Eating disorders and food dependency – What makes them different

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Eating disorders and food dependency – What makes them different

Food Dependency and Eating Disorders

What is food dependency and how is it different than an eating disorder?

Food dependency has yet to be acknowledged as a legitimate phenomenon. There is, however, a growing number of folks who do indeed see it as a bona fide affliction. Among these are a group of professionals, scientists, and “recovered food dependent individuals” themselves. One grass roots group has offered the following:

“Food dependency is a disease typified by loss of control over the ability to stop eating certain foods. Scientifically, food dependency is a cluster of chemical dependencies on specific foods or food substances. After the ingestion of highly palatable foods such as those containing significant amounts of sugar, flour, and highly processed foods, the brains of some people develop a physical craving for these foods. In addition, the more processed a food or substance is, the greater its’ potential to be problematic. Over time, the progressive eating of these foods distorts a person’s thinking and leads to negative consequences they do not want but cannot stop.” *[paraphrased from FAI]

Further, recognizing Food Dependency as an illness or disease is thought to be an even a greater stretch. Serving as a “devil’s advocate” two positions to consider:

The “Naysayers:” -Substances and compulsive gambling and/or behaviors are not necessary for life. Food is.

The “Believers:” –But so is water and air – However, people do not consume water & air beyond their biological needs or in ways that threaten their survival. So perhaps the problem is one of semantics.

drug dependency = not all drugs are problematic

food dependency = not all foods are problematic

So, does that mean emotions don’t play a part in all this? Simply stated, we don’t know to what degree food dependency (FA) is governed by cravings triggered by “certain highly processed foods” and how much is purely a matter of emotional eating. Is it “either or” or can it be both?

The following is a set of assumptions by the “food dependent community” as a way of looking at the difference between food dependency and an eating disorder [such as anorexia and bulimia]

Food dependency always involves a need to identify and abstain from offending food substances.

Food dependency might well be thought of as a substance use disorder, with the substance being individually identified food substances such as sugar, flour, certain fats, highly processed foods, and so on. Much like other substance use disorders, the substances [in this case food substances] may vary somewhat between people – yet generally lead to a “craving” that exceeds a “want” and becomes a “need.”

Eating Disorders do not always necessitate an abstinent stance from certain food substances common to food dependency. However, it’s important to recognize eating disorders and food dependency can exist together at the same time with the same person.

Eating disorders might be considered an umbrella from which food dependency (FA), may be included or in some instances viewed separately. Regardless, identifying and eliminating certain food substances as a pre-requisite to overcoming food dependency. This may not be the case for certain patterns of disordered eating. To be clear, some eating disorders such as restricting types of anorexia are apt to be considered a “stand alone” ED while other forms such as purging forms of anorexia may fit both bills. – it’s the wisdom to know the difference” that’s the challenge.

What are eating disorders?

Eating disorders are typically associated with various maladaptive patterns of behavior related to food, it’s consumption, and the ensuing effects on a person’s emotional and physical well-being. It may, or may not, include attempts to offset the “consequences” of these behaviors by the use or abuse of compensatory agents and behaviors such as purging, compulsive exercising, periods of self-imposed starvation, and so on.

The medical and psychiatric community categorize these disorders as separate entities, each with a distinct set of symptoms and characteristics. Familiar to most are: Anorexia [self-imposed starvation with or without purging behaviors], Bulimia [binge eating and purging], Binge Eating Disorder [binge eating w/o purging]. It is not unusual to observe these patterns as interchangeable, manifesting themselves at various “stages” during the course of an individual’s life span. In other words, periods of binge eating followed by periods of restricting, followed by periods of compulsive exercising then purging, ad infinitum. In fact, when untreated, many people will cycle through just about all the various ED behaviors aligned with each subtype of eating disorder. That said, it would not be unusual for someone to begin with anorexia and later exhibit a bulimic pattern, and even later attempt to control the binge eating by attempting to return to a more anorexic-like stance. In effect, “switching deck chairs on the Titanic thinking they will avoid drowning”.

Given the debate as to what causes someone to develop an eating disorder, the answer is not as simple as “one size fits all.” Historically, most clinicians treating these disorders believe the root causes are hidden within the emotional psyche of the sufferer. Whether anorexic, bulimic, or a binge eater, the persistence of overeating, starving, or purging is thought to be in part to be a misguided attempt to control unwanted emotions or, in many cases, avoiding the pain of experiencing past, present, or future trauma. Simply stated, this belief attributes disordered eating to an underlying psychiatric or emotional illness.

An ever growing number of professionals, believe the biological piece to the puzzle needs to be given ample consideration. As such, treatment begins with a search for the emotional AND biological factors interacting to drive an eating disorder. To be fair, a minority of individuals will recover from an eating disorder simply by gaining insight and skills to better manage a particular issue or traumatic event – perhaps by “resolving” or “working though”

their past trauma and emotional baggage. Too often, however, many may have only solved part of the puzzle with psychotherapy or counseling yet the physical piece [reactivity to high glycemic foods] remains undetected or ignored. To “close the circle” it may be prudent to consider both the nature of the [food] substances as well as the nature or emotional makeup of the person. Until science can come up with a reliable means to determine just what drives the ED, one would do well to consider addressing both. In other words, should years of talk and related therapies fall short of the mark, look to the food triggers being “among the likely suspects. ” Likewise, if adherence to a food plan eliminating trigger foods and controlling portions still fall short, then emphasis may need to be placed upon the emotional components. In either case, the answers will come if approached with an honest, open, and willing mind.

