We are all familiar with the idea that we can become dependent on alcohol and other drugs, but can we get addicted to food? Instinctively, it may seem implausible. After all, unlike drugs, we need food to survive so in that sense we are all dependent on food. But as with drugs, there are healthy and unhealthy foods.
A new piece of research investigated the parallels between addiction to drugs and food. At a neurological level, there are similarities. Dopamine, the chemical in the brain involved in giving us a good feeling and reward for activities, is found both in substance use and consuming some types of food. This isn’t problematic in itself; it’s only when this behaviour is followed by reward is overactivated that the potential for harm comes into play.
Increasing our intake of foods high in salt, sugars and fat has the potential to reinforce unhealthy eating via this neurological feedback reward loop.
The food industry has not been a passive bystander and has played a crucial role in recent years. The term “food crime” has emerged to describe the active way the industry has manufactured highly processed foods that it knows will appeal to our basic neurological hardwiring.
The current cost of living crisis has been a reminder of just how cheap and available food has become across the Western world, including the United Kingdom. Relative to income, food has become more affordable over the past three decades. Price and availability are the two critical factors driving many types of addiction. At the same time as food prices have fallen, rates of diabetes, obesity and other health related food problems have risen significantly.
This toxic mixture of cheaper food high in sugar, salt and fat and improved availability via retail is not a coincidental factor in this parallel rise with health problems. While the physical manifestations of overeating or eating too much of the wrong type of foods are all too easy to see, the psychological harms – including addiction – are less visible.
The American Psychiatry Association defines addiction as a “brain disease that is manifested by compulsive substance use despite harmful consequences”. By this definition, dependency on food or rather unhealthy food meets this criteria, as individuals continue to eat food that will have significant harm for their health. As with other types of addiction, some will be all too aware of the harm while others may not fully appreciate the relationship between diet and health.
Like smoking and drinking alcohol, few if any people will die instantly after eating a doughnut. The damage caused is incremental and goes almost unnoticed for years, other than weight gain along the way. Health economists refer to this time lag between current decision making and longer term consequences as health “discounting”. This theory suggests why it is so hard when you are young to start putting aside money for your retirement. The pain you experience by going without today is not deemed worth it given how far away you perceive retirement to be. So it is with making decisions about what you eat.
The enjoyment of eating some types of food today is viewed as preferable to the potential health gains by not doing so, and without seeing any benefit for years, if not decades, into the future.
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As with drugs, the “choice” that many people have about whether to eat healthy or unhealthy foods is not a real choice. Poverty, stress and lack of hope constrain the menu of options for many. It is no surprise, then, that many dietary related health problems are overrepresented in areas of social deprivation – just as they are with drug dependency.
Until we tackle the social determinants of health such as poverty, poor housing, unstable employment and mental illness, we will continue to see a rise in food addiction. The government has already rejected calls for new sugar and salt taxes aimed at reducing the harms caused by some foods. Just like the alcohol industry, the food industry has proved yet again how nimble and effective it is in shaping policy in its favour, even if it is not for our collective good.
Make no mistake, addiction to food is real. If you need proof, look no further than how the industry fights every attempt to reign in access to its addictive products.
Ian Hamilton is a senior lecturer in addiction and mental health at the University of York