is no behavior that is typical of the obese.

— Gina Kolata, Rethinking Thin

Emphasis mine.

But the mainstream media doesn’t seem to have heard of Albert J. Stunkard, or any of the other researchers who have come to the same conclusion. To reporters — to most of us — the idea that fat people generally eat just like thin people is unthinkable. Fat people eat too goddamned much!

And so the fact that a small percentage of fat people can’t stop eating too goddamned much, because they’re dealing with a serious mental health problem — which can lead to serious physical health problems — goes ignored. Those people, like all fatties, are merely weak-willed. They, like all fatties, just need to learn to push away from the table. They, like all fatties, are moral failures.

Worse still, people with these disorders internalize that message and fail to understand that their eating habits are not representative of the average (shameful, self-destructive) fat person’s, so they don’t seek out what help is available. Every time I post something saying that most fat people don’t overeat and fat people can be perfectly healthy, the most insistent objections come from people who eventually reveal that they do overeat compulsively and are unhealthy because of it. And they just don’t get that their experience is the exception, not the rule.

Why? Because the distinction is so rarely drawn. When the culture keeps telling us that fat people are fat because they shovel buckets of food down their throats at every opportunity, there’s no reason for people who do have an eating disorder to believe there’s anything wrong with them beyond what the culture tells them is wrong with them: they’re lazy gluttons with no willpower.

Personally, I buy into the “food addiction” concept where these disorders are concerned, but only as an imperfect metaphor. Addiction amounts to a nearly unshakeable belief that you need a particular substance, when you know intellectually that you don’t. But “food addicts” do need food. Overeaters Anonymous attempts to apply the abstinence-based 12-step model to food addiction by encouraging abstinence from “trigger foods.” (Sugar and white flour are two of the biggies.) To my mind, though, that’s swapping one form of disordered eating for another; it maintains the obsession with food that’s the hallmark of any eating disorder. It deprives people of the opportunity to learn how to listen to their own internal hunger cues, rather than fetishizing certain foods and rejecting any food that doesn’t fit into a predetermined eating plan. That makes me incredibly uneasy as a solution to disordered eating — although having said that, so little is known about these disorders that I can’t be sure a step like that is unnecessary in the first stages of breaking the cycle. I don’t really know what’s most helpful. Doctors don’t know. It’s fucking maddening.

But I can tell you what’s not helpful: articles about “food addiction” that seem far less concerned with discussing a largely overlooked eating disorder than with reminding fatties that IT IS STILL PROBABLY THEIR FAULT. The USA Today article ends with this:

Others pooh-pooh the idea of food addiction. “This is a dumbing down of the term ‘addiction,’ ” says Rick Berman, executive director of the Center for Consumer Freedom, a group financed by the restaurant and food industry. “The term is being overused. People are not holding up convenience stores to get their hands on Twinkies.

“Lots of people love cheesecake and would eat it whenever it’s offered, but I wouldn’t call that an addiction,” he says. “The issue here is the intensity of people’s cravings, and those are going to differ.”

Gee, thanks for the insight. Points to the author for noting who funds the Center for Consumer Freedom (which is why I never draw on them as a resource, even though they’re quite vocal about the obesity epidemic being overblown; I don’t like sources whose main goal is profit for large corporations, even if their reporting dovetails with what I’m trying to get across here), but why the hell does this clown get the last word?

Yeah, lots of people love cheesecake, but most of those people, even the fat ones, would not eat an entire cheesecake or two in one sitting. I love booze and take it damn near every time it’s offered, but I’m not an alcoholic (thank the fates). It is not a difference of “intensity.” It’s the difference between enjoying something in a healthy way (save the occasional hangover or tummyache) and making yourself chronically ill because you don’t know how to stop.

People who are immobilized by their fat and consumed by their eating behaviors are ill. And they are unusual. This article, like most, makes that distinction, but not to emphasize that people with Binge Eating Disorder need help and compassion — just to emphasize that other fatties aren’t off the hook.

Psychiatrist Nora Volkow, director of the National Institute on Drug Abuse, a speaker at the meeting, says the research in this area is complicated, but most people’s weight problems aren’t caused by food addiction.

