Michael Moss brought the topic of food addiction to the forefront with Hooked. He followed it up with many interviews to promote his book. In an earlier post I asked if an Oreo is as addictive as crack cocaine, but the post brought less interest than I anticipated. I suspect that half my audience assumed it to be true. The other half rejected it as ridiculous. That said, processed food addiction is a serious topic in social science research. Processed Food Addiction makes the case that processed food contains addictive substances. Further, the book presumes that these addictions are as serious as those from street drugs. In this paradigm, it is food that qualifies as a Substance Use Disorder (SUD). It is not a Process Use Disorders (PUD). If food caused a PUD, it would be an eating addiction. Examples of PUDs are gambling, sex, and videogame addictions.
To show why food addiction is a SUD and not a PUD, the book describes how food fits each of the eleven criteria (1). Reading through the criteria listed below, score yourself. How many of these criteria apply to your eating patterns? I’ll tell you my score if you tell me yours.
Unintended use. As it applies to food addiction, unintended use involves unplanned eating events. Or it could involve eating more than we expect to eat at a single snack or meal. From selecting an unintended dessert at a meal out to eating too many snacks at a meeting, calories add up over time. Unintended use involves weakness in personal resolve not to overeat. Peer pressure to eat as much as the next person can also contribute to the problem (2).
Failure to cut back. OK, we notice that we are gaining too much weight. Our clothes no longer fit. Losing weight becomes a more attractive option than shopping for new outfits. Vegan, Keto, DASH, Mediterranean, Flexitarian, none of the above? We scan the bookshelves at the local bookstore or log on to Amazon. Maybe we can take bits and pieces from each one. Going on a diet should work in the short run. Many dieters gain it all back in the long run. We have willpower, unlike so many others. We will make it work! An addict keeps on eating to the point of obesity and beyond for failure to cut back. Nonaddicts find a comfortable weight level and maintain it. Obesity comes with stigma (3). Labeled as a processed food addict does not?
Time spent. It could start out by making extra time to stop by Chick-fil-A once each week. Then the visits become more frequent. We spend more time at the supermarket to get the food we really want. We watch more TV and spend more time in bed. Snacking in front of the screen becomes a habit. Food begins to dominate our lives and becomes a mental obsession. There is less time to engage in the activities we enjoy, but we always find time to eat. The pounds begin to accumulate around the waist. How can we recapture all that time spent with food (4)?
Cravings. Our brain senses a desire to eat something special. It is not just a general desire. It is a desire for a specific food. Maybe we could eat something else, but the desire won’t go away. It could be an Oreo, or sour cream and onion potato chips, or a California roll! Whatever! It is a craving that will not go away until we have just one, or a few, or way too many.
Just like anxiety and depression, craving is a medical term. Craving is “The desire for more of a substance or activity (for example, drug of abuse, sex) consisting of a desire to experience the euphoric (or other) effects as well as the desire to avoid the withdrawal effects of abstinence.” Nothing screams addiction like cravings. Cravings are difficult to overcome during addiction therapy. Failure to overcome them leads to a relapse (5).
Failure to fulfill roles. Food begins to dominate our lives to the point that others can’t rely on us. We can’t meet our obligations at home, school, or work. Illnesses cascade making it more difficult to live a normal life. We may spend more time in bed these days, but we are sleeping less. Life collapses in on us (6).
Interpersonal problems. We irritate those around us, and they irritate us. Our self-image takes a hit as we put on weight. We become more sensitive to others who try to help us with our food issues. We self-isolate leading to fewer social interactions. Old friends begin to drift away. Relatives lecture us on our weight problems. When confronted we lash out. Our life spirals out of control driving us to even more overeating (7).
Activities given up relate to previous criteria. As we self-isolate we turn down invitations to parties and other social gatherings. Then the opportunities begin to disappear. Increased time devoted to food eats away at even the events we would like to attend. Our clothes options are shrinking. We don’t look good enough to go out. What will others say about us behind our back? What if we start binging out at the snack table? Our job stinks, but we really don’t want to get back into the interviewing cycle (8).
Hazardous use. Our weight and body shape limits what we can do. It affects our self-esteem and can lead to accidents. We eat dodgy food because its there. We lose our balance and fall injuring ourselves. We rush out to our favorite fast-food drive-thru late at night in rough neighborhoods. Our brain fog could lead to unsafe driving. We may engage in violence and contemplate suicide (9).
