Snippets from the science on addiction

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I say in my book, ”Fat Boy Thin Man” that when the ideas that I hold about compulsive eating and food addiction become mainstream, scientific advances will have been far more influential than anything I said. I believe my story of losing 150 pounds-plus and keeping it off for two decades deserves to be in the conversation, but as a counterpoint to the science, not a replacement for it.

That’s why I’m happy that this continues to be a very fruitful period for scientific studies that buttress the views I’ve been promoting. Here are three I’ve run across recently:

* The first is from Canada, led by Dr. Caroline Davis of York University in Toronto. It identified “food addicts” by using the seven criteria that the American Psychiatric Association uses to define substance-use disorders (its lingo for what we call addiction), and then found that the subjects who met those criteria “displayed an increased prevalence of binge-eating disorder and depression and more symptoms of attention-deficit/hyperactivity disorder. They also were characterized by more impulsive personality traits, were more sensitive or responsive to the pleasurable properties of palatable foods, and were more likely to ‘self-soothe’ with food,” according to a report on scienceblog.com.

There’s plenty of take-away from this study, but the first I want to point out is that you can’t identify something that isn’t there. Food addiction is there. The other thing I want to point out is that the APA does not say that food addiction exists, even while its criteria for addiction say that it does. The APA looks for any three of the seven — which include increasing tolerance and continued use despite ill consequences — to determine a disorder exists, and I have experienced all seven. Oh, those wacky psychiatrists.

* The second study of this set doesn’t address food addiction specifically, but all addictions. Until recently, addiction has been largely a psychological issue. But beginning with studies 15 years ago that showed brain activity peculiar to addicts, addiction as a physiological phenomenon worthy of medical attention has been gaining adherents.

In the latest evidence that the medical establishment is putting its weight behind physical diagnosis, “10 medical institutions have just introduced the first accredited residency programs in addiction medicine, where doctors who have completed medical school and a primary residency will be able to spend a year studying the relationship between addiction and brain chemistry,” according to a story in the New York Times.

The good part about this trend is that medical science offers more empirical data about conditions than a therapist’s assessment, and data should help satisfy skeptics, or at least give supporters more evidence than, say, my story. Though beautifully written, emotionally gripping, and metaphysically persuasive, my tale can still be described as “what some guy says happened to him.”

Another implication of medical attention is the possibility — or, I should say, the near-certainty, given our psychopharmacological-industrial complex — of drugs to control addiction. My quite-a-bit-less-than-mature reaction to that is, “I ain’t usin’ no stinkin’ drug to get better, so screw that!” But perhaps a more useful contribution is to note that therapy, support, and behavior modification have been helpful to this point — they have helped more addicts than anything else so far — so even if drug therapies are developed, modifying behavior will still be valuable.

* The third study, conducted by Barbara Fiese of the University of Illinois, offers data for a potent eating-disorder preventative: eating together as a family. There was a time when I would have knee-jerk scoffed at that as a conservative trope, but I am completely down with the concept today. Families that make the dining table a priority, above watching TV or ballet or ball practice, establish that eating, and being together, are important. Everyone gets to know what everyone else is doing, and thinking. Exchanging information, ideas, and feelings becomes a typical family endeavor. Emerging problems become evident, and can be addressed, earlier.

When I wrote yesterday about parental responsibility, I was including simple actions like this to avoid reaching the point where the state has to decide whether foster care is a fat kid’s only hope.


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