Dr Nora Volkow, Director of America’s National Institute on Drug Abuse, runs up to six miles a day and is extremely slim. Yet until fairly recently, she struggled to make sense of a habit that seemed impossible to control. No matter how much she tried, she couldn’t seem to subdue her frequent cravings for chocolate.
Dr Volkow, a psychiatrist specialising in addiction, was propelled to investigate, primarily to satisfy her own curiosity. Could food really be as addictive as cigarettes and cocaine?
Having researched the subject extensively, Dr Volkow now passionately lectures about her findings. She believes food can be every bit as addictive as drugs. And she has taken great delight in decoding much of the science.
Brain scans have repeatedly demonstrated that when people eat food that is rich in carbohydrates, it lights up the same reward areas in the brain as alcohol and drugs do. These foods include bread, pasta, pastry, sweets and chocolate.
But to further understand why some people describe their relationship with food in addictive terms, it’s helpful to have a basic understanding of what happens in the brain.
The neurotransmitter dopamine is the chief driver for addiction. Some people’s dopamine levels increase when they anticipate consuming substances such as drugs, alcohol and food, or engaging in behaviours such as exercise, sex and gambling. But dopamine does not produce blissful, rewarding feelings until it binds with something called the D2 receptor – and this typically happens when we actually start eating a substance or engaging in a behaviour. Crucially, over a given period, these sharp spikes in dopamine can alter our brain chemistry, leading to addiction.
However, when our addictive behaviour becomes excessive, the brain realises it’s being over-stimulated and releases chemicals that dilute our pleasure. It does this by reducing the D2 receptors that bind to dopamine. This is why, in any addictive process, the addict craves more and more of their chosen substance or activity to maintain their original level of pleasure and reward. It also explains why addiction is viewed as a progressive condition. Over time, the addict typically develops a tolerance to their drug of choice – be it a substance such as food, or a behaviour such as exercise or gambling. Should the addict fail to maintain their addictive behaviour, they face the prospect of withdrawal, which means they are subject to a depletion of serotonin (a key feel-good hormone) and are likely to feel empty and depressed. All the while, dopamine – the ‘drive’ hormone – is still secreted, effectively urging them to re-engage with their old behaviours, which is why putting down an addiction can feel so challenging.
The good news is that that withdrawal is only a temporary stage and once the brain gets used to going without, it soon adapts. However, just as we never ‘unlearn’ our ability to ride a bike, the addict never fully forgets the rewarding feelings triggered by their addiction. That is why so many return to old behaviour. Just as the alcoholic does not drink excessively because they are thirsty, the food addict does not eat excessively because they are hungry. Therefore, in order to tackle food addiction, it is important to make the distinction between physical and emotional hunger. Often we think we are physically hungry when in fact we are just lonely, sad, tired or frustrated. Food soothes and medicates, so it’s very easy for us to fool ourselves into thinking we genuinely need a meal or snack.
American market researcher and psychophysicist Howard Moskowitz recently uncovered a phenomenon known as the bliss point. This term signifies the amounts of salt, sugar or fat that manufacturers mix together to create the biggest high in our brains. Food giants have spent millions in its pursuit.
So why is it that some of us are more vulnerable to the bliss point – or addiction – than others? Why are some people able to resist a pudding, while others find it almost impossible?
Much evidence points to the presence of stress and trauma. Over time, exposure to these feelings can lead to changes in brain chemistry. These changes can severely affect the frontal cortex, which is responsible for regulating our emotions. We can end up over-sensitive and more prone to anxiety and depression. In order to cope with adversity, we learn from a young age that certain substances act as powerful painkillers. Therefore, something as seemingly innocuous as food becomes intrinsically associated with safety, comfort, reward and escape.
Of course, there are also those people who lack knowledge about food. They may become hooked on carbs due to habitual consumption and remain none the wiser. It is only when they cut down that they are hit with an avalanche of discomfort.
As with any drug of choice, once you’re addicted to carbs, you need to keep eating them simply to avoid the symptoms of withdrawal. It may be that the food no longer creates particularly pleasurable feelings but to stop seems virtually impossible.
I no longer drink alcohol, take drugs, eat white flour or sugar and I no longer purge myself bulimically.Elton John, Singer
In other words, Elton found white flour and sugar every bit as harmful and addictive as the hard drugs that blighted his earlier life.
While in the award-winning book In the Realm of Hungry Ghosts: Close Encounters with Addiction, Dr Gabor Maté advocates for a more compassionate approach towards the addict. He writes: “All addiction is an escape from pain. All addictions come from emotional loss, and exist to soothe the pain resulting from that loss.”
This is why so much addiction-recovery work focuses on empowering the individual via therapy and group work.
Watch Dr Nora Volkow deliver her TEDMED talk here: