Written by Dianne Piaskoski
Joseph Frascella, M.D., director of clinical neuroscience and behavioural research at the National Institute on Drug Abuse (NIDA), is working on the hypothesis that food addiction is comparable to drug addiction. The same brain circuits are involved in both addictions, and so he suggests that some obese patients may need to be treated in a similar way to those with substance addictions. Brain images have shown that the same decision-making processes that are related to drug addiction are impaired, thus preventing the addict from making the choice to abstain.
As Vancouver addictions doctor and author of In the Realm of Hungry Ghosts, Gabor Maté phrases it, it is not a question of lacking free-will, but a matter of lacking “free won’t.” The same inability to make the right decision happens with obesity and overeating.
One common method of treatment for obesity is bariatric surgery. This makes the stomach so small that people can’t eat much. Initially this allows them to lose significant amounts of weight, but it addresses neither the cravings associated with addiction nor the reasons why one turns to food for comfort. Frascella is promoting awareness that some of the methods of treating patients for substance addiction may be applicable to treating patients for obesity and food addiction.
He does note that not everyone who is obese is addicted to food, just as not all drug users are addicted to their drug of use.
On another issue, Frascella notes that, although the pleasure of sweets is often compared to drug addiction, little is known about sugar as an addictive substance. He recounts experimental evidence that sweetened water administered to lab animals is more rewarding than cocaine or heroin, suggesting the possibility that sugar is even more addictive than these drugs.
Developments in the area of medication are being made that could treat both obesity and addiction problems. Two current treatment options that we suggest are: the support groups of Food Addicts in Recovery Anonymous (FA) and Overeaters Anonymous (OA), both based on the 12-Step program of Alcoholics Anonymous. FA emphasizes abstinence of trigger foods which spur on overeating, with sugar being the number one culprit.
Frascella encourages looking at a disorder/disease/addiction from various points of view as it induces more questions which leads to more insights.
Source: Why curing obesity isn’t the same as curing food addiction. (2010). Alcoholism & Drug Abuse Weekly, 22(22), 1-6.