Overeating As Addiction

I have spent some lively hours debating with others on the Facething whether compulsive eating is an addiction; which asks for some reflection on the nature of the term "compulsive".


Then I did two BBC Radio stints on overeating, debating with two people who were relying on Overeaters Anonymous to help with their food addiction. It seemed that both participants had become "addicted" to eating as a way of dealing with different forms of loneliness, at different times in their lives.


There are not many eating disorder experts who buy into the notion that compulsive eating is an addiction although they agree the following;


1   You can sort of become addicted to sugar because it affects the same parts of the brain as the other suspects like drugs and alcohol.


2    Eating disorders share some features with addictions.


3 People who overeat speak in the language of addictions. "I can't carry on with my day until I have had my fix... I can't stop at one.... I can't stop when I have had enough".


On our website blog I have made a very short case in favour of not leaping to the conclusion that overeating, even quite horrible variants of it, is addiction. It doesn't help our patients to consider themselves addicts. There are lots of reasons for overeating, even the most compulsive forms. We can free people from their destructive relationships with food without you needing all the paraphernalia of overeating fellowships like group meetings, endless talking about food,  sponsors and a lifetime of thinking of your self  as "In Recovery".  Thousands of us used to overeat and  don't now. We are not "In Recovery."  We can help you to stop.


 Check out   http://eating-disorders.org.uk/emotional-eating-addiction/ 

In Search of The Best Diet For You

In Search Of A Personalised Diet BBC Horizon January 2015. 

Have we finally found the Holy Grail of weight loss?  Is this the way to personalize eating plans which fit the individual and will help them lose weight? An army of world famous weight loss experts cannot surely be wrong. Can they?

Well let’s see.

We are now in the dieting months and I’m already sick and tired of all the diet plans I’m seeing.  There is the Ice Diet being promoted by Peta Bee in the Times – sorry Peta, bad science. And even a diet called EAT! Which is just another variant on the low carb diets.  These diets are one size fits all and take no account of personal genes and nutrient responses. They are designed to fail in the long run, as all fervent followers will discover. 

A few years ago, the BBC ran a diet trials experiment at the University of Surrey which compared different types of diets for success. There was a clear winner which I won’t mention now but the take- home message in the long run is that different types of diet suit different people. People who don't like detail do well with a diet like Atkins, while some types of people do really well with a group approach. But in the long run it’s pretty much all the same. Failure, that is, for most.

So here we have an all-singing-dancing world expert scientific approach that is new. Do people really divide themselves into three obesity types?  The first “cant-stoppers” who are low on gut hormones. The second “constant cravers” who probably lack a good leptin response (science here) to tell their brains they aren’t hungry.  The third, “comfort eaters” who meet the day to day stress in life by using food as a feel-good drug.

Perhaps. They have all lost weight, HURRAY  - but that proves very little; it was poor research design, and the proof of the obesity pudding must surely be in how well they are able to keep it off.  Oh well, it makes good TV but probably very little else.

Professor Susan Jebb is an expert-expert on obesity but has said that losing weight is not a matter of will, but of habits. People have to change their habits for life. I know that, and part of the therapy I do is to help change habits from very deep inside.  This is useful for everyone and flexibility training was missing from the treatment given to these subjects.

But there is a whole new science of willpower – known as self-regulation theory which is available to obesity specialists and which is helping people to use their willpower to change their lives.  This can help comfort-eaters, constant-cravers and cant-stoppers too.  Why was this ignored?   So what’s going to happen to these happy weight losers?  Will they have to stay on their diets for life, an impossible task surely, unless they learn how to exercise their WILL.

I like it when people feel they have done something valuable and positive. Who could fail to be moved when men weep real tears by having help and support. But is this real science when it ignores real psychological strategies that work, like flexibility training and self-regulation training. Is the Intermittent Fasting Regime really the right approach for constant cravers  - WHY- and is group work alone correct for people who have failed to develop better ways of managing the stress of life and living with other people?  Who said it was?

