INTUITIVE EATING ~ IS FOOD ACTUALLY ADDICTIVE?
Many researchers have pursued the idea that food, like alcohol and drugs, may be addictive. Many people who struggle with their eating describe it as like having a food addiction and in some ways, it isn’t hard to see why.
HOW SOCIETY PERCIEVES ADDICTION
Alcoholism (and other addictions) are highly stigmatized in the same way that having a larger body is. That is, UNLESS the addict is in recovery. Being a recovering alcoholic is given a revered status and someone in recovery is generally treated with a lot of respect. We see it in films and tv shows all the time. A person is drinking heavily, hurting themselves and others around them, acting in socially unacceptable ways and taking risks with their health. They lose jobs, friends, family and money. It looks desperate and without hope. Eventually they hit ‘rock bottom’ and admit that they are an alcoholic. Suddenly the tables are turned, there may be a bit of skepticism but generally the people they have lost come back into their lives. They are supported, they are accepted, they are, once again, worthy of love. If you are a large-bodied person who has experienced a lot of the same isolation, stigma and loss of control, doesn’t this seem like a desirable outcome?
WHY DO PEOPLE LABEL THEIR EATING AS ADDICTION?
I believe that people label their eating as an addiction out of sheer desperation. They crave the same acceptance and promise of recovery as is apparently given those who admit that they have a drug/alcohol problem. The phrase ‘I am an alcoholic’ is almost seen as a magic spell. It holds power and the key to a solution. We are told again and again that admitting you have a problem is the first step in recovery, so it is natural to try to evoke the same words to try to overcome the perceived problem that is overeating.
I think we also use the language of addiction in the absence of another explanation for failing at losing weight over and over again. After all, we are told that we should be able to control our food intake, that weight loss is easy- it is just a matter of eating less and moving more. So, by describing eating as an addiction, something that by its very nature defies logic and good sense but is a socially accepted construct, appears far more appealing that the idea that being fat means that you are lazy, weak willed and greedy. In research I carried out into self-perceived food addiction, participants believed that they may be more accepted and less stigmatized if food addiction was a diagnosable health condition (Edwards et al., 2019)
ADDICTION AND DISORDER EATING
As a practitioner, I will admit that many clients who present with disordered eating do share similarities to that of addicts. I used to work in a treatment centre for alcohol and I have firsthand experience of what addiction feels like, so I am fairly attuned to these likenesses. When an alcoholic realises that they have a problem with drink they often start by trying to control it. They may try to follow certain rules- I won’t drink alone, I will only drink at the weekend, I will drink water in between every glass of wine, I will never drink spirits- etc etc. This rarely works and they continue to drink in dangerous amounts with consequences that hurt them mentally and physically. Their self-esteem plummets, they experience a loss of mental health, they become isolated and their friends and family express disgust at their behaviour. Eventually they may hit rock bottom and seek help. They often say things like ‘I just can’t do this anymore; drinking is running my life’. They are broken and at a point where they may be able to give up.
People who seek help for weight loss often have similar stories, so as a healthcare professional it may seem logical to substitute the word ‘alcohol’ or ‘drink’ for food. Are these people fighting a food addiction? They may be hiding their eating, feeling ashamed, bingeing, eating more than they intended, are obsessed with food and experiencing cravings when they do not eat. It sounds like a food addiction doesn’t it? I certainly thought so for a while.
ADDICTED TO FOOD OR ADDICTED TO DIETING?
But I had made a rather catastrophic misinterpretation of what was being said. The words ‘alcohol’ and ‘drink’ should never have been replaced by ‘food’ but with DIETING. My clients had not hit a food rock bottom, food was never the problem. They had hit a dieting rock bottom (a phrase I have borrowed from Intuitive Eating). Each new diet they tried was the equivalent of each time the alcoholic attempts to drink. Futile, painful and doomed to failure. And as healthcare professionals we encourage them to give it another go! Imagine I told an alcoholic at rock bottom ‘Don’t give up on drinking, together we can find a way that you can drink successfully’. I would be struck off. But that is exactly what many services do to chronic dieters, we push them back into the very behaviour that has made them unwell.
A HEALTH PROFESSIONALS EXPERIENCE OF ADDICTION AND DIETING
As a healthcare professional the concept of food addiction can be very appealing too. As I have already said, addictions are generally accepted as being illogical and difficult to treat. Active addicts are still widely stigmatized and are thought of as dishonest, noncompliant with treatment and are often judged as being morally inferior for ‘choosing’ to use drugs or alcohol over things like work, relationships and family. Putting our patients who fail at dieting in the same category subtly shifts the blame from us to them. We can attach all of the old wisdom such ass ‘they won’t change until they are ready’ and ‘you can’t do it for them, they have to do it for themselves’ to their care, dismissing them as ‘in denial’ if they do not follow our instructions.
Recovery from addiction is also often seen as a passive process that only happens as the result of some sort of divine intervention. You have to let the addict get on with their destructive behaviour until, one magic day, they wake up ready to recover. You are actually often discouraged from helping them before they are ready to give up, if you do you may be seen as ‘enabling’ them. Seeing people with disordered eating this way gives us permission to give up on clients we find challenging and we can comfort ourselves with platitudes such as ‘now isn’t their time but maybe we planted the seed’ to ease our guilt at not being able, or willing, to help.
FAT-PHOBIA IN THE HEALTHCARE SYSTEM
Seeing food as an addiction also gives healthcare professionals permission to act in fat phobic ways towards their patients in the name of treatment. Old addiction treatment models assumed that addicts are in denial and that this denial needs to be broken in order for them to accept help. In less modern treatment centers, sessions were arranged that had the goal of humiliating patients. The practitioners may invite an alcoholic’s wife and mistress into the center to confront him publicly to show him the effect of his behaviour. Or they may bring weeping children in to elicit guilt and shame to tell stories about what a parent did whilst on drugs. Horrible, traumatizing experiences masquerading as help. Plus, they did not work. Yet the sentiment has seeped into some weight management practice.
I have never witnessed any quite so extreme measures at weight loss clinics but some of this approach has impacted the way clients are treated in some services. Clients are often asked how their weight is impacting their ability to parent or care for others, visualisations that encourage picturing themselves in the future if they gain more weight- sick and miserable- are used as ‘motivational’ tools but in reality lead to shame and despair. This is often seen as part of the process, that you have to break someone down in order to rebuild them anew, in a better, smaller image.
WHY HAVING A LARGER BODY IS NOT THE SAME AS BEING AN ADDICT
My clients are not putting themselves in danger, they aren’t stealing to get money for food or getting themselves into debt. They are not bringing dangerous people into their homes or leaving their kids alone whilst they go out on eating binges. They just have a bit of a messed-up relationship with food and a very deep sense of shame around their body. Plus, a huge amount of health-related fear. None of these things are their fault and they have no reason to be made to feel guilty about their actions. They do not need to be broken, they need kindness, compassion and to be heard and supported to stop dieting and heal their relationship with food.
References
Edwards, S., Lusher, J., & Murray, E. (2019). The Lived Experience of Obese People Who Feel That They Are Addicted to Food. International Journal of Psychology and Cognitive Science, 5(2), 79-86.
Some other blog posts you might like
Dr. Sophie Edwards
I am a Chartered Health Psychologist, Educator, HAES Campaigner and an Intuitive Eating Counsellor in training. I have been practicing for over 8 years within the NHS and am passionate about assisting people on their journey to a healthy relationship with food, fitness and their bodies. I have a special interest in disordered and intuitive eating and I am a dedicated campaigner around HAES. My dream is to make health psychology more accessible to people from all walks of life.