Summary Notes: Food for Thought

Almost without exception, identification and complete abstention from certain food substances are a pre-requisite to overcoming a food dependency. As noted, this might not ALWAYS be the case for everyone with an eating disorder diagnosis or history. However, most abstinent food plans are at the very least healthy and can serve as part of an on-going and positive lifestyle. In effect, they do no harm. What are often referred to as “abstinent foods” typically consist of nothing more than healthy whole foods and tend to avoid highly processed food substances – devoid of the tendency to negatively impact the body’s delicate balance of insulin, blood sugar and metabolic processes. Think of it as “better living without chemistry.”

As such, those who have a history of binge eating, binge eating and purging [bulimia], compulsive overeating, and some forms of anorexia [usually purging types] would do well to identify and abstain [if not seriously limit] highly processed foods with limited nutritional value. In other words, they may harbor BOTH a biological, as well as, emotional set of factors driving their disorder.

At the risk of being redundant, suffice it to say the following:

Many people who fit the medical criteria for binge eating disorder, bulimia, and/or certain variants of anorexia also appear to fit the profile of food dependency. How much and how many food dependent individuals overlap with an ED is not known. This continues to be a source of speculation and debate. To be clear, the concept is what matters rather than semantics. The implications are a matter of securing effective treatment.

“The Mechanics” of Disordered Eating- What’s the Science Says

Bulimia, anorexia, binge eating, food dependency – all involve either an acquired or pre-existing [sometimes genetic] dysfunction of the reward system in the brain. The phenomena of “craving”, compulsion, obsessive rumination about a substance, and so on, are all biologically as well as psychologically driven. Much of the research confirms this. Today we can map the brain and see the neural reward pathways, the specific “feel good” chemical reactions, and the resulting structural changes in the brain. Indeed, there exists a graphic display of the differences between the chemical responses of an “eating disordered individual” and his/her non-eating disordered peers. This holds true for someone with an ED, food dependency or both

This means that the more a person consumes the foods they are “drawn” to, the stronger their cravings for those foods become. As an added note: restricting anorexics find starvation and compensatory behaviors intended to offset weight gain can also regulate moods and emotional states by affecting brain chemistry and neural reward pathways in ways similar to their overeating and bulimic peers. In all instances the chemical processes going on in the brain demand “more” of the substances or behaviors over time. These chemical processes not only change the brain in a way that reinforces cravings and compulsive behaviors, but also interfere with clear thinking. Adding insult to injury, the phenomenon of tolerance [needing more to achieve the same effect] takes place.

This makes it all the harder to abstain from eating the foods you are obsessed with or the dieting behavior to further starve your body. The cravings associated are so strong and thinking is so impaired, talk therapies tend to be much less effective – especially if used exclusively. Therefore, trying to teach someone with food dependency to eat their “trigger foods” moderately is almost always met with limited and short term success at best. Moderation is not the best treatment for food dependent individual. When moderation is prescribed to the individual with a food dependency, it is like suggesting an alcoholic learn to control their drinking and moderate their alcohol consumption.

But These Two Things Often Co-Exist…

Specialists, especially those experienced with identifying eating disorders, are quick to concede food dependency and ED often share more similarities than differences – albeit presenting themselves with different behavioral patterns at different times. This is what makes treating food and eating related disorders so complex and so challenging.

As is so often the case when both conditions are present, chemical dependencies on specific food substances [or the mood-altering effects of dieting and starvation] typically interfere with a person’s thinking, judgment, and self-control. Focusing on “a healthy food plan” would then seem the first order of business. There is, however, one caveat-namely abstinence from trigger foods and/or starvations diets is but the beginning. of the recovery process, not the end game. Failing to deal with “the whole enchilada” -physical, psychological, emotional, and ultimately spiritual [aka existential if you prefer] usually is the difference between a brief remission and sustainable recovery. This holds true for the food obsessed individual, someone with an ED, or any addictive or chronic illness for that matter.

It is important to understand that proponents of one side or the other of the “food dependency” versus “eating disorder” debate tend to be fighting a territorial and rhetorical battle. That battle is totally abstracted from what is actually going on with the people they are attempting to help. There is a need for people to avoid falling into the trap of black and white thinking and begin to see the various shades of gray associated with these disorders. We are ahead of the game when we remain teachable and not entrenched in defending any one position.

Our eating disorder treatments located in Florida. Contact us if you have questions

Marty Lerner, PhD
“I love working with such talented professionals and motivated patients who actively advocate for themselves and the betterment of their futures.” Dr. Lerner is the founder and CEO of the Milestones in Recovery’s Eating Disorder Program which he started in 1999. Dr. Lerner is a graduate of Nova Southeastern University. Dr. Lerner is a licensed and board-certified clinical psychologist who…