Just over 6 months ago I wrote a post on my belief that I am a food addict. Although it was a long post, it really only got as far as introducing the subject and I didn’t explain anything about how I found myself in that position, nor very much on what I planned to do about it. It was originally intended to be the first in a short series where I examined various aspects of food addiction, including my experience of it and the medical establishment’s view. It may yet become that but a lot has happened in that 6 months, not least my continued battle with that particular demon, and somehow I never quite found the time or energy to attack the next chapter… until now.
The thing that has really kicked me into writing about food addiction again is that I think I am entering a new phase of the problem and it is worth documenting what has happened so far. The time is right to talk about my experiences and, so, back to the beginning of the story:
I can’t remember exactly when, but sometime around the start of last year I stumbled across the Yale Food Addiction Scale and it’s score card. I suspect I was Googling “food addiction” during a low moment and getting even lower when all I could find was the standard mantra of “diet and exercise” as the solution. I was probably stuffing my face with chocolate and cake at the same time, possibly using both hands.
I did the quiz, mostly to wallow in my misery but perhaps also out of some half hearted attempt to scare myself into doing something about it. And I was scared, because someone very close to me, who has struggled for much longer with their weight than me, was going through serious health difficulties because of it, and I felt I was staring at my future if I didn’t find a solution. It was not a happy time.
I did the quiz and, to my absolute complete and utter not even remote amazement found I scored exceedingly highly, in fact, the only areas I didn’t score so highly were the ones to do with whether it was interfering with my work life – in other words, I discovered I was a high functioning addict. But even that was beginning to change, because the fatter I got, the more I disliked the way I looked, the worse I felt about myself and the harder it was becoming to leave the house. It was beginning to have an affect on the other parts of my life and it was getting rapidly worse. Really, not a happy time at all.
I don’t know why or what it was that triggered it, but while I was staring miserably (but with a strange sense of morbid satisfaction) at my score, I had one of those rare moments of clarity; suddenly a solution of startling simplicity was staring me so obviously in the face that I just could not understand how I hadn’t seen it before.
One of the oft repeated cliches of food addiction is that, unlike all other addictions, you can’t go cold turkey with food. One of the harshest parts of such a problem is that the addict must continue to eat a small amount of their addictive substance every day to stay alive. I had been thinking along the lines of food addiction for a long time before finding out my Yale score, hence the Googling, and I had done it more to find out the scale of the problem than in any real hope of finding a solution, after all, I knew the above cliche, I was living it, and I really didn’t see how anything I could do would change it. But somehow, sitting staring at the score sheet, something in my head went “click” and I realised that that received wisdom just isn’t true[1].
On the bottom of the questionnaire is a list of foods and you are asked to circle the ones you have problems with. It includes the usual suspects, but there are also entries for lettuce, carrots and strawberries. I was sitting staring at it thinking “seriously, lettuce?! Who is addicted to lettuce??” when it occurred to me that the answer is probably no one[2]. And there is was, staring me in the face and making me feel stupid for not spotting it earlier: I’m not addicted to all foods and, if I’m not addicted to all foods then it must be the specific food that is the problem, not the act of eating it. If that is the case, it follows that I can go cold turkey after all, it just means cutting out the foods I’m hooked on and living off the others[3] instead.
Suddenly, instead of an insoluble problem, I had one that was merely very difficult. Going cold turkey is hard, but it can be done.
I decided the first thing I would do would be to cut out refined and added sugar. Fruit and fruit juice (diluted) would be ok, but anything else sweet and sweetened would be out. I immediately went through my apartment and threw out everything that met that description. Three days later I had developed a staggering withdrawal headache that stopped me being able to think and didn’t respond to pain killers, the headache lasted three more days and then it was gone, and with it my desire to eat sweet things. A year later, my cupboard is still bare of anything containing sugar. I won’t say it was a completely smooth road, there were a few occasional wobbles while I figured out the rules, and it would be untrue to say I now never eat anything containing sugar; I do eat the occasional biscuit or ice cream[4] and on Christmas day anything goes, but I don’t crave sweet things and cutting out sugar is more a practical difficulty (it often hides where least expected) than a physio- or psychological one. So far, so unexpectedly easy. It turns out I never was addicted to sugar, merely habituated to it. If that were the end of the story, things would be great, but sadly it isn’t.
