March 7, 2011: National Post - Canada

Food addiction and the fat stigma

Controlling bingeing and other unconscious eating patterns can be as hard for some people as kicking an alcohol or drug addiction, doctors say, which is why reducing the stigma around seeking help for the conditions is one of the keys to fighting the obesity epidemic.

Melissa Leong, National Post · Monday, Mar. 7, 2011

In the first of a three-part series on food addiction, Melissa Leong examines some of the psychological underpinnings of problem overeating, and the addiction-coping strategies that some patients have adopted from alcoholism treatment.

As a development consultant, John taught people how to live authentic and fulfilling lives. In the day, he would deliver seminars to hundreds of people. Then at night, he would return to his hotel room and in despair, he would binge.

“I was living two different lives,” the 55-year-old Calgary man says. “I wandered around at 3 o’clock in the morning with a bag of food. I was lost. I couldn’t think straight. I would sit on the park bench like a drunk.”

John, who asked that his real name not be published, is the CEO of a company and the father of three daughters. He is affable and forthright.

“I fit the profile of a successful person,” he says. But he has struggled with an addiction to food for all of his life.

“To hold the cravings down created a whole amount of tension inside of me. It felt like holding a beach ball under the water.”

There is a growing demand for services that help sufferers of food addiction. Membership to Food Addicts in Recovery Anonymous grew by more than 50% in Canada from 2008 to 2009. Sheena’s Place, a Toronto-based non-for-profit, added a second binge- eating disorder group to its programs in 2009 to reduce the number of people on waiting lists. While food addiction is not listed in the Diagnostic and Statistical Manual of Mental Disorders, there is heightened appreciation that, for some people, food can trigger a response in the brain similar to addictive drugs.

“Weight management is very difficult for everybody, for these people, it’s three times as hard,” says Dr. Valerie Taylor, chair of the mental health task force at Canadian Obesity Network. “They’re just being driven to eat. People will do things like throw out food and go back to the garbage and get it later. People will often hide food, order something on the way home, then get home and have dinner. There’s eating large amount of foods at one time or a constant grazing throughout the day, but by the end of the day, they’ve consumed 4,000 or 5,000 calories.

“Many people come to see me because they’ve been told they’re at risk of losing their jobs. I’ve seen people who’ve gone out of the country and had their jaws wired shut. That’s how desperate people are, and they cannot control themselves.”

Often, there is a trigger that leads to unhealthy eating patterns. Perhaps, people were active and then they became injured. Perhaps, food became a coping mechanism for trauma. Sometimes, they suffer from other mental illnesses such as depression. As with other addictions, food addicts feel a rush, or calmness or euphoria from eating.

“Some people are just predisposed to not being able to stop once they start. Some people just get more of a dopamine release when they eat food. That perpetuates the cycle,” Taylor says.

“Right now the medications that are becoming available are the same kinds of medications that are used to treat substance addiction. The most recent drug that has been approved by the FDA in the treatment for obesity is the combination of an anti- depressant and naltrexone, which is a drug used to treat opiate addiction.”

Another available treatment option are 12-step programs that are modelled after Alcoholics Anonymous. Some groups ask that members identify a single food that they must abstain from. Others, such as Food Addicts in Recovery Anonymous, require members to have three measured meals a day and abstain from sugar and flour.

The trouble with abstinence is you cannot stay away from food, says Dr. Christine Courbasson, head of the eating disorders and addiction clinic at the Centre for Addiction and Mental Health.

“People should not stay away from a specific food. They should learn that they can eat any food in a normal way, without eating it compulsively. If they stay away from a specific food, that food is going to become more desirable and they’re more likely to think about it a lot, which then interferes with their functioning,” Courbasson says.

“The last thing I would tell people to do is go on a diet. People try to lose weight and go on crazy diets and are not sustainable. They need to go see a professional who can help normalize their eating and have a relationship with food that is healthier.”

CAMH’s eating disorder program is 16 weeks long.

“We help them see the antecedent of this overeating episode. We help to look at their emotions and start recognizing them and experience them as opposed to having to numb them.”

However, sufferers such as Darren, a 37-year-old Toronto man with two children, say Food Addicts Anonymous is the only thing that works for them.

“I’ve tried tons of diets, Weight Watchers, algae programs, therapy, group therapy, self-help programs with the goal of being happy.”

Darren weighed 214 pounds at the age of 12. He lost 60 pounds and then climbed to 260 at 23. The pants in his closet ranged from a size 34 to 44.

“Once I got sugar and flour out of my system, the cravings lifted,” he says. He has stayed at 165 pounds for 10 years.

“Whether or not it’s defined from a medical journal standpoint is irrelevant. It helps me to think of it as a disease of the mind, body and spirit which has no cure for it,” he says. Darren is also not his real name. “People did not think alcoholism was a disease. There are millions of people who are in AA and they’re getting better. Food addiction has only come to the forefront in the last 10 years. I just think it’s a matter of time.”

John joined Food Addicts in Recovery Anonymous when he was 40. He has been sober for 15 years.

“There is so much shame in our society around food. People think you just need more willpower and you can control your food. If you’re not an addict, that is true. One of the things that this program gave me was the [assurance] that we’re not bad people or weak-willed gluttons, so I could stop beating myself up,” he says.

“There’s a lot of hope here. I can tell you stories. There’s a woman here who has kept 200 pounds off of her body for 40 years. This isn’t a short-term fix. It’s given us freedom.”

mleong@nationalpost.com