So for me the jury is out.  Some bits of this interesting programme hold out hope for people who cannot lose weight.  It's good for someone to know that they may be lacking in a gut hormone that helps them to feel full.  Its good to suggest that an emotional eater is not just weak-willed and greedy. It may be useful to know that a constant craver might not be feeling leptin in their brain.

But I’m waiting for 18 months down the line to see if you can change habits (as Susan Jebb suggests) by putting people on a diet that suits their “obesity phenotype.”

World experts should know better than to suggest that what they have done is a solution. It is just one of a number of things that must be properly explored in properly designed clinical trials before we can truly discover a personalized solution for obesity. And we experts know better than to think that any single diet can provide a quick fix even when the experts say "genes".

Sugar Addiction

Are you a sugar addict?


Can you be addicted to sugar?




There is a robust review on the subject commissioned for the National Institute of Mental Health in the USA which should settle the matter. There is only  weak association of attachment to sugar among people who diet or restrict carbs, while sugar given freely in a balanced diet may have no influence on behaviour such as escalation, tolerance and withdrawal.

Evidence for Sugar Addiction: Behavioural and neurochemical effects of intermittent excessive sugar intake. Neuroscience Bio behavioural Review 2008 32(1) 20-39 published online 2007 Avena, N., Rada, P. and Hoebel, B.

Psychologically speaking, work on the subject of sugar addiction by Terence Wilson published in Binge Eating, Nature and Treatment edited by Fairburn suggests that the so-called addiction to sugar is largely psychological. People only lose control of eating sugar when they BELIEVE they have eaten sugar, demonstrating NO evidence of intrinsic addiction to the substance at all.

The role of sugar in the hedonic systems of the brain are not equivalent in effect or severity, as drugs like cocaine and nicotine, even though there is an effect on endogenous dopamine.

Sugar is present in many foods such as vegetables, potatoes, tomatoes, lentils and other pulses so eliminating sugar from the diet seems impractical. Sugar is not equivalent in its physical effects as fructose including high fructose corn syrup further confounding the evidence.

Sugar-fat combinations are as potent in promoting the surges of endogenous dopamine as sugar alone if not more so. Thus there is danger in focusing solely on the so-called addictive properties of sugar. Based on a macronutrient analysis of binges by Susan Yanovski in 1998, it seems that it is fat which binge eaters really crave when fat is made palatable by sugar.

Thus while clients talk in the language of addiction to sugar,  the evidence-based success of cognitive and cognitive-emotional / behavioural treatments for compulsive eating warn us of the dangers of focusing on sugar as an addictive substance. Addiction approaches to treatment which ask you to remove sugar and white flour from the diet might be unhelpful. It keeps people well only when they continue to restrict their diet. This approach merely fosters the all or nothing thinking that pervades eating disorder work.

 I used to get sugar cravings long ago, but I know now that it was just too much dieting.  I now eat a broad diet which contains all nutrients including a reasonable amount of refined sugar. And I'm fine.


But if you think you are a sugar addict and need help, call us on 0845 838 2040 OR  visit www.eating-disorders.org.uk

Intermittent Fasting: Our Professional Opinion

Hello everyone.


For an in depth overview of our latest opinion of Intermittent Fasting, follow this link.


http://eating-disorders.org.uk/intermittent-fasting-if-our-version/


We can tell its summer here, the phones have gone quieter. Does this mean that people aren't worrying about their weight and their eating?  I don't think so, this is the time of the dreaded swimming costume; this is the month of ice cream and holiday splurging.


What have I been doing? I've been reading two separate accounts of anorexia which the writers wish to publish. I have been immersed in their private and intense suffering. What a terrible illness anorexia is, I'm so ANGRY with it and so SAD about it.


What is clear to me that Anorexia is the tip of the iceberg. The ONLY reason anorexia comes in to someone's life is that there is a fundamental weakness in someone's ability to manage life and other people. Life is stressful. Relationships are the source of joy and also pain. We need a web of confidence and inner strength to be able to cope with it all. Anorexia is a story of holes in this web. We all have some holes but if there are too many holes the web caves in.


Different stories, but the same symptoms, the same presentation, the same pain. Do we need more accounts of anorexia to help us KNOW what to do about it? Your thoughts appreciated.


Happy holidays...