Today's headline has multiple meanings: Food addicts often experience medical complications as the result of their actions, for which they (we) are responsible. But that's not what I meant with the headline.

For multiple reasons (more complication!), a problem eater could have several reasons for their problem. Notice that my organizing principle is "problem eaters," not "food addicts." All food addicts are problem eaters, but not all problem eaters are food addicts.

Some problem eaters just have bad habits, or a lack on knowledge about nutrition. I wonder about this group, or about the latter half of it, anyway. So much about nutrition is common sense, and the parts that aren't are discussed in plenty of books and on plenty of websites. All one has to do is lift a finger, which would fit comfortably under the rubric of taking personal responsibility.

Another group could be called emotional eaters, who might be eating over specific trauma, for example.

Yet another group could be called food addicts: We have biochemical reactions to some foods, some processes of food (such as refined sugar, or flour), and some behaviors around food (specifically, eating for volume) that lead us to act in all sorts of whacko ways.

But here's the complication (OK, one of): A food addict could ALSO be an emotional eater — they might have biochemical sensitivities AND be eating over trauma. AND, such a person could also lack information about nutrition, or have developed poor food habits. Other combinations of these factors exist, of course, and there are other factors that lead people to eat.

It is most often among the sarcastic and snide, those who flame and ridicule the very possibility of food addiction, that I note the lack of understanding about the complications that are in play, as well as the absence of curiosity over whether anything more sophisticated than "NO!" could be involved.

I was moved to write about this this morning by a post by White Picket Fence Counseling Center of Winter Park, Fla., which came up in one of my Google Alerts. I don't know any more about the place than this post, but they started on an upnote, in my estimation, with this:

People struggling with eating disorders need more than just the trite answers of "just eat less," "push yourself away from the table" or "just say no!"
Recovery from emotional eating requires both structure and support. Now by structure, we do not mean rigidity. Food plans, daily schedules and group meetings are all used as tools, but what's most important is that those tools are meeting your needs and fit with where you're at today.

And by support, we do not mean instructions. In fact, a recent article in the NY Times points out that doctors who just hand out instructions (sometimes paired with stern judgment) have little impact on their patients' success. However, doctors who work to motivate their patient to take charge of their own recovery make a real difference.

For emotional eaters who are considering bariatric surgery, take note. While this might seem like a quick and viable solution, surgery cannot remove emotional eating. Maintaining the weight loss will be very challenging, if not impossible, if you have not addressed that. Whatever got you to that weight is still with you.