And in case you missed that, or the opening paragraph, or the closing paragraph from a source the author fucking notes is questionable, she repeats Volkow’s position on this matter one more time:

She does not believe that most people are overweight because their brains’ dopamine systems don’t function properly.

Yeah, we get it. Most people don’t have this problem. Which is why this disorder needs more attention.

All right, credit where credit is due time: immediately after that, she at least acknowledges two factors that don’t rely on calories in/calories out. (“Genetic vulnerability and stress.”) And the quotes from researchers are lengthy, fair, and informative. And this one’s especially worth cheering:

“It’s surprising that our field has overlooked this concept for so long,” he says. “Society blames obesity only on the people who have it and has been close-minded to other explanations.”

Damn skippy.

Unfortunately, the slant of the article remains clear: we should be skeptical of people claiming “food addiction” exists, because it might make people who aren’t addicted to food think they have an excuse to keep being fat. So instead of shedding light on an issue that might help some people realize they have an eating disorder and are allowed to ask for help, the overall message is: you probably do not have a disorder, fatass.

Statistically speaking, that’s true. The vast majority of fat people aren’t food addicts. But when the ones who are can’t even recognize it, because all they ever hear is, “It’s your fault! Just stop eating so goddamned much!” a little more thought about how we frame these issues is in order. And if reporters truly believe that “Binge Eating Disorder is very real and devastating, and it’s been historically overlooked by eating disorder specialists” is a less important message to take from this study than “Most fat people have no such excuse for their fatness,” I don’t have much hope that that kind of thinking is gonna come any time soon.




Filed under 09_kate_harding

24 responses to “So Close, And Yet So Far

  1. NameChanged

    I would much rather that some mass of obese people rush to get help for a possible eating disorder than those who do have it sit at home and obsess over food, their bingeing, and spiral down mentally.

    Those that don’t have the disorder will get the message they need about changing thier lifestyle if they need to, and those that have the disorder will finally get the help they need. I remember in junior high when everyone had an eating disorder. While some of this was a bit attention whoring, those who truly had a problem were not so ashamed of getting help, and they knew how to get it.

  2. Interesting that your last blockquote should be from Kelly Brownell. He’s a strange case; one moment he’s giving “yay” quotes like the one above, and the next minute he’s a nag telling us fatties to quit eating so damn much for the sake of Public Health.

    Not surprisingly — but dismaying nonetheless — is that dieting is not mentioned in the USA Today article as a possible trigger of bingeing. But it makes sense, doesn’t it? Tell someone she can never have fries again, and next thing you know she’s at Claim Jumper eating ten pounds of ’em in five minutes? I’ve been there. And when I stopped dieting, the bingeing went along with that. Didn’t make me thin, though.

  3. Kate217


    Depressed? It’s probably not clinical. Just snap the fuck out of it, pussy.

  4. Paen

    I personaly would have trouble believing anything coming from one of the professional liars at the National Institute on Drug Abuse.

  5. Jewel

    Kate, thanks for pointing out the difference between enjoying something intensely and being addicted. It’s a crucial distinction.

  6. I read that article this morning.

    Re: food addiction/compulsive overeating. I have times when I am not even a little big hungry, but it’s like my mouth has to taste something. I’ve been noticing this a lot lately, since I’ve been doing the Weight Watchers Core plan, which is essentially designed so you get 5-7 servings of fruits & veggies, 3 servings of milk, 2 servings of healthy oils, 8 servings of water, lean proteins to your satisfaction, and some room to have other foods of your choosing.

    That’s a lot of food. I am not hungry physically. But my mouth is constantly begging me to give it something sweet, something salty, something rich and tasty.

    This is a harder plan for me to follow, but it is interesting from my perspective that for the first time in a long time, I’m noticing the difference between physical hunger and taste hunger.

  7. My problem, Name Changed, is that this just perpetuates the “all fat people eat too much” myth. No, not all fat people eat too much.

    And I take your point about it being good to discuss this stuff so that people who DO genuinely have a problem feel less shame in pursuing health. I really do and I agree that is a worthy goal. I just think there ought to be some way to do it that doesn’t slap the rest of us in the face.

