Is eating an addiction?

In Australia, the New South Wales government is introducing a quitline to help tackle obesity. You call them up, they tell you to stop being so fat, I guess. It’s going to be called a “get healthy” line. Because

fat /= healthy

fat = smoking (?)

There’s the unspoken implication here that people will call up for support when they’re in the midst of restricting their food intake, and forcing themselves to do more exercise — because they’re hungry, sore, exhausted, demoralized, and they need a cheerleader to convince them to carry on. Which, to me, bodes…not well. If you’re trying to make a change that could be both physically positive and enjoyable, but treating it like it’s the incredibly unpleasant task of fighting an addiction, then you’re fucked. You’re not going to make it, because you’re turning what should be a positive, self-affirming experience into an onerous, burdensome chore.

And also, eating is not an addiction. Food can be used in pathological ways, and people might need support to change that behaviour (a.k.a. “disordered eating”) — but eating itself is not an addiction. Let me explain.

There exist very intensely pleasurable biological pathways to reward animals for survival-enhancing behaviours. Like eating food, drinking water, licking salt, and having sex. Addiction happens when a non-essential, and in fact toxic, substance insinuates itself into one of those pathways, replacing the life-affirming behaviour with something life-diminishing. Even in the extreme throes of an eating disorder, food is not an addictive substance, and eating is not an addictive behaviour. The behaviour may be pathological, like a compulsion — but a compulsion /= an addiction. I believe Linda Bacon will address this in her upcoming book, but this has always been my understanding of the issue.

On the surface, the shades of difference between “addiction” and “compulsion” may seem purely semantic, but I’m afraid that categorizing basic survival behaviours — even when they become distorted into pathological habits — as “addictions” can lead to a dangerously slippery slope. At the bottom of that slope lies fear of food, fear of the body, and the moralizing of fundamentally amoral behaviours. (Though, of course, I don’t believe addictive substances need be considered immoral either — it’s just that humans commonly use the short-hand of “bad” — morally bad — to describe things that are potentially harmful. And because the consumption of heroin or cigarettes is not fundamental to sustaining life, there’s really no harm in labelling these things as “bad.” But food? Categorizing food as “bad” — morally bad — can be very harmful.)

Let’s put it another way — an eating disorder is a symptom of an underlying problem, possibly biological, possibly psychological. It is not purely a function of the substance, food, or the behaviour, eating. An addiction (though these often do have underlying biological and psychological causes themselves) can come about simply from exposure to an addictive substance. An unborn baby, with no psychological issues or significant biological impairments, can become addicted to a narcotic simply by being exposed to it in the womb. That is an addictive substance.

Sometimes people with iron deficiency experience pica, or a compulsion to eat non-nutritive substances. It is their body’s messed-up way of signalling that there is a deficiency, that something ain’t right. These people will compulsively eat many different substances: ice, chalk, dirt, clay, even socks. Does this mean that socks are an addictive substance? Do they need to go to sock-detox? Or should they go on a low-sock diet, and maybe get some telephone support to help them stick to it, rah! rah!

No. They need to fix the underlying problem.

If someone has disordered eating — whether it’s an extreme eating disorder or a milder form of disordered eating, like overeating — they don’t need a diet, and they certainly don’t need a phone-line to encourage them to diet. They need therapy, training in some form of intuitive eating or demand feeding (possibly with some structure, as I’ve mentioned in the past — pure demand feeding doesn’t work for everyone), maybe medication, and they need Health at Every Size. It may not be a perfect, one-size-fits-all solution, but so far it seems to be the best we’ve got.

A phone call won’t stop the cycle. It’ll only give a push to another revolution of the diet merry-go-round we’ve been collectively riding for the last century. I don’t know about you, but that’s not the kind of revolution I’m interested in.

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9 Comments

  1. sannanina
    Posted June 7, 2009 at 3:41 am | Permalink

    Oh, Michelle, can I just say I love you? Can you be my nutritionist, please? (I am kidding, but I wish there would be more people like you around.)

    I am so fed up with people thinking I am addicted to food because I have BED and that restricting certain foods could somehow “cure” me. Wake up, people, I have restricted food, this is what got me into this in the first place. How could I have become addicted to food while restricting it? In addition I have been on many diets (and actually was quite “successful” in the short term). If I am addicted to food shouldn’t I experience some kind of withdrawal when I am dieting and shouldn’t the withdrawal symptoms get better after a while? Well, I never experienced physical withdrawal, only hunger, and the urge to binge was still there even after months of dieting, in fact it got worse. How is this similar to an addiction? Or how do people with an addiction get just as compulsive about withdrawal as about consuming the substance they are addicted to? (You bet that I am compulsive about dieting – when ever I did diet I ended up restricting a little more all the time. I also had night mares about breaking my diet and a week in which I lost less than a kilogram was a bad week.)

