Tina is a “bag open, bag empty” kind of eater. She’s eaten a loaf of bread with mayo in one sitting, fished food out of the trash, eaten it off the ground and shoveled it in when still half frozen. Needless to say, “It didn’t have to be gourmet,” says Tina, a 65-year-old retired educator in the Boston area who, like others in this story, requested to use only her first name to protect her privacy and honor the guidelines of Overeaters Anonymous, to which she belongs.
In retrospect, Tina has always been that way. As a kid, she’d sneak downstairs and eat her aunt’s lunch. When her brother bought one ice cream, she’d buy two. As she got older, the compulsion to eat and inability to stop took a significant toll on her health, career and relationships. “I didn’t care that I was at my best friend’s wedding or first Communion,” she says. “It was, ‘How can I get more food without people knowing?'”
Tina considers herself a food addict, a term that’s more controversial than drug addict or alcoholic, since the scientific jury is still out on whether or not people can be addicted to food the same way they can be to drugs and alcohol. “We definitely need more research on the topic,” says Ashley Gearhardt, an assistant professor of clinical psychology at the University of Michigan who studies food addiction and treatment.
Still, for Tina and others, defining their problem as an addiction provides validation, support and a path to recovery. Until she went to her first Overeaters Anonymous meeting in 1989, Tina thought she was “the only one who ate an entire half gallon of ice cream and then went and ate a bag of candy,” she says. Since then, she has lost — and kept off — 65 pounds from her highest weight of 213 pounds and hasn’t eaten sugar in 26 years. More important, she has a new sense of self-worth and enjoys life. “I’m a better person, and I’m a kinder person.” Now, Tina says, “I’m addicted to OA.”
The Science of Food Addiction
Compared to research on alcohol and drug addictions, research on food addiction is thin and inconclusive. A 2014 review of studies in the journal Neuroscience & Biobehavioral Reviews found little evidence that food can be a substance-based addiction, or that the brain responds to food the same way it does to, say, cocaine. But the paper did find support for behavioral food addiction, meaning that similar to gambling, the good feelings the brain associates with eating can drive addictive behaviors in some people under certain circumstances. (Unlike gambling, however, food addiction is not acknowledged in the American Psychiatric Association’s Diagnostic and Statistical Manual, though binge eating disorder — a condition that people with food addiction could have — is included.)
“Even if [people] have a little bit of addictive potential, that combined with a really toxic food environment is really concerning, especially for children,” says Gearhardt, who was not involved in the study.
Other research suggests some foods hook eaters more than others , as anyone who’s ever polished off a pint of Ben and Jerry’s or a tin of Pringles — but not a plate of broccoli — can attest. “It’s not all foods that people seem to struggle with — it’s these high-sugar, high-fat, highly-processed foods,” says Gearhardt, whose February study in the journal PLOS One found that foods such as chocolate, pizza and french fries have addictive properties. “There’s a reason there’s a tagline, ‘Bet you can’t eat just one.'”
For Dave, a 46-year-old engineer in Silicon Valley, that tagline applied to his everyday behavior — not just an occasional splurge or moment of weakness. “I couldn’t open a bag of Doritos and not finish it,” he says. At the grocery store, he’d buy two family-sized bags — one for him and one for his family. “I have memories of my mouth hurting because it was so salty, but I couldn’t stop eating,” says Dave, a member of Food Addicts in Recovery Anonymous.
Still, the fact that most of us can eat just one (whether or not we want to or choose to) can make the notion of food addiction harder to accept than an addiction with a clear biological basis, says Marlene Schwartz, director of the Rudd Center for Food Policy and Obesity at the University of Connecticut. “People have a lot more anecdotal evidence to refute the idea that this is an addiction,” she says. “Everybody thinks they’re an expert because everybody eats.”