    I’m not sure what you mean by those who don’t have the disorder will finally get the message they need about changing their lifestyle. I am trying not to jump to conclusions but what you seem to be saying is that finally fatties will get the message that they need to eat less and exercise more and…. Yeah, no. Can you clarify your statement, please?

  8. wriggles

    Is there help out there for compulsive eating? Because if there is, it’s passed me by, what exactly does this entail?

    And if everybody believes that eating more than is seemly, is a question of greed, how would compulsive eating show up differently enough to merit a totally different approach, whatever that is. As Meowser said, compulsive eating and bingeing is most reliably set off by (before, during and after) dieting the same as anorexia & bulimia.

    To me this is typical of a certain preciousness about ED’s that may seem to be well meaning or right but is often not.
    I did have a long spell, of CE, and I can state for the record that I was not anymore worthy of sympathy or understanding than any other fat person, theoretically, if you want to describe general fatness as self inflicted, then I cannot see any appreciable difference between the supposed self-inflictedness of fat and CE, they both are equally unasked for.

    And like the common or garden variety of fat person I am now, I ‘suffered’ most egregiously, not from what was happening, but from the internalized fat hatred that was burning me up, it was undoubtedly making it worse, both the condition itself and the stress that seemed to provoke it. Fat acceptance would help people with these issues just as much, if not more than fat people without them, it is not a matter for divide and conquer politicking.

  9. Kate Harding

    To me this is typical of a certain preciousness about ED’s that may seem to be well meaning or right but is often not.

    Wriggles, I’m intrigued by this comment, but not quite sure what you’re referring to. Help?

  10. NameChanged

    The Rotund re: clarifying my statement

    I realized after re-reading how that came off, and I am not in the “all obese people are unhealthy” crowd. Thank you for calling me on it though, as I need to be more aware of my words.

    What I meant was, since many people who feel they may have a binging disorder shrug off a healthy lifestyle due to self-diagnosis. With studies like this becoming more prominent (even though they still perpetuate fat-hatred) those who feel that they have a disorder are more likely to will see a Dr. who focuses on the health of a person, not the fat of a person (a disorder specialist or something similar). Therefore they will likely get information on Health at Every Size and less “you’re fat, go diet” that many Dr. dole out to heavy people. This way they can stop hating themselves, be happy and healthy without guilt.

    The fat-acceptance movement is not so wide that many of us know what to do with ourselves when we are tired of hating ourselves, and yet “conventional” methods don’t work. When I said change their lifestyle, I meant stop the focus on the food and the fat, and begin the focus on their life, but I am not very clear lately. (Which is quite obvious here.)

    I hope that makes more sense and clarifies my position.

  11. Kate Harding

    Thanks for clarifying that, NameChanged. I guessed from your previous comments that you weren’t trying to say what The Rotund heard, but I understood the confusion and am glad you cleared it up.

  12. Thank you, Name Changed. I had this moment of real dissonance because what I was reading wasn’t matching up with what I have read from you in other comments! That all makes a LOT more sense. And I think we can definitely agree on your points – if the visibility of studies like this one lead larger groups of people to health care providers that actually focus on health it can only be a good thing.

    The fat-acceptance movement is not so wide that many of us know what to do with ourselves when we are tired of hating ourselves, and yet “conventional” methods don’t work.

    You know, this is something that the fat acceptance movement probably ought to be addressing. There really needs to be a support system in place for helping people find that balance in their lives.

  13. While I believe there’s probably such thing as addictive over-eating and certainly such a thing as deprivation and/or hunger-triggered bingeing, I also believe that a few people have hunger/satiety systems that don’t work properly.

    There was somewhat about this in _Rethinking Thin_–there are people who always feel as though they’re literally starving because their brain never gets the message that they have fat reserves.

  14. alison

    “The fat-acceptance movement is not so wide that many of us know what to do with ourselves when we are tired of hating ourselves, and yet “conventional” methods don’t work.”


    “There really needs to be a support system in place for helping people find that balance in their lives.”

