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Is Your Appetite Out of Control?

 

The Overeating Epidemic

My name is Maura, and I'm an addict. My substance of choice isn't as dangerous as heroin or cocaine. No, my habit is...peanut butter. I feel shaky and out of sorts every morning until I get my fix, ideally on whole wheat toast with blueberry jam. In emergencies, however, I spoon it straight from the jar.

But there's more to it than that. See, I can get kind of crazy about it. My last boyfriend started calling me a PB junkie after witnessing some of my peculiar behaviors: I keep a stash of no fewer than three containers in my cupboard — backups for when I finish the one in the fridge. I showed up for my first weekend at his apartment with Trader Joe's Creamy and Salted in my overnight bag. And I stuck a jar in the glove compartment before we set off on our first road trip. "What gives?" he asked. I told him I'd have a meltdown if I ever ran out. "You're addicted!" he retorted. I laughed; wasn't that a little extreme? The next morning, I waited until he was in the shower before digging yet another container of PB out of my luggage and sneaking a few spoonfuls.

My ex was onto something. Startling new research has found that the way some people respond to food is very similar to the way substance abusers react to the drugs they're hooked on. Additionally, a number of experts believe that the level of food addiction in the United States may be epidemic. "Overeating and obesity kill at least 300,000 Americans every year due to diseases such as diabetes, heart disease, and cancer," says Mark Gold, MD, of the division of addiction medicine at the University of Florida College of Medicine in Gainesville. "While no one knows exactly how many of those people might be food addicted, we estimate it's half of the total."

Women may be at the greatest risk: 85 percent of those who join Overeaters Anonymous are female. "Many of our members will say they're obsessed with food and that they think constantly about what they'll have next," says Naomi Lippel, the organization's managing director. "They also talk about eating until they're in a fog — until they're essentially intoxicated."

Take Angela Wichmann of Miami, who used to overeat until she couldn't think straight. "I could eat almost anything compulsively," says Angela, 42, a real-estate developer who tipped the scales at 180 pounds. "I'd buy junk food and eat it in the car or consume it at home in secrecy. My favorites were crunchy things like M&M's or chips. Even crackers would do the trick." She always felt shame and regret afterward, but says, "I was embarrassed that I couldn't control myself. In most areas of my life I've been able to achieve anything I set my mind to — I have a PhD, and I've run a marathon. Kicking my eating problem was another story entirely."


This Is Your Brain on Food

Experts are just now beginning to understand that for people like Angela, the compulsion to overeat starts in the head, not in the stomach. "We've discovered that they have abnormalities in certain brain circuits that are similar to those of substance abusers," says Nora D. Volkow, MD, director of the National Institute on Drug Abuse. For example, a study showed that morbidly obese people may, like drug addicts, have fewer receptors in their brains for dopamine, a chemical that produces feelings of well-being and satisfaction. As a result, food addicts may need more of a pleasurable experience — such as dessert — to feel good. They also have trouble resisting temptations.

"Many talk about craving food; about overdoing it despite the fact that they know how bad it is for their health; about withdrawal symptoms like headaches if they stop eating certain things, like high-sugar sweets," says Chris E. Stout, executive director of practice and outcomes at Timberline Knolls, a treatment center outside Chicago that helps women overcome eating disorders. And like an alcoholic, a food addict will do anything to get a fix. "We often hear about patients stashing cookies in their shoes, their cars, even in the rafters of their basement," says Stout.

It turns out that the brain's role in deciding what and how much we eat goes beyond what most scientists ever imagined. In a groundbreaking new study at the U.S. Department of Energy's Brookhaven National Laboratory, principal investigator Gene-Jack Wang, MD, and his team found that when an obese person is full, different areas of her brain, including a region called the hippocampus, react in a way that's surprisingly similar to what happens when a substance abuser is shown pictures of drug paraphernalia. This is significant because the hippocampus is not only in charge of our emotional responses and memory but also plays a role in how much food we eat. According to Dr. Wang, this means that instead of telling us to eat only when we're hungry, our brains do a more complex calculation: They take into account how stressed out or grumpy we are, the size of our last snack and how good it made us feel, and the comfort we've gotten in the past from eating certain foods. The next thing you know, a person prone to overeating is wolfing down a carton of ice cream and a bag of chips.

For Angela Wichmann, it was emotional upset that led to her binges: "I did it to numb myself when things got me down, like relationships, school, work, and the way I could never seem to keep my weight steady," she says. Two years ago, Angela joined a self-help group for overeaters and lost nearly 30 pounds; she now weighs 146. (For more about such groups, see "Hungry for Help," page 5.) Amy Jones, 23, of West Hollywood, California, says her urge to eat was motivated by boredom, tension, and obsessive thoughts. "I couldn't stop thinking about the food I wanted until I ate it," explains Amy, who considers herself addicted to cheese, pepperoni, and cheesecake — foods her mother strictly prohibited when she was an overweight teen.


How We Get Hooked on Eating

Experts say our frenzied, jam-packed lives can encourage food addiction. "Americans rarely eat because they're hungry," says Dr. Gold. "They eat for pleasure, because they want to boost their mood, or because they're stressed out." The problem is, food is so abundant that overindulging becomes, well, a piece of cake. "Neanderthals had to hunt for their meals, and in the process they kept themselves in great shape," Dr. Gold explains. "But today, 'hunting' means driving to the grocery store and pointing at something in the butcher case."

