Multifaceted Addiction – Beyond Drugs and Alcohol
Celine has struggled with her weight from her adolescence, when the hormonal adjustments occurred as she got her first period and her body changed or rather expanded (so she believes). She says she has tried it all – the fad diets, slimming pills, fitness regimes – with zero results. Although she is not overweight, she still feels fat and wishes to lose the love handles, the muffin tops, the bat wings and all that need to be lost.
As a result and an unexpected turn of events when she came face to face with quarantine, she decided to lose weight (yet again). However, this time she didn’t seek help from Lord Google and instead relied on self-observation. A week into this introspective program, she found she had a weird relationship with food. She loved her food and yet hated herself for loving it. She also realised that food was not only fulfilling her physiological needs but other unknown unnamed needs as well.
This is what she found about herself by the end of her 2 months of self-observation:
- Eating as a habit – breakfast, lunch, dinner.
- Eating as a perk – she had her regular dose of chips, cookies, chocolates, doughnuts, etc. between her main meals
- Eating more – as the days progressed, she wasn’t satisfied with just a pack of chips, she had to have more (the largest size available and make that two)
- Thinking of food – when she was not eating, she was thinking of / planning what to eat.
- Craving for food – her cravings for crunchy/ sweet food increased along with consumption
- Stress eating – she found all her answers to stressful events in a bag of chips/cookies
- Recreational eating – she marked every little moment of joy with a pack of chocolates/ cookies.
- Refraining – when she refrained from unnecessary eating, the next day she found herself compensating by eating twice the normal amount.
- Quitting – she couldn’t stop eating even when she was full.
- Regretting – she felt bloated and exhausted physically and she hated herself for being unable to stop eating.
Is Celine addicted to food?
APA defines addiction as a complex condition manifested by the use of a compulsive substance(s) – such as alcohol or drugs, despite harmful consequences. Although food may not fall into the category of alcohol or drugs, the behavioral consequences show similarities with an addictive disorder. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), it would take meeting 2-3 of the following criteria to define addiction:
- difficulties in controlling substance use;
- a strong desire or craving for the substance;
- tolerance such that increased doses of the substance are required to achieve intoxication or the desired effects;
- adverse effects of acute withdrawal from the substance;
- neglect of alternative interests, and social, family and occupational activities;
- unsuccessful attempts to quit use; and
- continued use despite knowledge of physical or psychological harm caused by the substance
Looking at Celine’s eating habits, she meets more than 2-3 criteria above thus her eating habit has developed into addiction. In an article “Compulsive Overeating as an Addictive Behavior” Caroline Davis, PhD, writes “an apparent dependence on highly palatable food – accompanied by marked emotional and social distress and deficiency – is, in essence, an addiction disorder.”
Ashley Gearhard and friends have studied eating habits of people and developed Yale Food Addiction Scale (YFAS) to identify those who are likely to show similar behaviors as that of substance dependence with the consumption of high fat/high sugar foods. An abridged version of the test above to identify food addiction is available here.
There is undoubtedly a thin line between a habit and addiction. Also, for a habit to morph into an addiction, there are bound to be some underlying causes. Once a habit develops into addiction the recovery process takes a different form. Mere willpower may not be enough. The treatment procedure may include medication as well as counseling and therapy, along with support from family and friends.
Therefore, it is necessary for each one of us to introspect our habits and also our relationship with food, drinks and recreational indulgence. Since addiction is not limited to substances like drugs and alcohol, let us be aware of the multifaceted addiction, aware of our ‘self’, and help spread the awareness.