    I think a lot of blogs I read, and lurk at (now daily) do just that,
    TR. I have found a lot of help and peace in reading Shapely Prose, The Rotund, and quite a few other blogs. This has had a profound effect on how I take care of my self more and more each day. So, thank you. And you deserve more credit than you give yourselves.

  15. Nancy, yeah, you’re referring to the same research I was in the passage I quoted — that’s all Stunkard. (I believe he files it all under Binge Eating Disorder, too, though it’s been a couple months since I read the book.) I am really curious about how much of overeating is caused by sincere feelings of hunger; I can’t wait to see more research on that.

    I should note, though (and did in an earlier draft, alas) that the study in the article was on people who are literally chairbound and do practically nothing but eat. Which is, of course, an even tinier percentage of the population than people with non-crippling overeating disorders.

    Alison, thank you so much!

  16. Alison, thank you SO much.

  17. Shade

    I’m coming a bit late to the party, so I doubt anyone will see this, but here goes:

    Re: feeling hungry and overeating

    For several years during the late 90’s and early 00’s, I experienced CONSTANT hunger. I never felt full. And I gained weight like crazy (approx. 60 pounds in a year).

    At first I dieted. Vegetarian. Low-fat. Low-carb. ULTRA low-fat combined with excessive exercise. Nothing even slowed down the weight gain, much less stopped it. (I stopped dieting when it started to make me light-headed and nauseated. I could think of nothing BUT food–I believe I was literally starving at that point, but was still gaining weight.)

    At my worst, I could eat a huge meal, feel full to the point of pain, and still be hungry. Turns out I had a rare pituitary condition. Started treatment, hunger returned to normal. So, yeah, Kate, excessive hunger definitely exists. Check out any of the “pituitary tumor” support groups.

  18. Yikes, Shade! I’m sorry you had to go through that, and I’m so glad you found out what was causing it.

    And I hope I didn’t sound like I was skeptical of the concept of constant hunger in my reply to Nancy. Even aside from pituitary tumors, I’m extremely curious about natural variations in hunger from person to person, which may be quite extreme. But curious is all I am, because I haven’t read much about the subject — I’ve just seen a few tantalizing hints that there’s probably more to the story than we know.

  19. Jess

    Is there help out there for compulsive eating? Because if there is, it’s passed me by, what exactly does this entail?

    Well, Overeaters Anonymous would have you (where “you” is any person with any ED) avoid all “trigger foods.” If you’re prone to binging or eating compulsively, that could mean all foods beyond what’s absolutely necessary for survival. I only have one acquaintance who I know for a fact went through OA, and post-“recovery” she pretty much ate cereal in soy milk with protein powder. Exclusively.

    Obviously that’s not really sustainable. Cognitive behavioral therapy is another option. But that one only works if a) you have health insurance, which many fat people can’t get and b) you can recognize (or be told) that your eating habits are abnormal, and not just typical behavior for a fattie.

  20. Can you actually be addicted to something that’s nessessary to your survival???

    That’s like saying: “I’m so addicted to AIR”
    Live healthy, exercise, enjoy life – the rest is all bullshit.

  21. wriggles

    “To me this is typical of a certain preciousness about ED’s that may seem to be well meaning or right but is often not.”

    “Wriggles, I’m intrigued by this comment, but not quite sure what you’re referring to. Help?”

    Excuse me quoting myself, what I mean by that is what I said in the paragraph underneath the above.:)

    I think it’s more important to gain fat acceptance, to stop fat people being judged one and the same, and then all else should follow. If you believe that all fat people are pathological in their eating habits, how can you recognize disturbed eating patterns in them (or perceive it in those that are slim)?

  22. A Compulsive Overeater who Can't Stop - YOU WOULD NEVER KNOW!

    Dear All,

    I normally don’t spend time surfing the net, but here I am at 4:42am on a Friday night, eating, and typing as I eat (as opposed to eating as I type) because that’s what I do to distract myself from the pain of a binge while I am doing it – I could never just sit down and eat this quantity of food; it’s sickening to me to think about eating all of it when I buy it, let alone when I’m done putting it all down there.

