In 2013, an undergraduate research project suggesting Oreos activated more of the brain’s pleasure centers than either cocaine or morphine set off a storm of media attention. However, the study was done in rats and never directly compared Oreos to either drug. Another blitz of media coverage, this time claiming cheese was as addictive as crack cocaine, was predicated on a study by Ashley Gearhardt, an associate professor of psychology at the University of Michigan. Ironically, Gearhardt’s study only mentioned cheese a few times.
Bad science journalism aside, can foods be addictive? Is food addiction a valid behavioral health condition?
According to the American Society of Addiction Medicine, addiction is a chronic brain disease where “an individual pathologically pursues reward and/or relief by substance use and other behaviors.” While this definition is harsh upon first reading, it is important to note that not everyone exposed to something addictive develops an addiction. For instance, only 8 to 12 percent of people (still a concerning statistic) who misuse prescription opioids, e.g. taking them not as their doctor ordered, develop opioid use disorder. So no need to fear, yet, Oreo lovers.
Oreos, cheese and other foods some would label as addictive have one thing in common: the bliss point. The bliss point is the right amount of salt, sugar and fat to maximize a food’s irresistibility. Like the tobacco companies that genetically modify tobacco plants to double their nicotine content, food companies meticulously design processed foods to take advantage of our evolutionary cravings for salt, sugar and fat for more sales.
Anthropologists estimate that Homo sapiens has been around for about 300,000 years and, for a vast majority of our species’s time on Earth, foods high in sugar, fat and/or salt were a luxury. Since we need all three of those nutrients to live, it makes sense we evolved neural circuits that reward us for obtaining fatty, sugary and salty foods. Fast forward to 2018, however, where a vast majority of humanity gets the nutrition it needs from these foods and you run into a problem: We no longer need to seek fatty, sugary and salty foods to survive, but the neural circuits of 300,000 years ago still exist.
The one thing that trips people up the most about the idea of food addiction is the question, “How can food be addictive if we need it to live?” We still need fat, sugar and salt, however, we have innumerably more sources of these ingredients than our ancestors did. Something a lot of people do not realize about drugs like marijuana is that their addictive properties are rooted in biology. Your body is coursing with naturally produced chemicals that are structurally similar to a molecule of THC. That is why THC is able to activate your endocannabinoid receptors and cause the effects one feels when smoking or eating pot. Marijuana would get no one high if THC was not similar to anandamide, a brain chemical.
Why do I draw the parallel between marijuana and food? The brain needs a molecule to activate the endocannabinoid receptors. Both anandamide and THC will do the trick, however, they are not the same. I apply the same concept to food. We need food, yes. However, an Oreo and a cucumber are not created equal nor should they be treated as such.
In my conversations with people at the School of Public Health’s Department of Nutritional Sciences, I have observed that people readily fall squarely into the “yes, food addiction exists” and “no, food addiction does not exist.” I have already presented arguments for the former, but what about the latter camp?
The most consistent and cogent argument I hear against food addiction as a concept is that it is seen as conflicted with the “intuitive model of eating.” Intuitive eating is all about learning to respect your internal cues for eating, such as fullness, and rejecting external cues like diet culture. This model also maintains that no food is a bad food. On face value, the idea of addictive foods flies in the face of intuitive eating. It’s an external cue that makes some food “bad.”
I respect this argument and the intuitive model of eating, however, I believe the conflict is rooted in misunderstanding, not fundamental incompatibility. We label drugs of abuse like opioids and cocaine as “bad” and the dominance of Alcoholics Anonymous and its cousin Narcotics Anonymous in the addiction treatment world lead many to believe that abstinence is the only treatment for addiction. If that were the case, then we would tell people to avoid certain foods which could be addictive, which as I said before, goes against intuitive eating. While AA and NA have done worlds of good, their total abstinence mindset is unhelpful at best.
I, along with many others, believe in a harm reduction approach to addiction. I do not want to treat someone with opioid-use disorder because heroin is “bad” but because they could be harmed by their behavior. For food addiction, a harm reduction approach may look like helping a person realize what foods may be triggering for them and the potential health consequences of eating too much of these foods.
I have heard the idea of labeling foods like Oreos as potentially addictive. I do not support this because, while I lean more toward the “yes” end of the food addiction argument, I believe there must be a broader consensus among experts about the topic. If we are going to sound the alarm about food addiction, we need doctors, nutritionists, therapists and researchers to be on the same page.
Ali Safawi can be reached at asafawi@umich.edu