The mental signals that urge us to consume are related to those ancient survival instincts: Our brains tell our bodies to store up more fuel, in case it will be a while before we find the next meal. That drive can be so powerful that for some people all it takes is seeing a favorite restaurant to set off a binge, Dr. Gold says. "Once that desire is set in motion, it's very difficult to suppress it. The messages our brains receive that say, 'I've had enough' are much weaker than the ones that say, 'Eat, eat, eat.'"

And let's face it, food has become more tempting and better-tasting than ever, which makes us want more and more of it. Dr. Gold says he's seen this illustrated in his lab. "If a rat is given a bowl full of something tasty and exotic, like Kobe beef, he'll gorge himself on it until there's none left — similar to what he'd do if he were given a dispenser full of cocaine. But serve him a bowl of plain old rat chow and he'll eat only as much as he needs to keep running on his exercise wheel."

Foods high in carbs and fat (think: french fries, cookies, and chocolate) are the ones most likely to be habit-forming, though researchers don't yet know why. One theory is that these foods spur cravings because they cause rapid and dramatic spikes in blood sugar. In the same way that smoking cocaine is more addictive than sniffing it because it gets the drug to the brain faster and the effect is felt more intensely, some experts surmise that we may get hooked on foods that cause fast, potent changes in our bodies.

Right about now, if you're not overweight, you might be thinking that you don't have to worry about becoming addicted to food. Wrong. "Any one of us might become a compulsive eater," says Dr. Volkow. "Even someone whose weight is under control could have a problem, though she might not realize it thanks to a high metabolism."
So am I a peanut-butter addict — or in danger of becoming one? "You should be concerned if a good part of your day revolves around your food habit," says Stout. "If food dominates your thoughts, then you have a problem." Phew! According to those criteria, I'm okay; I think about PB only when I wake up. So who is at risk? "Anyone who lies about how much food she is eating — even little fibs — should watch out," says Stout. "It's also a problem if she hides food, if she frequently eats enough to feel uncomfortable, if she regularly stuffs herself to the point where it makes her sleep badly, or if she feels guilt or shame about eating."


Take Charge of Your Appetite

If you don't have a compulsive-eating problem, consider yourself lucky. Still, experts say it's important to take steps to avoid developing one. "It's harder to kick an addiction to food than to alcohol or drugs," says Lisa Dorfman, RD, a sports nutritionist at the University of Miami. "You can't cut food out of your life; you need it to survive." Here, eight strategies for sensible, healthy eating.

Make a plan and stick to it. Consuming the same basic foods week to week will help prevent you from thinking of meals as rewards, says Dorfman. "Never use treats like ice cream as a gift to yourself after a hard day."

Don't munch on the run. Our brains feel gypped if we aren't sitting down at a table with a fork in hand, says Stout. You should eat breakfast and dinner in your kitchen or dining room as often as possible, adds Dorfman. Otherwise, you may end up conditioning yourself to eat anytime, anyplace — like when you're lying on the couch watching TV.

Avoid noshing in the car. "Your waist will count it as a meal, but your brain won't," says Stout. Not only that, but you can quickly become trained, like one of Pavlov's dogs, to eat whenever you're behind the wheel. "The same way that people who smoke want a cigarette every time they have a drink, it's easy to get used to having food every time you're on the road," he says.

Have a healthy snack, like fruits and veggies, 30 minutes before you eat a meal. It can take as long as half an hour for fullness signals to travel from the stomach to the brain. The sooner you start eating, says Dorfman, the sooner your belly will get the message to your brain that you've had enough food.

Downsize your dishes. "Unless our plates are full, we tend to feel cheated, like we haven't eaten enough," says Dr. Gold. So use a dessert dish for your entree.

Bust your eating triggers. "If you can't control your noshing when you're watching prime time, then don't sit in front of the television with a bowl of snacks," Dorfman says.

Exercise, exercise, exercise. It will help you maintain a healthy weight, and it can prevent compulsive eating because, like food, it produces stress relief and a feeling of well-being, says Dorfman. Dr. Gold explains, "Working out before meals can be especially beneficial. When your metabolism revs up, you may get the 'I'm full' signal faster, though we aren't sure why."

Finally, if you're trying to overcome a food habit, take heart. Says Dorfman, "Once you've developed healthy habits, it feels just as good not to overeat as it used to feel to do it."


Hungry for Help

If you can't stop eating, you're not alone. Overeaters Anonymous (OA) began in 1960 with one mission: to help compulsive eaters. Some members are obese; others are underweight. What they have in common is an obsession with food. There are 6,500 OA groups with an estimated 50,000 to 70,000 members worldwide. A majority — 85 percent — are women. OA follows a 12-step program modeled after the one used by Alcoholics Anonymous. Members start by admitting they are powerless over food. Meeting formats may vary, but all seek recovery on three levels: physical, emotional, and spiritual. OA recommends trying six different groups before deciding on the one that's right for you.

However, the program may not be a good fit for everyone. According to a 2002 survey of members, 56 percent said their food obsession had been lifted, but 44 percent said it hadn't. For more information, go to oa.org.

— Susan Koeppen, consumer correspondent for CBS News' The Early Show and our new contributor

Originally published in FITNESS magazine, March 2007.

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