    I stumbled upon this message board by typing in the following combination of words in the google search bar: “I can’t stop fucking eating.” I typed that in because I can’t stop fucking eating, which has been a problem for me since 1997 and has subsequently torn my life apart.

    I don’t know why I am bothering to post this comment, because I will wake up tomorrow hungover from my binge (yes, this really happens – the day after is terrible, which is much of why you want to binge again by the afternoon of the next day), and I may not even remember most of what I typed here – chances are, I’ll have a vague recollection, and I’ll wonder why I ever took the time to do that (I feel like most of what I do on the web is a waste). Nonetheless, I am here now, and I am amazed at the passionate “good opinions” of people who have never experienced an eating disorder commenting on this issue.

    One of the first therapists I ever saw was quite overweight and always had a extra large cup of soda on hand during our sessions; she had to have weighed at least 80 pounds more than me, but I knew she wasn’t a compulsive overeater when I was telling her about a binge one night and her response was, “Ok, so you overate!”, as in, “no big deal!” — at least I hadn’t smoked pot, my other addiction of choice (which, contrary to what you might be thinking, actually replaced the food when it worked, which is why drugs were preferable — they were much more socially graceful than binging…) Well, what I had to explain to my therapist is that no, it WAS a big deal, bingeing — that I might as well be cutting myself, and I still believe this anaology is true today.

    Contrary to what most people would think, compulsive overeaters come in all shapes and sizes. What I’ve learned in the past four years of trying to achieve recovery is that 1) Not all fat people are compulsive overeaters, and 2) Not all compulsive eaters are fat. Try walking into an OA meeting sometimes – almost everyone I hear who comes for the first time is shocked to find the majority of people at meetings of a normal weight or even less, sometimes. COMPULSIVE OVEREATING AND BINGEING IS A PROBLEM THAT IS BEYOND OUR CONTROL!

    Imagine waking up, getting ready for the day, leaving the house, and feeling so compelled to walk out into the middle of oncoming traffic that you just can’t help yourself – you do, and you get a broken ankle from the person who hits you. Swearing that you learned your lesson and you will never do it again, you go on with your day. The next morning, you wake up, do your same routine, leave the house, and feel that compulsion AGAIN to walk out into the middle of the street — you KNOW it’s not logical, you know it’s dangerous, you know you’re going to get hurt and that you will feel enormous pain, but you are absolutely obsessed with the idea of it, and only doing it will calm the obsession… so you walk out into the middle of the street, for the second day in a row, and this time some car breaks your rib. the recovery time is even longer than that of your broken ankle. And yet, two days later, or perhaps even the very next day, what do you do? Walk straight into moving traffic again – you can’t help it.

    This is the feeling of a binge eating disorder, only sometimes I think the pain of it is worse than if I were physically hit, because aside from the physical pain: the stomach upset, the exhaustion, the neaseau, the disgusting fullness that makes you want to cut yourself open, there is the devastating emotional pain of remorse, despair, shame, self-loathing and helplessness. I’ve carried these feelings, along with many extra pounds on and off, for the past ten years, and at times they have been devastating to the point of not being able to function.

    I do agree that everybody overeats sometimes – everybody turns to comfort in food sometimes — they make jokes in movies and TV shows about girls who break up with boys and go buy gallons of ice cream. But if you did that every time you had even the most minor bit of discomfort and found that, no matter how much you DIDN’T want to eat any more ice cream, you could not stop yourself, your life would start to change – fast – and I don’t mean for the better.

    It is impossible to transmit the experience of addiction to someone who has never experienced it. I can understand why people might think, “why don’t you just eat less? Stop dieting – eat whatever you want, and eat it in moderation.” I wish this could be true for me. I cannot tell you how much I wish this could be true.