Scientifically validated or not, calling it an addiction helps some people like Matt, a 31-year-old actor in Los Angeles who used food to cope with family problems growing up. “Being able to call it an addiction is being able to acknowledge that I have used my disorder as way to help me through my life,” he says. “Being able to call it an addiction is also an individual choice to admit that the compulsion isn’t helping me anymore, but it’s hurting me.”
Are 12-Step Programs the Answer?
By the time Matt reached 340 pounds, he had tried everything — diets, excessive exercise, even chewing and spitting out food. “I had the experience of losing weight, but not having any sanity around the food,” he says.
Matt “hit bottom” when he couldn’t land a job. He followed each loss with a binge at restaurants at Universal CityWalk, a tourist area in LA, and wound up spending the money reserved to kick off his career in a new city on food. So he looked up Overeaters Anonymous and went to his first meeting. Since then, he’s lost — and kept off — 160 pounds and hasn’t compulsively overeaten in eight years. “OA has absolutely saved my life and has given me a life,” says Matt, who no longer eats products with sugar or flour.
What’s the secret? Twelve-step programs such as Overeaters Anonymous, Food Addicts in Recovery Anonymous and Food Addicts Anonymous are modeled after Alcoholics Anonymous, valuing anonymity and swapping the word “alcohol” for “food.” Members of such programs accept that they have no power over certain foods and put their trust in a higher power, be it God or something or someone else. In most programs, members have sponsors, follow individualized meal plans and attend regular meetings. They must practice abstinence, be it from flour, sugar or both, or simply from compulsively overeating in general. Even people who don’t eat enough or otherwise have unhealthy eating habits are welcome to join. Many programs also have a service component that encourages members to take on a leadership position in the organization or support one another through sponsorships. “I was wired to never air dirty laundry — I had to solve everything on my own,” Dave says. “What this program has allowed me to do is ask for help.”
There’s little research on 12-step programs for food addiction, in large part due to the fact that the programs are anonymous, says Schwartz, whose dissertation looked at Overeaters Anonymous. But many of the tenets align with what’s known to be effective for weight loss: accountability and support. “There’s a validation that comes from being in a group with other people,” Schwartz says. “It makes you feel that you’re not crazy, that other people go through this too and there’s a name for it.”
One component that’s controversial? Abstinence, since considering certain foods off-limits can backfire if it causes people to feel guilty about indulging. One 2012 study, for instance, found dieters who ate high-calorie breakfasts that included a dessert like chocolate cake lost nearly 40 pounds more on average over eight months than those with low-calorie and treat-less breakfasts, who initially lost weight but then regained it. The bigger breakfast group also reported being less hungry and more satisfied.
“It’s definitely plausible that for some people, you could create more disordered eating” by forbidding foods, Gearhardt says. But the opposite is plausible, too, she says. “We need this research because if [food] is addictive, just telling people to try to moderate is a fool’s errand for certain people.” It’s also important to remember that evidence-based treatments for addictions and disordered eating, including medications and cognitive-behavioral therapy, do exist, Gearhardt says. Ultimately, treating addictions is not a one-size-fits-all approach.
For people like Meg, a 56-year-old IT project manager in Minneapolis, abstaining from sugar, artificial sweeteners and other processed foods was the only method that worked. “Society thinks it’s a matter of willpower,” she says. “I have tons of willpower, but when I eat certain things, I am like a crack addict, I’m like an alcoholic. I can’t put it down even though I want to.” After joining Overeaters Anonymous, she lost half her body weight (she dropped from 260 to 130 pounds) and has maintained it for the past three years by following a mostly vegan diet. “I think more clearly. I am more happy about my life,” she says. “I don’t feel bad if I can’t have a Snickers or ice cream, because my life was hell.”
More from U.S. News
The Eating Disorder Spectrum — From Pregorexia to Drunkorexia
5 Extreme Diets You Shouldn’t Try
How to Find the Best Mental Health Professional for You
I’m an Addict. A Food Addict. originally appeared on usnews.com
