Background: It has long been suspected that food has addictive qualities. Recent evidence suggests that certain foods have the ability to disrupt, even hijack the brain, much like an addictive drug. Dr. Dennis will discuss how the dopamine and opiate systems, pre-frontal cortex, sugar and more all play a role.
Definition of Addiction
Types of Addiction
Substance
Process
Food addiction
Substance Dependence
Binge Eating Disorder
Food and Reward
Dopamine System
Neuroimaging research
PET imaging studies
Opiate System
Endogenous opioids in the brain
Shared Risk Factors Substance and Eating Disorders
Trauma
Occur in times of transition or stress
Common brain chemistry
Common family history
Low self esteem
Depression, anxiety, impulsivity
Unhealthy parental behaviors and low monitoring of children's activities
Unhealthy peer norms and social pressures
Susceptibility to messages from media
Similarities
Behavioral
Brain Circuitry: the Reward Pathway
Major structures: the ventral tegmental area (VTA), the nucleus accumbens and the prefrontal cortex.
“National Addictions”
Sucrose-Dependent Rats
Sugar Addiction
Hoebel’s research
Animal Models
Animal research of Eric Nestler, MD
Yale Food Addiction Scale
Sample Questions YFAS
Human Studies
Yale Study
Findings
Treatment Implications and Approaches, including 12-Step Principles of Recovery
12 Step Myths
12 Step Meetings
How to refer your patient or client
Signs of a healthy meeting
Signs of an unhealthy meeting
Abstinence as it relates to Food
Summary
Addictions and Eating Disorders
Family History
Clinical Similarities
Biological Brain Pathways
Food Addiction, subgroup of ED patients
It has long been suspected that food has addictive qualities. Recent evidence suggests that certain foods have the ability to disrupt, even hijack the brain, much like an addictive drug.
At the center of this puzzle is dopamine, a neuro-transmitter that motivates people toward food, sex, etc. Certain chemicals such as cocaine and heroin activate the same reward circuits in the brain that food or other natural rewards do. When triggered by ingesting a rewarding substance or engaging in a rewarding activity, this pathway results in dopamine release, the “high.” Originally, it was thought that obese or drug addicted individuals would register high levels of dopamine receptors; however, brain scans indicate it is the exactly opposite. This is because repeated exposure to repeated hits of dopamine when the reward pathway is activated results in fewer dopamine receptors.
The body is designed to maintain a steady state, and this is one of the ways it does it. Although high levels of dopamine are generated, they are not experienced unless the dopamine binds to dopamine receptors. Therefore, in order to get the same reward, substantially more of the substance is required. Additionally, rodent studies prove it isn’t just high quantities of food, but large amounts of calorie-dense (high in sugar or fat) food that reduces the dopamine receptors. This is also the case with “hyperpalatable,” or highly processed food.
The prefrontal cortex, the part of the brain that controls impulses, decision making and exercising judgment, is also involved. In some people with obesity and an eating disorder, the decrease in dopamine receptors is connected to decreased activity in this area of the brain. A vicious cycle ensues as these individuals consume greater quantities of calorie-dense food to achieve the reward, they are less able to exert control over the behavior.
Addictions and eating disorders are family diseases, and progressive, chronic and potentially fatal. Patients with eating disorders frequently have a family history of addiction. Clinical similarities between substance and behavioral addictions include common underlying biological, emotional, relational, and spiritual problems. There appear to be similar biological brain pathways associated with addictive food behaviors and substance addictions.
Dr. Kim Dennis is a board-certified psychiatrist who specializes in eating disorder treatment, addictions recovery, trauma/PTSD and co-occurring disorders. As CEO & Medical Director at Timberline Knolls, she supervises the medical staff and sets the overall vision and direction for the treatment program. Dr. Dennis received her undergraduate degree from the University of Chicago. She obtained her medical degree from the University Of Chicago Pritzker School Of Medicine and completed her psychiatry residency training at the University of Chicago Hospitals, where she served as chief resident. She is a member of several professional organizations, including iaedp.