I had decided tracking my weight would be unproductive, would focus my mind on the wrong problem and would probably make me more likely to fail. After a month or so of barely letting a single sucrose molecule cross my lips, however, I was desperate to find out if the new regime was having an effect. I duly purchased some bathroom scales and, for two weeks, diligently plotted my weight on a graph each day. Nothing. Nada, not a jot. Beyond the initial shock at just how high my weight had crept while I’d been steadfastly avoiding finding out what it was, all I discovered was that I hadn’t shed an ounce. Sugar, it seemed, was not the problem. Bugger.
I sat on my sofa and stared and thought and, while I was thinking I continued to put handfuls of the mixed salted nuts in front of me in my mouth. As I did so, it slowly dawned on me that I wasn’t remotely hungry and, furthermore, although I had developed a bad habit of skipping breakfast so that I was ravenous come lunch time, I couldn’t remember the last time I’d actually woken up hungry either. Hmmm. Perhaps this was a clue? I decided that, from then on, I would stop eating as soon as I was no longer hungry and I wouldn’t start eating again until I was. I put the nuts away.
This it turns out, was the key. And it was tough.
It took me a long time to get hungry again, something like 12 hours, and when I did, I wasn’t really sure. It turns out it was so long since I’d been properly hungry that I didn’t recognise the signs any more; even my lunch time ravenings seemed to be more the addicts need to find their hit than actual hunger. I finally found empty on the gauge, and then I started to figure out where full was. This too was far from trivial, all the signs your body uses to tell you seemed to have stopped working and it probably took 5 months before they were really working again, even now they’re a bit shaky.
This was a painful phase. It was literally painful, with symtoms remarkably similar to the dopamine withdrawal seen by those withdrawing from other better known addictions, albeit with less severity. First I got a headache, not quite as bad as the one from quitting sugar but stubborn enough, then I got the shakes and finally I went through a series of mood swings from hyper to disconsolate and back again. For a week I would show up at work, stare at my computer in confusion and then, fidgety and unable to concentrate on anything and in emotional turmoil, decide it was pointless and go home. Fortunately, a week was all it lasted.
I’m not aware of any research covering withdrawal symptoms from food addiction, but it makes sense to me. Depending on the substance, the symptoms of withdrawal are caused by a reduction of the amount of dopamine in the brain. Meanwhile, food addiction is known to create a dopamine response in the addicts brain (at least, if the addict is a rat) similar to that for cocaine. It seems logical to me that finding and stopping the cause of the dopamine response would lead to the symptoms of withdrawal. For me, it wasn’t the eating of any specific food that caused the dopamine response – it was the feeling of being over full.
I have long thought that, when my blood sugar gets too low, I get grumpy. This, it turns out, is not so. Once I got over the withdrawal phase and I got used to being hungry, I realised it doesn’t make me grumpy at all. If I really went too long without eating, which I did on occasion as I was figuring things out, and my blood sugar really did dip too low, I would get one of those stubborn headaches that pain killers don’t touch and that’s all. As soon as I ate something, it would go away within 5 minutes. The grumpiness, the inability to concentrate and the almost unbearable urge to find food was seemingly all just me jonesing for my next fix.
And so we have our solution. It isn’t eating in general that’s the problem, it’s the feeling of fullness I get from over eating. Diet would solve the problem if I really could eat everything in sensible amounts, but I can’t: there are certain trigger foods that I just like too much. It’s not an addiction to those foods as such, I don’t miss them while I’m not eating them or crave them, it’s just once I start I can’t stop and that leads to overeating and a “hit”.
