Addiction and NCDs

Despite billions of dollars in research into causes and efficacious treatments of obesity and other NCDs, we still seem to be losing the battle.  A relatively new trend in this research proposes a reason why- this research looks at the addictive qualities of certain foods and the relationship to dietary decision making and food addiction.  Some studies seem to indicate that from a biological perspective, some of the same hormones and genes are at work in the food choices made (particularly in obese and overweight individuals) as in individuals who are in some stage of addiction to drugs and alcohol.  This seems to be particularly true in certain trigger foods, particularly those that are salty or sweet because of the physiological reaction of our bodies to such foods.

Most people are familiar with the notion of comfort food or of food as a reward/punishment.  These studies take this a step further by indicating that the same reward system and associated hormones/neural indicators are at play in the abuse of drugs and food.  Furthermore, just as addictive personalities are often associated with poor impulse control, the same can be said for those who choose junk foods over healthy ones, or who espouse more sedentary lifestyles over active ones.  This presents an interesting paradigm, wherein the treatment methods employed for addiction could ostensibly serve as a model for the treatment of overweight and obesity, as well as other chronic illness impacted by dietary choices.  This could come in the form of twelve step programs, intermediary drugs to wean the patient off of such behavior (akin to methadone in the treatment of heroin addiction), behavior replacement therapy, sponsors, and the like. 

Recent research shows that implementing a tax on nutrient poor/energy dense foods is at least marginally effective in curtailing spending on them.  If such a tax were to be implemented at a comparable rate to other sin taxes (alcohol and cigarettes), perhaps purchases would decline even more.  I am still a bit unclear on this point if we are to focus on the similarities between drug and food addictions.  Drug addicts do not stop purchasing drugs when they become unaffordable, they simply find a way to afford them, or another way to get them.  If we assume the pathologies are comparable, than I assert that a multi-faceted approach is still needed in the eradication of overweight and obesity.  Perhaps as a corollary to sin type taxes, it would be effective to treat the foods as alcohol is treated and have separate junk food stores (like liquor stores).  Much emphasis is placed on the sedentary lifestyles of the vast majority of obese individuals; perhaps removing the convenience factor from convenience foods would be an effective way of diminishing their purchases.  Moreover, advertising space for cigarettes and alcohol has been limited and regulated for years, why can the same not be done for foods that surpass instituted regulations for poor nutrient density?  Although the evidence is not yet conclusive, These studies do leave one to ponder the efficacy of current policies.  If a causal relationship can be proven between addictive and obesogenic behavior, than we will be presented with an entirely different set of strategies for treatment and prevention that will likely be much more effective than those currently being used.

1. Gearhardt, Ashley et al. “Can Food Be Addictive? Public Health and Policy Implications.” Addiction. 106, no. 7 (2011): 1208-12.

2. Gearhardt, Ashley and Kelly Brownell.  “Can Food and Addiction Change the Game?”  Biological Psychiatry.  73, no 9 (802-3).

3. Nair, Sunila G. et al. “The neuropharmacology of Relapse to Food Seeking: Methodology, Main Findings, and Comparison with Relapse to Drug Seeking.” Progress in Neurobiology.  89, no. 1 (2009): 18-45.

4. http://www.npr.org/blogs/health/2010/03/junk_food_jones_is_wired_in_yo.html