More research needed to see if food can be truly addictive

Alcohol, nicotine and cocaine are just a few of the substances known to be addictive. Now some scientists wonder if food should be added to the list.

"Are there certain things in food that act on the brain and set up a classic addictive process, like tolerance, withdrawal and craving?" asks psychologist Kelly Brownell, who organized a recent scientific meeting on food addiction at Yale University. While the research is scanty, the evidence that exists "is extremely interesting and provocative and suggests to me that something is there," Brownell says.

That's not news to many Lean Plate Club members who e-mailed me recently about their own food struggles. Most asked not to be named, reflecting how they feel stigmatized by behaviors they have trouble controlling.

"I feel addicted to food at times," one wrote. "Food is like a drug to me. It can change my emotional state. For many years, I have 'used' food as a feel-good panacea, self-medicating with warm chocolate chip cookies or a pint of Chunky Monkey. I will sit down with a food I like in an upset state of mind and will eat it all immediately, beyond the feeling of fullness. It's like a compulsion to finish the entire thing."

Another member described how "thinking about food is like a pounding obsession -- a hammer beating in my head that is driving no nail. ... I hate feeling full. I'm not in control and I hate letting this demon take over me. I want to stop and nobody has any idea."

Those descriptions certainly sound like the feelings that doctors associate with addiction. But whether they stem from the same physiological changes that occur with drug and alcohol dependency is not known. "Is it an addiction to food or an addiction to eating?" asks Susan Yanovski, director of the obesity and eating disorders division at the National Institute of Diabetes and Digestive and Kidney Diseases. "Or is it another manifestation of a compulsive behavior like gambling or shopping?"

Brain imaging may soon provide answers. At Brookhaven National Laboratory, psychiatrist Nora D. Volkow and her colleagues map dopamine receptors on brain cells. This powerful neurotransmitter plays a key role in addiction. Dopamine systems are disrupted by addictive drugs, from alcohol to methamphetamine, which hijack the control of volition and the quest for rewards.

It turns out that food also affects the brain's dopamine systems. When Volkow, who also is director of the National Institute on Drug Abuse, compared brain images of methamphetamine users with those of obese people, she found both groups had significantly fewer dopamine receptors than healthy people. Even more interesting: The higher the body mass index, the fewer the dopamine receptors, opening the door to a better understanding of why it can be so difficult for some people to lose weight and keep it off.

What role dopamine may play in obesity -- and how eating affects it -- is still to be determined. No one knows if the brain changes occurred before or after people became obese, or if they can be reversed with weight loss. Are some people more susceptible to certain popular foods such as sugary, high-fat fare? Might food additives, preservatives and other substances have an effect on dopamine receptors?

"It's a fascinating topic, but I don't think that it's ready for prime time in terms of suggesting intervention or suggesting that this (food addiction) is a real phenomenon," Yanovski says.

Even if food prompts feelings and behaviors in some people that are like addiction, there probably will be many treatment challenges ahead. "You can be totally abstinent in using drugs or alcohol, but you can't be abstinent with eating," Yanovski notes.

That's why some people who feel that they've been snared by food addictions sometimes try to eliminate the specific foods that seem to trigger their overeating.

"My name is Lisa and I am a compulsive eater," wrote one Lean Plate Club member who has eliminated refined, processed foods high in sugar, white flour, artificial sweeteners and food additives from her diet. "I am addicted to food, and for me, to attempt to eat certain foods in moderation is no different than suggesting that a crack addict or alcoholic smoke crack or drink alcohol in moderation. It simply is not possible."

Other Lean Plate Club members view chronic overeating as a symptom of a bigger problem. "Compulsive eating to me is a sign that my soul is hungry for something else," wrote one. "I try to think of it as a sign that I need to change something in my life. When I think of it as a tool for self-knowledge, it becomes a gift and much more manageable."

Join Sally Squires online from 10 to 11 a.m. Tuesdays at www.leanplateclub.com, where you also can subscribe to the free Lean Plate Club weekly e-mail newsletter.