Food Addiction: Chemical Dependency’s Twin

Most addicts start on the path to addiction using food as the first drug. The addict “to be” starts life with a genetic predisposition. Whatever was happening in the future addict’s life to set him/her on the addiction journey (with this genetic vulnerability), happened at an early age. The young “Addict in Training” couldn’t say to his/her family, “You’re not meeting my needs, you’re abusive or absent or nuts, I’m packing my bags to live with the Jones family down the street, they are a nice, warm, loving, open, nurturing, supportive, functional family.”

Since the “Addict in Training” couldn’t leave the situation, s/he needed a coping mechanism – and food was there! And it worked, to distract; to numb; to comfort; to fill the emptiness. And, most likely, the family was also using food for the same reasons. As the addict grows and finds “better living through chemistry,” the food may or may not take a back seat. But it is always there.

Food addiction is not about weight, but about “using” a substance for distraction, for numbing feelings, for comfort, and for a mood change. Food addiction involves biological, psychological and social factors as does alcoholism/drug addiction.

When the addict comes into recovery, and puts down the alcohol/drugs, food, especially sugar and refined carbohydrates, still remains as a major coping tool. And, it most likely has been an important support for the addict to put down, and keep down, the alcohol and/or drugs and deal with/continue to medicate the emotional pain lurking underneath.

The addict views himself, as does the lay population and the treatment and recovery world as now switching to food. In reality, the addict is only returning to or continuing number one substance—the one that has been there the longest and is most deeply rooted.

Those with alcohol dependence and/or drug addiction commonly hit bottom with those substances before hitting bottom with their food addiction. What are your answers to the following questions: “Now that I’m sober and clean, Is my eating out of control?” “I am concerned that I behave with food as I did with alcohol/drugs?” “Am I preoccupied with eating?”

Just visit any AA meeting with their serving of coffee and sugary bakery items, i.e., cookies, Danish, etc. The eating of sugar (as candy or chocolate) is also recommended in the “Big Book,” (that’s the pet name for “Alcoholics Anonymous,” the text of AA).

The phenomenon of craving is the curse/scourge/tormentor of any addict. In order to deal with the cravings, the addict uses sugar (in any form) to satisfy the cravings. So a candy bar, cookie, sugary soda, etc. will help the addict not pick up a drug or a drink. The problem is that eating sweets/refined carbs satisfies the cravings only to have them return when, in processing the sugar/refined carbs, the body’s glucose (blood sugar) levels start to plummet (crash) and the addict has to then get more sugar (or other quickly absorbed refined carbs) to bring blood sugar levels back up again.

That’s why addicts gain weight in recovery. They are looking to the food to help them feel OK. Also note that smoking/nicotine is also a substance/behavior that works in the body in a similar fashion as sugar.

Many people with solid sobriety, actively recovering in AA or NA, have a lack of willingness to seek help in treatment or attend 12-Step food recovery focused fellowships (OA, FAA, CEA-HOW, FA). Often the key “rationale” for the resistance is that their compulsive eating (overeating, binge eating) is not thought of as an addiction or a serious medical disease. Even as those alcoholics and drug addicts have celebrated their recovery, there is often ongoing denial in them and others regarding the seriousness and impact of their “using food” to deal with their lives.

Their “disordered” eating behavior is justified, rationalized by the thoughts of “It’s better than picking up a drink or a drug,” “My weight is OK,” “It’s just a Twinkie, a candy bar, a soda, etc.,” “I’m not doing anything illegal.” For others, suffering is dealt with more secretively and silently—adding to the unmanageability and shame they already feel as a result of tiohaving food addiction.

There is also the general attitude in AA and NA, as in society in general, that those who have eating problems should just exercise a little more “will power.” That is, there is an unwillingness or inability to apply the principle of “Step 1” (powerlessness and honesty) to their relationship with food: “Surely I’m powerless over drugs and alcohol, but eating is something I SHOULD be able to control.”

There is much more denial within our society about the dangers of food addiction (eating disorders, especially compulsive overeating). It is much easier to blame fatalities on coronary artery disease or heart attack rather than food addiction, a disease that requires a recovery solution to keep it in remission, one day at a time.

If the food addiction is not concurrently treated, the addict is vulnerable to relapse and is short-changed in achieving a level of self-esteem in recovery that only emerges when a person is not “using” a substance to deal with life.

Cross-prevalence of food addiction with alcohol and drug addiction is high. Food addiction and chemical dependency are two sides of the same coin. Both are biologically based, affecting the reward pathways of the brain, and both are addictions that make a person’s life unmanageable. And, it is common for addicts to switch back and forth between the behaviors.

