By Paul Bicknell, PharmD Student Cedarville University
Over-eating is a significant problem in western culture. For evidence, one need merely look at the ever expanding waistline of its citizenry, but evidence from studies also points to the same conclusion. One study that utilized just over 3.8 million US citizens from around the nation as subjects found that roughly 70% of Americans are either overweight or obese1. Other sources demonstrate the dangerous health effects and economic problems that obesity causes2, 3. However, the cause for overeating remains open to debate to a larger extent, and if cause could be established, people could be assisted in a better way to maintain a healthy weight. One key question is if addiction to food is a factor in our chronic weight gain and how much of a factor it is. Particularly high-fat and high-sugar foods are suspect. This was the case in a study performed by faculty and students at Connecticut College that looked at how rats responded to Oreos as compared to rice cakes and how they responded to an injection of Cocaine or Morphine compared to salt water4. They then examined the rats brains to find that their pleasure centers had been activated by the cookies in a similar way to the drugs4. The researchers argued from this that Oreo cookies are as addictive as cocaine and morphine4.
The implications of this study were analyzed here in the article “Food Addiction: Does the Oreo Study Prove Anything?” published on WebMD5. This article seems to support the existence of food addiction, but calls into question the ability of the study of a food addiction in rats to predict the same degree of addiction in humans5. The article argues to that end that our biological response to satisfying foods has been evolutionarily beneficial, but can and should be dealt with effectively on a higher level then would be possible for rats since it is not needed to as much of an extent in our well-fed modern society5. At the end is listed a few techniques to try to help deal with food addictions, which includes being mindful of hunger and fullness cues and eating without self-judgment, keeping healthy foods stocked up and only eating high-fat/high-sugar foods in small amounts with a meal, eating meals and snacks only at scheduled times, and trying to eliminate stress which is stated to increase desire for unhealthy foods5.
The study was limited in that it did not present clinical data with human subjects. The human brain is far more advanced then the mouse’s, and humans express a higher level of free thought then mice. The researchers also established a common addiction between the drugs and cookies without comparing them to each other, or even to the same control (drugs compared to salt water, cookies to rice cakes), which makes it hard to establish equality in addiction between the two. The article examining the study also was limited in its reference to outside sources, citing expert opinion a few times and one trial other then the one that was being analyzed.
There is, however, scientific evidence to back up a lot of the suggestions that were made in the article to help deal with food addictions. Free choice has been demonstrated to have an effect in eating habits6, so the higher level of free will in humans would create more control. The benefits of being mindful about eating cues were shown to be effective at reducing tendency to binge eat7. Stress is also demonstrated to be a causal factor that can lead to overeating8, which means attempts to decrease stress may also have a beneficial effect on food addictions.
I would say I agree with most of the content of this article. The helpful tips seem to be in agreement with the primary literature. The other points about making too grand of extrapolations from the data that was collected in the Oreo study seem to also be generally in line with scientific thought. The article gave me ideas for how to counsel on overeating that I intend to implement in my practice, but as a whole, they seem to be pretty consistent with established standards for how to deal with a desire to overeat. I might also add that when a patient faces a desire to eat something unhealthy, he or she could first perform a task that needs to be done, and then eat a very small amount of the desired food as a reward, being sure to only eat a small amount.
Some key question emerges from a discussion about food addiction. What else can be done to help patients deal with their desires to eat too much unhealthy food? How should physicians, pharmacists, nurses, or even government regulating bodies be involved or uninvolved in this task?
1. Kapetanakis, V; et al. OP26 By-State Comparison of Obesity Trends in The Adult Population of the United States of America. Journal of Epidemiology and Community Health. 2012;66:A10-A11 doi:10.1136/jech-2012-201753.026.
2. Wang, Claire; et al. Health and economic burden of the projected obesity trends in the USA and the UK. The Lancet. Volume 378, Issue 9793, 27 August–2 September 2011, Pages 815–825.
3. Sorensid, Thorkild; et al. Obesity as a clinical and public health problem: Is there a need for a new definition based on lipotoxicity effects? Biochimica et Biophysica Acta (BBA) – Molecular and Cell Biology of Lipids Volume 1801, Issue 3, March 2010, Pages 400–404.
4. Student-Faculty Research Shows Oreos Are Just As Addictive As Drugs In Lab Rats. Connecticut College News 10/15/2013.
5. Jacobsen, Maryann Tomovich. Food Addiction: Does the Oreo Study Prove Anything? WebMD 10/18/2013.
6. Fleur, S E La; et al. The snacking rat as model of human obesity: effects of a free-choice high-fat high-sugar diet on meal patterns. International Journal of Obesity (27 August 2013) | doi:10.1038/ijo.2013.159.
7. Kristeller, Jeatn; et al. Mindfulness-Based Eating Awareness Training (MB-EAT) for Binge Eating: A Randomized Clinical Trial. Mindfulnes February 2013.
8. Tsenkova, Vera; et al. Stress Eating and Health Findings from MIDUS, a National Study of US Adults. Appetite Volume 69, 1 October 2013, Pages 151–155
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