    I’ve been in the Overeaters Anonymous 12-step program for almost four years — during that time, I’ve been at both my lowest weight and my highest weight. Throughout all of it, I’ve been obsessed with food. I’ve tried to follow every different food plan (NOT a diet – a food plan is just that: a plan for what KINDS of foods and how much of them are healthy for you to eat at given points throughout the day, and just a few months ago, I got so fed up with the whole process of obsessing over the “right” food plan that I just said, “fuck it.” I’m opening it all up. And you know what? Things got better… for a little while. Now I am back to bingeing every night on bags and containers full of foods made mostly from sugar and flour (and my heroine: chocolate – the potent combination of sugar and caffeine).

    The effects of these substances when we take them into our bodies are indisputably documented by scientists as being similar to that of cocaine. I don’t blame physical addiction for my compulsive overeating problem, much liked I never blamed nicotine addiction for my smoking habit — I always believed it was more of a psychological issue. But the part that I was missing, and I still sort of am with food, is that I AM NOT IN CONTROL! I am smart, young, pretty girl – valedictorian of her HS class, well-liked, athletic, graduated magna cum laude from college (still don’t know how I made it, with all the food I was eating and drugs I was doing along the way), always lauded by employers – I’ve had plenty of problems with my family and self-esteem throughout the course of my life, but on the outside, I always seemed successful. My point: you would not THINK I was a compulsive overeater. In fact, it drives me crazy when my friends in drug and alcohol recovery say, “but you look fine!”, as if to say, “you don’t need any help with your weight.” But they don’t understand that compulsive eating is NOT about weight – it has just as little to do with weight as it does with food. Compulsive eating is just that — it’s a compulsion, an obsession that can keep you away from your thoughts, feelings, vulnerability, relationships, and the success of which you are so afraid. I can use many compulsions as a distraction, including activity, men, and continually keeping myself in a state of near-poverty, almost as if by intention.

    At the same time, weight is an unintended and very unwelcome consequence of an active food addiction, especially if you are not purging or over-exercising to get rid of it, which MANY compulsive overeaters do. To give an example, after 9 months of abstaining from compulsive binge eating and a year and a half of sobriety, I lost my mind, went back to the food at the very end of October 2005, and by the middle of December, I had gained 40 pounds — imagine how much you have to eat to gain that much weight in such a short period of time. I simply could not stop. I was bingeing every day and every night, and I could think of nothing else but food. I ended up going into a in and out-patient hospital program, which didn’t help. Finally, once I started taking a low dose of anti-depressants (which I refused until I was literally suicidal and realized I needed to try something, anything, to get out of that hell), I got my life back. I stopped eating compulsively and started working again, and I went from 0 to 60 in about one week. Low and behold, a few months later, I discovered the hard way that I have bipolar disorder, and that it seems that when food is not masking it (which it has been for the past ten years), I get manic, after which, things get out of control, and I start eating again. This is NOT to say that all, or even most, compulsive and binge eaters have an accompanying mental illness, but many people I have met in recovery from various addictions do. I don’t think we start medicating ourselves for no reason – there is obviously something out of whack to begin with. Many recovering compulsive overeaters, when they tell their story, talk about having memories of overeating, the comfort it gave them, and the shame they felt afterwards from as early as the age of two. These kinds of childhood memories of an awkward and/or uncomfortable relationship with food are very common among us.

    I chose to respond to this article for two reasons (other than the fact that I was up eating and couldn’t stop):

    1) I appreciated Kate having posted the article in the first place – it was balanced and open-minded, and it was nice that someone not personally connected to the disorder was interested in it, to be honest

    2) After having read the replies, I felt a need to put this out there for anyone else who is reading and starts to internalize comments such as: “just exercise and be healthy.” For people whose problem is obesity, being overweight is a physical condition. For people who suffer from food addiction, extra weight is simply one consequence of a devastating disorder.

    Thank you very much,

  23. A Compulsive Overeater who Can't Stop - YOU WOULD NEVER KNOW!

    It is noteworthy to mention:
    I ended up going to a hospital program that I knew wasn’t right for me because it was the only one in the immediate midwest that my insurance would approve — why? Because binge eating disorder gets classified as “Eating Disorder Not Otherwise Specified”, which does NOT count as a “serious” illness like anorexia and bulimia do, and therefore receives a much lower rate of coverage.

  24. alan

    Thanks, e! That was a great post, very illuminating
    to hear that from the point of view of someone who has
    been through (and is still going through) that wringer.