We know that female food addicts who, as part of their illness, are preoccupied with their weight and body image and attempt to control their weight by dieting and in some cases purging. Some of these women, maybe starting in adolescence, as a form of purging, find and use alcohol, speed (amphetamines), cocaine or other stimulants which causes them to lose their appetite and to lose weight. What magic! But now, they have another problem—alcohol dependency and/or drug addiction! (That’s what happened to me—and launched me into a 20-year addiction to amphetamines!) In some cases, these individuals jockey back and forth—using alcohol and/or drugs to not eat, and sometimes using the food to not drink or use drugs. What a trap!

Most observers of alcoholics and drug addicts and addicts themselves believe that when they put down the alcohol and drugs their eating becomes more significant—less controllable—more important.

I agree with this view, but I disagree with the idea that the addict has now “switched” to food as his/her substance.

Since I believe that all addicts start on the road to addiction with using food as a substance before they find “better living through chemistry (alcohol and drugs),” I don’t believe that when they put down the alcohol and drugs they then begin using food. The food has been there from the “get-go” and maybe took a “back burner” position when the addict discovered drugs and/or alcohol. When the addict comes into recovery and embraces sobriety, the food is there—and has been waiting patiently to be called to the forefront of the addict’s need to deal with cravings and feelings.

Insofar as addiction is an issue of brain chemistry imbalance (see ASAM’s latest definition of addiction), poor diet, deficient in essential nutrients, prevents the body from adequately producing important neurotransmitters. That’s what precipitates the onset of anxiety and increases the urge to self-medicate.

Healthy diet, which tends to be overlooked by many traditional treatment programs and 12 Step fellowships, is one of the most crucial aspects of holistic recovery. Studies show that improper nutrition perpetuates the cycle of addiction. In addition, chemical dependency combined with poor diet can wreak havoc on the immune system and lead to emotional turmoil. In order to restore healthy brain function, it is imperative that harmful junk foods, sugar, caffeine and starches be removed from the person’s diet.

A growing number of experts readily agree on the fact that biochemical intervention (proper diet along with supplements, i.e., vitamins, minerals, and essential fatty acids) has the power to heal the root symptoms of chemical dependency, i.e., depression, anxiety, sleep problems, mood swings, etc. There is much evidence that biochemical repair leads to a dramatic drop in the addict’s symptoms and diminishes the likelihood of relapse—which is common among recipients of traditional treatment approaches.

Also, it important for the “recovering” chemically addicted person to know that often their symptoms of depression, anxiety, mood swings, low energy and sleep disturbances will, in time, abate with abstinence from alcohol and drugs, abstinence from over/undereating by following a structured food plan that normalizes blood sugar levels, moderate exercise and sufficient sleep.

Often these symptoms are direct biological consequences of the alcohol/drugs rather than symptoms of an underlying psychological condition.

It’s a sad reality that the brain is being damaged during drug/alcohol use. But the brain has an amazing ability to repair itself—with the help of good self-care.

Clinicians agree that compulsive behaviors for both chemicals and food must be addressed for a person to achieve and maintain recovery from chemical dependency. Most also agree that the chemical addiction must be tackled first, unless the eating problems are so severe that the person requires immediate medical attention. “Most people think the best way to treat someone with both problems is to address the problems concurrently,” says Elke Eckert, MD, professor of psychiatry and director the Eating Disorders Clinic at the University of Minnesota. “Yet you can’t treat the eating disorder without first dealing with the chemical issues. It doesn’t work. If people are using substances, they are not cognitively aware enough to deal their eating disorder. If they are still using chemicals, that [the work involved in food recovery] all goes out the window.”

At Realization Center, clients focus on their chemical dependency first, but they also begin learning about how their chemical use and food addiction are connected. Food addiction does not cause chemical dependency, nor does chemical dependency cause food addiction, but the two aggravate each other and may contribute to dual relapse. Our clients learn that for “True Recovery,” their eating behaviors must be addressed.

Dianne Schwartz developed and has been the Director of the Food Addiction Treatment Program at Realization Center for 18 years.  She provides weekly psychoeducation series to all clients on the relationship between food addiction and chemical dependency and the importance of changing/improving eating patterns for relapse prevention and improving over-all functioning. Dianne has presented numerous times at trainings to various treatment facilities and presentations to Community Organizations on Eating Disorders.  She mostly recently presented at the NASW – 45th Annual Addictions Institute – Innovations in Addictions Treatment Conference: “Exploring the Real Culprits in Food Addiction – It’s Not Broccoli!!” 

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