***The following blog article is based on personal & professional experiences and research. It is important to consult with a healthcare professional before making any significant changes to your diet or lifestyle routine.
The addiction paradigm
Addiction is an overpowering craving to repeatedly engage in an activity that provides temporary relief at the expense of often unwanted consequences.
People feel compelled to do something.
Disordered eating can also have addictive traits where some people do not feel fully in control of their behaviours (even though “control” may be a key component of restriction).
Addiction is a survival, defence and self-protection mechanism.
It’s also a process that is powerfully driven by our behaviour, neurotransmitters, familiar routines and environmental cues.
Addiction solves a problem.
People will engage in addictive behaviours to escape painful feelings and unpleasant truths. It’s driven by the same motive: to check out, numb, escape, and/or self-soothe.
Addictions travel in packs.
People with compulsive disordered eating may also tend to excessively:
drink
smoke
gamble
shop
work
exercise
engage in "toxic" relationships
People may also experience powerful emotions, such as anxiety and controlling behaviours in an attempt to manage the addiction.
Addiction is often situational.
People with disordered eating might say they eat (or restrict) when they are experiencing a particular emotion or they are in a specific situation. They will often have very detailed knowledge of food and eating/not eating; exercise; calories; carbs/fat grams, etc. They will have excellent (and very specific ways) to get or avoid food. They will often engage in ritualised behaviours and movements (doing a “cupboard circuit”).
The chemistry of addiction
Addiction is complex. But there’s strong evidence for susceptibility towards it.
One of the most important features of an addiction is the “hit”.
The rush.
To an addict, the hit is everything.
And the hit can be anything — anything that gives the brain a shot of feel-good chemicals, such as the following:
Dopamine is one of your “yay!” neurotransmitters. It’s the “rush” neurotransmitter that’s involved in excitement and getting a reward.
Serotonin and GABA are a couple of your feel-good neurotransmitters. They soothe and calm you. Reduce anxiety.
Oxytocin is a love drug. It’s involved in both sexual and parental bonding, and it makes us feel connected to others.
Opioids and endocannabinoids are natural painkillers.
We synthesize all of these chemicals (both in our brains and GI tracts), and can also get them either through food itself, the act of eating, or the act of anticipating eating.
For example:
Simple sugars and starches can give us a serotonin rush.
Stimulation of the trigeminal nerve at the jaw when we chew can stimulate serotonin production; stimulation of the vagal afferent nerve can produce oxytocin release.
People with genetically lower dopamine are more motivated to eat, and they eat more, than people with genetically higher levels.
Casomorphin in dairy and gluten in wheat both contain opioid peptides that can affect mood.
Processed foods are manufactured specifically to give us a huge hit from eating them.
Furthermore, exogenous (external) administration of these feel-good chemicals can affect appetite, food intake and gastric activity.
Many antidepressants (which work on serotonin receptors) can cause a lack of appetite and digestive problems. In excess, serotonin can cause nausea and diarrhoea.
Opioids inhibit gastric motility, leading to the dreaded post-surgery constipation.
Endocannabinoids seem to increase both “wanting” and “liking” food. They also suppress nausea.
We may think of disordered eating as a logical outcome of humans’ natural self-calming and pleasure-stimulating machinery.
We’re already wired to produce our own drugs. All we need is a way to do it - whether that’s food, sex or any other kind of “hit”.
Evidence suggests that neurochemically:
People with restricted food intake have a “reverse” serotonin setup. Not eating and controlling their food intake is what gives them the “hit”.
People who purge may be seeking the rush from the purge, not the binge. The purge is the “hit”. The binge is just a way to get there.
What does the evidence tell us?
Disordered eating may not be a cognitive choice. It’s not just a simple matter of “wanting to be thin” or “making unwise choices”.
Disordered eating is a phenomenon that involves the body, mind, and spirit. Our beliefs. Our behaviours. Our biochemistry.
What approaches can you adopt to get back to "normal" eating?
Normal eating is a very broad term, What's normal for me might look disordered to you. Let's refer to an overall balanced, nourishing diet here.
For many disordered eaters, trying to manage addictive foods is often more difficult than just letting go of them. However, some of them may do better with a gradual reduction of the behaviours, triggers and addictive substances and situations.
Try asking yourself these questions:
What strategies have they already tried to deal with your disordered eating?
What worked? Why?
What didn't work? Why not?
Was it easier to manage some behaviours than others?
Use a food journal to record your food intake along with your feelings, both positive and negative. Note which strategies are more or less effective.
Look at your behaviour as a chain of events.
For example, a binge may begin several hours earlier, during a stressful situation at work.
You may then plan to eat when you get home, stop to buy food on the way, settle into your favourite eating spot in the house and so on,
The earlier you can intervene in this chain of events, the better chance you’ll have to avoid the unwanted behaviour.
Ambivalence and contradiction.
Food "addiction" is a way to solve a problem, until it becomes its own problem. It works as a coping mechanism until it's not. You may find yourself feeling puzzled or confused. You may want to stop but feel unable to do so.
Use your food journal to observe and record the competing motivations and thoughts you are experiencing. Write down whether you noticed any thoughts or feelings that seemed to be pushing or pulling you in different directions.
There is a problem that you are trying to solve with food. What this might be?
Be mindful of potential nutritional deficiencies.
These deficiencies may come from, or contribute to, disordered eating thought and feelings, including:
gastric malabsorption of nutrients from inflammatory bowel or food intolerances
deficiencies of trace minerals such as magnesium and zinc
deficiencies of important vitamins such as B vitamins
omega-3 deficiencies
very low-carb or low-protein diets
skin/hair problems
hormone imbalances
neurotransmitter imbalances
Work with a nutritional professional to assess and correct any underlying GI issues and nutrient deficiencies.
Make sure you cover the nutritional and lifestyle fundamentals by consuming colourful fruits and vegetables, enough lean protein (we need protein for synthesising many crucial neurotransmitters) and sufficient carbohydrates. Many disordered eating patterns develop as a direct result of carb restriction. Sometimes one sweet potato, bowl of quinoa or lentil salad a day can make a real difference. Ensure that there is enough saturated fat in your nutrition plan, including eggs, meat, coconut oil or butter.
Consider working with a nutritional professional to assess potential nutrient deficiencies. If you do not tend to eat enough red meat, you might need to supplement with minerals and animal-based vitamin A. If you do not get enough sunshine, you might need to
supplement with (subject to the blood test results and personalised advice):
vitamin D (1000-2000 IU)
B vitamins
Omega-3 (1-3 grams)
A high-quality probiotic
Habits are powerful. But awareness is powerful too.
A food journal can be a great tool to increase your awareness and motivate you to change, especially If you’re ready to embrace patience and persistence.
So, can we develop a real addiction to something we absolutely need to survive?
I think this question will remain controversial for a while.
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