Use in spite of consequences. Chronic overeating leads to brain fog, confusion, fatigue and memory loss in the short term. Longer-term consequences include anxiety, depression, irritability, obesity, and metabolic syndrome. Processed food addiction affects our behavior. It degrades our emotional, mental and physical stability. And yet we still continue to overeat creating more distress. We know better but we don’t do better (10)!
Tolerance. A small package of Oreos or a large smoothie used to be enough. Now we binge on large packages of the cookies in a single setting or a quart of chocolate ice cream. Make that a half-gallon. What used to satisfy now requires more. Family members begin to notice that we eat more processed foods. They note the larger containers that line the shelves. We begin to hide food in different locations so our habit won’t look quite as bad as it does. The longer our addiction progresses, the greater our problems grow (11).
Withdrawal. Don’t take away our peanut butter cups or our snacks! We can moderate how much we eat! Processed food tastes good. We promise not to eat too much! Man, we don’t feel so good just eating meat, fruits, and vegetables. Salads are OK, but where is the ranch dressing? Can’t we have just a few cookies today? We won’t binge out on them (12). We promise. And we have to give up coffee! How are we going to stay awake at work? We’ve got to have our caffeine or we will crash (12).
Are we able to withdraw from our coffee habit?
Am I a processed food addict? How many criteria did you meet? I am susceptible to cravings. Reading this book provided more cues and triggered more cravings in my brain than usual. I notice that late in the afternoon I become ravenously hungry. That classifies as unintended use. It leads to eating snacks while preparing the evening meal. None of the other criteria fit my eating patterns. Here is how to score the quiz at home:
2-3 categories denotes a mild addiction;
4-5 categories, a moderate addiction; and
6 or more, a severe addiction (1)
My score suggests I am a mild food addict. How about you?
Perspective and analysis. Joan Ifland and her colleagues fitted processed food addiction into every SUD category. I find hazardous use to be a stretch. The authors gave plausible explanations for the other ten criteria. The strongest evidence for a SUD is triggering the dopamine pathway and neuroimaging. The greatest argument against processed food addiction is no link to specific chemicals. There is no there there! Note, this book and post are not a joke. A serious group of social scientists are making a case for processed food addiction. In their minds we are setting our kids up for a lifetime of addiction!
Next week: Is food addiction real?
(1) Donovan, D.M. and J. Ifland, 2018, Diagnosing and assessing processed food addiction. Processed Food Addiction 121-136.
(2) Ifland, J. and H.T. Wright, 2018. DSM 5 SUD criterion 1: Unintended use. Processed Food Addiction 157-164.
(3) Ifland, J. and D. Rohrbach, 2018. DSM 5 SUD criterion 2: Failure to cut back. Processed Food Addiction 165-174.
(4) Ifland, J. and E. Epstein, 2018. DSM SUD 5 criterion3: Time spent. Processed Food Addiction 175-186.
(5) Ifland, J. 2018. DSM 5 SUD criterion 4: Cravings. Processed Food Addiction 187-204.
(6) Ifland, J. and C.L Willey, 2018. DSM 5 SUD criterion 5: Failure to fulfill roles. Processed Food Addiction 205-215.
(7) Ifland, J. and R. Piper, 2018. DSM 5 SUD criterion 6: Interpersonal problems. Processed Food Addiction 217-229.
(8) Ifland, J. and R.L. Epstein, 2018 DSM 5 SUD criterion 7: Activities given up. Processed Food Addiction 231-240.
(9) Ifland, J. and J.M. Cross, 2018. DSM 5 SUD criterion 8: Hazardous use. Processed Food Addiction 241-254.
(10) Ifland, J. and R.S. Roselle, 2018. DSM 5 SUD criterion 9: Use in spite of consequences. Processed Food Addiction 255-262.
(11) Ifland, J. and C.L. Willey, 2018. DSM 5 SUD criterion 10: Tolerance. Processed Food Addiction 263-276.
(12) Ifland, J. and H.T. Wright, 2018.DSM 5 SUD criterion 11: Withdrawal. Processed Food Addiction 277-287.