    Regarding this:
    “The effects of these substances when we take them
    into our bodies are indisputably documented by
    scientists as being similar to that of cocaine.”

    There IS in fact good pre-clinical evidence now that
    sugar and fat have effects on the brain very similar
    to the prototypical drugs of abuse — opiates and
    cocaine/amphetamine. Here are a couple items, FYI…

    Obes Res 2002 Jun;10(6):478-88

    Evidence that intermittent, excessive sugar intake
    causes endogenous opioid dependence.

    Colantuoni C, Rada P, McCarthy J, Patten C, Avena
    NM, Chadeayne A, Hoebel BG

    Department of Psychology, Princeton University,
    Princeton, New Jersey. Department of Physiology,
    University of Los Andes, Merida, Venezuela.

    [Medline record in process]

    OBJECTIVE: The goal was to determine whether
    withdrawal from sugar can cause signs of opioid
    dependence. Because palatable food stimulates neural
    systems that are implicated in drug addiction, it
    was hypothesized that intermittent, excessive sugar
    intake might create dependency, as indicated by
    Male rats were food-deprived for 12 hours daily,
    including 4 hours in the early dark, and then
    offered highly palatable 25% glucose in addition to
    chow for the next 12 hours. Withdrawal was induced
    by naloxone or food deprivation. Withdrawal signs
    were measured by observation, ultrasonic recordings,
    elevated plus maze tests, and in vivo microdialysis.
    RESULTS: Naloxone (20 mg/kg intraperitoneally)
    caused somatic signs, such as teeth chattering,
    forepaw tremor, and head shakes. Food deprivation
    for 24 hours caused spontaneous withdrawal signs,
    such as teeth chattering. Naloxone (3 mg/kg
    subcutaneously) caused reduced time on the exposed
    arm of an elevated plus maze, where again
    significant teeth chattering was recorded. The plus
    maze anxiety effect was replicated with four control
    groups for comparison. Accumbens microdialysis
    revealed that naloxone (10 and 20 mg/kg
    intraperitoneally) decreased extracellular dopamine
    (DA), while dose-dependently increasing
    acetylcholine (ACh). The naloxone-induced DA/ACh
    imbalance was replicated with 10% sucrose and 3
    mg/kg naloxone subcutaneously. DISCUSSION: Repeated,
    excessive intake of sugar created a state in which
    an opioid antagonist caused behavioral and
    neurochemical signs of opioid withdrawal. The
    indices of anxiety and DA/ACh imbalance were
    qualitatively similar to withdrawal from morphine or
    nicotine, suggesting that the rats had become
    sugar-dependent. PMID: 12055324, UI: 22051071



    Oral Sucrose and Pain Relief for Preterm Infants

    Anita Mitchell, RN, PhD, Patricia A. Waltman, RNC,
    EdD, NNP

    Pain Manag Nurs 4(2):62-69, 2003. c 2003 W.B.

    Studies support the theory that sucrose and pain
    relief are interrelated through the body’s
    endogenous opioid system that provides natural
    analgesia (Barr et al., 1995; Nikfar, Abdollahi,
    Etemad, & Sharifzadeh, 1997). Sucrose as an
    analgesic was first studied using laboratory rats.
    In 1987, researchers demonstrated that rats
    receiving an oral infusion of 7.5% sucrose
    experienced a significant elevation in pain
    thresholds compared with groups of rats that
    received an oral infusion of water or no infusion
    (Blass, Fitzgerald, & Kehoe, 1987). The analgesic
    effect of sucrose is reversed with administration of
    naloxone, an opioid antagonist, suggesting that
    sucrose activates the central endogenous opioid
    system with an action similar to that of opioid
    analgesics (Barr et al., 1995; Blass et al., 1987).
    The analgesic action of sucrose may involve
    descending pain-modulating mechanisms, with
    inhibition of pain transmission at the spinal level.
    The presence of sucrose in the mouth also may
    stimulate the release of endorphins from the
    hypothalamus (Ren, Blass, Zhou, & Dubner, 1997).

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