In my case, my food addiction isn’t an addiction like any other: it is indirect. Whereas with other substances, taking some gives you your hit and your addiction is satisfied, with food addiction things are more complex. If that is true for other people, as I suspect it is, it may explain why it has been so hard for researchers to pin down the causes of the obesity epidemic. They’ve been looking for addictive responses to specific foods, but each time they find something suggestive in the various transgenic animals they test, it is absent when looked for in humans. Instead, perhaps they need to look for an addictive response to whatever chemical is released when we feel full? There would be a logical evolutionary imperative for that in a species that has experienced periods of feast and famine (and still does). Pile on the pounds while the going’s good and your reserves will carry you through when that is no longer the case; if you only stuff yourself when a specific food is plentiful, you will fail to stock up on some valuable sources of energy and are more likely to die when food is scarce.
It took enormous restraint to abide by the rules I had set myself and I was only able to do so by cutting out virtually every food I enjoy eating. The response of some people to that fact is horror at the loss of pleasure that must mean. Well yes, perhaps, but here’s the rub: no one is addicted to a substance they don’t enjoy consuming, that is rather the point[5]. In fact, it isn’t that bad. Because of the the indirect link between the food I eat and the addiction itself, I can slip now and then with no major harm. As long as I work very hard not to eat so much of the item in question that I start to feel over full I can, very occasionally, eat some of my trigger foods. Conversely, unfortunately, as I have cut more and more things out, foods that were once safe have become dangerous. For example, when I started this a year ago, a bowl of lentils was a good nutritional filler that would keep me going until bed time, similarly, a bowl of yoghurt and muesli was a great breakfast. Now, the delicious sweetness of the dried fruit combined with the tangy freshness of the yoghurt is a joy, while the creaminess of red lentils cooked together with a tin of tomatoes to give it some added richness delights me. I can eat a lot of lentils and muesli at a sitting[6]. Damn.
And so, finally, we come to the new phase I have entered. I’ve done the easy part, I’ve figured out both the problem and the solution and I’ve ridden the highs and lows that accompanied that exploration. It was, until now, all shiny and new and an interesting experience, even if it wasn’t often fun. But now the hard slog starts, because now I have found the point where I really do have to exercise will power. The fight goes on, and it will always be one, because, while I can avoid the obvious culprits enough of the time to keep things on the straight and narrow, my tastes are always changing and I am constantly finding new things that are suddenly very difficult to leave on the plate. This is not over, I am and always will be a recovering food addict.
On a more positive note though, I just reread my original food addiction post from back last July and it is full of acknowledgements to myself that I was fat, not just “big-boned” but properly, indisputably and increasingly grossly, fat. I am currently sitting comfortably in a pair of UK size 14 jeans and so, while I am not exactly thin, I think it would be safe to say I am no longer fat either. That in itself is enough to keep me fighting.
1. Always beware the received wisdom.
2. Alright all you pedantic scientists, I’m sure in the panoply of human psyches and psychoses out there someone is addicted to lettuce, but for the purposes of this narrative the percentage of the general population is so tiny it rounds to zero.
3. Like lettuce. I am SO not addicted to lettuce.
4. Although, crucially, for me “ocassional” means no more than one sweet item a month. It’s not a restraint thing, it’s just that’s about how often I find myself in the sort of social situation that makes declining very difficult. If any of what I have written is chiming with you and you think occasionally is the same as once a day, or even once a week, you may want to sit and have a good long think.
5. I remember a conversation I once had with some work colleagues over coffee, one of whom was unable to understand how anyone could allow themselves to get fat. Someone else at the table asked if he liked eating and he responded that, no, he didn’t particularly. There were far more fulfilling things he’d rather be doing with his time and if he could forgo eating and still live, he’d be much happier. QE, as they say, D.
6. If I ever find myself developing that sort of a response to lettuce, we really will have a problem.