    Plus, while I disagree that eating disorders of any kind are not about food at all, they are not only about food. Right now I do not even binge that often, and when I binge my binges are relatively small compared to the binges I used to have. I do, however, have an extremely bad body image – basically I cannot stand seeing myself in the mirror and any negative comment about my physical appearance can throw me into a really dark place for a while. Is this normal? No. But hardly typical of how a “food addiction” would look like.

    What makes me angry about this is that people who insist that food is an addiction stand in the way of my recovery. Yes, in the end, I am the one that has to take responsibility for recovering (and I do). And yet, it would be nice if there would be more people around who understand this disorder and could support me.

    • Posted June 7, 2009 at 10:27 am | Permalink

      Hey Sannannina! I’m so glad to see you.

      I totally, totally agree with you about eating disorders, BED in particular. I’m glad you’re willing to talk openly about it, because it can be such a contentious issue, both from a fat-hating perspective and even from a fat-acceptance perspective. But I have friends with BED, and it’s important to hear people’s experiences with it.

      Please, please stay around and give us more of your brilliant comments.

    • cassie
      Posted July 11, 2009 at 4:20 pm | Permalink

      Sannanina, I also struggle with BED, and I am with you 100%. It is hard because people just don’t understand. It is not that I “shouldn’t eat that second helping” or struggle with overeating; binging is something totally different. I feel much more comfortable talking with others with different ED behaviors than I do with nondiet and FA advocates, because they DO understand. I go to EDA (eatingdisordersanonymous) and I love the support and compassion I receive there. You might see if there is a group near you.

      Cassie

  2. meerkat
    Posted June 7, 2009 at 12:49 pm | Permalink

    That quitline is both hilarious and terrifying.

  3. sannanina
    Posted June 7, 2009 at 2:50 pm | Permalink

    Thanks for the welcome :o) I certainly will stick around.

    And you are right, BED is a difficult topic even in FA circles, or at least I have the impression that it is. I think talking openly that there are fat people who do binge/ overeat is not easy because it can be misunderstood by outsiders as admitting that the stereotype of fattie bingeing on fast food is correct. (Then this stereotype is not even true for binge eaters – for example, I am a binge eating vegetarian who loves fruits and veggies, which is something that usually blows people’s minds.)

    • Posted June 7, 2009 at 5:05 pm | Permalink

      I think talking openly that there are fat people who do binge/ overeat is not easy because it can be misunderstood by outsiders as admitting that the stereotype of fattie bingeing on fast food is correct.

      Exactly. And that is part of the reason I’ve always been a little wary of “stereotype-busting” efforts. Because, in all the effort to prove that certain stereotypes are not true, we end up throwing some of our own under the bus, by disowning them and denying their existence just because they happen to share some of the characteristics of the stereotype.

      The truth is, stereotypes can never apply accurately to *an entire group of people* because a stereotype consists of *individual characteristics.* Some individuals in the group are going to have those characteristics, and others will not. That does not prove or disprove the stereotype one way or another. Because the stereotype is inherently inapplicable to the group.

      I am far more interested in helping fat people, whatever their eating issues may or may not be, than I am in busting stereotypes. Because I don’t even want to dignify stereotypes with an attempt to bust them — they are inherently worthless as descriptors of groups of people, and they engender dehumanization and hatred.

      Anyway, of *course* there are fat people who overeat. Just as there are thin people who overeat. There are also fat people who undereat, and who have all the diagnostic signs of anorexia nervosa, except for the weight criteria. It’s counterproductive, and deeply discompassionate, to deny that.

  4. Posted June 15, 2009 at 7:21 am | Permalink

    Michelle, I just want to say IMPRESSED I am with your new blog! It is awesome, YOU are awesome. I am bookmarking so many of your posts so far and I am just nod nod nodding along to practically everything you say. I am so glad their are FAers like you around and so glad there are nutritionists like you around and so glad there are people like you around!

    THANKYOU!!!!

    PS I adore that photo of yourself you have up – gorgeous!

  5. Posted June 15, 2009 at 2:35 pm | Permalink

    Thanks, Bri — your encouragement means a lot.

    Also, I noticed your new site redesign. It’s lovely. And best of luck in your post-grad studies! I’m excited to read what you have to say.

  6. Posted June 15, 2009 at 11:26 pm | Permalink

    Hi Michelle, thank you so much for this important post. I live in Sydney, NSW, I have BED, and I was horrified when I first saw the health line ads on TV last week. It’s great that our government wants to do something about health and obesity – but I can’t help but feel that this helpline will not achieve much at all.

    There is plenty of information out there already telling us what we should and shouldn’t eat, how much to exercise etc. What we need are resources put into helping us understand the underlying causes of why we overeat. Telling a person with BED to ‘just eat less’ is like telling an alcoholic to ‘just stop drinking’. Of course, like you said, food isn’t necessarily an addiction the way alcohol is, but it is a very powerful coping mechanism. Without understanding why we overeat we will never stop overeating.

    The Australian government has done one good thing in this area, by now subsidising 12 psychology sessions per year. This is a great first step for those of us with eating disorders, but there is still a long way to go.

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